So What If Mandatory Helmet Laws Save Lives and Taxpayer Money?

One popular retort after someone cites some statistics at you in the comment section is to say “’There are three types of lies—lies, damn lies, and statistics.’ Mark Twain said that, bro.” It’s a slightly classier way of saying, “Well, numbers can prove anything,” without implying, “except my position.” It’s a comeback you can reasonably expect to see under articles about states requiring all motorcycle riders to wear helmets, because the statistics all point to the laws saving lives for decades—and if that's not convincing—they also save taxpayer money.

An article in The Economist sidestepped questions of personal liberty and nanny states and pointed out that the argument for mandatory motorcycle helmet laws could be a simple matter of mathematics and cost reduction.

The helmetless [riders who get in accidents] are distinctive, says Dr Lori Terryberry-Spohr: they suffer “diffuse” internal bleeding and cell death across large areas. Such patients typically run up $1.3m in direct medical costs. Fewer than a third work again. A study of helmet-shunning bikers admitted to one large hospital, cited by the Centres for Disease Control (CDC), found that taxpayers paid for 63 percent of their care.

The article went on to explain that 19 bills were introduced in 11 states to repeal all-rider helmet laws, but none passed, possibly due to the monetary argument. It’s not a new argument, as the CDC points out, “in one year, cost savings in states with universal motorcycle helmet laws were nearly four times greater (per registered motorcycle) than in states without these comprehensive laws.” California’s mandatory helmet law is estimated to have saved the state $394 million, in terms of medical, productivity, and other costs.

In spite of this, the trend as of late is against mandatory helmet laws. Today, 19 states and the District of Columbia have universal helmet laws. Only three states have no helmet requirements—Illinois, Iowa, and New Hampshire—while the rest have age-specified requirements. The American Journal of Public Health points to the laws that protect minors, saying that they prove "that legislators and some antihelmet law forces have accepted a role for paternalism in this debate."

Some but not much, it seems. Since 1997 seven states have repealed their universal helmet laws. No state has enacted a universal helmet law since Louisiana reinstated the law in 2004. A Nebraska state senator in The Economist article sounded determined—dead-set—on repealing the mandatory helmet law in the Cornhusker state in 2014, even though he couldn’t get it repealed this year.

The debate isn’t about whether riding with a helmet makes riding motorcycles safer—the National Highway Traffic Safety Administration estimates that wearing a helmet reduces the risk of dying in a crash by 37 percent. Unhelmeted riders are three times more likely than helmeted ones to sustain traumatic brain injuries in the event of a crash. The NHTSA estimates that helmets saved 1,829 motorcyclists’ lives in 2008 and that 822 of the unhelmeted motorcyclists who died would have survived if they had worn helmets.

The debate also doesn’t seem to be about whether universal helmet laws makes riding safer, or whether repealing them leads to more fatal crashes and injuries. Without mandatory helmet laws, about 50 percent of riders wear helmets. With them about 84 percent of people do—this has been consistent since the 1980s, with a slight increase in people opting to wear helmets even if they aren't legally required to in recent years. When Louisiana brought back universal helmet requirements in 2004, the number of fatal crashes dropped for the first time since 1999—when the universal law was initially repealed. When Michigan repealed its universal helmet laws in 2012, biker deaths rose by 18 percent.

Rather, at least in the comments below The Economist article, the debate is about who’s causing the accidents and the fact that the government shouldn’t be telling anyone what to do.

There are some numbers that speak to the first point—46 percent of motorcyclist deaths in 2011 occurred in single-vehicle crashes and 54 percent occurred in multiply vehicle crashes according to the Insurance Institute for Highway Safety. No one is saying that people in cars are all good drivers and most motorcycle safety websites mention something about how drivers need to "start seeing motorcycles." Encouraging better drivers just isn't mutually exclusive with helmet laws, though.

The other objection to motorcycle helmet laws—that the government can’t tell you what to wear—has a long and fairly interesting history. In 1967, the federal government required states to enact universal helmet laws in order to qualify for certain highway safety funds and by 1975 all but three states did. But motorcyclists organized themselves into a powerful lobby, and got the National Highway Safety Act revised to allow states to change their laws in 1976.

With the federal requirement down, 28 states repealed their helmet laws within four years. Ironically, the mass repeals really should have given fodder to the pro-helmet-law side of the debate. As an article in the American Journal of Public Health put it, "Over the past 30 years, helmet law advocates have gathered a mountain of evidence to support their claims that helmet laws reduce motorcycle accident fatalities and severe injuries. Thanks to the rounds of helmet law repeals, advocates have been able to conclusively prove the converse as well: helmet law repeals increase fatalities and the severity of injuries."

But even with all that statistical evidence behind them, the pro-helmet-law people have trouble getting traction against the impervious rhetoric of the anti-helmet-law side. What's their secret?

Bruce Davey was from the Virginia chapter of an anti-helmet lobby called A Brotherhood Against Totalitarian Enactments (ABATE), which helped break the federal government's enforcement of helmet laws, said that the laws were not only unjust but discriminatory, saying:

The Ninth Amendment says no law shall be enacted that regulates the individual’s freedom to choose his personal actions and mode of dress so long as it does not in any way affect the life, liberty, and happiness of others. We are being forced to wear a particular type of apparel because we choose to ride motorcycles.

Are the extra costs considered an impact on others? Will proving that individuals who choose not to wear helmets incur a cost on everyone be adequate to strike down the libertarian appeal?

Don’t count on it. This tactic has been tried before—and dismissed by sliding it down a slippery slope. Pointing out that there are specific laws that target drivers of other vehicles—requiring wearing seat belts or buying insurance—don't work. Comparisons to state-required vaccinations didn't work either. As long as the debate about helmets can be framed as one about personal liberties, the mythic motorcycle rolls over objections.

“Would you urge us then, at the federal level, to mandate diets and to investigate homes as far as diets are concerned? We would save a lot more money if we had good nutrition in this country,” said Senator James Jefford in a 1989 hearing on helmet laws (and somehow not in a comment on a Youtube video with Michelle Obama and Elmo). “I grant the arguments are there on cost, but the arguments are there on cost in nutrition, as well. I have a hard time, philosophically, accepting that the role of the government is to tell us how to lead our lives.”

What The Economist, and the CDC and the National Institutes of Health—and anyone else who thinks that real-world outcomes have anything to do with helmet laws—don’t seem to realize is that statistics just don’t work against an emotional appeal of comparing laws to tyranny. It's likely that anti-helmet groups are fully aware of the danger, and that's part of the appeal. It's a little harder to make a case for laws to allow for that, which is perhaps why anti-helmet-law groups appeal to personal liberties rather than stats or their own love affair with danger. Rather than compiling statistics, it's possible that only another emotional appeal can address that.

Although the pro-helmet-law groups have tried that too, like in this 1991 video also by the Insurance Institute for Highway Safety, which shows survivors of motorcycle crashes who weren’t wearing helmets struggling to regain basic motor functions and interviews with one of the ex-riders mothers.

It probably won’t change any laws, and maybe it shouldn’t. After watching that video it doesn’t seem like the government should have to tell someone to wear a helmet; it just seems like something you’d choose to do for yourself.