Even the lifesaving drug treatment access is not even the price differential between rich and poor countries is huge w.h.o. Says a 3 month course of treatment for hepatitis c. Cost about $40.00 in India Pakistan in Egypt which produced generic drugs the same treatment in the United States 2 years ago cost $84000.00 hepatitis c. Pills now can be purchased in California for $18000.00 under Medicaid Lisa reporting from Geneva on Louise Schiavone n.p.r. News Washington support for n.p.r. Comes from n.p.r. Stations other contributors include the state of Joan b. Kroc whose bequest serves as an enduring investments in the future of public radio and seeks to help n.p.r. Produce programming that meets the highest standards of public service in journalism and cultural expression. When you think about unintended consequences when you think about 2 stories it would seem to have nothing to do with each other it is hard to beat the stories we're telling today the 1st one if you follow the news even a little bit should be familiar to you it concerns one of the most contentious issues of the day new developments in the escalating battle over abortion the last went in Missouri on the verge of closing today and the battle goes back at least in 1073 when the u.s. Supreme Court took up a case called Roe versus Wade the Supreme Court's good. News completely a private matter could be decided by a mother and. 3 months of pregnancy a few years before Roe v Wade abortion had been legalized in 5 states including New York and California Supreme Court made it legal in all 50 states but lately several states have been pushing back hard a dozen states are now imposing new restrictions this year including your an issue that appeared to be settled 4 and a half decades ago is once again so raw that it's a prominent feature of the 2020 presidential campaign meanwhile if you go back 30 or 35 years there was a totally different story dominating media coverage and the political conversation but I was roll up our sleeves to roll back this all out of violence and reduce crime in our country if you weren't around then it's hard to remember just how bleak the outlook was crime had begun to rise in the 1960 s. Continued on through the seventy's and eighty's and by 1980 it seemed that everyone was scared everywhere all the time crime became a top priority among Democrats it doesn't matter whether or not they were deprived as a youth and Republicans to experts call them super predators everyone agreed that violent crime was out of hand but the criminals were getting younger and that the problem was only going to get worse as a top. The wave of juvenile violent crime right over the horizon but the problem didn't get worse in the early 1990 s. Violent crime began to fall and then it fell and fell and fell some more in many places today violent crime is at historic lows it's used New York City as an example in 1990 there more than 2200 homicides in the last couple of years fewer than 300 a year it wasn't just New York with a few exceptions crime across the u.s. Has plunged why what led to this unprecedented and wildly unexpected turnaround I was spending most of my waking hours trying to figure out this puzzle about why was it the crime after rising for 30 years from 1901990 had suddenly reversed that Steve Levitt my Freakonomics friending co-author he is an economist at the University of Chicago he's always had an intense interest in crime I had looked into all of the usual suspects and no pleasing and imprisonment the crack epidemic but really you could not and you cannot effectively explain the patterns of crime booking at the kinds of components that people typically talk about when they try to understand why crime goes up and down eventually wrote a paper called Understanding why crime fell in the 1990 s. 4 factors that explain the decline and 6 that do not the 6 factors that according to his analysis did not contribute to the crime drop the strengthening economy the aging of the population innovative policing strategies gun control laws right to carry laws and the increased use of capital punishment will each of these in theory might seem to have some explanatory power level found they didn't the relationship between violent crime and the greater economy for instance is very weak. Capital punishment he found at least as currently practiced in the us simply didn't act as a deterrent against future crimes then there were the factors he found did contribute the increase in the number of police an increase in the number of criminals imprisoned and the decline of the crack cocaine trade which had been unusually violent but these 3 factors could explain only a portion of the massive drop in crime perhaps only half it was as if there was some mysterious force that all the politicians and criminologists and journalists weren't thinking about at all I had the idea that maybe legalized abortion in the 1970 s. Might possibly have affected crime in the 1990 s. One day paging through the Statistical Abstract of the United States which is the kind of thing that economists like Leavitt do for fun he saw a number that shocked him at the peak of us abortion there were 1500000 abortions every year that was compared to roughly 4000000 live births the sheer magnitude of abortions surprised Levet and he wondered what sort of secondary effects it might have he wondered for instance if it might somehow be connected to the huge drop in crime and I had actually gotten obsessed with the idea and had spent maybe 3 weeks working around the clock and I had decided that the idea was a very good one that it didn't make sense and I had a huge file of papers that I had put away and it moved on to another project level like a lot of researchers was juggling a lot of projects with a lot of collaborators one of his collaborators was named John Donoghue and I'm a professor of law at Stanford Law School Donahue also had a Ph d. In economics so he and Levitt spoke the same language. Donahue is particularly interested in criminal justice issues gun policy sentencing guidelines things like that for instance he found that minorities who kill whites receive disproportionately harsher sentences in Connecticut this research ultimately led to changes in that state yet clearly it played a role in the initial legislative decision to curtail the death penalty in Connecticut as well as in the final Connecticut Supreme Court decision abolishing the death penalty Donahue had been doing a lot of thinking about the rise in crime starting in the 1960 s. . He thought the drug trade was one big factor yeah it does seem that large illegal markets are important contributing factors to crime it was also a time of great flux around the Vietnam War and of course the Vietnam War had multiple influences that contributed to social unrest and at the same time there was pressure going in the opposite direction to try to reduce the harshness of punishment and perhaps pull back a little bit on elements of policing and so the combination of those factors I think exacerbated the crime rate so one day John Donoghue and Steve Levitt were sitting in Levitt's office and I remember it like yesterday John says you know I have the craziest idea I mean it's like totally absurd and I thought oh what is it and he said Well I think maybe legalized abortion might have reduced crime in the 1990 s. And I said That's so funny and I reach into my filing cabinet pulled out this huge thick thing and I slammed it down on the desk Yeah that's right when I talked to Steve about it as is often the case since he is such a creative mind he said oh yeah you know I wondered about that and I said I had that same idea but it's not right and he said well what do you mean and I walked him through my logic and I hadn't thought deeply enough about it and I had been focusing on the fact that when abortion became legal there was a reduction in the number of children born and John said Yeah but what about on what Ignace and I quote I mean on what it is what did Donahue mean by unwanted mis he was referring to the expansive social sciences literature which showed that children born to parents who didn't truly want that child or weren't ready for that child those children were more likely to have worse outcomes as they grew up health and education outcomes but also. These so-called unwanted kids would ultimately be more likely to engage in criminal behavior Donahue had begun to put the puzzle together when he attended a conference and I heard a paper being presented at the American Bar Foundation by Rebecca Blank who's a distinguished economist today blank is chancellor of the University of Wisconsin Madison she declined our request for an interview and she was talking about who gets an abortion in the United States that is after Roe v Wade what were the characteristics of the women most likely to get an abortion and she was highlighting that it was poor young unmarried inner city minority women and as I was looking at the elements of crime in the u.s. There was quite an overlap between the populations that were involved in this increase in crime with the group that she was a dent a finding as the group of women who are most likely to be experiencing higher rates of abortion and so that got me thinking about could have Borsch and actually influence crime rates how did the population of women who were having abortions change from before Roe v Wade or really from before abortion was legalized state by state to afterwards. Yeah that's a great question and of course there's much that we don't know about what was happening before because of the illegal nature of abortion in most states but we can sort of infer from the changes that did occur and the fact that in you know some states legalized in 1970 and became avenues for travel to have abortions done we can sort of piece together who was traveling to have abortions and and see how things changed. And then abortion became legal everywhere and so one thing that we did see is that affluent women did travel to have abortions in the period between 1970 when New York legalized and 1973 when Roe versus Wade was decided but it involved travel and expense and therefore was too much of an impediment for the the group of women that we are most interested in which are the ones who are usually at the lower end of the socio economic scale and did not have the opportunity and resources that would permit them to travel so then John and I just been a little bit of time making back of the envelope calculations of how important this unwanted Miss effect could be and it was really shocking remember the magnitude of abortion was huge at its peak there were 345 abortions for every 1000 live births and so when you took the magnitude and you interacted with this very powerful unwanted in its effect that's been documented elsewhere it actually suggest to us that abortion could be really really important for reducing crime 15 or 20 years later the mechanism was pretty simple unwanted children were more likely than average to engage in crime as they got older but an unwanted child who was never born would never have the opportunity to enter his criminal prime 15 or 20 years later Donahue and Leavitt created a tidy syllogism unwanted Miss leads to high crime legalized abortion lead to less unwanted Miss therefore abortion lead to lower crime but syllogisms are easy What about evidence so it's not that easy to convince people that there's a causal impact of legalized abortion on crime because this is certainly not a setting in which I'm never going to be allowed to say run around. Experiment in which I decide who does or doesn't get abortions and so instead what we have to do by necessity is to look at a collage of evidence so a bunch of different all quite imperfect sources of variation that allow us to get some sense of whether there might be some causality between legalized abortion and crime so Levon Donohue set out to assemble this collage of evidence the 1st one we look at relates to the fact that before Roe vs Wade there were 5 states who had already legalized abortion in some way shape or form and these were New York California Washington state Alaska and Hawaii so unfortunately not the states you would want to say our representative said of states because why well they're all liberal I mean so Alaska and why it is we are different from helpful at all New York and California are on the cutting edge Now one thing that's really important to stress is that the states that legalized abortion earlier didn't just get a 5 year head start on the legalization of abortion before Roe v Wade they actually were states that had many many more abortions a much higher abortion rate in the other states so if you look at the data now these state even today have abortion rates that are almost double the abortion rates of the rest of the u.s. Which again I think points out how poor it is as a natural experiment given that limitation it wouldn't be enough to just measure the crime rate in the early legalizing States and compare them to the rest of the states you know want a more precise measurement so we divide States into 3 equal sized groups the highest abortion rate states the medium abortion rate state and the lowest divorce rate States and then we just look at those 3 groups and we track them over time what happened to crime and so we're able to look and see well is it really true that the highest abortion states in the Los to worsen States had similar crime trends when you. Expected them to have similar crime trends and it turns out in the data that that's exactly right we found that there was roughly a 30 percent difference in what happened to crime between the highest abortion States and the lowest abortion States by 1907 that seemed to be firm evidence in support of the thesis now Donahue and Levitt looked at crime data state by state by age of offender so the nice thing in the data that we had available was we could look at arrest rates by single age individual so if I'm born in 1902 in Minnesota well I probably live a pretty similar life to someone who's born in 1904 in Minnesota Ok in terms of other things like policing or you know drugs or other things in the environment but the difference is that those who were born in 1904 were exposed to legalized abortion and those who were born in 1902 weren't and we find numbers there that are completely consistent with the rest of our notice that those who are born just a few years apart do much less crime than those who were born in their earlier years because the abortion rates were rising so sharply in the seventy's these cohorts were coming into their crime ages in a stacked fashion and we could a dent if I which abortion rates were associated with each particular age and the higher the abortion rate was for e.j. The greater the crime drop occurring so as you're putting together this collage of evidence what did it feel like to see the strength of this evidence of the link between legalized abortion and crime did it immediately suggest policy or political or health care follow ups Stephen I I think both had the sense of something really unusual has suddenly happened in crime in the United. States and we really just want to understand what that is I really wasn't thinking very much about the way in which this would be received I really just want to understand is this a factor that has altered the path of crime in the United States. And Donahue would go on to publish their paper the impact of legalized abortion on crime in the May 2001 issue of the Quarterly Journal of Economics what happened next that's coming up right after the break. Freakonomics Radio is supported by Progressive Insurance offering snapshot a device designed to reward safe drivers learn more at progressive dot com or 1800 progressive Now that's progressive Freakonomics Radio is supported by the size Sims foundation since 1905 supporting progress in education science and the arts information at size Sims Foundation dot org When China announced a new state wide system reports made it sound like it was monitoring and grading its people it was scary Orwellian frankly evil and most of the reports were wrong the real story about China's social credit system on the world. Katie b.s. 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Visual Arts briefs are supported by Spanish village Art Center in Belle ball park and there are 37 working artist studios and galleries and the Lux Art Institute presenting their summer camp Art Show see hundreds of art pieces by their young artists professionally showcased in the galleries on Aug 17th Lux Art Institute dot org. This is Freakonomics Radio here's your host Stephen Dubner. Legalized abortion appears to account for as much as 50 percent of the recent drop in crime. That was the stark conclusion of the 1st paragraph of the study published in 2001 by John Donoghue and Steve Levy but even before the paper was published their findings hit the news I remember coming into office and my voicemail was full it was a whirlwind of reaction and some of it was a little unnerving because people were reading into the study things that we certainly did not intend. And everybody hated it people who are in favor of right to life were upset because their arguments seem to be in Dorothy in The idea that legalized abortion had a positive effect but many people who believed in right to choose they were also upset because we were kind of saying well you're killing these fetuses so they never get a chance to grow up to be criminals the number of death threats that I got from the left was actually greater than the number of death threats I got from the right because the other thing that I'm or urged out of the media coverage is that it very quickly became a question of race even though really our paper wasn't about race at all some people started to say that you know we we were trying to go back to the times where people were pushing for. Control of the fertility of certain groups and maybe even racial groups and that was certainly not anything that. We even considered we we were just trying to figure out when public policy had changed in this profound way did it alter the path of crime we certainly weren't eugenicists as some people initially argued initially perhaps but recently to this past May the u.s. Supreme Court turned down an abortion related appeal from Indiana but Justice Clarence Thomas in an accompanying opinion wrote quote Some believe that the United States is already experiencing the eugenic effects of abortion. His citation Freakonomics whether accurate or not he continued these observations echo the views articulated by the eugenicists and by Planned Parenthood founder Margaret Sanger decades earlier I actually think that our paper makes really clear why this is nothing to do with eugenics in our part this is what happens is that abortion becomes legal women are given the right to choose and what our data suggest is that women are pretty good at choosing when they can bring kids in the world who t