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Risk Homeostasis and the Futility of Protecting People from Themselves (IP-1-1999)
January 20, 1999 Issue Paper Introduction There is a growing body of evidence--to be presented in detail in this paper--that points to the surprising conclusion that most coercive measures intended to increase safety either have no effect or an opposite effect. Thus for example, when the government mandates the use of automobile seat belts, fatality rates do not decrease as expected. This counter-intuitive result is consistent across a broad range of governmental attempts to protect people from themselves. Such lack of progress suggests that:
Moreover, there is evidence that more effective alternatives exist. I. Biological Homeostasis Homeostasis is well established in biology. We know that the normal human core body temperature is 98.6 degrees Fahrenheit. The body maintains this interior temperature despite wide variations in the ambient temperature. Such homeostatic mechanisms are ubiquitous in all living things. If blood is lost in an injury, the body produces just enough new blood to re-establish homeostasis. If heavy exercise increases lactic acid in the muscles, the body increases the heart rate and the breathing rate, along with many other adjustments, so as to bring the level back to normal. There is even evidence that whole populations of organisms exhibit homeostasis. For example, if guppies are allowed to reproduce in a tank, their numbers do not grow indefinitely. Even with ample food, no predation and no disease, after a certain population is reached the population stabilizes. Breeding continues but in this case at least, numbers are controlled by cannibalism of the young just after birth. Although we accept homeostatic mechanisms inside organisms, it may seem odd to think that the behavior of groups is governed by homeostatic mechanisms as well. There is ample evidence that it is, at least in species other than man. This paper will discuss research that points to the operation of one form of homeostasis in humans as well--risk homeostasis--and will discuss the public policy changes that this implies. II. Risk Homeostasis Defined The theory of risk homeostasis predicts that people become accustomed to some acceptable level of risk, and that when they are required to reduce a risk they are exposed to, they will increase other risks until they have re-established the level of risk they have become accustomed to. If they are required to wear seat belts, the evidence suggests they drive faster, pass other cars more dangerously, put on make up, and so on, so as to maintain the level of risk they are comfortable with. In effect, they "consume" the additional safety they are required to have by changing their driving behavior so as to attain other desirable ends. A. The Mechanical Analogy It may be helpful to relate homeostasis to the mechanical concept of feedback. Feedback is the name given to systems that use information from the output of the system to regulate the behavior of the system. The household furnace thermostat is the most familiar example, although thousands of feedback systems help control automobiles, computers, and nearly every other complex modern device. The thermostat on the wall of a house contains a switch connected to a thermometer so that when the temperature drops to the level selected, the switch turns on the furnace. As the furnace heats the house, the thermometer in the thermostat slowly rises until it disconnects a switch which shuts down the furnace. Thus the temperature of the house is fed back to the furnace to regulate its behavior. Note that implicit in the system is a preset degree of error. The house will slowly cool and then rapidly heat as the system cycles, so that the actual temperature is usually slightly below or slightly above the ideal temperature. All feedback systems share this characteristic, as does homeostasis. For example, the body's core temperature rises slightly above 98.6 degrees during heavy exercise and will be found to be slightly below 98.6 when one feels chilled. C. Risk Compensation People routinely behave more cautiously when they consider themselves at risk. Any rational person would walk more slowly into a strange dark room than she would into the same room with the lights on. We drive more slowly in the rain, and so on. In the parlance of safety engineering, this is known as risk compensation and is not seriously questioned. What is questioned is risk homeostasis, that is, do we completely consume any mandated safety efforts by taking more risks in areas that are not as well controlled? D. Is it Plausible? Risk Homeostasis has plausibility. Unlike safety engineers, who dedicate their lives to reducing accidents, people do not usually want to keep their accident rate at the absolute minimum. Indeed, many people voluntarily engage in risky behavior, such as car racing, mountain climbing, some forms of illegal drug taking, hang gliding, rodeo riding, gambling and so on. Thrill rides in amusement parks seem to get more and more scary. Many more people enjoy risk vicariously, as evidenced by the huge popularity of frightening movies and thriller novels in which the hero narrowly escapes death or some other horrible fate again and again. Video games featuring the risk of wrecking your car or crashing your fighter jet or being killed by a dragon are also hugely popular. Although some car advertisements promote the safety features of their cars, many car ads feature high speed driving, extreme cornering, flying gravel and other manifestations of obviously risky driving. People enjoy watching sports such as football, boxing and hockey, all of which entail risk. So people do accept or desire various levels of risk, some wanting more than others. It seems unlikely that simply by requiring an individual to act more safely, this imposition of outside control will change the amount of risk the individual has become accustomed to. Finally, people optimize, rather than minimize. For example, it is a good idea to save for retirement, but if one minimizes current consumption, she is less content than if she finds some optimal balance between current consumption and saving for retirement. Fatty foods are, well, fattening, but the wise dieter optimizes such consumption (consuming a reasonable amount of fat), rather than going to the inconvenience of eliminating fat altogether. We probably do the same with risk. E. "But I know I'm Safer with my Seat Belt" Most people, when confronted with the possibility that safety devices have little effect on safety, react similarly. They believe that they are in fact safer driving in a car that, because of their seat belt, clearly reduces their chance of injury in a collision. You will be safer wearing a seat belt, but only if your driving behavior does not change. There is evidence that, consciously or unconsciously, behavior does change. III. Evidence Supporting Risk Homeostasis Among Drivers A. The First Evidence The earliest manifestation of risk homeostasis was among drivers. The debate began with the publication of the classic paper by Sam Peltzman, "The Effects of Automobile Safety Regulation." In it he stated: "The main conclusion [of his paper] is that safety regulation has had no effect on the highway death toll." He analyzed fatality data from 1947 to 1972. In 1968, Congress mandated, among other safety equipment:
The safety community predicted a roughly 20 percent reduction in fatality rates as a result of the huge expense of installing this equipment in millions of cars. Yet Peltzman found none. B. Seat belts This surprising result has triggered a number of studies, most of which have come to similar conclusions. In fact, no jurisdiction that has passed a seat belt law has shown evidence of a reduction in road accident deaths. To explore this odd but highly robust finding, experimenters asked volunteers to drive five horsepower go-karts with and without seat belts. They found that those wearing seat belts drove their karts faster. While this does not prove that car drivers do the same, it points in that direction. A similar study was done with real drivers on public roads. When subjects who normally did not wear seat belts were asked to do so, they were observed to drive faster, followed more closely, and braked later. Statistics from the United States indicate that as more and more states required seat belt use, the percentage of drivers and passengers killed in their seat belts increased. The cliche that seat belts save lives is true in the lab and on paper, and it's true if driver behavior does not change. But behavior does change. C. Air Bags The most recent effort by the government to make driving safer is to require air bags for front drivers and passengers. Yet here again, evidence that they save lives is dubious. The usual figure cited is 2,000 lives saved per year by air bags in America. Yet an article in Consumer's Research magazine states that this number is arrived at by simply looking at the number of fatalities in cars with and without air bags, without analyzing the individual crashes. For example, if a passenger was wearing a seat belt with a shoulder harness, such safety equipment could have easily saved her life without an air bag, yet the air bag, if installed, would get the credit for a life saved. The article goes on to state: "The [National Highway Traffic Safety Administration] data make clear that air bags offer only marginal improvement to occupant safety, vastly overshadowed in importance by seat belts." But if seat belts do not save lives, it is doubtful if air bags do either, and there is no doubt that air bags kill, 113 people so far, 66 of them children. D. Antilock BrakesAntilock brakes would appear to be an obvious life saver. These brakes prevent wheels from locking up, no matter how hard the brake pedal is pushed. In tests, they reduce stopping distance and allow directional control to be maintained during a panic stop, even on a curve. Yet researchers can't find accident reduction related to their use. According to Consumer's Research magazine, "What will surprise a lot of people is that antilocks are not reducing either the frequency or the cost of on-the-road crashes that result in insurance claims for vehicle damage." A three year study of taxicabs in Munich, Germany, came to the even more surprising conclusion that the half of the cabs with antilocks had slightly more accidents than the half without. Furthermore, the cabs were mounted with accelerometers, which showed clearly that the drivers with the safer cars accelerated faster and stopped harder. A Canadian study cited in the same article used ordinary drivers and found they too drove faster and braked harder when their antilock brakes were switched on. Here is clear evidence of behavior modification as a result of added safety equipment. E. The 55 MPH Speed Limit In 1973, in response to the oil shock, the US government reduced the speed limit to 55 MPH and then allowed the states to raise it again in 1987. Since some states did so, and others did not, researchers were quick to compare the results. Again the conventional wisdom held that highway fatalities would go up by 4,400 to 6,000 per year. Forty states did increase speed limits, but rather than suffer an increase in highway fatalities, they enjoyed a slight reduction in state-wide highway fatalities of 3.4 percent, as compared to the states that did not increase their speed limits. When people were forced to drive more "safely," they apparently "consumed" their safety in daydreaming, or aggressive lane-changing, or some other behavior, so as to re-establish their prior risk level. When allowed to drive faster, they seem to have realized the additional risk and adjusted their driving behavior accordingly. F. Driver Training Another effort to improve highway safety involves driver training. There is general public agreement that mandatory high school driver training and driver education classes reduce accident rates. Yet the data stubbornly refuse to agree. According to Changing Road User Behavior, What Works, What Doesn't: "As traditionally defined, motorcycle rider training and advanced driver training suffer from the fact that increased skill does not automatically lead to safer driving. Indeed, increasing skill may lead to more crashes." This odd result seems to be due to overconfidence in trained drivers, as opposed to the caution exercised by a driver trained by parents in a Sunday morning parking lot. Again people seem to adjust their behavior so as to regulate the risk they expose themselves to. G. Drunk Driving Efforts to keep drunks from causing accidents are widespread, including stiff penalties for drunk driving, random checkpoints, designated drivers, organizations like Mothers Against Drunk Driving, and so on. Yet the data suggest that while drunk driving fatalities have gone down, sober driving fatalities have gone up so as to leave the overall traffic fatality rate about the same. H. Traffic Lights It seems obvious that traffic lights should reduce accidents at intersections. But again, not so. According to Gerald S. Wilde, the leading proponent of risk homeostasis, "Numerous studies on the effect of traffic lights on accidents have compared the numbers of accidents at intersections before and after installation. The effect is that fewer right-angle accidents happen, but more rear-end accidents, as well as left-turn and side-swipe collisions occur, and the total frequency remains roughly the same. Clearly traffic lights help more cars get through the intersection and this partly explains why accident rates do not change. The likelihood of an individual car getting into an accident is less, but the total number of accidents at the intersection stays nearly constant. This is another example of drivers "consuming" their extra safety in increased mobility. IV. Risk Homeostasis in Other Contexts A. Cycling Bicycling is similar to driving in that if risk homeostasis is a valid theory, cyclists will "consume" their additional safety in faster or more exciting cycling. This turned out to be the case when the University of California at Santa Barbara tried to reduce the bicycle accident rate on its campus. With some 10,500 bicycles entering the campus each day, the campus suffered an average of 249 bicycle accidents per year. Measures to reduce this included the construction of a roundabout or traffic circle for bikes, a wider bike path and the closing of an accident-prone fare to bikes. Researchers found that most of the changes increased the accident rate including the accident rate at the bicycle roundabout. The studys author wrote: "It is hard to immediately know what to make of this finding. Perhaps the round-about made bike riding more hazardous or, alternately, bike riders took advantage of the improved traffic flow to increase their speed. The latter is the interpretation apparently favored by University engineers." B. Childproof Medicine Bottle Caps The often cited study by Viscusi found that while the Consumer Product Safety Commission (CPSC) has had the mission of improving consumer safety in the US since 1973, "There is no evidence in the aggregative data of any beneficial effect on product safety." Specifically, he found that the CPSCs claim that their child proof aspirin bottle caps increase safety were based on the total number of poisonings, which indeed did decline. This, however, is not necessarily a sign of success, since the high risk population declined, which would naturally reduce the number of poisonings, and aspirin was being replaced by more modern pain relievers, such as Tylenol, which would also "reduce the aspirin poisoning rate." This deceptive claim of success without taking such obvious factors into account was refuted by Viscusi, who found that:
Here it would appear that medicine users are "consuming" the additional protection which the government mandates in more carelessness in dealing with dangerous materials. Again the findings are consistent with the theory of risk homeostasis. C. The Occupational Health and Safety Administration By now it should not be surprising that a study by Harvards Kip Viscusi found that many coercive attempts to make the work place safer are also futile. Apparently, workers again "consume" the extra safety with faster work or more careless work. D. Playgrounds Modern children's playgrounds are built in two basic ways. The first is typified by the sort that fast food restaurants offer, with extensive padding, smooth surfaces and no opportunity to fall any appreciable distance. The other is the "adventure" playground, with log construction, climbing ropes, high places to dangle from, hard concrete tunnels to wiggle through and so on. It would appear that the first would be safer than the second, but several sources indicate just the opposite, citing boredom and hooliganism as reasons for the additional danger in the "safe" playgrounds. An insurance company even quoted lower rates to insure the adventure playgrounds. V. Arguments Against Risk Homeostasis A. Caveat Most data supporting risk homeostasis use fatality rates rather than accident rates. This is because statistics collected for fatal accidents are more accurate than those for non-fatal accidents. Not only do the people filling out the forms take a fatality more seriously, but many non-fatal accidents are never reported and so never brought to the attention of the statistic gatherers. It may be that risk homeostasis is not as robust in non-fatal accidents, but it seems unlikely. B. Evidence Against Risk Homeostasis Those who have spent their lives, and built their careers, trying to reduce accident rates by forcing people to do things to make them safer (and whose funding often depends on demonstrations of success) naturally reluctant to accept the idea that their efforts have been wasted. Thus a number of papers have been published attempting to refute risk homeostasis. For example, it is fairly easy to demonstrate that the death rate per mile driven has been reduced by various mandatory safety measures. Here we must digress briefly to discuss how fatality rates are measured. At first glance, the risk of death per mile driven may seem nearly identical to the risk of death per hour driven, but they are very different. If we return to the discussion of traffic lights above, it is clear that when a traffic light is installed, more cars will get through the intersection per hour. People can get where they are going more quickly. But to an observer watching the intersection with a clipboard, the important thing to her will be the number of accidents she sees each hour. As we have seen, this number will stay about the same. What she is observing is the accident rate per hour. On the other hand, if she were to also count the number of cars, and combine these data to get the accident rate per mile driven, she might or might not see a decrease. Different studies show different results, but the important point is that if people really do consume" their extra safety with faster driving, then the accident rate per mile may change while the accident rate per hour, as we have seen, stays the same. A study frequently cited as refuting risk homeostasis was done in Newfoundland before and after a mandatory seat belt law took effect. Researchers attempted to measure average speeds, following distances, and the rate at which drivers ran yellow lights before and after drivers were required to wear seat belts. They found none. The reason is that traffic accidents are extremely rare. To achieve risk homeostasis, drivers only have to alter their driving behavior by the tiniest amount. This tiny amount would not turn up with the roadside measurements used. Further "evidence" cited against risk homeostasis borders on the fraudulent. For example, one of the major critics of the theory, Frank P. McKenna, wrote a paper in which he criticized risk homeostasis. He cited a paper by John D. Graham as evidence. Yet Graham states in his paper: "It should be emphasized that the findings presented above are not inconsistent with the rational-choice theory of driver behavior." (Rational-choice and risk homeostasis are used interchangeably in the safety literature.) Risk homeostasis has been criticized as requiring some sort of collective consciousness; in other words, humans must band together into some sort of supernatural meta-brain, which then decides how much risk to tolerate and then somehow transmits this information back to the individual brains. However, the evidence for risk homeostasis is still valid where no such collective consciousness is theorized. Person A may be such a careful driver that the presence or absence of seatbelts makes no difference to her safety, while person B may be so eager to sort through the junk mail that the perceived additional security of a seatbelt allows more of such distracting behavior. The theory does not require that every driver modify her driving behavior in response to mandated safety measures, only that enough do to affect the statistics. D. The Degree of Risk Compensation As stated earlier, most researchers agree that people adjust their behavior to compensate for the risk they perceive. The question under debate is how much do they compensate? The theory of risk homeostasis predicts that people will "consume" roughly all the enhanced safety imposed upon them in other desirable yet risky activities, such as more exciting driving to fight boredom, getting to an appointment on time, eating fast food while driving, leaving the cap off the medicine jar because it is annoyingly difficult to deal with and so on. Those who dispute risk homeostasis argue that although people compensate for the additional safety, they do not completely compensate, leaving a net gain in safety. Is there a way to estimate which side is right? There are three possibilities:
If we re-examine the findings noted above, it becomes clear that the studies show either no change or a slight increase in accidents. For example, in the Munich taxicab study cited above, the finding was that the drivers whose cabs were equipped with antilock brakes had a slightly higher accident rate than the control drivers. The change was not significant statistically, yet it may point to a net loss in safety. The 55 MPH speed limit seems to have resulted in higher fatality rates, since they came down after the speed limit was raised to 65. We saw in the driver training section that such training sometimes leads to overconfidence and a higher accident rate. We saw that the bicycle accident rate increased after safety measures were instituted on a college campus. Regarding child proof caps, Viscusi found they may have had an adverse effect on poisonings. When reflectors were installed along certain curves of Finnish highways, it will no longer be surprising to learn that the marked curves resulted in higher nighttime driving speeds.However, accidents along the curved stretches of highway not only did not go down, they may have gone up slightly. These findings suggest that the theory of risk homeostasis probably understates the case. People may resist attempts to make them safer so vigorously that they slightly overshoot the mark. It's impossible for the average citizen to measure accurately the amount of carelessness that would exactly compensate for some additional imposed safety. People may think the safety measures have made them so safe that they take more risks than would compensate for the measures imposed on them in the name of safety. VI. Lessons from Risk Homeostasis A. Misdirected Regulatory Resources The above findings call into serious question the hundreds of safety regulations imposed by the government. The Federal Drug Administration will not allow a drug on to the market until it has been proven without a doubt that it is effective. The Federal Aviation Administration will not allow an aircraft to fly without first being absolutely satisfied that it is as safe as possible. Yet the Consumer Product Safety Administration, the Occupational Health and Safety Administration and the National Highway Safety Administration do just the opposite. They impose safety requirements which:
If such measures were costless, they might simply be inconvenient, but in fact they cost billions of dollars annually to implement and enforce. Furthermore, air bags have killed many people, and there is evidence that making drivers safer causes them to drive faster and more carelessly, resulting in more deaths suffered by pedestrians, who are not protected. Might there be better use of these vast resources? B. What Does Work?The above findings are discouraging. Those who have had loved ones killed as a result of accidents with drunk drivers, or in some other way that seems amenable to a technological fix, are highly motivated to press for such fixes, even in the face of evidence that such fixes do not fix anything. This is understandable, but if such efforts can be redirected toward methods that really do reduce accident rates, more progress would be made. There are two broad areas that are effective: rewarding safety, and increasing the cost to the one who causes the accident. C. Rewarding Safety Are there such methods? There is evidence that there are. If people do maintain a set level of risk, as predicted by the theory of risk homeostasis, then if a way can be found to alter that set point, accident rates should decline. This is in fact what happens. To return to the thermostat analogy, if one finds the house too hot with the furnace running, it would be possible to cool it down by opening windows in every room, but it would be more sensible simply to turn down the thermostat. When experimental programs have rewarded people for not having accidents, accident rates have gone down. Typically, such programs reward company drivers with relatively small cash awards for accident-free driving. The benefits in reduced costs to the company far outweigh the costs in award payments, perhaps by seven to one. Also, these programs work over time, one of which has been in effect for over thirty years without reduced effectiveness. A review of 24 studies stated: "The major finding was that every study, without exception, found that incentives or feedback enhanced safety and/or reduced accidents in the work place, at least in the short term. Few literature reviews find such consistent results." Another survey of over 120 evaluations showed them to be generally more effective in enhancing safety than were technological solutions, stricter selection of employees, disciplinary action or stress reduction programs! In addition, they are more popular, which is not surprising. A little carrot works better than a big stick, and people like carrots better than sticks. The government can implement such programs, not only at no cost, but at a savings to the taxpayer. For example, by offering a reduction in drivers licensing fees for accident free driving, accident rates would probably drop enough to more than make up for the lost license revenue. Factories could be offered tax breaks for lower accident rates. Furthermore, we have seen that high schools could eliminate advanced driver's education costs without increasing accident rates. This would have the additional benefit of giving schools more time to teach basic skills such as reading and math. D. Increasing the Cost of Accidents to the Person at Fault Not surprisingly, it has been found that increasing the cost of accidents to those involved reduces their rate. Legislation requiring no fault insurance, on the other hand, has had the perverse effect of reducing the cost of an accident by tending to make both drivers insurance rates go up. Without no fault insurance, if one driver was judged to be at fault, only that drivers insurance rate would go up, and it would go up by more than it would have under no fault. Such a change in legislation would again not cost the taxpayer anything. Workers compensation programs, if overly generous with payments after minor injuries, may actually reward people who have accidents in the work place. Again, reducing such benefits would save money, both in the worker's compensation program and in the costs of the accidents themselves. E. The Role of Insurance At first glance, it might appear that insurance companies could play a role in accident reduction. Without government intervention in the form of no-fault laws, insurance does tend to put the cost of the accident on the party at fault. But beyond that, the picture becomes cloudy. The very act of offering insurance may increase accident rates because the benefits guaranteed by the policy reduce the perceived risk of an accident. On the other hand, discounts for good driving rates, and higher premiums for bad drivers, should encourage safe driving. Discounts for smoke detectors should reduce the risk of house fires, and so on. Insurance companies must compete for customers, and computers are enabling companies to get better at determining which customers are prone to accidents and which are not. As companies learn more, they will adjust rates accordingly to punish and reward. For example, until about 20 years ago, life insurance companies made no distinction between smokers and non-smokers. Today, rates are higher for people who smoke. Increased accuracy in determining risks should tend to make those who are accident-prone pay for their carelessness, and thus reduce accidents. F. The Delta Analogy Some insight into the accident prevention dilemma can be gained by comparing the accident rate to a river delta, as does Wilde. If a river empties into an ocean through a delta and divides into three channels in the process, the flow of water into the ocean cannot be reduced by damming two of the three channels. The river will simple widen the remaining channel or `open new channels. Attempts at coercive accident reduction seem to be similar to blocking river channels. It is possible to nearly eliminate motorcycle accidents by banning motorcycles, but it is unlikely that former Hells Angels will take up needlepoint to replace their motorcycles. With this in mind, let us consider some ramifications. G. The Demand for Risk One curious inference of risk homeostasis is that there is a demand for risk. That is why some people participate in risky sports such as parachuting, or engage in other high-risk behaviors. There is of course a demand for safety as well, but the very fact that safety devices must be forced by law on unwilling consumers illustrates the fact that there is relatively little demand for some types of safety. Merely taking away opportunities for risky behavior does not appear to change the demand for risk. H. Immoral Accident Shifting If risk homeostasis theory is correct, then coercive attempts at accident reduction sometimes have the effect of shifting accidents around. This not only is pointless and expensive, but in many cases shifts accidents from the person responsible for the accident (who is protected by the engineering change) to innocent bystanders, who are not. For example, a mandatory seat-belt law induces a driver to drive more aggressively; as a result, he hits a pedestrian, and she is killed. This is highly immoral, and should be taken into account when legislators consider safety regulations. VII. Summary and Conclusions The evidence supports the theory of risk homeostasis--that is, people "consume" the additional safety forced upon them in other, more risky behavior. Therefore efforts coercively to drive down the accident rate are usually doomed to failure. However, rewarding safe behavior does drive down accident rates, and because the government takes peoples money in so many ways, it nearly always can reward safety by simply not taking as much. Finally, risk homeostasis suggests that efforts to coercively drive down accident rates often merely shifts the accidents around, often injuring innocent bystanders.
Copyright 1999, Independence Institute INDEPENDENCE INSTITUTE is a nonprofit, nonpartisan Colorado think tank. It is governed by a statewide board of trustees and holds a 501(c)(3) tax exemption from the IRS. Its public policy focuses on economic growth, education reform, local government effectiveness, and constitutional rights. JON CALDARA is President of the Institute. He formerly served as Chairman of the Regional Transportation Districts Board of Directors. He also as director of the successful 1997 citizen campaign against a sales tax increase for transportation ("Guide the Ride"), and the successful 1998 citizen campaign to defeat a proposal to allow the Colorado state government to retain a billion dollars of excess revenue, rather than refunding it to the taxpayers ("Referendum B"). DWIGHT FILLEY is a Senior Fellow in Market Principles at the Independence Institute. PERMISSION TO REPRINT this paper in whole or in part is hereby granted, provided full credit is given to the Independence Institute. Additional Independence Institute resources on education reform can be found at the Independence Institute website: http://i2i.org. Nothing written here is to be construed as necessarily representing the views of the Independence Institute or as an attempt to influence any election or legislative action. Copyright 1999 |
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