Keith Bailey of Ames, Iowa, joined Mothers Against Drunk Driving in 1986, shortly after his daughter, Kim, 28, was killed by a 21-year-old drunk driver with a history of driving drunk and underage drinking.
The next year, Iowa converted its 220 stores to private franchises while maintaining control of liquor sales and distribution.
Privatizing the stores brought one unmistakable change in Iowa: The number of outlets selling alcohol has more than doubled in the past 20 years. It has never been easier for Iowans to buy beer, wine or spirits.
But, contrary to what one might expect, privatization in Iowa has not spawned a marked increase in underage drinking or alcohol-related traffic deaths. "It would be my impression that privatization didn't really have any effect," said Mr. Bailey.
Where problems have turned up, it can usually be tied to how aggressively particular counties enforce the law, said Lynn Walding, administrator for Iowa's Alcoholic Beverages Division.
"At the end of the day, what it turns on is enforcement."
Whether the issue is privatizing state stores, or shipping wine directly to private homes, the prospect of minors purchasing alcohol gets prominent attention in the argument against changing Pennsylvania's current system.
Intuitively, less government control of liquor sales, plus more outlets, would seem to equal greater consumption and more underage drinking problems. There's some research to back that up.
A recent analysis by the Pacific Institute for Research and Evaluation, one of the few to directly address the public health effects of privatization, concluded that retail monopoly states such as Pennsylvania do see less underage and binge drinking, and experience fewer underage drunk driving deaths.
"Enforcement is more important than a private system, but I think the Pennsylvania system certainly has saved some kids' lives," said Ted Miller, lead investigator of the study.
Dr. Miller said the state store system is probably twice as effective as other means, such as sobriety checkpoints or zero tolerance policies, in preventing underage drinking. If Pennsylvania privatized its liquor sales, Dr. Miller estimates there could be close to a 30 percent increase in deaths due to underage drinking. In 2006, the most recent Pennsylvania data available, there were 50 fatal car accidents involving an underage driver who had been drinking.
"It [the liquor control structure] clearly needs to be retained," he said, "but it would be a lot more effective if beer was sold in state stores, too."
On the other hand, the Governors Highway Safety Association, which represents state highway safety agencies across the U.S., does not stress state liquor control in its various public campaigns against drunk driving.
"We don't view the liquor control issue as a big one for reducing underage drinking and drunk driving," said GHSA spokesman Jonathan Adkins. "It's one of a host of things that could be done, but it's not a top priority."
Nationwide, all but 18 states have gone private since Prohibition ended in 1933, and none has reverted to a control system.
State-to-state comparisons on the impact of privatization are difficult because of variations in laws and enforcement -- some states control spirits, but not beer and wine; others, like Pennsylvania, group wine and hard liquor together; and others are entirely privatized.
And sometimes comparisons can run counter to expectations: MADD ranks privatized Iowa as having the 10th lowest percentage of fatalities involving a drunk driver in the U.S. -- liquor control state Pennsylvania, on the other hand, is 32nd.
The prospect of increased underage drinking was one of the primary reasons cited by Pennsylvania's MADD organization last year for retaining a state controlled retail system.
"Logically, it [privatization] would lead to more availability which would lead to more consumption which would lead to more problems. We like the controls that are in place. It has been a system that has worked," said Rebecca Shaver, executive director for MADD in Pennsylvania.
Yet, she said, MADD has decided not to oppose a proposal by Sen. Rob Wonderling, R-Montgomery, to privatize retail wine and spirits sales after reviewing the planned bill's tight provisions for clerk training, identification checks and other concerns.
Ultimately, good academic research that directly measures the impact of privatization is both limited and mixed, said Michael Flaherty, executive director of the Pittsburgh-based Institute for Research, Education and Training in Addictions, or IRETA.
"The reality is, if youth want to get alcohol, they have many avenues to get it," he said. Privatization would "negligibly" contribute to underage drinking, he believes, but it is less important than education and community-wide efforts to stop underage drinking.
"When I ask young people who come into my office, they say they get [alcohol] from asking someone who is old enough to buy it for them."