The War on Drugs is not only fought on the home front. In fact, it is the longest running world war. While Portugal has decriminalized all drugs, Uruguay never criminalized personal drug use and possession, the Czech Republic has decriminalized possession of small amounts of illicit drugs, and Norway and Mexico contemplate decriminalizing all drugs, the world-wide war on drugs continues apace. And drug prohibition’s futility and destruction are on world-wide display.

I have written about the resurgence of methamphetamine use and methamphetamine related overdose deaths in the US, despite state and federal efforts to solve the “meth crisis” earlier in this century. Now comes a report from the United Nations Office on Drugs and Crime that Southeast Asian gangs are making $60billion (US) per year flooding Asia with methamphetamine, and laundering the money through Southeast Asian casinos. 

Most of the methamphetamine originates in the “Golden Triangle,” the region where the borders of Myanmar, Laos, and Thailand converge. The Northern Shan State in Myanmar is a hub of clandestine meth-making, but it is best known as a center of heroin production and distribution.

While heroin has been the export staple of the Golden Triangle, meth is reportedly the new “cash cow.” The largest market for the meth and heroin is China, but sophisticated distribution networks carry it throughout Asia, as far away Japan. And now motorcycle gangs in Australia and New Zealand have joined the distribution network.

As I have said repeatedly, fighting the war on drugs is like playing a game of whack-a-mole. Prohibition only serves to drive the drug trade and drug use underground, where it is more dangerous and deadly. As more countries around the globe are figuring this out, an end to the war becomes a more realistic possibility. But I fear that until the “big dog” in this war—the US—decides to call it quits, we can expect more death and destruction for quite some time.

I have a letter to the editor in today’s Washington Post: 

The July 8 front-page article “Court’s ruling on ACA could cost GOP” claimed that the Supreme Court upheld the Affordable Care Act “twice,” presumably referring to National Federation of Independent Business v. Sebelius in 2012 and King v. Burwell in 2015.

King v. Burwell did not uphold the ACA. On the contrary, King overturned part of the ACA.

The King plaintiffs challenged the Internal Revenue Service’s unexplained decision to spend funds that the ACA plainly does not authorize it to spend and to impose the ACA’s mandate penalty on millions of Americans whom the plain language of the statute exempts. Chief Justice John G. Roberts Jr. affirmed that “the most natural reading” of the operative statutory language favors the plaintiffs. In other words, the plaintiffs sued to uphold the ACA as written.

The court nevertheless upheld the Obama administration’s rewriting of the statute. In so doing, it overturned part of the ACA.

Note the present tense. The ACA still says the IRS doesn’t have that authority. 

No matter. The ACA is dead. Long live ObamaCare.

Last year, the Departments of Treasury, Labor, and Health and Human Services worked within federal law to expand consumer protections and restore Americans’ freedom to choose the health insurance that meets their needs. On Friday, a federal court rebuffed an effort to block those protections and force Americans into ObamaCare. First, a little background.

In 1996, Congress exempted “short-term limited duration insurance” from federal health insurance regulations. Congress never defined what “short-term” or “limited duration” meant. So in 1997, the Clinton administration gave meaning to those terms by decreeing that health insurance plans qualify for the exemption so long as they have a contract term, and a total duration, that last less than 12 months. The Bush administration finalized this definition in 2004. 

When Congress enacted the ironically named Affordable Care Act (ACA) in 2010, it tied that law’s copious regulation of the individual health insurance market to the same definition of health insurance Congress created in 1996. That means — you guessed it — “short-term, limited duration insurance” is also exempt from the ACA’s costly regulations.

When the ACA began to make the cost of health insurance soar in 2014, the Obama admininstration noticed that consumers were taking refuge in the short-term market, where premiums could be 50–70 percent lower than ACA premiums. So in 2016, the Obama administration arbitrarily shortened the maximum allowable contract term of such plans to 3 months.

This had the effect of stripping protections from consumers in the short-term market. Under the 12-month rule, consumers who bought a short-term plan in January then got a cancer diagnosis in February could have continuous coverage until they enrolled in an ObamaCare plan the following January. But under the 3‑month rule, those consumers would lose their coverage in April and face 9 months of medical bills without any health insurance coverage at all, because ObamaCare deliberately outlaws the sale of health insurance to such consumers until January of the following year. (Rationing, anyone?) Real people got hurt by the Obama administration’s stripping consumer protections from short-term plans. Importantly, leaving people who didn’t buy ObamaCare plans with less protection was the purpose of the Obama rule, which sought to force people into ObamaCare plans by making short-term plans unappealing.

In 2018, the Departments of Treasury, Labor, and Health and Human Services revisited and revised the definitions of “short-term” and “limited duration” to give these plans the maximum flexibility allowed by law. 

• First, the departments reverted to the pre-ACA definition of “short-term” — i.e., less than 12 months, rather than 3 months — which Congresses and presidents of both political parties had accepted for 20 years, and which the Congress that enacted the ACA saw fit to leave undisturbed.
• Second, they said that while the initial term of such plans could not exceed 12 months, insurers and enrollees could renew these plans up to two times, such that the total duration of such plans would match the 36-month maximum duration of COBRA coverage. In other words, for the first time, the departments gave meaning to the phrase “limited duration,” rather than treat it as surplusage, as the Clinton, Bush, and Obama administrations had.
• Third, the departments clarified that not only can consumers purchase as many consecutive 36-month short-term plans as they wish.
• Fourth, the departments clarified that under federal law, issuers are free to combine short-term plans with a guarantee that the issuer will continue to sell the enrollee as many consecutive plans as the enrollee wishes, without new underwriting. Under such arrangements, short-term plan enrollees who develop cancer could keep their coverage while still paying healthy-person premiums.

One effect of this rule is that it will expand consumer protections in the short-term market. Another is that it can reduce ACA premiums by keeping sick people out of ACA risk pools.

In Association of Community Affiliated Plans v. Treasury, interest groups that participate in the ACA sued to block the rule. But federal district court judge Richard J. Leon would have none of it. In a tightly reasoned opinion released on Friday, he explained the departments were well within their authority to revert to the prior definition of “short-term” and to give meaning to the separate term “limited duration.” Judge Leon stressed that, contrary to the plaintiffs’ claims, the Congress that enacted the ACA seemed to have no problem whatsoever with the 12-month maximum term. He further noted that the plaintiffs’ insistence on a 3‑month maximum term would actually reduce the very protections in the 1996 law that Congress was trying to promote.

The ruling should boost the market for renewable term health insurance by giving such plans greater regulatory certainty. Even so, the plaintiffs say they will appeal the ruling. It’s hard to see how they could win, but crazier things have happened when ObamaCare comes before the courts.

Congress should moot that appeal by adopting the departments’ final rule by statute. Doing so would give consumers a permanent, free-market alternative that would compete with ObamaCare on a level playing field — something advocates of a “public option” say they want — and could even reduce ObamaCare premiums. 

In a recent Wall Street Journal column entitled Even Heroes Can Struggle With Addiction, Timothy McMahan King offers convincing evidence that the great British abolitionist and statesman, William Wilberforce, responsible for ending the slave trade within the British Empire in 1807, was an opium addict for much of his adult (and productive) life. Because of the stigma attached to addiction, most historians and biographers have hidden, ignored, or buried that fact.

Similarly, few of us who rely mainly on the history lessons we received in high school are aware of the regular and (by today’s standards) excessive use of alcohol, opium, and other drugs by our nation’s founders.

Even many in my profession do not know that the great William Halsted of Johns Hopkins University Medical School, considered the “father” of modern American surgery, and creator of hospital residency programs for medical school graduates, was addicted to cocaine and morphine for most of his professional life.

This weekend, in a letter to the editor of the Wall Street Journal entitled Should Drug Addicts Be Criminals as Well?, I commended King for amplifying the fact that there are “functioning addicts” who, if they live in the right neighborhood, have the economic means, and the right connections, can keep their lifestyle private, avoiding not only the ostracism that comes with the stigma of addiction, but victimization by the criminal justice system as well. Many accounts of functioning addicts are provided by Jacob Sullum in his excellent 2003 book, Saying Yes: In Defense of Drug Use.

I also elaborated on King’s observations about the “consequences society has chosen to impose on people with addiction. You can be addicted without suffering them.” Indeed. And so many harmful consequences are a direct result of the dangerous black market prohibition inevitably creates.

In his article, King wrote, “The world would not have been a better place had Wilberforce languished in prison instead of fighting the slave trade.” It is heartbreaking to reflect on the countless numbers of less fortunate people who languish in prison today instead of helping to make the world a better place.

I was born in August 1969, a few weeks after Neil Armstrong’s “small step” onto the moon. Nonetheless, I was a child of the space age, idolizing Armstrong and his fellow astronauts, scrapbooking articles on the Viking landers and Voyager probes, and building lots (and lots and lots) of model rockets. NASA’s feats and American space policy were awe-inspiring.

Yet, from today’s vantage point, it’s hard not to question the Apollo program. Yes, we got to the moon, but to what end? Of the 10 Apollo missions originally planned for the lunar surface, only seven flew, and one of them aborted its landing; the rest were cancelled. It’s as if, once the Apollo astronauts completed their initial science mission and trundled off some 800 pounds of moon rocks, policymakers asked, “OK, now what?” The mission cancellations suggest they didn’t have an answer.

Related Content

Space Force: Ahead of Its Time, or Dreadfully Premature?

In December 2019, Congress established the U.S. Space Force as an independent uniformed military service within the Department of the Air Force. Although many defense analysts had long argued for a reorganization of the Department of Defense’s space capabilities, few had settled on this particular solution. This policy analysis evaluates the reasoning behind the Space Force’s establishment, concluding that the service’s creation is premature.

Read the Study

That pattern played out again with Skylab, the United States’ first space station. It hosted all of three missions before it was abandoned like an orbiting foreclosed house and ultimately crashed to earth.


In fairness, other NASA manned missions fared better. The space shuttles (STS) flew 135 missions between 1981 and 2011. (Also worth remembering: two missions ended tragically.) The International Space Station (ISS) continues its manned mission that began in 2000, conducting experiments and observations. And NASA’s unmanned programs have yielded stunning achievements, as have seemingly countless other government and commercial satellites. The unmanned programs, STS, and ISS had answers to the “Now what?” question: conducting ongoing scientific research, providing services (e.g., communications, weather-monitoring, reconnaissance), and delivering and servicing satellites. Those benefits are ongoing; in contrast, Apollo brings to mind the Simpsons spoof, “The Moon of Earth.”

Some will point out that Apollo wasn’t just about reaching the moon, but also spurring technological innovations like heavy-lift rocketry and ARPANET. This—along with space-based scientific research—is a nod to a legitimate public purpose: the conduct of “raw” and specialized science, a public good. But at least some of these innovations aren’t really public goods because they find plenty of incentive in private markets. Moore’s law keeps chugging along, plus or minus a few months, and the commercial space race is intense.


Another answer some offer is that the moon shot was important as a national achievement, delivering on John F. Kennedy’s 1961 call for “landing a man on the moon and returning him safely to Earth.” To this day, oldsters tear up at the memory of Armstrong stepping off the LM and uttering his famous (and apparently misheard) line. But is that feeling of national pride enough of a justification for the enormous cost in human life and public money?


I write this not to tarnish the achievement of Armstrong, Buzz Aldrin, and Michael Collins, their fellow astronauts, and NASA’s employees and contractors. They boldly and faithfully carried out their missions. Rather, I want to underscore the importance that policymakers answer the “Now what?” question for manned space flight, especially since they’ve given NASA new missions of a manned return to the moon and manned missions to Mars and an asteroid. Spaceflight has a high cost in blood and treasure, and policymakers must have a very good answer to “Now what?” before any more astronauts leave the ground.

The Washington Post recently received access to a database maintained by the Drug Enforcement Administration that tracks the manufacture and distribution of every prescription opioid in the country. It reported that 76 billion pills were distributed throughout the US between 2006 and 2012, with higher volumes shipped to the areas that were most hard hit with opioid-related overdose deaths. 

This is being offered as proof that the overprescribing of prescription opioids caused the overdose crisis. But this flies in the face of other powerful evidence. Research reported in the Journal of Pain Research last February that examined data from the National Survey on Drug Use and Health as well as the Centers for Disease Control and Prevention show there is no correlation between the number of pain pill prescriptions and “past-month nonmedical use” or past-year diagnosis of “pain reliever use disorder” among adults. This was corroborated by a study published by the Cato Institute the same month.

Research from the University of Pittsburgh shows overdose deaths from nonmedical use of licit and illicit drugs have been on a steady exponential increase since the 1970s, with no evidence of slowing. The only changes over the decades pertain to the particular drug in vogue during any period. In the early part of this century, the drugs in vogue were diverted prescription opioids. 

To be sure, the lure of easy money offered by a black market fueled by drug prohibition brings out the worst in people, and doctors and pharmacists were no exception. Some doctors and pharmacists leveraged their professional licenses and teamed up with regional drug dealers to supply nonmedical users with large quantities of their preferred drug. But the blame for such behavior should be placed where it belongs: drug prohibition.

Those unethical health care providers were the exception, not the rule. And they were providing drugs to mostly nonmedical users, sometimes under the guise of providing patient care. Meanwhile, the nonmedical use of prescription opioids peaked in 2012, as heroin became cheaper and more available than diverted pain pills. The prescription of high-dose opioids peaked in 2008 and the number dropped more than 58 percent by 2017. Yet the overdose rate accelerated as the prescription numbers decreased, because nonmedical users migrated to more readily available heroin and fentanyl. By 2015 there was already evidence that heroin was becoming the new drug in vogue, as up to one-third of heroin addicts undergoing rehab stated they initiated drug use with the opioid heroin.

The CDC released preliminary estimates of 2018 opioid-related overdose deaths July 17, and they suggest the death toll may be tapering off slightly, down to 47,590 from roughly 49,000 in 2017. One aspect of these numbers the media failed to report was that 67 percent of those deaths involved illicit fentanyl, one-third involved heroin, and just under one-third also involved cocaine. About one-fourth of opioid-related overdose deaths involved any prescription pain killer, and more than three quarters of them also involved heroin, fentanyl, cocaine, or tranquilizers. 

The overdose problem has never been a product of doctors treating patients for pain. It has always been a product of (a growing population of) nonmedical users accessing drugs in a dangerous black market fueled by drug prohibition. While the possible downturn or leveling off in the mortality rate is encouraging, this can largely be attributed to the adoption of harm reduction measures, such as naloxone distribution and needle-exchange programs, which need to be more widely-adopted.

The number of opioids prescribed greatly increased during the early part of this century, as doctors were–rightly–encouraged to be more concerned with alleviating pain and patients were–rightly–assured that opioids in the medical setting have a low overdose and addiction potential. That meant more pain pills were available for diversion to the black market for nonmedical use. And, as mentioned above, there were some doctors and pharmacists who were unethical and unscrupulous. But, at the end of the day, there is no correlation between the number of pills prescribed and the incidence of nonmedical use or use disorder.

The continued obsession about the number of pain pills being prescribed causes patients to go undertreated for their pain and will not make one IV drug user pull the needle out of their arm.

NASA’s Apollo 11 blasted off 50 years ago today sending astronauts to land on the moon and return safely to earth. The mission was planned rapidly and executed almost flawlessly. The Saturn V rocket was the most powerful

engine ever built. The computers available at the time were primitive, yet everything about the timing of burns and entry angles had to be precise. Neil Armstrong, Buzz Aldrin, and Michael Collins were unbelievably brave. It was a stunning achievement. An American triumph.

If the mission were pursued today, the president would be tweeting undignified comments and hogging the spotlight. The launch would be years behind schedule and the computers would jam like during the Obamacare launch. Environmental lawsuits would shut down the launchpad. Labor regulations would slow astronaut training. NASA executives would be indicted for graft. Federal budget squabbling would close the federal government and mission control, leaving the astronauts to find their own way home from the moon. It would be a mess.

Policymakers these days keep on dreaming of big spending projects for the government. But Washington is running trillion-dollar deficits and is far more dysfunctional than in 1969. I discuss the structural reasons why the government fails so much in this study.

The federal government has suffered from corruption, cost overruns, pork barrel spending, and nasty partisan battles since the beginning. But the problems have grown worse because the government has grown far too huge to manage and oversee properly. The federal government’s budget is 100 times larger than the budget of the average state government. As Milton Friedman said, “because government is doing so many things it ought not to be doing, it performs the functions it ought to be performing badly.”

The 1969 moonshot remains awe-inspiring, as the new Apollo 11 movie captures. But looking ahead, we would get more out of the government if it did less. We would be better off letting entrepreneurs take the lead both in space exploration and in the many challenges we face here on earth.