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On the back of prior discussions about forced 'voluntary' reporting of sleep apnea diagnoses in the State of Maryland in order to qualify for a drivers license, I'd like to draw attention to something similar happening with autism diagnoses in Queensland, Australia. Last year there was an update to the Assessing Fitness to Drive standards to list autism as a medical condition deemed to have an impact on driving.
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There's a fair bit more in the article that goes on about a few individual cases, but the gist of it seems to be that in the state of Queensland you need to provide medical clearance to drive from your doctor to the TMR (DMV) if you wish to apply/maintain your license once you are dignosed with autism. Most other Australian states seem to have a more reasonable 'you are legally required to report any ongoing condition that effects your ability to drive' standard.
In Queensland it seems like the above stated “Jet's Law” came about when someone with epilepsy had a fit resulting in a car crash that killed a baby and left his brother in a wheelchair for life. So this law was created To Do Something that then through bureaucratic ignorance has expanded to include other conditions such as autism as the Assessing Fitness to Drive standards were used as a list to determine what these conditions were. And then people have possibly decided to stop being diagnosed rather than deal with the hassle/stigma of reporting.
This is just so banal and unjust that someone diagnosed as being on the autism spectrum would then have to report that straight to the government or risk being fined thousands of dollars and stripped of their ability to drive. Luckily there is some pushback with a guy in the above link apparently filing a case with Queensland's Human Rights Commission, but still, it shouldn't have gotten this far.
Edit: fixed formatting
Why don't we get rid of driver's licences entirely and just rely on car insurance? If you pose a risk to others by not having the skill to drive or by having some medical condition, your insurer could require its own tests. It could ask you to get a licence from a third party private organization. Then the free market would figure out the optimal test of driving ability.
I don’t like the idea of a market where the insurer sets the rules and collects the profits, but all the work of enforcement still falls on the state.
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what if someone just doesn't get insurance then...
Well that would be a crime and could be deterred in the usual ways ("What if someone just gets drunk and gets behind the wheel of a car tho?") except that enforcement would be a political problem because of so many illegal immigrants who can't get insurance.
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Do you think the type of person who won't/can't get a driver's licence will have insurance? And if insurance companies won't cover you unless you pass a test, then you just drive without insurance.
But surely nobody would be so careless! Well, about that...
Some people don't have insurance because they can't afford it. Some because they don't give a damn about anyone but themselves. And seeing as how you may be more likely to be hit by a bad driver, the combination of "no licence/no insurance, what you gonna do about it?" doesn't fill me with confidence.
It seems like the responsible types get lumbered with the fallout from the careless:
To be less serious, it seems we can blame the French for introducing driving licences:
I cannot figure out what your point is. Yes, I agree that people driving without insurance is bad. But I don't see how my proposal would have any effect on the number of people driving without insurance.
You're shifting the licensing requirement from the government to the insurers. Now, either insurance companies insure everybody regardless of competence (which means they get landed with responsibility for 'this legally blind drunk driver ploughed into a line of toddlers and you insured him') or they use their own set of tests before insuring drivers.
If they set their own set of tests, it's likely that some people will fail them. So they still end up with no licence. And if people are lying on forms or avoiding going to the doctor because of conditions they think will disqualify them from getting a licence, they'll either lie the same way to the insurance companies, or just not bother with getting insurance. And allegedly 13% of drivers in the USA are already driving uninsured, so driving without a licence isn't that big a step either.
Sure, but at least they'll only have to lie about things that actually affect their driving ability enough for insurance companies to care about them, and the insurance companies will be incentivized to find ways around these problems, such as by making certain medical tests mandatory.
Then if the insurance companies make tests mandatory or no insurance, how is that different from the government making regulations?
I do think there is room in between "ah feck it, if you can turn the key in the ignition you get a licence" and "if you so much as sneeze you're off the road", but I don't think this is a problem that is solvable purely by market forces. The first person injured or killed in an accident by someone 'licensed' by the insurance company, and there will be calls for more stringent standards. More stringent standards = incentive to lie or not report conditions. And that brings us back to where we started, except that now they're lying to the insurance company, not the driving licence department.
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it necessarily would increase it if there are more people on the road. but how many people it has an effect on doesn't matter. in your proposed world, if X% of drivers don't have insurance, that's X% of drivers that have never been tested.
look, driver's tests may be incredibly easy to pass, but it is a working high-pass filter. if someone (not on the basis of discrimination like what the Aussies want to do) can't get a driver's license because they've failed a driver's test, what makes you think they're going to get insurance for driving if they can't pass that exam?
and what's even worse now is that you have people who have been previously filtered out of driving altogether are now both on the road and uninsured.
that sounds like a recipe for disaster.
Tons of people drive with no license or with a revoked license. If they're willing to break the law by driving without insurance they'll certainly also break the law to drive with no license.
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That's what I had thought as well. It might work in a place with functional public transportation, where most of the potentially uninsured aren't working jobs that require carrying many tools, but in most of the US people still need to drive, whether they're insured or not.
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I suspect that insurance companies would ask you to take a driving test, how else are you they supposed to know you have the minimum acceptable levels of competence, before further actuarial concerns?
OK, so why don't we find out? There's a good chance they would come up with a better system of testing and licensing than we have now. Is there any reason the government needs to issue licences?
I am modestly libertarian, so I have no fundamental disagreement with 3rd parties providing licenses or the insurance route, I just happen to think government licensing is adequate and the majority of the debate is over whether refusals to license based on specific diseases like autism or sleep apnea are warranted.
We wouldn't need to have those debates though if we relegated the question to the free market, and I'm wondering if there is any good reason why we don't just do that.
Why you think so?
Effect on public safety depends on how well payouts of insurance companies (via laws and court system) are correlated with damage to public safety.
If payouts for accidents caused by someone driving with sleep apnea without XYZ treatment are much higher, then insurance companies will demand the same as discussed here.
If they can avoid payouts while damaging public safety they will happily do this.
You still need to decide on payouts via legislation/shaping court system. With the same debates happening in a bit different place.
(unless you propose to privatise also legislation and court system and have multiple ones competing at once but that is clearly not "why we don't just do that.")
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The level of competence that maximizes insurance company profits is not necessarily going to be the same as the level of competence which best* satisfies the tradeoff between public safety and the individuals' interest in being able to drive.
*There can of course be a variety of best tradeoffs, since "best" depends on how one weighs the competing interests. But insurance companies do not directly take either of those factors into account when deciding whether to insure someone.
But it likely does maximize the tradeoff between public safety and the individuals' interest in being able to drive plus their interests in saving other costs. And it probably maximizes the tradeoff you mentioned better than driver's licences do.
I don't see how you can know that, nor is it likely to be true, given that the insurance company doesn't particularly care about either one.
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Your simple faith in this religion of the free market is touching, I have to say. There's an argument that the instances in the original post are indeed over-regulation for the sake of it, but to put it all on the free market is optimistic in the extreme.
Every insurance company has its own licensing body? Multiple licensing bodies? Or in effect a monopoly? Any common standard, or LicenzRUz gives you one if you can turn the ignition on, nothing more required (and the insurance companies that take this licence then charge you out the nose for coverage) while Rules Rule Inc. ask for your family medical history three generations back?
Law cases even more lucrative for lawyers as the survivors of person killed in crash by "minimum requirements only" licence holder fight it out with the insurers, and judges have to rule on whether the driver was adequately licenced or not? This is where we get things like "Jet's Law" in the first place, and the subsequent over-reach. Adjusting the free market grave by grave may be one way of doing it, but I think most people would prefer a less final method than "Okay, fifty thousand extra deaths due to lax licence rules, pressure on insurers to put pressure on third party bodies to tighten up their requirements".
Whatever way you do it, the government is going to get dragged in by cases such as led to Jet's Law. After all, the 'free market' allowed the epileptic driver to operate a vehicle, and it was the consequences of that which involved the government:
If it were faith, I wouldn't be asking for reasons why it might not work. I don't think you're quite going this far, but there's this really common and very annoying thing that a lot of people do where, if you express any kind of belief that markets ever work, you're accused of being a free market fundamentalist. It's a subject on which people struggle to see nuance and seem to default to gesturing vaguely at market failures which they've heard exist but can never explain why any given case is one.
Competition and choice would be great, but we can't do worse than the current monopoly.
Why would it matter whether the driver was licensed? The compensation would be based on the harm caused and who was at fault. Why would this be any more difficult than it is already?
How so?
I'm not following this at all. What do you mean by "final"? Why would there be an increase in deaths? Why would there be any kind of grave-by-grave adjustment of the free market?
Why would the government get dragged in?
Because the government has the legislative power, and when the public want Something Must Be Done, it's the government that gets called on to do it - mostly to pass laws so This Can't Happen Again.
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Very simple example: If I speed, I cop a fine and a certain number of demerit points off my license. If I lose too many demerit points, I lose my license and risk going to jail if I continue to drive without a license. All of this applies pressure to me to drive at a safe speed.
In an insurance-only system, I face no penalty until I cause a crash and potentially kill someone.
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How is criminal law meant to tie into this? People who value retributive justice aren’t going to be satisfied with someone simply getting sued out their arse.
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We have this in the Netherlands too. When you first get a license you have to fill out a form asking about your health, and if you check 'yes' on any of the questions you have to go for a review process which, given bureaucracy and staff shortages, can easily take more than a year to resolve. It's no wonder that even official examinators will outright tell you to lie on the form. But there are cases of people having their driver's license revoked upon seeking help for a mental illness that has nothing to do with driving, even if they've been driving for 10 years and hundreds of thousands of miles without incident. I've known people to avoid getting even normal healthcare for fear of their license.
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This public reaction is predictable and ultimately going to be worse than the relatively small chance of a disorder being the direct cause of an accident.
This is why red-flag laws in the USA are so dangerous. People won’t consider seeing a psychiatrist or psychologist if the potential consequences are “they’ll take away my family’s guns”. So now people who might be considering suicide or have other issues will get worse without treatment, and perhaps avoid getting help for the kids if there’s a risk that that could get on a watchlist.
I'm looking at Irish standards, and they're based on EU guidelines:
I think the problem is as pointed out: people who have mild versions of the illness or it is well-controlled aren't a risk and that is acknowledged. People who are not treated are the risk, and if they're avoiding healthcare because they're afraid they won't get a driver's licence, then that is the dangerous consequence. They are putting themselves and others at risk because they are not getting treatment, and they are still driving.
It's a balance, and how do we strike that balance? "I need to be able to drive for my work" "Yes, but right now you are a genuine risk to be on the roads".
Stop the person driving? They suffer the effects of that, and it may even be "lose my job". Let them drive untreated? They may lose their life in a crash.
Let them drive temporarily while they get treatment sounds like a moderate compromise, but again - if the person is involved in an accident, there's going to be public outcry and demands for "Something Must Be Done!"
And I don't think the free market alone can solve that one.
What are the odds of both scenarios? Stating it as an either or is very misleading... Lose your car you're probably going to lose your job. Leaving it untreated will increase you risk by how much? Very little I'd imagine...
I think a moderate compromise only makes sense when you have good data.
I don't understand what this means aside from capitalism == bad. How about it should be difficult to take away the rights of people?
You show me where there is a divine right to drive a motor vehicle, and we can then talk about taking away rights.
Yes, it should be difficult to take away rights. But it should also be difficult to engage in behaviour that endangers others on the public roads.
Let's bite this bullet: for many people in the world, especially in the United States, being able to drive from one's house to a different physical location is highly-correlated with being able to eat. In theory, driving is an optional system not critical to the basic functions of civilization. In practice, much of society is arranged around the automobile, which has given rise to entire movements whose slogan is "fuck cars."
So I would indeed argue that, so long as being able to exist in modern society relies on being able to drive, having one's legal ability to drive be abrogated is as drastic as a suspension of other rights guaranteed in the Amendments.
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Show me where there is a divine right to anything :marseyshrug:
Again, what are the odds of both (that was my point)
What's the actual risk? Where do we draw the line line between safety and freedom? Going all or nothing on either side is silly.
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It's trivially true that some people are too severely autistic to be able to drive safely (e.g. my brother) but it's also the case that those people are too autistic to pass a driving test and get a license. Just make that argument to the transport minister and ask him to get the standards changed. Filing a case with the human rights commission is a waste of everyone's time.
Ash, you are among the tiny minority of Australians who work in a situation where some fraction of politicians actually listen to the words you say some fraction of the time. The rest of us have to figure out various wheezes for creating a ruckus that will draw the attention of the Powers. Judicial and quasi-judicial processes like the HRC are one example.
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The transport minister has presumably already made that decision, which is how autism got added to the list in the first place.
Nah. It would have been ticked off by the minister, but as @CertainlyWorse says, this policy reeks of public service safetyism. He probably signed off on it with half a dozen other minor things that he doesn't remember either. I'd be shocked if he actually had a considered policy view on the issue.
At the risk of Godwinning where the comparison is genuinely hyperbolic, “if only the Fuher knew”?
I’m not intimately familiar with Aussie politics, but I’m familiar enough to give a list of recent cases where stupid bullshit safetyism ended up with friends in high enough places for politicians to happily stand by them, whether that be the various recent fishing bans (ban shark fishing to prevent shark attacks!), the Adler shotgun, or the obnoxiously early ADS-B mandate.
I mean, it might be worth a shot, but the assumption no one has taken that try simply because it hasn’t changed already is hilariously naive.
The Adler shotgun issue is the only one of those I've been actively involved in, and while it was absolutely stupid, I do think it was a structurally different kind of stupid.
On the object level of course it was ridiculous to ban the Adler. But Aussies genuinely are very pro-gun-control, while at the same time mostly being profoundly ignorant about the particulars of specific guns. So there's a very real political danger to doing the sensible thing in that situation. Popular-but-stupid policies are a problem!
But they are a different kind of problem to stupid policies that don't have a constituency supporting them. With issues where the public doesn't care one way or the other (which is most issues) you really can get policy change by winning over the elites to your side.
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Do you expect bureaucratic policymakers to actually listen to that? I seriously don’t, I expect them to declare it misinformation and refuse to admit they made a mistake until forced to by the human rights commission.
My plan in such case would be to interact with human rights commission until they do such thing (if I would care about this law enough to do something).
Probably start from doing their work for them and write something so they would only sign off on what I wrote (and maybe rephrase it) and forward it to bureaucratic policymakers.
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If you send one email and then go away, no, that's not likely to go anywhere. But it's not as if there's any constituency or interest group invested in making life annoying for autists. The only resistance you're going to face is inertia. And yeah that's not nothing, but it's hardly insurmountable either.
My expectation is that the minor amount of attention the issue has already received will be enough to compel a change.
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Having the issue blow up in the media would probably be the most effective thing in getting the rules changed around this. Politicians are otherwise slow to act and hide behind statements like 'following the best medical advice' rather than using common sense.
The generally high risk aversion of the public service is one of the root causes behind this. The above problem is just a symptom of banal bureaucracy where the chain of public servants presented with this issue decided to take the safe 'just following orders' route of following standards without any risky personal interpretation up to the point of injustice.
I agree that there are people with autism who shouldn't be driving, but the lack of nuance in the legislation doesn't differentiate between someone mildly on the spectrum with a few social quirks and someone who is completely non-verbal. From the public servant's point of view, its best to classify them the same just to be sure.
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