Column: Riding Free and Free Riding in N.H.

Sunday, March 23, 2014

The Free State Project, which is devoted to recruiting “liberty-loving people to New Hampshire,” cites 101 reasons to move to the Live Free or Die state. One of them is the absence of a motorcycle helmet law, a sure sign apparently that New Hampshire is a libertarian utopia.

Only two other states share the dubious distinction of refusing to implement a helmet law. The small number might be explained by the fact that this particular personal liberty comes at a steep price. An honest examination of the consequences of not requiring the use of helmets should force even a state with a strong libertarian streak to question the wisdom of its policy.

A recent article in The Economist on state legislative battles over helmet laws reported that every motorcycle accident victim suffering from a catastrophic head injury resulting from the failure to wear a helmet will typically run up $1.3 million in direct medical costs. Fewer than one-third of these same victims will ever work again. The Centers for Disease Control also reports that helmetless riders are more likely to suffer severe brain injury, and median hospital charges for these victims are 13 times higher than those without such injuries. Moreover, riders who choose not to wear helmets are less likely to be insured and thus more likely to rely on publicly funded care.

In a 2012 study, the CDC estimated that if universal helmet laws (no exceptions allowed) were in force in all states, up to $4.4 billion could be saved annually. The Economist reported that when states weaken helmet laws, as several have, accident deaths increase markedly. For example, when Michigan repealed its helmet law in 2012, accident deaths rose by 18 percent. In Texas, deaths-per-bike-mile rose 25 percent when its helmet law was repealed.

So what are we to make of some states’ steadfast refusal to restrain their motorcycle-riding citizens from killing and maiming themselves — and then passing the bill to the rest of us? As in too many public policy debates today, ignorance seems to be more a product of design than chance. In the same way that the CDC had been legislatively blocked from researching the causes of gun violence, it is now under fire for seeking to study the costs of motorcycle head trauma. Rep. Tom Petri, R-Wis., chairman of the House Subcommittee on Highways and Transit, wants the CDC to cease research into motorcycle helmet safety, saying, “I don’t think there is that clear a correlation” and accusing the CDC of having an anti-motorcycle agenda.

How ironic, then, that New Hampshire — where few public expenditures are regarded as vital in the pursuit of small government and fiscal austerity — is prepared to lavish taxpayer funds and indirect medical and insurance costs on those who yearn to feel the wind in their hair.

But if New Hampshire’s lawmakers refuse to acknowledge the mounting research on this subject, then perhaps a group of developing countries, where motorized two-wheelers are treasured even more than here in the Granite State, could provide a lesson in public safety and fiscal prudence.

While traveling in Southeast Asia, one can’t help but be astonished by the feats of agility and sheer recklessness shown by millions of motorbike riders. For the most part, these countries are the so-called “tiger” economies that have experienced explosive growth over the past 20 years — and the ubiquity of motorbikes is probably one of the most obvious manifestations of the new prosperity. People there really love their motorbikes. In Vietnam, for example, it’s common to see a family of five arranged on a small bike like a circus act, whizzing through traffic — with three small children perched on laps, knees or any available surface. In my travels through Southeast Asia, I have seen small motorbikes carrying large plate-glass windows, towing water buffaloes, transporting small sofas and delivering loads of construction material. A colleague reported seeing a motorbike driver in India in a hospital gown, riding alongside another bike and attached to an IV drip held by the other driver.

Sadly, the explosion in motorbike use has had deadly consequences. According to the Asia Injury Prevention Foundation, Vietnam alone suffers 9,000 motorbike fatalities each year and 18,000 severe head injuries; worse, 90 percent of all these incidents involve children. To put that in perspective, if a comparable rate of injury occurred in the U.S., it would result in 27,000 children being killed annually.

Unlike New Hampshire, many Asian countries have responded by embracing the most obvious solution: They’ve enacted helmet laws. Across Asia, countries have rushed to educate and require their citizens to adopt basic safety practices — first among which has been helmet use. While motorbike riders’ reactions have been mixed, and enforcement zeal varies from country to country, the results have been clear: significantly fewer deaths and incidents of serious head trauma.

With the support of the World Health Organization, Asian Development Bank, World Bank and a variety of nongovernmental organizations, Vietnam has made great progress in its effort to provide helmets appropriate to the tropical climate and sized suitably for children. Six years after the passage of a helmet law in Vietnam, 77 percent of adult riders in Ho Chi Minh City (formerly Saigon) are now wearing helmets. Alas, only 32 percent of children are.

While much work remains to be done, the effects of common-sense safety laws are apparent everywhere you look. In Manila, amid constant heat and humidity you see motorcycle riders wearing not just helmets, but also pants, long-sleeved jackets and proper shoes. It’s the law. In Jakarta, Indonesia, where motorbikes have commonly given way to full-fledged motorcycles, the latest helmet designs enjoy near universal acceptance among both drivers and passengers. The fact that this has occurred in countries where local laws are often selectively observed and enforced indicates that public education and promotion of safety precautions have had a profound effect.

So if we know that riding without helmets can kill and maim people, shift costs to unsuspecting taxpayers and burden the state’s economy in terms of lost productivity and higher disability and insurance costs, why wouldn’t the New Hampshire Legislature act, as 47 other states have?

Yes, I know: A state that allows concealed handguns on the floor of its Legislature has already betrayed a willingness to sacrifice common sense to the cause of individual liberty. Likewise, a state that didn’t jump at the chance to use federal money to extend coverage to the uninsured working poor — a straightforward way to reduce some of the cost-shifting that results from uninsured people seeking treatment in emergency rooms — is not about to infringe on the right of motorcycle riders to pass on the cost of their reckless behavior.

But think about the decisions taken by countries with a lot less experience in public safety than we have here in New Hampshire — countries with vastly fewer resources but a willingness to respect science and encourage safe practices. Now, wouldn’t following that sort of model be a reason to be proud to live in New Hampshire?

Peter Clark is a natural disaster management consultant with the Asian Development Bank in Southeast Asia. He resides in Hanover when not in Asia.

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