May 23, 2018
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Being cheap can make us smarter

By Dr. Erik Steele

Like it or not, the richest country on earth has to start being cheaper than truck stop coffee. With any luck, that will force us to be a lot smarter about how we spend our money.

There’s a great example of this being hashed out right now in Maine, which those of us who live here like to think as the center of “smaht” thinking in America. The Maine Legislature is trying to decide what the penalties should be for people convicted of dealing in bath salts, which are relatively new and dangerous street drugs. (If you are in the know, they are also known as White Lightening, Kryptonite and other cool names, but if you are reading this you are probably not in the know.)

What’s hanging the Legislature up is not whether people who deal bath salts should be put in the slammer, but how to afford the cost of doing so because the state has its budgetary butt in a very tight vise. If Maine puts 10 more dealers in jail it adds about $400,000 to the state’s budget costs that Maine cannot afford.

That’s not just a Maine problem, it’s an American problem. In Arkansas it’s probably methamphetamine dealers, in Connecticut it might be cocaine dealers and so on.

All of that means America can no longer afford its current war on drugs, in part because its principle method of combat has been putting both dealers and users in very expensive jails.

We can’t just abandon that battle and stop imprisoning drug dealers. Instead, we must be smarter about how we treat the drug user population because we have to be cheaper about how we fight the war on drugs.

Maybe we could imprison fewer users, treat their drug problems as a health problem and not criminal problems because good treatment is more effective and cheaper than jail, and thereby free up their jail cells and dollars spent on imprisoning users for the scum who deal to them.

There are lots of examples of how thoughtful, cheaper approaches to common problems could build a better America for less money than we are currently spending on a worse America.

We currently invest most of the money we spend on health problems and social problems when people get into trouble; commit crimes, get sick, etc. What if we spent more on preventing those problems? What if, for example, we invested relatively few dollars in visiting nurses to new moms to help them raise their children more successfully? That would help prevent some of those early child-raising problems that screw up little, developing brains and then force us to spend more money when those screwed-up kids drop out of high school, get pregnant as teenagers, develop mental illness or drug and alcohol addiction, or end up unemployed or in prison.

There are similar opportunities in virtually every area of government and spending to do this kind of work.

What this takes first and foremost, however, is resistance to the urge to just abandon efforts to solve these costly problems, and persistence grinding through the hard work of finding these cheaper, smarter solutions. Old assumptions about what will and will not work have to be put aside and rhetoric has to be tossed and ignored.

Discussions based on ideology and its evil twin partisan politics have to take a back seat to discussions about effectiveness.

The usual questions we often battle over have to be turned on their heads.

In Maine, for example, the question should not be whether we can afford to imprison bath salt dealers (we must, of course). The question should be, why don’t we get some of the people who are now in jail because they were drug addicts into treatment programs so we can jail drug dealers without adding costs?

In the rest of America, for example, we need to stop just asking how we treat diabetes more effectively, but also how we prevent the obesity epidemic from producing 10 million more American diabetics in the next decade.

Having less money can make us cheaper and smarter, or it can make us just poorer. Let’s pick the hard work of being cheaper and smarter.

Erik Steele, D.O., a physician in Bangor, is chief medical officer of Eastern Maine Healthcare Systems.

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