# Banning Cheap Alcohol to Reduce HSE Expenditure



## One (13 Sep 2012)

Here are 3 facts;

1/. The government commissioned report “On a National Substance Misuse Strategy, February 2012” stated that……. Alcohol-related illness cost the healthcare system €1.2bn in 2007. In 2007 it was estimated that alcohol led to costs of €500m in the acute hospital sector, €574m in GP and allied health services and €104m in mental health services.

2/. The HSE recently announced €130 million in health cuts. (I know there was a change in some of these cuts in the meantime).

3/. Nine doctors in Donegal made clear their opinion on cheap alcohol and its high cost.

[broken link removed]

http://www.drugsandalcohol.ie/18292/

I would love to know do AAM contributors think banning cheap alcohol is the best way to achieve a reduction of HSE expenditure? 

Answer yes, no, or criticize the question if you want. (I do of course realise that there may be legal obstacles to banning the sale of cheap alcohol in Ireland).


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## TarfHead (13 Sep 2012)

One said:


> Here are 3 facts;
> 
> 1/. The government commissioned report “On a National Substance Misuse Strategy, February 2012” stated that……. Alcohol-related illness cost the healthcare system €1.2bn in 2007. In 2007 it was estimated that alcohol led to costs of €500m in the acute hospital sector, €574m in GP and allied health services and €104m in mental health services.
> 
> ...


 
AFAIK, there is, in Scotland, a minimum price for alcohol. Anyone know how that has worked out for them ?


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## One (13 Sep 2012)

My understanding of the article below is that there seems to be the political will to take steps but potentially it will end up in the European Courts, and will be judged upon whether such a policy is against the ideals of an open market and fair trading.

Minimum-alcohol-price-scotland
In this country, we are effectively accepting a reduction in HSE benefits to a lot of people who need them, instead of cutting the cause of alot of the health problems of our nation.


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## T McGibney (13 Sep 2012)

Is it not rather fanciful to expect that people with alcohol dependency (who as a group are most susceptible to alcohol-related illness) will quit drinking if it is more expensive?


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## ajapale (13 Sep 2012)

Is there any evidence to show that any of the following lead to a reduction of consumption which in turn leads on to lower public medical costs?

A)Bans on promotion and advertising of alcohol.
B)Bans on below cost selling of alcohol?
C)Minimum price controls.
D)More regulation in the sale and distribution of alcohol
E)Public Information campaigns
G)Age restrictions 18, 19 and 21 in some cases.
H)Prohibition

I know some states in the US and some Nordic countries control the distributions channels effectively with a state monopoly in the distribution and sale of alcohol.

In any event I have not seen any evidence that any of these interventions work.


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## PMU (15 Sep 2012)

This proposal to introduce a minimum price for alcohol, just shows how inept we are in Ireland when dealing with social problems. Rather than engineer a solution to the problem (i.e the cost of drunks to the health service), the typical Irish ‘solution’ is to interfere in the market, tax something and raise costs on those who are not part of the problem, i.e. it’s a way of finding cash to ‘treat’ the problem, but not to solve it.  
  If a minimum tax on alcohol is introduced the HSE will continue to spend large amounts on drunks, but will now have a ready stream of income to do this.    So this is really a way of finding cash to keep public servants in cushy jobs rather than solving the problem of the social cost of drunks.  
  If the HSE wants to reduce the cost of drunks on the health service they could (a) refuse liver transplants to drunks; (b) charge drunks for their treatment;  and the Government could (c) force all drunks to undergo alcohol education and awareness training (at their own expense; (d) reduce social welfare benefits or increase taxes on persistent drunks, with the money raised going to those who are the victims of drunks (i.e. victims of drunken driving, drunken assaults, etc.)  Of course in Ireland we will never to do this as it’s always easier to tax than to spend time and effort on engineering a solution.


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## mathepac (15 Sep 2012)

To me there's a couple of ready-made solutions available to us to begin to reduce the toll alcohol is loading on us societally and financially, all we need is the will to use existing laws as they were designed.

Refuse service to people who appear to be already drunk in pubs, clubs, ,etc. Prosecute licencees who fail to comply with this condition of their licence.
Arrest and charge the parents of drunk under-age children and those who procure alcohol for them.
In what will undoubtedly prove to be an unpopular suggestion, I'm going to amalgamate ways of controlling the effects of licit drugs on society; the drugs are alcohol and tobacco.

Cut consumption by every means possible
Reduce private profit to a bare minimum
Take the taxation of these drugs out of the hands of the politicians and tie taxation to consumption. If consumption rises, increase tax, otherwise tax does not change.
Eliminate advertising, sponsorship and promotion of all kinds, ban product placement in films, and in particular eliminate the obscene sight of pre-teen children wearing tee-shirts advertising alcoholic drinks
Treat addicted drinkers and smokers
Ban drinking and smoking in public
Reframe international trade agreements and allow countries that wish to put trade barriers in place for imported alcohol and tobacco products to do so
Encourage out-bound customs and border agencies to check for contraband before a shipment arrives at its destination
Put a bounty on contraband intercepted internationally
Regain control over access, if necessary ban off-sales of alcohol and have the government nationalise it. Nationalise tobacco sales and ration off-sales of alcohol and tobacco.
Anyone interested in solving the problems will have no hesitation in signing up to my programme; anyone who has issue with signing up wants a different outcome to me.

Suggested reading materials:

Cocaine, Dominic Streatfield
Matters of Substance, Griffith Edwards
Loosening the Grip, Jean Kinney


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## truthseeker (16 Sep 2012)

mathepac said:


> To me there's a couple of ready-made solutions available to us to begin to reduce the toll alcohol is loading on us societally and financially, all we need is the will to use existing laws as they were designed.
> 
> *Refuse service to people who appear to be already drunk in pubs, clubs, ,etc. Prosecute licencees who fail to comply with this condition of their licence.*
> Arrest and charge the parents of drunk under-age children and those who procure alcohol for them.



Just to point out that alcoholics rarely appear to be drunk in pubs, clubs etc... They can consume huge volumes while appearing to be fairly with it. Not only that but as the need to hide the condition deepens, they will buy the booze in off licences and supermarkets while sober (or relatively so), bring it home and consume it there.


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## Protocol (16 Sep 2012)

*excise tax or min price?*

Amidst all the plans from Roisin Shorthall, one thing I haven't heard explained about this proposal.

Will it be:

(1) a min price where the extra revenue accrues to the supplier and retailer?

OR

(2) a new type of excise duty, with the increased excise accruing to the State?


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## mathepac (16 Sep 2012)

truthseeker said:


> Just to point out that alcoholics rarely appear to be drunk in pubs, clubs etc... They can consume huge volumes while appearing to be fairly with it. Not only that but as the need to hide the condition deepens, they will buy the booze in off licences and supermarkets while sober (or relatively so), bring it home and consume it there.


Your information is only partially correct, if you pre-fix "alcoholics"in your post with "some" the it becomes more accurate.

On the other hand, chronic alcoholics with liver damage or other problems can drink very little with becoming obviously intoxicated.

All of that aside, my proposals break into two phases, a) those that can be implemented / enforced immediately, and b) those that will take longer to implement.

The second phase would catch those that drink dangerously at home.


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## mathepac (16 Sep 2012)

ajapale said:


> Is there any evidence to show that any of the  following lead to a reduction of consumption which in turn leads on to  lower public medical costs?




"A)Bans on promotion and advertising of alcohol."
_We have no evidence in Ireland because we have never instituted these bans_

"B)Bans on below cost selling of alcohol?"
_We have no evidence in Ireland because we have never instituted bans on below-cost selling in Ireland_

"C)Minimum price controls."
_We have no evidence in Ireland because we have never instituted price controls based on the cost/unit of alcohol_

"D)More regulation in the sale and distribution of alcohol"
_We have de-regulated the sale of alcohol in Ireland with filling-stations and corner-shops now having off-sales licences. We have abolished the "holy-hours" and extended opening times for on-sales. The results of these measures? I think they speak for themselves in relation to consumption figures and damage caused._

"E)Public Information campaigns"
_Public information campaigns and alcohol education in Ireland have been a waste of time, money and effort. As expenditure on these campaigns has risen, so has alcohol consumption and so has the damage caused by alcohol. See my response to D) above. Now is the time to stop this nonsense and enforce existing laws and introduce new ones.

There is clearly a massive contradiction in reducing licensing controls and legislative measures and warning people of the dangers of this drug that is priced lower, and more readily available for longer hours than ever_

"G)Age restrictions 18, 19 and 21 in some cases."
_21 and enforce it with severe penalties for breaches._

"H)Prohibition"
_If nothing else works, try this_


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## ajapale (16 Sep 2012)

mathepac said:


> _We have no evidence in Ireland because we have never instituted these bans_



Is there any evidence anywhere in the world that any of these measures work?


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## One (17 Sep 2012)

T McGibney said:


> Is it not rather fanciful to expect that people with alcohol dependency (who as a group are most susceptible to alcohol-related illness) will quit drinking if it is more expensive?


 
I think it is fanciful to think that people with alcohol dependency will quit drinking if it is more expensive. But I think that the extremely high costs to the HSE from alcohol realted illnesses is not just from people with alcohol dependency. It is from binge drinking episodes, that results many injuries such as car crashes, or attempted suicides, or injuries from fights on the streets/pubs/nightclubs, etc, etc.


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## One (17 Sep 2012)

mathepac said:


> "A)
> 
> _There is clearly a massive contradiction in reducing licensing controls and legislative measures and warning people of the dangers of this drug that is priced lower, and more readily available for longer hours than ever_


 
That is a really good point.


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## One (17 Sep 2012)

I just think it is an awful shame to hear of the possibility of cuts to home care, disabled people, etc, in an effort to save 130 million euro when 1.2 billion euro is being spent on alcohol related illnesses, which is to a certain extent self-inflicted. Ireland has a very unhealthy relationship with alcohol. I could see it when I was growing up, and it has only got worse. Alcohol has become more and more accessible to teenagers now, and I can that relationship with alcohol get more problematic. 

I think Ireland were leaders with the smoking ban. I would like to see Ireland leading the way on banning cheap alcohol too.


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## shnaek (17 Sep 2012)

The problem I have with banning things is that it assumes the stupidity of one section of society, and the wisdom of another. Usually the 'stupid' are the people, and the 'wise' are the people in charge. 

In order for a country to be mature, it must treat it's citizens as mature. This happens in many European countries, where alcohol is cheaper and pubs stay open 24 hours. Some drugs are legal in these countries. And I dare say that these countries are in a better position than ours, economically and socially. I'd rather live in a country that treats it's people as mature. I don't believe in the wisdom of our leaders. They have not yet proven to be wise.


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## mathepac (17 Sep 2012)

One said:


> ...
> I think Ireland were leaders with the smoking ban. I would like to see Ireland leading the way on banning cheap alcohol too.


The non-smoking thing is only half-done at best.

Try walking into a pub, restaurant, club, hospital or betting shop and you have to brave the fug of second-hand smoke surrounding the entrances.

"Enforcement Officers" in hospitals and other public buildings have no powers to fine, eject, report or otherwise impose penalties on detected smokers.

Meanwhile, the footpaths, drains, roadways and green areas in cities and towns are littered with a growing collection of cigarette butts whose cellulose filters take between 7 and 8 years to decompose. If you add in discarded wrappings, packets, matches, lighters, plastic tips from cigars, etc this Green Isle of ours is turning into a huge smelly ash-tray.

Anyone pointing to the smoking ban as an unqualified success or as a model for banning cheap booze needs to open their eyes and their noses.

Harney & Co rode off into the sunset with a string of unfinished projects behind them but with their pensions at 100% and their paying directorships pocketed.


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## ajapale (17 Sep 2012)

I think the smoking in the work place ban has been an unqualified success! There is some evidence which suggests that the incident of lung disease among bar workers has decreased since its introduction.

While it might be true that ""_Enforcement Officers" ... have no  powers to fine, eject, report or otherwise impose penalties on detected  smokers_" it appears to me that the regulations are in general being adhered to and that the light touch enforcement approach taken in this case works.


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## truthseeker (17 Sep 2012)

mathepac said:


> Try walking into a pub, restaurant, club, hospital or betting shop and you have to brave the fug of second-hand smoke surrounding the entrances.



This simply is not true in all cases. Many establishments have a smoking area that is not at the entrance so you dont have to walk through anything. 



mathepac said:


> "Enforcement Officers" in hospitals and other public buildings have no powers to fine, eject, report or otherwise impose penalties on detected smokers.



I did not know this.  



mathepac said:


> Meanwhile, the footpaths, drains, roadways and green areas in cities and towns are littered with a growing collection of cigarette butts whose cellulose filters take between 7 and 8 years to decompose. If you add in discarded wrappings, packets, matches, lighters, plastic tips from cigars, etc this Green Isle of ours is turning into a huge smelly ash-tray.



Has this worsened since the smoking ban? Its horrible, but it does not impact on peoples health so its not really relevant to what is being discussed - however, rant at will, it is disgusting.



mathepac said:


> Anyone pointing to the smoking ban as an unqualified success or as a model for banning cheap booze needs to open their eyes and their noses.



Imo it has been a success. It has helped to change the cultural attitude towards smoking - thats something that usually takes a number of generations to bed into the pysche.


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