There is a
viewpoint that the unavailability of iodized salt is a market failure since people would pay for it if only salt producers would iodize. This is supported mainly by this
New York Times piece.
The benefits of iodine are unquestioned. Iodine is a preventive treatment for goiter, stunted growth, and cretinism or "low IQ". Some of these uses of iodine have been known for almost 200 years in the developed world (the use of iodine-containing foods such as seaweed has been known for much longer). Salt is an inexpensive means of distributing iodine to a population without access to other sources, so iodized salt is readily available in the developed world. In countries where iodine is available through the food supply -- Japan through seaweed, England through various means -- iodized salt is neither necessary nor mandated.
Sponges, seaweed, and other seafood were noted as cures to goiter thousands of years ago. More recently, in 1819 Jean-Baptiste Dumas showed that iodine is a remedy for goiter. Later research found a link between iodine and cretinism or IQ. Thus, iodine became a popular nutritional supplement, with governments becoming active in it only relatively recently.
Salt, however, has been a subject of intense government interest for much longer. Salt was valued as a germ-killing preservative before wide-scale refrigeration was available, giving us salt-cured ham, bacon, jerky, pickled goods, and so on. The Romans paid their soldiers
salarium, salt money, giving us the word "salary". Salt in those days was a source of power and wealth: Salzburg (salt town) was a seat of power in central Europe and Poland's early wealth came as a result of its salt mines, which diminished as Germans developed technology to create salt from brine.
As a source of wealth and power, and a daily necessity, salt of course was the subject of extensive taxation. The Chinese began taxing it 4000 years ago. The British Empire in India paid for its exploits by "the hated salt tax". One of Gandhi's first acts of defiance to the Empire was to march to the sea and make salt, circumventing the tax and declaring that it is every man's right to make salt. Today, Indians still recall that act as they
fight against iodine mandates with online petitions. It is currently hotly debated in China again. In Mark Kurlansky's
Salt: A World History, he points out that Myanmar (Burma) mandates iodized salt, but people in the highlands can't get it so they trade illegally with China to get it. Sometimes they don't, since unscrupulous black market traders frequently sell untreated salt as iodized.
In the U.S., it is frequently asserted that iodization has been mandated. It is not. Salt companies began voluntarily adding salt in 1924, and Morton began distributing it nationally that year (see
this article). Recommended Daily Intake levels are suggested for iodine in
21CFR101.9 (c)(8)(iv) to be 150 micrograms/day.
There has been a recent explosion in noniodized salt availability in the U.S. as an interest in higher quality raw materials for cooking has taken hold. This worries the professional experts, who believe that this will lead to a return of goiter and cretinism. "The National Health and Nutrition Examination Surveys found that from the 1971-1974 to 2001-2002 examinations, iodine excretion in adults dropped from 320 mcg/L to 168 mcg/L -- by nearly half -- and the
frequency of iodine deficiencies in pregnant women jumped from 1% to 7%" says
this site, emphasis in the original. Note that the fall in adults is from over twice the RDI to slightly above it. Similar trends are reported in
this article, which also notes that a similar reduction has occurred in Canada, where iodization is mandated.
Too much iodized salt in a diet is not a good thing, possibly leading to hyperthyroidism or hypertension. The former is typically a problem only in those areas of the world where iodine is a supplement, suggesting that while iodized salt may be a good thing, it is not a perfect solution. "Too much iodine increases the incidence of iodine-induced hyperthyroidism, autoimmune thyroid disease and perhaps thyroid cancer. Too little causes mental retardation, goiter, hypothyroidism, and other features of the so-called iodine deficiency disorders. The global push to eliminate iodine deficiency in the current decades has put both excess and deficiency of iodine in the spotlight. Some countries have already moved rapidly from severe iodine deficiency to iodine excess, while others are only now recognizing iodine deficiency as a problem. Their experience, as well as that in the USA and Canada, emphasizes the need for continued monitoring to assess trends in iodine intake." (from
Thyroid Manager Chapter 2 linked above)
Even a cursory reading of the NY Times article would show that this failure in Kazakhstan is not purely the fault of the market:
- It points out that the problem was not solved in the days of the Soviet Union, when there was no market.
- It points out that one of the factors working against iodization was the advertising of the iodine pill industry, proof that there is not market failure but rather an education failure. The desired goal, after all, is the intake of adequate quantities of iodine, not the production of iodized salt. A market need only make it available at affordable prices, which was the case.
- The article begins by stating that a public relations program led by a charity organization was the primary contributor to turning the situation around. Yes, the charities received aid (the PR campaign was paid for by the US AID program and UNICEF paid for the original salt sprayer and potassium iodate used by the main manufacturer), but the program would not have worked without the involvement of the organizations because of the massive distrust of the government. The author writes, "Also, Ms. Sivryukova's network of local charity women stepped in. As in all ex-Soviet states, government advice is regarded with suspicion, while civic organizations have credibility." No wonder nobody believed in iodized salt - and it wasn't the market's fault.
- That problem is underlined when the article points out that the problem was completely solved in neighboring Turkmenistan, where maximum leader Saparmurat Niyazof has mandated the giveaway of iodated salt. As I will argue in the next post in this series, I'm not sure I want to live in a country with this level of efficiency, and that isn't even considering that this is the same autocrat who names days of the week after his family and mandates that his own face be present on all clocks.
- One company makes 98% of the salt in Kazakhstan. No doubt a former state monopoly, it has access to the salt mountains near the Aral Sea. The article specifically points out that this condition enabled the central mandate to be successful. In other countries with many suppliers, like Pakistan, central mandates are unlikely to work as well.
The obvious solution to the final problem is to tighten government control of the salt industry, made easier by eliminating those competitors without the means to add the spraying equipment, and perhaps by restricting the competition by granting a monopoly. Given the history of government intervention in salt markets (still fresh in the minds of societies that don't have a refrigerator in every house), it is easy to understand how people in those areas might get the idea that iodization may be both newspeak for "government monopoly" and a new way to tax the poor. It's easy to dismiss such people if you lack such historical perspective, you believe that the poor are foolish, you easily entrust the government with large amounts of power, or you stand to gain from such grants.
One final point: many people fail to notice that a market failure does not always mean a 100% lack of the desired article. Private roads exist (and were much more common before the government started supporting railroads). Despite Akerlof's paper on the market in lemons and the supposed impossibility of a used car market, used cars are successfully sold every day. In
this USAID report, we find that iodized salt was available in Azerbaijan in 2000, 3 years before the intervention started in 2003:
"Consumption of iodised salt by households significantly increased by years: in 2000 was 41.3% adequately iodized salt; 44% in 2002 increased to 70 % in 2003 and selling of iodized salt at the market increased from 30% (2002) to 68% in 2003; In 2004 consumption of iodized salt at households increased to 84%4. However, a WFP survey conducted in rural areas shows consumption of iodized salt to be around 66%."
Likewise in Ghana, Unilever
increased iodized salt production in order to increase market share. A market failure is the underproduction or overproduction (and/or underconsumption or overconsumption) of a product, not the complete absence of it. Optimal consumption is that point at which the marginal social cost equals marginal social benefit. I doubt that we know the marginal social costs or benefits with any precision for anything. We could go on arguing about that for any number of products endlessly, and we will finally conclude that it seems likely that all products are under- or overproduced to some degree.
[UPDATE: A concerned reader fears that paragraph eight ("Too much iodized salt...") will leave readers with the impression that I think iodine is dangerous and should be avoided because the quoted material begins, "Too much iodine increases the incidence of iodine-induced hyperthyroidism, autoimmune thyroid disease and perhaps thyroid cancer. " I will point such readers back to paragraph two ("The benefits of iodine are unquestioned...") and also point out that I can't find much evidence linking excessive iodine to cancer.
Iodine-induced hyperthroidism (IIH), the
Wolff-Chaikoff effect, and
Hashimoto disease, however, seem to be real, but probably not for you if you are reading this online.]
Labels: failure, poverty, state-capitalism