• The EPA has forced the agricultural sector to bear millions of dollars in costs in an effort to reduce carcinogenic pesticide residues in food.
• Yet based on rodent experiments, the (formaldehyde) risk from breathing air for one day at work is 11,600 times greater than the daily risk of consuming pesticides in food.
• If eliminating pesticides from food is a reasonable goal, closing down all of the nation's office buildings would appear to be almost 12,000 times more reasonable.

"There is no greater risk from breathing formaldehyde in the workplace than from drinking two Cokes a day or a glass of wine with dinner."

Real Problem:

Real Problem: Sick Building Syndrome. BRI is relatively rare. A more common problem is the sick building syndrome (SBS) characterized by general complaints such as headaches, fatigue, nausea, eye, nose and throat irritation, coughs and muscle pain. These symptoms are thought to be caused by a combination of airborne substances. [See Table II.] Overall:

• The World Health Organization estimates that up to 30 percent of new or renovated energy-efficient buildings may suffer from sick building syndrome.9
• The EPA estimates that sick buildings cost the U.S. economy
• $60 billion a year in medical expenses, absenteeism, lost revenue, reduced productivity and property damage.10

How Government Has Contributed to the Problem. Many sick buildings are partly the result of federal government policy.11 In response to the energy crisis in the 1970s, the federal government introduced subsidies and mandates to encourage the construction of energy-efficient buildings. These over-insulated structures, which have thick walls, low ceilings, sealed windows and poor ventilation systems, tend to trap chemical fumes that otherwise would disperse. The effect is intensified because in such buildings indoor air is recirculated more often than in conventional buildings. The construction of excessively insulated buildings is still encouraged by government regulations, even though energy prices are now lower in real terms than they were in the early 1970s.

How the Federal Government Manages Its Own Buildings. Before giving government more power over indoor air in the private sector, we should ask how well the federal government has managed its own indoor air.

• In 1991, eight employees of the EPA filed a multimillion-dollar lawsuit against the agency, alleging that the air quality in the EPA's Washington, DC, headquarters was making them ill.12
• An outbreak of Legionnaires' disease at the Social Security Administration's office in Richmond, California, produced ten victims, including one death, and led to a $9.5 million lawsuit.13
• Another outbreak of Legionnaires' disease hospitalized a worker at an Internal Revenue Service (IRS) building in Ogden, Utah.14

"The EPA's own building is apparently a 'sick building'."

Solving Problems Without Regulation

Individual Choice. Individual preferences differ. The willingness of different people to pay for higher quality also differs. Higher quality air is often (although not always) more expensive, and avoiding lower quality air usually involves a cost - if only in terms of inconvenience. One way of satisfying different preferences is to let people make their own choices.

Most of us voluntarily accept less-than-perfect indoor air quality - at work and away from it. As noted above, the air quality in most homes is far from perfect, and few of us would be willing to spend the money or suffer the inconvenience required to achieve perfection. We also voluntarily accept less-than-perfect air in other places. International air travelers often experience discomfort from air that is recirculated during long flights. Presumably the cost of this discomfort is outweighed by the advantages of air travel.

People also choose to accept less-than-perfect air quality when they choose professions and employers. Those who are strongly averse to prolonged exposure to recirculated air presumably choose not to be astronauts, airline pilots or deep-sea divers. Those who are strongly averse to polluted air presumably choose not to be coal miners or lumber mill workers. On the other hand, those whose tolerances are higher often earn more for working in less pleasant environments.

Market Incentives. There are obvious limits to individual choice. Whether in airplanes or office buildings, everyone's ideal cannot be met. Airplane manufacturers and building developers must make trade-offs between air quality and cost. The marketplace gives them strong incentives, however, to satisfy most of their customers most of the time. Building owners, even if they never enter their buildings, find that buildings, with poor indoor air quality are less valuable and produce less rental income.

"The private sector already has financial incentives to provide clean air." Consider that the typical absentee rate for office workers is less than 5 percent.16

• If because of indoor air pollution the absentee rate increases from 5 percent to 7.5 percent, which is not uncommon in sick buildings, the building owner's expected loss will be $3 to $5 per square foot of floor space per year.17
• The present value of $5 per year, assuming a discount rate of 5 percent, is $100 - which rivals the construction cost per square foot for many buildings.
• Thus building owners have strong economic incentives to correct the most serious problems and improve indoor air quality.

The tort law, however, gives victims recourse.18 Indeed, one of the fastest-growing areas of tort law is indoor air lawsuits - which have even named architects and interior designers as defendants. Fear of lawsuits is a motive for maintaining high-quality indoor air, and the majority of building managers are well aware of the potential threat.

Private Sector Solution: Open the Window. In most cases of unacceptable indoor air quality, the best solution is to improve building ventilation.19 For example:

• In a study of more than 200 sick buildings, the National Institute for Occupational Safety and Health (NIOSH) found that inadequate ventilation was the primary problem in 48.3 percent.20 [See Figure I.]
• Another NIOSH study found that, from 1978 to 1988, 53 percent of the complaints in 532 buildings were attributable to inadequate ventilation.21

The importance of proper ventilation was acknowledged in a U.S. General Accounting Office (GAO) report that stated, "Correcting ventilation problems ... can reduce indoor air pollution problems more quickly and extensively than trying to identify and control individual indoor air pollutants."22 Some specialists say that the problems in approximately 80 percent of all sick buildings can be eliminated by simply improving existing ventilation systems. And according to a recent study, quadrupling the minimum ventilation rate23 would cost less than 5 percent of the average energy operating costs in a typical building.24

"Most indoor air problems can be eliminated with proper ventilation."

Private Sector Solution: Grow Plants. A surprising finding of recent research is that many plants are capable of removing pollutants from indoor air. According to Dr. Ray Walverton, a former researcher for the National Aeronautics and Space Administration (NASA):25

• For every 100 square feet of office area, one or two Boston ferns can clean so much formaldehyde out of the air that it is no longer detectable.
• Other toxin-eating plants include the azalea, poinsettia, dieffenbachia, gerbera daisy, corn plant, pot mum, Chinese evergreen and various species of philodendron, schefflera, chrysanthemum, tulip orchid and ligustrum.

So far, studies have shown that plants can remove from the air three carcinogens: formaldehyde, benzene and trichloroethylene. It is likely that they can remove many other toxins as well. Interestingly, the finding that plants can absorb airborne toxins grew out of NASA research on ways to keep the air clean on long space flights. Similar findings are reported by former Soviet space scientists who now seek to market their knowledge as a cure for sick buildings in the West.26

Private Sector Solution: New Technology. If government regulation of indoor air followed typical regulatory practices, the regulators would tell building owners how to manage their air. An advantage of the marketplace is that anyone with a better idea is free to compete. In response to the growing recognition that poor air quality can be costly (in terms of low productivity, lawsuits, etc.), a thriving industry has developed - with a steady stream of new products and new ideas to solve the problem. Almost every issue of Indoor Air Review, Pollution Equipment News, Environment magazine and the Journal of Environmental Health contains advertisements for new products or notices of conferences and seminars on indoor air quality.

The Government's Record on Outdoor Air

"The EPA spends the most money on programs that are least likely to improve the environment."

Misplaced Priorities. Most environmentalists, regardless of other differences, agree that the EPA has done a poor job:28

• In an internal study, EPA staffers were asked to rank the agency's programs in order of their environmental importance.
• When this ranking was compared to a ranking of EPA expenditures, priorities were found to be almost reversed.

Mandating Methods Rather than Achieving Results. One way to achieve higher air quality is to set a limit on pollutants and allow industry to find the least-cost way of achieving the result. Another way is to tell industry how to control pollutants. The EPA usually chooses the latter method.30 It relies on a highly centralized command-and-control approach that is susceptible to political manipulation, is unresponsive to local information and almost always results in higher costs.

Typically, the EPA responds to a pollution problem by requiring that all polluters install the same type of emission control equipment. For example, in attempting to reduce sulfur oxides emissions from coal-powered generating plants, the EPA has required that all new plants be constructed with expensive stack scrubbers, even though burning low sulfur coal is often a more effective and less expensive way of achieving the same goal. Indeed, when the EPA began implementing the stack scrubber policy in 1978, as required by the 1977 Clean Air Act amendments, they found that in some cases scrubbers actually increased the emissions of sulfur oxides.31

Telling producers how to control outdoor air pollutants can be extremely costly and ineffective. Several studies have attempted to determine the cost difference between the least-cost method and the EPA's approach.32 As Table III shows:

• In almost all cases, EPA command-and-control regulations resulted in a higher cost of pollution control than the available alternatives.
• In one case, EPA regulations cost 22 times more than an alternative.

Failure to Use Cost-Benefit Analysis. Quite apart from the question of how to achieve a result is the question of whether the result is worth achieving. The EPA often imposes millions of dollars of costs on industry and achieves negligible or unmeasurable results. Although the agency does its own cost-benefit calculations, such analysis is often ignored in its cost-is-no-object approach to pollution control. The EPA is not alone; OSHA and other federal agencies are guilty of similar regulatory sins.

Failure to Use Science. To scientists, the EPA is notorious for sometimes ignoring and other times misusing scientific studies to promote its own aims. The agency all too often uses such studies to advance a political agenda rather than to judge whether the agenda should be pursued. Among the well-publicized examples are EPA risk assessments in the 1980s that grossly exaggerated the dangers of radon, dioxin and asbestos. A special advisory panel of prominent scientists convened by the EPA to study the agency's programs published the following indictments:33

"The EPA's own study showed the agency routinely misuses science."

• "Scientists at all levels believe the EPA does not use their science effectively."
• "EPA science is perceived by many people, both inside and outside the agency, to be adjusted to fit policy."
• The" EPA often does not scientifically evaluate the impact of its regulations."
• "The interpretation and use of science is uneven and haphazard across programs and issues at the EPA."

Case Study: The EPA's War on Cancer.35 About one in every three Americans will get cancer. About one in five will die from it. What should be done? An EPA executive has said that the most effective way to combat cancer would be to give the entire EPA budget to the National Cancer Institute.36

But that's not what the bureaucrats are doing. Despite the fact that industrial products and food additives cause less than 3 percent of all cancers,37 the federal government is imposing billions of dollars of costs on the American public in its efforts to prevent exposure to trace amounts of environmental chemicals. The most common government standard is that a chemical should be outlawed if one person out of one million exposed over a lifetime could theoretically get cancer from it. Even though 300,000 people out of one million will get cancer anyway, regulations cost the public billions to prevent one more theoretical case.

Typical EPA methods for evaluating the public health risks from air pollution greatly overstate those risks. For example, the EPA calculates potential risks from exposure to an air pollutant by testing the chemical for toxicity in laboratory animals:

• The chemical is administered to rats and mice in massive daily doses just below the amount that would kill them immediately.
• At these high levels of exposure, one out of every two chemicals ever tested (both natural and man-made) eventually causes cancer in at least one species of rodent.
• The EPA then extrapolates from rodents to humans and estimates the human risk of cancer from exposure to the same chemical.

• Even with these pessimistic assumptions, the EPA estimates that only 1,700 to 2,700 cancers are caused each year by exposure to approximately 90 potentially hazardous air pollutants.
• While that hypothetical number may seem large, it is a small fraction of the almost one million cancer cases occurring each year in America.38

The EPA's extreme risk models are notoriously faulty, however. A study of Allegheny County, Pennsylvania, the site of the largest concentration of industrial coke ovens in the country, concludes that the EPA's estimate of cancer caused by coke emissions is exaggerated by a multiple of 100:40

• By the EPA's calculations, its regulations on coke emissions cost
• $6.8 million per cancer prevented.
• Based on more realistic calculations, the cost is $682 million to prevent a single instance of cancer.

• By the EPA's calculations, its new benzene regulations will cost
• $59 million to prevent a single instance of cancer.
• By more realistic calculations, the cost of each cancer prevented will be $5.8 billion.

"Outdoor air regulations require industry to spend $6.5 billion per hypothetical life saved."

Applying this more realistic standard to all air toxins, it appears that the Clean Air Act's new regulations may prevent three to five cancers per year rather than the 350 to 500 estimated by the EPA. The cost per cancer prevented will be between $4 billion and $9 billion per year. [See Figure II.]

The National Cancer Institute's goal is to reduce the nation's 470,000 annual cancer deaths by one-half by the year 2000. The institute does not even mention reducing carcinogenic chemicals in the environment as one of its objectives. However, as suggested by the EPA's own science advisory panel, using resources efficiently is not necessarily an agency goal.

Case Study: The Worst Regulations. The cost-benefit ratios shown in Figure II are by no means the worst examples of regulatory costs. Both OSHA and the EPA have imposed other regulations that cost billions of dollars per life hypothetically saved. For example:42

• A 1987 OSHA limit on occupational exposure to formaldehyde imposes a cost of $86 billion per life saved.
• A 1991 EPA regulation governing atrazine/alachlor in drinking water imposes a cost of $92 billion per life saved.

• And a 1990 EPA regulation governing wood preservatives imposes a cost of $5.7 trillion per life saved -which implies that the EPA is willing to spend the entire GNP to avoid a single premature death.

First, as individuals we are not willing to spend all of our income pursuing any environmental goal. As noted above, most people are willing to live with chemical risks in the air of their own homes because a chemical-free environment is not the only thing they care about. Money spent ridding the environment of pollutants is not available to purchase other goods and services. And just as individuals face trade-offs, so does society. No rational person would want to spend all of society's wealth eliminating a single risk.

Second, even if we believe that health should be pursued at all costs, the regulations described above are indefensible. Millions of dollars spent to save one hypothetical life at some undefined point in the future is money not available for prenatal care or AIDS research. The dollars the EPA requires industry to spend could be spent elsewhere to save many more lives.

Third, even if we believe that broad environmental goals should be pursued at all costs, the regulations described above are indefensible. Millions of dollars spent to achieve a trivial, hypothetical benefit is money not available for other worthwhile environmental aims.

Finally, the regulations described above are self-defeating even on their own terms. The reason? Spending enormous amounts of money on a single risk lowers the take-home pay of workers, and numerous studies have confirmed that higher incomes and better health go hand in hand.43 When people have more income, they seek more preventive medical care, drive safer cars and reduce countless other risks to health and safety in their daily lives. For example:44

"Regulatory spending can cost more lives than it saves."

• One study concluded that every time society spends from $5 million to $12 million in regulatory costs, an additional death is caused because of the lower standard of living that results.
• Based on this analysis, if the EPA requires industry to spend more than $12 million to save a life, it kills more people than it saves.
• We discuss the implications of this study for indoor air regulation below.

Options for Government on Indoor Air

Option 1: Do Nothing. The strongest argument for doing nothing is that if government does anything, the cure is likely to be worse than the disease. Could regulators conceivably improve on private sector solutions? Yes. Are they likely to do so? Based on our experience with the regulation of outdoor air, no.

The second strongest argument for a do-nothing policy is that most of the private sector is responding responsibly as more information becomes available about real risks. A sensible cost-benefit approach toward indoor air quality is more likely if the matter is left in private hands.

In general, the private sector is much better able to solve indoor than outdoor air problems. Outdoors, there are thousands of polluters and thousands of victims. The costs of polluting more are mainly imposed on others, and the benefits of polluting less are mainly enjoyed by others. Indoors, things are different. Although the initial effects of poor air quality are felt by building inhabitants, ultimately the bulk of the cost is borne by building owners - as tenants leave, file lawsuits or pay less rent. Building owners, therefore, tend to bear the cost of their failure to maintain high air quality and reap the benefits of their efforts to improve things.

Option 2: Provide Information. A serious problem with indoor air pollution is that it often goes unrecognized by those at risk. Thus government may have a role in providing information on the existence of a potential problem.

A government agency might, for example, determine the level of air quality in buildings and post this information with some explanation of its significance. Such a policy would inform customers, workers, proprietors and employers. As people responded to the information, building owners also would respond. In some cases, the response would lead to significant improvements in indoor air quality. In other cases, the improvements might be minor.45

Is there a practical way to provide such information? A multipage document listing the concentration of hundreds of chemicals along with other technical information would be worthless to most people. However, the American Society of Heating, Refrigerating and Air Conditioning Engineers (ASHRAE) already has developed a ventilation standard for buildings.46 The standard could serve as a norm in the following way: People would ordinarily assume that a building met the ASHRAE standard and was periodically checked for dangerous containments. Owners of buildings that failed to meet the standard would be required to post warnings listing the ways in which the building deviated.

"Instead of regulations, why not give people information and let them make their own choices?"

A policy of posting information on indoor air quality and letting those with the most at stake respond as they see fit is similar to the current policy of local public health departments that inspect restaurants and post sanitation ratings in each. When information on cleanliness is available to customers, restaurant owners have a strong incentive to keep their establishments clean. Building owners would have similar incentives.

Why would people want to enter or work in a building with substandard air quality? One reason is that there is not one "best" air quality in all buildings. As noted above, in some cases it is profitable for building owners to improve air quality. But in other cases higher air quality comes with a price tag.

As discussed below, when higher air quality involves significant cost, that cost is likely to be borne by workers in the form of lower wages.

Clearly, there are differences among workers in their willingness to trade take-home pay for clean air. But even if all workers had the same preferences, the cost of clean air varies radically from workplace to workplace. Thus the same willingness to trade money for clean air would result in quality differences from building to building.

There are also likely to be differences among the preferences of customers of different buildings. For example, those who are enjoying an evening in a local bar or pool hall may be less concerned with high indoor air quality standards than are those who are recovering from illness in a hospital. Also, people patronizing an establishment are usually interested in a package of attributes, of which air quality is only one. People choosing between restaurants may go to the one with better food or more appealing decor, even though they know it has lower air quality. There is no one best level of indoor air quality for all situations.

Even if there were a best level, it would be extremely difficult for the EPA or any other bureaucratic organization to discover it. And it is completely impossible for any government agency to determine the appropriate air quality in each of the millions of U.S. businesses. Decisions on air quality are best made by those who have to compete for workers and customers, assuming those individuals have information on the air quality in different establishments.

"Instead of a command-and-control approach, why not set standards and give industry the freedom to meet them?"

Option 3: Setting Air Quality Standards. More aggressive than providing information would be to mandate an acceptable level of indoor air quality, allowing owners and managers of individual buildings to choose their method of reaching that level.

For example, the federal government might adopt the ASHRAE standard for ventilation and require that all buildings meet it. This would deny people the right to make their own choices about the level of air quality, but it would allow the private sector to find the least expensive ways of achieving the standard.

When an indoor air pollution problem is identified, the least-cost response will vary. In some cases, the best solution may be to simply open some windows or bring in a couple of Boston ferns. Some problems can best be solved by moving certain tasks to a more remote or better ventilated part of the building or by contracting the task to a firm that can perform it more safely. In other cases, the best solution may be to reassign an environmentally sensitive employee to another work area. In extreme situations, say in the case of a particularly serious health hazard, the best action may be to demolish an existing building and build a new one.

Option 4: Regulating the Sources of Pollution. If government were to regulate indoor air the way it regulates outdoor air, it would single out particular sources of pollutants and try to regulate those sources in specific ways. This approach would be a mistake for several reasons.

First, a command-and-control approach is inevitably more costly. As Table II shows, when government tells the private sector how to control pollution, the method it imposes is almost always far more expensive than allowing people to experiment and to adopt the least costly method.

Second, attempting to improve indoor air by regulating individual sources of pollutants does not guarantee improvement unless every source is regulated. A contaminant may come from many different sources, and frequently the source is not known. In any event, attempting to regulate the tens of thousands of potential sources of pollutants is probably impossible.

Hundreds of potentially harmful pollutants can be found indoors, most of them are not readily noticed and, when they are, the symptoms they produce are not always traceable to a specific pollutant. Indoor pollutants, particularly in offices, may be generated by building materials, furniture, carpeting, office equipment, cleaning compounds, human metabolism and outdoor air. In addition to these organic compounds are the host of common fibers, dusts and microbes that can cause adverse physical reactions. Furthermore, most of these pollutants cause similar symptoms.47 For example, it is impossible to differentiate the symptoms caused by formaldehyde from adhesives, ammonia from microfiche machines, oxides of nitrogen from combustion processes, ozone from laser printers and volatile organic chemicals from carpets.48

"Instead of regulating each individual source of a pollutant, why not simply clean up the air?"

Rather than regulating each source of each pollutant, a better approach may be to remove whole categories of pollutants from the air.

Finally, allowing an agency such as the EPA to regulate individual sources of indoor pollutants undoubtedly would create many of the same problems caused by EPA regulation of outdoor pollution sources. These include the practice of requiring the private sector to bear billions of dollars of costs in order to achieve trivial benefits.

The Costs of Indoor Air Regulation

Lower Take-Home Pay. The effect of indoor air regulation costs would be similar to a tax on labor. Since the purpose of the regulations would be to protect employees, the more employees there are, the higher the cost.49 Roughly speaking:

• If the private sector were required to spend $10 billion to improve indoor air, that would be equivalent to a $90 tax on every employee.
• A $100 billion regulatory cost would be equivalent to a $900 tax on each employee.

"The cost of indoor air regulations would ultimately be borne by employees."

Many proponents of aggressive regulation assume that the costs will somehow be borne by "business." However, business is a relationship - between workers, managers, consumers, stockholders. Although government frequently taxes relationships, relationships don't pay taxes - people do. Ultimately, all taxes are paid by individuals. And, employees are the individuals most likely to bear the full costs of indoor air regulation.50

Regressive Taxes. The cost of indoor air regulation would be imposed on workers like a regressive tax. The lower the employee's income, the higher the burden as a percent of income. [See Figure III.] For example:

• At $900 per employee, the cost of clean air would be almost
• 10 percent of the annual income of a minimum-wageworker.
• By contrast, the cost would be less than 1 percent of the income of a $100,000-a-year employee.

• If regulatory costs were $40 billion, about 360,000 jobs would be lost.
• An $80 billion regulatory burden would eliminate about 720,000 jobs.

The incidence of cancer is another example. A primary goal of many proponents of indoor air regulation is to reduce the level of airborne carcinogens and, therefore, the risk of cancer. But if regulation reduces employee income, the exercise could be self-defeating. According to the National Cancer Institute, poverty is one of the most important causes of cancer.53 For example:54

"According to the National Cancer Institute, poverty is one of the most important causes of cancer."

• The incidence of cancer is 6 percent to 10 percent higher among blacks than among whites.
• But at the same income and educational level, blacks may have a lower incidence of cancer than whites.
• Table IV shows the results of these and other links between mortality and low income. As the table shows:
• A white male earning the minimum wage has a 78 percent higher probability of dying in any given year than one with an income of $50,000.
• A white female has a 43 percent higher probability of dying if she is earning the minimum wage rather than $50,000.

"A $100 billion regulatory burden would mean $900 less take-home pay for every employee."

"Studies show that lower take-home pay leads to higher mortality."

Figure VA shows the likely increase in mortality as a result of potential indoor air regulatory burdens. As the figure shows:

• Each $1 billion of regulatory costs is likely to lead to 193 additional deaths.
• To justify, say, $20 billion in regulatory costs, the regulations must be shown to save more than 3,855 lives -since that is the number of deaths likely to be caused by the regulations.

• With $10 billion in regulatory costs, a male earning close to the minimum wage would have an increased probability of dying that is 10 times the increase for a male earning $33,000 and 218 times the increase for one earning $66,000.
• A female earning close to the minimum wage would have an increased probability of dying that is more than five times greater than a female earning $33,000 and 46 times greater than one earning $66,000.

The Politics of Indoor Air

Agency Turf Battles. The EPA is trying to extend its regulatory authority over indoor air pollution (Senate Bill S455 is a product of this effort), which is now the primary responsibility of OSHA. Such attempts on the part of federal agencies to expand their authority are common and stem from their desire for increased budgets. OSHA is responding with more aggressive regulations of its own.

"Smoking is a problem in only 2 percent of buildings."

The Antismoking Lobby. To gain political support for more control over indoor air, the EPA has found it convenient to single out tobacco smoke as the major source of indoor pollution.56 Yet the antismoking concern is misdirected. When it is being candid, the EPA recognizes that indoor air pollution is best addressed as a broad problem.57 And even if it did make sense to focus attention on particular pollutants, tobacco smoke would be a low priority.58

• As noted above, the National Institute for Occupational Safety and Health found that tobacco smoke was a problem in only 2 percent of the buildings it examined.59
• In a study of 412 sick buildings over the period 1980-88, Healthy Buildings International found that tobacco smoke was the primary pollutant in only 3 percent.60

"Every $1 billion of regulation is likely to cost 193 lives."

"The risk would be greatest for the lowest paid employees."

• Other categories, some of which include large numbers of individual pollutants, are far more significant sources of indoor pollution than tobacco smoke. [See Table II.]

Conclusion

A reasonable public policy is to encourage the private sector to continue seeking cost-effective solutions. For if we allow government to regulate indoor air the way it regulates outdoor air, the results would be devastating to the real estate industry and to workers in many industries - workers who would suffer from income reductions, lost job opportunities and even higher mortality rates.

NOTE: Nothing written here should be construed as necessarily reflecting the views of the National Center for Policy Analysis or as an attempt to aid or hinder the passage of any bill before Congress.