The Weeds on weed: what a Dutch study tells us about legalization

by Carly Sitrin

The Weeds crew have finally discussed weed — specifically, marijuana use and policy. On the July 19 episode of the podcast, Vox’s Sarah Kliff, Matt Yglesias, and Ezra Klein talk about a paper — aptly titled “High Achievers” — out of the Netherlands that found marijuana use correlates to worse academic performance.

The 2015 Maastricht University study followed university students and tracked their academic achievement, with the intent to measure a temporary policy change in the city of Maastricht that restricted legal access to cannabis based on nationality.

For decades, marijuana use and sale had been legal in the Netherlands and could even be purchased at coffee shops and cannabis shops around the region, which led to a massive increase in drug tourism — people coming to the Netherlands with the intention to purchase or use pot. In time, the city of Maastricht saw its crime rate triple compared with that of cities further from the border. To curb the drug tourism problem (mostly coming from, as the study authors write, “bad tourists” from France and Luxembourg), cannabis shop owners in 2011 issued a “partial prohibition” policy change, which only allowed people from specific nationalities to buy cannabis on their premises. Interested customers had to present a valid Dutch, German, or Belgian ID to be granted entry to a cannabis shop. 

This policy created a unique situation, the study authors write, where students at the university could be separated into groups — those that could legally obtain marijuana and those that could not — and their academic performance could be measured. They concluded that students who could no longer legally buy cannabis increased their grades substantially — particularly in classes that required more math or numerical knowledge. 

In this episode, the Weeds team discusses these findings as well as how alcohol policies compare to marijuana policies, and the effect the war on drugs has had on legalization efforts in the US.

Sarah, Matt, and Ezra also discuss the state of the rapidly changing health care debate in the Senate, and the dynamics that are creating such a turbulent situation: moderate Republicans balking at the prospect of the uninsured population shooting up; far-right senators refusing to accept anything less than a full repeal of Obamacare as nearly enough; and a lack of leadership from Mitch McConnell and Donald Trump.

Sarah also unpacks the interesting case of “Obamacare in Alaska,” where insurers received funding from the state to pay for high-cost patients, which, in turn, lowered premiums for everyone — though it cost the state around $50 million.

Here’s Sarah explaining how Alaska got the Trump administration to pay for high-cost patients in the state:

SARAH: Alaska did something really interesting that other states are following. They were in a pretty typical situation in 2016. Premiums were set to rise 40 percent in the state. It was like one of those Obamacare horror stories about how premiums were going to just be jacked up, everyone would be paying a lot of money, so the insurance regulator there, this woman Lori Wing-Heier, she comes up with this really interesting plan where she says, “What if we promise to pay back the insurance companies that have really high claims, the people who get stuck with super expensive patients.” And they set up this scheme funded by the state so they are putting — it did cost the state about $50 million or so.

MATT: $50 million insurer bailout fund.

SARAH: An insurer bailout fund passed by Alaska where the Alaska legislature said, “We will pay you back for the high claims, so don't jack up your premiums if you get someone who has one of these...” I think they identified 33 high-cost diseases and said, “If you get someone with this, we will help pay the claims.” So instead of premiums going up 40 percent this year, they went up 7 percent. So it was a huge decline.

One of the things Alaska quickly realized is because premiums did not go up a lot, they were getting less money from the federal government. The tax subsidies weren't as big because people needed less help to pay their premiums. So they were like, “Wait a minute, we are saving the federal government, like, $40 million; they should pay for this reinsurance program. They should give us the money just in a different format.”

So they went to, then, the Obama administration, and said, “Hey, we want you to give us this money instead of us putting up the state funds.” The Obama administration said, “Yeah, we think that's a good idea.” The [Democrats] lost the election; [Alaska] had to reapply essentially with the Trump administration, who just last week said, “Yes, we think this is a good way to stabilize Obamacare in Alaska.” So it was this kind of surprising way that the Trump administration is making Obamacare work a lot better in Alaska.