The forward-thinking, life-saving Pennsylvania Liquor Control Board

By Jonathan Purtle

Getting booze in Pennsylvania is a hassle. You can't buy it at the supermarket. If you want beer, you can't buy less than a case from the distributor. If it's wine or liquor you desire, you have to go to a separate store entirely — often to be met with high prices and long lines. Most states don't operate this way but Pennsylvania has since 1933, when the heavy-handed, state-run system was established to suppress alcohol consumption in the wake of the 21^st Amendment and prohibition reform.

Irksome as the current system is, and illogical as it may seem, the Pennsylvania Liquor Control Board (aka "state stores") might be a public health blessing in disguise—something that state lawmakers should consider as they contemplate the recent proposal by House Majority Leader Mike Turzai (R., Allegheny) to privatize and revamp the state's alcohol control system.

Earlier this year, the effects of privatizing alcohol sales were assessed by the Community Preventive Services Task Force — an independent body whose members, appointed by the director of the Centers for Disease Control and Prevention, are charged with making evidence-based recommendations about what programs and policies keep people healthy. The task force, which was not focusing on any particular state, reviewed the results of 17 studies. It recommended against the privatization of alcohol sales based on the "strong evidence that privatization results in increased per capita alcohol consumption, a well-established proxy for excessive consumption." In most states that would mean a controversial and politically difficult reversal of current policy. Pennsylvania is ahead of the curve.

The task force's review, published in the American Journal of Preventive Medicine, found that privatization resulted in a median increase in alcohol sales of 44 percent after municipalities underwent privatization.  One of the studies that was included, an exhaustive analysis of drinking policies in Nordic countries, found that alcohol-related hospitalizations, suicides, and motor vehicle crashes all declined after Sweden reverted back to a state-controlled system of retail beer sales.

Excessive alcohol consumption is responsible for approximately 79,000 deaths annually in the United States and costs the nation an estimated $223.5 billion in lost productivity, health care, and criminal justice costs — with state governments bearing around $53.5 billion of the financial burden. These figures don't even begin to account for the social costs of excessive alcohol consumption among children and families.

Turzai has estimated that his proposal would generate $1.9 billion in state revenue. Others say it would bring in less. Either way, would it be sufficient to counter the public health costs of privatization?

As Gifford Pinchot, who is best known as the father of American conservation, said while serving as governor of Pennsylvania in 1933, the state's alcohol control system was designed to "discourage the purchase of alcoholic beverages by making it as inconvenient and expensive as possible." While the current system wasn't informed by the recommendations of the U.S. Preventive Services Task Force, it is aligned with them.

From a public health perspective, Pennsylvania has a good thing going — and shouldn't throw it away as a short-term solution to our fiscal woes.

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