The Fairness of Measure 50

Nick Wirth

While reading the Oregonian’s politics blog, I couldn’t help but notice a post evaluating advertisements from both sides of the Measure 50 debate. The analysis of tobacco companies’ latest ad is dead on, but I was much less enthused after reading their review of the latest Healthy Kids tv spot:

This is a straight-ahead appeal that equates passing Measure 50 with helping children get health care. It makes no mention of the guts of Measure 50: an 84.5-cent-a-pack tax on cigarettes and higher taxes on other tobacco products.

Instead, the ad describes Measure 50 as a "fair" way to provide health insurance without giving any hint why a roughly 70 percent increase in the cigarette tax is fair.

The post inevitably suffered from the common (and false) impression in the mainstream media that criticizing both sides of an issue is fair. So the best the Oregonian could come up with is that the Healthy Kids ad calls Measure 50 fair. Without even explaining why!

That analysis doesn’t do justice to all of the good Measure 50 will do if it’s passed. But beyond that, the ad is absolutely right; raising the tobacco tax is fair.

The Center for Disease Control estimates that every pack of cigarettes purchased costs Oregon $5.68 in future health care expenditures. That’s over $1 billion every year! That’s not to mention another $5.48 per pack that cigarettes cost Oregon in reduced productivity.

So who do you think ends up paying these costs? It’s definitely not smokers. Currently, the tax rate on a pack of cigarettes in Oregon is $1.18. That doesn’t even begin to cover the health care costs per pack. As a result, those costs end up getting passed on to the rest of us taxpayers who don’t smoke. Until the state taxes tobacco as much as tobacco costs the state, Oregon is effectively subsidizing tobacco use.

The money that each pack of cigarettes costs the state could be used for so many better purposes. But instead Oregonians pay for people to use a product that at this point everyone knows is harmful.

People can choose to smoke if they want, that’s their right. However, if they do use tobacco, they should also bear all of the consequences, including the monetary cost. Raising the tobacco tax requires smokers to pay a great share of the costs that they incur by using tobacco. It also means that 100,000 children will get the health insurance they need. Could anything be fairer?

Comments

  • Taoiseach (unverified)
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    Also to consider:

    -Smokers suffering from chronic tobacco-related diseases often need to exit the workforce for treatment or because of disability. This raises the overall cost of tobacco expenses per pack to about $11.

    -Oregon spends money on uninsured, ailing smokers that should be spent on uninsured children instead. The ~$140 million generated by M50 replaces that money spent on tobacco users.

    -An increased price in cigarettes discourages teens from starting to smoke, or from increasing, in greater incidence than for adults. This is the #1 reason why Big Tobacco opposes M50: it takes away a big chunk of their future clientele.

    -Meanwhile, their current customer base is suffering or dying, or will soon if they don't quit. M50 also provides money for Tobacco Cessation programs through TPEP, the state's prevention program.

  • Larry McD (unverified)
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    Also to consider:

    There's an argument out there that this measure would unfairly punish the lowest income strata in the state. The truth is that lower income smokers are those most likely to need state-funded health care for their own smoking-related illnesses. Furthermore, they are also the ones most likely, for whatever reasons, to expose children in their care or custody to second-hand smoke thereby generating childhood conditions that require immediate, intermediate, and long-term medical care.

  • Ross Williams (unverified)
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    Most of the money from this measure is going to come out of the pockets of the tobacco companies, not smokers. If you add 84.5 cents to the cost of a package of cigarettes, the companies are going to have to eat a good share of that cost to still sell as many cigarettes. That's why the tobacco companies are spending so much money fighting it.

  • Jeff (unverified)
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    Actually, smokers save the government money on net because they tend to live shorter lives and thereby don't claim a lot of the government services that are given based solely on age > 65.

    As for the costs of leaving the workforce, you have to only include the external costs imposed on others.

    And furthermore, it's tyrannical to arbitrarily pick one group to fund a general revenue program. If the cigarette tax is too low as you claim due to these negative costs imposed on society, then it should be raised BY ITSELF. It should have nothing to do with chilren's health insurance. Picking one group of people to fund a government program is tyranny, plain and simple.

    Finally, if you guys believe in nanny-statism, then why don't you just ban cigarettes? If you say that it's a restriction on freedom, then why isn't a high tax on a specific product a restriction on freedom? By that argument, if some Republican wanted a $1,000 tax on abortion services, I guess he could say it's not a violation of Roe because you can still get an abortion -- you just have to pay a tax for it.

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    The self-stated point of M50 isn't to recover costs but to provide health care for children whose parents either can't afford any or can't afford enough.

    Lack of insurance, or more accurately, the lack of money with which to purchase private health insurance is the problem which M50 claims to address.

    Interestingly enough, cigarette smokers are concentrated among the lowest socio-economic strata and the data seems to indicate that raising tobacco prices further concentrates them lower and lower.

    Even more interesting, cigar smokers tend to be among the highest socio-economic strata, at least compared to the average. And M50 includes a neat section which will allow the legislature to cap cigar taxes at 50 cents... which just happens to be what they are currently capped at. However I'm pretty sure that the tobacco in cigars is no healthier than the tobacco in cigarettes.

    Yes, the cap on cigar taxes is designed to help bring at least SOME cigar tax revenue into state coffers. Granted. But that whole dynamic simply underscores how the tax burden continues to be concentrated more and more on the lowest socio-economic classes.

    So what we have here is a measure which is designed to place the bulk of the financial burden for health care for underpriviledged kids upon their underpriviledged parents.

    On the flip side... I've recently made a couple trips to Ontario Canada and even if M50 passes our tobacco taxes won't be anything close to what they are in Canada! $10 per pack! Unlike Oregon, however, the Canadians also tax cigars extremely heavily and are apparently considering a new tax just on cigars which would impose an ADDITIONAL $10 per cigar tax.

  • (Show?)

    Actually, smokers save the government money on net because they tend to live shorter lives

    Remind me to send a thank you note to tobacco comapnies.

    In any case the nanny-state argument is complete bull. What's "nanny-statism" is when the government shields tobacco users from the full consequences of their actions. That's exactly what happens now when the cost of health care for tobacco users gets passed on to the rest of us.

    And I'd hardly call this an arbitrary tax. Is the gas tax arbitrary? The point of the gas tax is that people who use the roads the most, and therefore gas, end up paying for their construction. The money doesn't necessarily go to their specific home street. Is it tyranical? After all, it only targets drivers, if you bike to work, you don't have to pay. I don't see how a cigarette tax is any different, it taxes the people who are the largest drains on our healthcare system.

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    Kevin:

    You should read the blog post on Oregon Liberal that I tagged earlier today on BlueO.

  • Jeff (unverified)
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    Nick: Sorry, but I'm just stating a fact.

    You say that smokers impose costs on others in terms of higher government spending. I'm telling you that they actually save government money. In other words, your argument is gone.

    And it is an arbitrary tax when the tax amount EXCEEDS the negative costs they impose on society.

  • Jeff (unverified)
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    And you know what's funny about your argument? You are arguing that those who cause the healthcare costs should pay for it. Well...you've joined the free market side because that's exactly what happens when the government isn't involved in healthcare.

    But somehow I doubt blueoregon.com is marching against universal healthcare.

    The main problem I have with government provided healthcare is exactly this...not necessarily that it merely raises taxes or that we shouldn't be helping the poor.

    Even if smokers did impose positive NET external costs on government (which they don't as has been proven by study after study), you will lead inevitably to a nanny-state following this line of reasoning. What about obese people? Should I have to be responsible for their bad choices? What about those who sleep with multiple sex partners? Maybe we should ban sleeping with multiple partners since that increases the chance of getting AIDS and thereby the high healthcare costs (again even they they may actually save money because they die earlier).

    Pretty soon government can rationalize total control over your entire life -- in the bedroom, in the car, in the workplace, in the kitchen -- all in the name of saving other taxpayers money from possible healthcare cost ramifications because you believe in the benefit principle yet oppose the true benefit principle -- free market.

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    Nick: Sorry, but I'm just stating a fact.

    Well then I'm sure that you won't mind citing your source.

    Mine are, as stated above: The Center for Disease Control (ie the US Government), to cite but one of the CDC's many many studies that detail the cost of tobacco usage The Oregon Department of Human Services

    The only place I've heard your argument from before is tobacco companies. Which frankly, is not that suprising.

  • Adrian R (unverified)
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    It's really a win-win situation. The children get their health care, and smokers can feel good for supporting a great cause. Is that not a great advertising point; light one up for the kids?

    I'm fine with M50, but I don't agree that the money will come out of the tobacco companies' pockets. The reason they don't want this to pass is because it sets precedent, which leads to more taxes down the road (and also the reasons Taoiseach mentioned.)

    But just for consideration, how would people respond to a fat tax? Obese people are a huge strain on taxpayers, they account for millions in health care costs, airline costs, etc.

  • Glen (unverified)
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    I don't mind lighting one up for the kids, but don't insult me by saying it's fair. If you really thought it was fair you wouldn't be trying to hide your agenda behind the kid's pigtails and braces.

    Let's say we frame it differently, ie. honestly:

    Measure 50: Let's arbitrarily raise the taxes on a minority whose high-risk behavior is no longer in vogue, to fund a cause which is.

    I think its important to our state to have health care available to all of its citizens. Obviously, not enough of us think that way, we'd rather pawn the problem off to someone else to pay.

    First, they came for the smokers and I said nothing...

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    Unlike smoking, there are a number of reasons for being obese.

    I can eat as healthy as I like, and exercise, and still never get below a size 16. Anything lower than a 14 would actually be unhealthy for me, according to several doctors. I'm unlucky enough to come from a family that is from NE Germany and Russia. And large individuals tend to run in the family. I have excellent blood pressure, low cholesterol, etc.

    It's not as easy as cigarettes, which you choose to smoke. You may choose to be fat, eating lots of fried foods, junk foods, etc. Or you may be unlucky enough to have bad genes. It's not as cut and dried as a choice to pick up a cigarette and smoke it, endangering not only your life, but those around you.

  • Miles (unverified)
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    But beyond that, the ad is absolutely right; raising the tobacco tax is fair.

    Here's why it's not fair Nick: Oregon isn't spending nearly enough on tobacco prevention and smoking cessation. As I posted over on Oregon Liberal, the additional tobacco prevention spending funded by M50 doesn't even get us close to what the CDC and Campaign for Tobacco Free Kids says we should be spending.

    We could have fully funded tobacco prevention so that every Oregon smoker who wants to quit has access to programs that help them quit. . . and we still would have had tens of millions left over. So why didn't we do it? Is it because we need those smokers as an easy revenue source to pay for our favorite programs in a politically palatable way?

    Absent well-funded smoking cessation/prevention programs, M50 is simply a tax on drug addicts to pay for a program that benefits everyone. That's neither fair nor progressive.

  • Brian (unverified)
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    Perhaps I'm just a stubborn curmudgeon with a libertarian streak, but I'm inclined to vote nay on most all tax increases by default, especially those that dramatically expand or create new government bureaucracy. How's that been working? I could care less if smokers pay 100 bucks for a carton of smokes, but Measure 50 doesn't pass the smell test. It's a whole lot more about taking another large step toward government controlled health care than it is about the ills of tobacco use or the children. I'll pass.

  • Kurt Chapman (unverified)
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    This measure will go down in flames (pun intended). The voters aren't stupid enough to vote in an exponentially rising cost (children's health care) funded through a declining tax base (tobacco). This is an evil tax foisted upon the lower class to fund another nanny state feel good measure.

    Who is addicted more? The smokers or big spenders in government who tax tobacco at the cultivation, processing, distribution and consumption levels?

    If you want to tax tobacco out of existence, why try to tie funding to a legacy program to it?

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    As I posted over on Oregon Liberal, the additional tobacco prevention spending funded by M50 doesn't even get us close to what the CDC and Campaign for Tobacco Free Kids says we should be spending.

    The Legislative Revenue Office has a report showing the revenue distribution if Healthy Kids passes. By the next fiscal biennium (09-11) we're at the cusp of the CDC minimum. By my math, we'd be the 4th best state in the nation in terms of meeting the CDC standards.

    I agree, we should be funding tobacco prevention, and Measure 50 does just that.

  • (Show?)

    I guess some people don't get the math. Let me give it to you in real terms.

    Say there's 100,000 smokers in Oregon. They buy 10 packs of cigarettes a week. That's 1,000,000 packs of cigarettes a week.

    The cost of those people smoking those cigs to the government is $5,680,000 (Yes, that is $5.68 Million).

    The added tax brought in to the state would be $845,000.

    Say 2,000 people quit smoking either because cigarettes now cost too much and/or they've received help from the state to quit.

    That's 20,000 less packs smoked each week.

    Which means $16,900 in less taxes.

    Which means $113,600 not spent because 20,000 packs of cigarettes were never smoked.

    Every time someone stops smoking, that's less money the government has to put out in health care costs. It also means less second hand smoke and the now non-smoker will be healthier than if they continued smoking.

    The cigarette tax may be a declining revenue source as people stop smoking, but when you take into consideration the cost of a smoker to the government, we actually end up with more money.

  • Jeff (unverified)
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    http://links.jstor.org/sici?sici=0022-2186(199910)42%3A2%3C575%3ATGCOTI%3E2.0.CO%3B2-Z#abstract

    Even the liberal Tax Policy Center which supports the SCHIP bill in Congress says this:

    http://healthaffairs.org/blog/2007/08/21/schip-is-increasing-the-tobacco-tax-to-expand-coverage-a-good-idea/

    Other arguments used to justify cigarette excise tax increases are less compelling. For example, some argue that a tax is justified because smokers impose costs on others because of their higher health costs. In Smoke Filled Rooms: A Post-Mortem on the Tobacco Deal, W. Kip Viscusi examined all of the measurable costs of smoking and concluded that, on balance, smoking saves the rest of us money. Smokers’ premature deaths reduce payouts from Social Security and pensions and reduce Medicaid costs to pay for long-term care, more than offsetting the costs of higher health spending (both public and private), higher group life insurance premiums, smoking-related fires, and sick leave. Viscusi concluded that existing excise taxes already more than compensated for any other costs, such as those attributable to second-hand smoke.

  • Ross Williams (unverified)
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    I am trying to understand how the "benefit" of smokers dying early translates into additional money for kid's health care. Afterall, the tax is not going to pay retiree's social security, its going to pay some of the health care costs of kids. Some of the high cost of providing that health care is attributable to the tobacco companies and the costs the system puts into treating their customers/victims. Is there some reason their produces shouldn't be taxed to help pay for it?

  • tl (unverified)
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    For all those who fear government encroachment, "nanny state-ism", and the perceived unfairness of the M50 tax, I ask, should all children in Oregon have access to affordable health care? If so, how would you propose to fund it? I don't disagree that M50 has its faults. But for all those opposed (some with reasonable objections), I have yet to see or hear a reasonable, practical alternative funding solution for children's health care - and one that could actually be voted into law. What say you?

  • tl (unverified)
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    For all those who fear government encroachment, "nanny state-ism", and the perceived unfairness of the M50 tax, I ask, should all children in Oregon have access to affordable health care? If so, how would you propose to fund it? I don't disagree that M50 has its faults. But for all those opposed (some with reasonable objections), I have yet to see or hear a reasonable, practical alternative funding solution for children's health care - and one that could actually be voted into law. What say you?

  • (Show?)

    Well of course it's "unfair" and it does amend the Oregon Constitution which is treated more like a grocery list hanging on the side of my refrigerator than the central document codifying our state's approach to law and citizenship.

    Also, of course, it does single out a group of people to punish for their particular vice. I, for example do not smoke cigars or cigarettes so my lungs are not in play, but I do chew tobacco, and will pay the increased tax just because my demographic has been completely ignored (other than a few well placed snickers I'm sure).

    <hr/>

    All of that having been said, I'm going to vote for this stinker, because children in good health will get a tiny bit of help in grasping the greased bottom rung of The Ladder, which will in turn lower the criminal population and maybe add a couple of people a year to the miniscule ranks of critical thinkers who can assist in governing this mess.

    As for the practicality of it, as long as the New and Improved pricing sets cigarette prices at one cent lower than the cost in California, and Washington, smkers will keep buying them here.

    <hr/>

    Who knows? sometime in a distant and rosy future, The People might repair the Oregon and the National Consititutions, and propose and pass laws. based on straightforward and honest argumentation.

    <hr/>

    Call me a dreamer........

  • (Show?)
    Kevin: You should read the blog post on Oregon Liberal that I tagged earlier today on BlueO.

    I read it, Nick, and found it less than compelling. Several of it's assertions have been made here and essentially debunked or put into context here at BO.

    Fact is, your post here is easily the most compelling pro-M50 post I've seen anywhere. I'm still not persuaded by a long shot... but I do think you made the strongest case possible for M50.

    Kari et al did well by choosing you, IMHO.

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    Hey Jeff...

    You pretend to offer us two sources for your silly "smoking saves us money because people die earlier" argument.

    But actually, your second source cites your first source -- and calls it "less compelling".

    And let's take a look at your first source. It's a paper by W. Kip Viscusi. To be fair, Professor Viscusi has had lots of prestigious academic jobs. But there's also this:

    Professor Viscusi has served as both a consultant and expert witness for the tobacco industry on secondhand smoke issues. According to a 1995 Tobacco Institute budget document, he was paid a total of $32,810 for comments and testimony he gave on the industry's behalf during 1994 and 1995 to help the industry counter Occupational Safety and Health Administration (OSHA) and U.S. Environmental Protection Agency (EPA) efforts to address secondhand smoke issues in the workplace. [1] The Philip Morris Privilege Log (a list used by the court of people and organizations involved with Philip Morris) describes him as "Viscusi, W. Kip: Cogan Professor of Law and Economics at Harvard Law School, Consultant to Philip Morris--Defense Expert-Economist."

    Can you cite a single source for your argument that wasn't bought and paid for by the tobacco industry?

    And beyond that, are you really arguing that it's a good thing that people are dying early?

    That's unbelievably cynical and cruel.

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    One more thing, with my editor hat on: Could you please add a secondary identifier to your name? We have lots of Jeffs around here, including one of our editors. A last name would be preferred, but "Jeff X." or "Jeff from Tigard" or whatever would be fine.

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    It's probably worth starting the comment with the observation that Nick's main point is on the half-assed coverage by the O. If the paper is going to debunk the "fairness" argument, it actually has to debunk it. They did a sloppy job mainly, I think it's obvious, because the argument is so weak. In this battle, you have a straightforward ad campaign and a completely duplicitous one.

    I am personally WHOLLY unpersuaded by the fairness argument. Almost no tax is actually evaluated by fairness, which is why the state essentially taxes all individuals at the same rate (at least that was the case four years ago when I looked at the state's data for all taxes). If we used fairness as a benchmark for taxation, we'd have a radically different system. When RJ Reynolds' profits are about to take a hit, "fairness" becomes a big issue, but when we're talking about corporate income taxes, not so much.

  • LiberalIncarnate (unverified)
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    I will vote in favor of this because I have witnessed the downfall of my own father to cigarettes over the past several decades. He turns 65 this month, but physically he is more like 85. He looks older than his own father who is alive and well at 86! He has few lung problems, but the veins in his legs are collapsing and cause him great pain to walk. He cannot work and lives on disability.

    As a child, I remember playing in rooms filled with dense smoke. I cannot remember a time when my father did not smoke, did not have a set of clothes or furniture without cigarette burns, did not have poor teeth or yellowed fingers.

    Is it his choice to smoke? Certainly! Was it my choice to breath it? No! Luckily, I spent my money as a teenager on video games rather than cigarettes and never picked up this bad habit.

    I suspect that he will live quite a few more years, getting worse each year. He has good genes. So, on a very personal level I do not buy the argument that most smokers die before 65. Even his mother lived longer than this and she smoked, as did his father!

    As to the nanny-state argument, I think that it is a bunch of bull. As a gay man I have been told that I can never marry (no domestic partnerships don't count... sorry). So, I have little sympathy for those yelling "no nanny state", but still willing to vote for M36. The fact is, libertarians are willing to restrict some things and not others. They are as hypocritical as the rest of us. Welcome to the club.

  • Jonathan Radmacher (unverified)
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    One point of Jeff's, a ridiculous point I think, that no one has addressed is this notion that "the government" would save money when smokers die. It's a Libertarian-esque description of the amorphous "government." At best, he impliees that smokers would not draw on Social Security. Social Security is the federal government program; it's (supposed to be) in trust, so savings in Social Security is not passed on to health care programs. And since lots of health care costs are dumped on state and county governments, there is no tie-in between smokers dying and saving money on health care costs. Unless, of course, you believe that those mysterious government people are all connected, in which case, you really should read the constitution.

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    That's unbelievably cynical and cruel.

    Kari, do you agree with Jeff Alworth's point that fairness in tax policy isn't overly relevant? If so, what difference does it make if you deem one approach as cynical and cruel? Surely you recognize that others might deem taxing a disadvantaged class to provide services to that same basic class as cynical and cruel too.

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    The Legislative Revenue Office has a report showing the revenue distribution if Healthy Kids passes. By the next fiscal biennium (09-11) we're at the cusp of the CDC minimum.

    The revenue was already there, before M50 was thought up, via the National Tobacco Settlement funds. In fact I recall reading on (I believe it was) the CDC website a chastizement of Oregon for not seriously funding ceasation programs with those very settlement funds.

    It seems to me that M50's ceasation funding is nothing more than a bone thrown in to make it more politically palatable. It doesn't appear to me that the state government is nearly as interested in the negative health consequences of tobacco usage as in the potential revenue stream. Which, if that's just the way it is (i.e. real politik) then we ought to at least be honest with ourselves and the public about what it is that M50 is really about.

  • paul g. (unverified)
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    Nick

    I don't think it does liberals any good to buy into the same misleading spin machine that has been used so masterfully by the GOP for the past two decades.

    Your posting ostensibly criticizes the Oregonian's analysis of the ad, but your post, and later responses, show how the Oregonian's analysis was correct.

    You actually provide an argument why a tobacco tax may be "fair." But the pro Measure 50 ads do nothing of the sort.

    The tobacco company ads are playing the "don't mess with the Constitution" card. The advocates are playing the "It's good for children" card. Neither are completely accurate, in my opinion. And the "O" pointed that out.

    If you're playing in the straight political arena, trying to get people to vote for Measure 50, fine. But you/we should not be criticizing a media outlet for providing a fair analysis of an advertisement, just because it is one of ours.

  • Miles (unverified)
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    Nick wrote: The Legislative Revenue Office has a report showing the revenue distribution if Healthy Kids passes. By the next fiscal biennium (09-11) we're at the cusp of the CDC minimum.

    So the point doesn't get lost, Nick is absolutely right and I was wrong. I was looking at the first biennium, when tobacco prevention/cessation will get 4.9% of the tax. That's not enough to fully fund these programs. But in the next biennium (and every one after that), tobacco prevention programs get 10% of the revenue, and that will be enough to get close to the CDC minimum. Thanks, Nick.

    As for whether smokers impose a public cost or a public benefit, it's an extremely complicated analysis. Viscusi is not the first to argue that smokers save us money (after all, it's pretty obvious that smokers save Medicare and Social Security money), but some of it depends on whether you look at just the public costs (i.e., costs of all state and federal government programs), or include the private costs (higher insurance premiums for everyone in the insurance pool, for example). I would be careful accusing Viscusi of bias, however. I mean, most of the reports showing the high costs of smoking are paid for by the anti-tobacco forces, so are they any more objective? Very little research is done purely in the public interest, without any political agenda, and all should be approached with a healthy skepticism.

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    If you're playing in the straight political arena, trying to get people to vote for Measure 50, fine. But you/we should not be criticizing a media outlet for providing a fair analysis of an advertisement, just because it is one of ours.

    If I thought the Oregonian's analysis was fair (here we go again haha), then I wouldn't criticize it. My point, as to the "ad watch", is that the Oregonian ostensibly believes that if it criticizes one ad, it has to criticize the other side's ad to maintain their journalistic integrity and objectivity. I think that's bull. I also think complaining that the ad uses the word "fair" is totally arbitrary (and at least in my opinion inaccurate), and they're just debating semantics at that point. If the Oregonian wants to do an "ad watch" article, they should be checking the factual accuracy of the ad and leave it at that.

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    I've changed my mind and decided to vote for M50. But it isn't fair. The kids health insurance program should be paid for by everybody. Tobacco taxes should be dedicated to smoking prevention and cessation programs.

    People write as if smokers only pay for the health costs smoking creates through tobacco taxes. Although smoking skews towards lower income, most smokers are working people and insured. Those smokers pay for the costs through higher premiums just like the rest of insured people, and more -- you get charged higher premiums if you smoke. They pay other taxes too. Insofar as smoking related health costs come out of other taxes, they contribute there. Further health-related costs are borne by near relatives of smokers and not society in general.

    Finally, smokers pay very high costs in painful ill health. That isn't just because they're stupid. They're addicted. My grandfather suffered a massive collapse of several systems due to lifelong smoking ca. 1972, my parents spent his life savings on hospital and nursing home care for a year, then brought him to live with us. He survived for another five years, his personality much diminished, essentially living for his next cigarette, my mother constantly having to struggle with him to keep him down to a pack or a pack and a half a day from his preferred three, mourning all that time the loss of the ebulliant father she had known in the half-life he suffered and we all suffered watching. He wasn't a stupid man. He wasn't a bad man. He earned a good living, paid his taxes, saved enough to have investments at a time when that was less common, had insurance. He was an addict, and paid a terrible price for it.

    Smoking is not just a simple choice. Once you start, it's highly addictive and it requires a great deal of persistence to quit, on average quitters try 8 times before they succeed. Historically the military actively encouraged smoking among soldiers -- the big boost for cigarette consumption came in World War I when the military actually distributed them. Why? Smoking, although a body stressor in other ways, functions to relieve other stresses, e.g. in war but also other situations of pressure. The higher prevalence of smoking among working class people is partly a matter of sociability (used to be more of a cross-class phenom, watch movies from the 1950s sometime) and more importantly a response to work stresses. It's not an accident that work breaks are smoke breaks for so many folks.

    Choices are constrained. Liberals and progressives often recognize that when it comes to other matters. It's true in health as well. Personal responsibility is overstated and overrated. We create social contexts that encourage some choices and discourage others.

    People focus on the evils of tobacco marketing but then lose all compassion for those who fall afoul of it and into addiction. What gives?

    Smoking is also an interesting case study of how media context affects choices. The contrast of having consistent anti-smoking ad campaigns related to legal but toxic and deadly drug is quite astonishing, compared to the lack of counter-advertising to so many things that deserve it. Dedicating tobacco taxes to prevention and cessation would do even more to change the context and constraints on choices.

    Focusing only on the social costs smokers create and then using that to justify singling them out for a tax we should all pay because insuring kids & working poor families makes society better for everyone is regressive blame-the-victim crap, pure and simple.

    The myth of unconstrained choices affects a whole lot of other dimensions of health too. It is the most effective meme against the social solidarity needed to create a health system based on well-being, illness prevention, and timely and effective treatment when needed. Ill health is about social choices as well as individual choices.

  • bbc (unverified)
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    Miles Thanks for pointing out that both sides can pretty easily be accused of bias. Experts can be found on both sides and few, if any, are completely free of links or political agenda.

    There are a couple of things about the M50 tax that bother me (aside from the insanity of putting specific taxes in the constitution). One that has already been mentioned is the disproportionate impact on low-income brackets -- which is bound to have a financial effect on their children. I did not realize, until reading it in this thread, that cigars are maneuvered out of this tax increase. That seems very convenient -- and adds to the impression that lower-income people are the target.

    The other problem is that in the "ideal" world nobody would smoke -- there are campaigns against smoking and programs to help people stop, etc. etc. Smokers as a group are targeted for extinction. Ask any supporter of M50 if he'd be pleased to wake up tomorrow and find that every smoker had stopped. It seems cynical, or maybe just hypocritical, to try to build healthcare funding on a source (tobacco use) that we fervently hope to eliminate at the first possible moment.

    I'm no fan of tax increases, but why don't we tax something with a much broader (and continuing) base.

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    Surely you recognize that others might deem taxing a disadvantaged class to provide services to that same basic class as cynical and cruel too.

    Actually, I'm going to cite the source that Other Jeff cited above. (The one he claimed was pro-tobacco, but actually isn't.) It relates to SCHIP - not the state Healthy Kids program - but I suspect the numbers are similar.

    Tobacco Taxes Are Regressive, But Families Gaining New SCHIP Coverage Would Be Big Net Winners, Even If Family Members Smoked Cigarette excise taxes are regressive. Lower-income people are more likely to smoke than those with higher incomes and the tax is a larger percentage of income for someone making lower income than for someone earning more. For example, a pack-a-day smoker would pay $164 in additional taxes over the course of a year under the House proposal or $223 under the Senate plan. That amounts to about 1 percent of income for a family earning $20,000, compared with 0.2 percent or less for a family earning $100,000, assuming no change in smoking behavior. Of course, the insurance financed by the cigarette tax increases also disproportionately benefits lower-income households since it is targeted at children with incomes below 200 percent of the Federal Poverty Level (FPL). Current estimates (calculated from the Congressional Budget Office’s March 2007 baseline) indicate that the average annual cost per child of SCHIP coverage is approximately $1,700. Thus, low-income families with children who obtain coverage under SCHIP would gain much more than they lose, even if one or more family members smoke.

    I personally don't care about the regressivity of the tobacco tax - since it's an entirely voluntary tax. But given that poor families with children will get health care in return, it's a good deal for them - even if they smoke.

  • bridget (unverified)
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    I smoke and I will vote for this tax. I have two cats and if they wanted to tax cat food to cover children's health care I'd go along with that too. I also drink our wonderful Oregon wines, and I'd be fine with a tax for kids' health. I eat fattening foods and if you wanted to tax drive thru restaurants $5.00 per car to support health care for kids, I'd vote for that too. I really don't have a problem with taxes when they pay for something really really useful, rather than some politician's meal at Mortons. Police, firefighters, libraries, schools, roads, all benefit everyone at some time or another. The thing is, lets get the kids some great healthcare. If everyone stops smoking, then we can tax the cat owners. Then the pinot drinkers. Then the drive thrus. Pick your order.

  • Ross Williams (unverified)
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    I would be careful accusing Viscusi of bias, however. I mean, most of the reports showing the high costs of smoking are paid for by the anti-tobacco forces, so are they any more objective?

    Of course they are. The "anti-tobacco forces" are not a self-interested party, they arrived at their position based on their evaluation of the evidence. It doesn't mean they are correct, but they are not remotely comparable to people receiving a paycheck from the tobacco industry.

    Again, I will point out that this tax is mostly going to come out of the tobacco industry's bottom line, not tobacco users.

    (after all, it's pretty obvious that smokers save Medicare and Social Security money)

    That is not obvious. Its really a question of whether savings from early deaths outweighs the combined costs from disability payments, early retirement and increased Medicare costs for treating them prior to death.

  • Jon (unverified)
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    None of your arguments have shown me a reason to vote for this measure. Jennie, where do you calculate the pension, SS, federal excise tax and health care payments made by the smokers? Not to mention the added burden to pension and SS funds by those who quit. Nick, the same argument is true for the CDC study, the purpose of which is to encourage people to stop smoking, not analyze the NET impact (or lack thereof) on society. Ross, HMOs routinely fund anti-smoking campaigns and organizations thanks to cash cows like this.
    The Viscusi study appears to be the only relevant one because it's the only one that comes close to telling a complete story. He may have worked for big tobacco, but I have yet to find anyone who has debunked his work.
    But neglecting any fiscal or constitutional arguments, I can dismiss this ballot measure based simply on the fact that a bunch of politicians are targeting a 21% minority of voters for a tax that, if childless, has zero benefit to them and addresses conditions they have nothing to do with. Gutless, classist and unfair are the adjectives that come to mind.
    I don't see how non-tobacco users can feel any better about this either because, let's face it, they aren't contributing anything. This tax should be designed to address child health issues. Oregon Health and Human Services did a childhood obesity study that indicates poor diet and exercise habits as the single biggest health risk for Oregon's children. Since the only comprehensive study I've seen states that excise taxes overpay for the effect smoking has on the health care system, perhaps it's time to address the detrimental effects of fat and cholesterol by placing taxes on high-fat fast food, snacks and candy. This may seem impractical, but it's fair.

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    This whole discussion is bizarre and disgusting. A good friend of mine who is a wonderful, committed, generous with her time and wisdom college teacher and phenomenal poet in her 50s has been smoking since her college days. I am sure it is going to take years off her life. The value and cost of that has very little to do with fiscal burdens wherever they fall. It's in her fantastic humanity. If she does die early absolutely NOTHING will be saved that compares to the human loss.

    Taxing fast food has the same regressivity problems as cigarettes. There is a growing body of public health literature on unavailability of fresh healthy foods in low income neighborhoods in American cities as a major factor in overweight and obesity. If you don't have a car or have to work long hours to make ends meet driving a long way to shop may not be a real option.

    It's not just fast foods anyway. Huge portion sizes are selling points for all sorts of sit-down restaurants, particularly the chains. And sedentarism is quite as much to blame -- why not tax cars, computers & t.v.s for their health costs.

    This is going at things the wrong end around. The point is to build a health system that supports healthy living and prevention and provides effective treatment when needed. But such a system cannot work without changing other contexts -- e.g. overwork that hurts health both by cutting time for exercise and cooking, as well as stress at work and stress from trying to juggle too many tasks. A social system that isolates too many of us from face-to-face contact (he says typing messages to people he doesn't really know), separates work communities from residential areas, makes it hard for kids to just hang around and play in many areas due to parents' fears, entertainment based on sitting around watching screens dominated by definition of the good life by consumption, in general and in bad food in particular. Do you know what the second strongest predictor of hypertension is after diet? Exposure to noise.

    We need a national health promotion system and a general welfare culture -- not as in "the dole" but as in "to promote the general welfare" as a key goal of our society set out in the constitution: what the French called "fraternité" along with "liberté" and "égalité," what Poles and others have called solidarity -- call it community, mutualism, co-operation, agapé; pick your word that says us helping each other. Everyone's got risks, everyone makes bad choices sometimes. Trying to change that with finger-pointing, blame games and I'm-alright-Jackism just isn't going to work.

  • Jim Reemsnyder (unverified)
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    I am all for universal health care. I am not for taxing 20% of us to pay for that. I believe this is called the tyranny of the majority. the 80% of you can make the 20% of us pay to keep your conscious clear, you can all sleep better in your SUV's which is causing far more health problems with their exhaust and generating global warming gases. Smokers charge the state so much in health related costs, and the overweight don't. This is why I hate the initiative process, it is total democracy and we are a democratic republic, the masses can be so easily led to destruction, just look at Germany in the 30's. All you non-smoking perfections of human existence can all sleep more easily, knowing that someone else will pick up the charge for your wet dreams.

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    Chris,

    I agree, but then again according to the hoard if you oppose this measure your a tobacco lobbyist according to Ross and others including the guy that wrote the blog that was promoted on BO a few days ago.

    You are definately not alone, I have voted against it and been attacked by many on BO for my own personal stance. It will be interesting to see if it's close or like everyone else who's voting for it believes that it will pass by a comfortable margin.

  • andy (unverified)
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    M50 is nothing more than tyranny of the majority which is why I'll vote no. If people really want to create a new give away program for the kids then be honest about it and raise either the income tax or property tax. Or pass a sales tax. If you can't get the votes to come in the front door then don't expect to get in the back door. Besides, I still don't see any reason for the new giveaway program. Let the parents pay for the kids healthcare. If the parents don't have the money then there are programs available for them. And the last reason I'll vote no is because I'm pretty sure that the whole thing is a fraud. The cig tax won't begin to pay for this new giveaway program which means that in a few years the taxes will start to show up. But by then it will be a lot harder to make changes. I think this is the true objective of the M50 backers. They want to get a new program started that they know can't be funded but they hope the voters are too stupid to figure it out. Once they get their pile of money and their constitutional protection they'll spend freely.

  • Bob Tiernan (unverified)
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    Liberalincarnate:

    I will vote in favor of this because I have witnessed the downfall of my own father to cigarettes over the past several decades. He turns 65 this month, but physically he is more like 85. He looks older than his own father who is alive and well at 86! He has few lung problems, but the veins in his legs are collapsing and cause him great pain to walk. He cannot work and lives on disability.

    Bob T:

    So the solution is to..........raise the tax to get more money for health care for children?

    Liberalincarnate:

    So, I have little sympathy for those yelling "no nanny state", but still willing to vote for M36. The fact is, libertarians are willing to restrict some things and not others. They are as hypocritical as the rest of us. Welcome to the club.

    Bob T:

    Hmmmm, what poll of libertarians are you getting you information from, regarding M36?

    As for being hypocritical, speak for yourself.

    Bob Tiernan

  • Bob Tiernan (unverified)
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    Nick Wirth:

    People can choose to smoke if they want, that’s their right. However, if they do use tobacco, they should also bear all of the consequences, including the monetary cost.

    Bob T:

    You know, everyone trots out this "monetary" cost thing, but where does a smoker get the power to get yellow fingers on part of my income in the first place? From the government, of course. The real consequences the smoker faces are paying for their own health care. If they can't, that still doesn't mean they have a right to your income or mine. This cost, then, is a problem not with smoking but with the collectivist type of program.

    Nick Wirth:

    Raising the tobacco tax requires smokers to pay a great share of the costs that they incur by using tobacco. It also means that 100,000 children will get the health insurance they need. Could anything be fairer?

    Bob T:

    Sure -- where's the Twinkie and Ding Dong Tax?

    Bob Tiernan

  • paul g (unverified)
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    Nick,

    Perhaps I am just splitting hairs, but I'm still not with you on your analysis.

    You seem to know that the Oregonian decided it had to criticize both sides in order to be "balanced." An alternative explanation is that the writer of the article actually believed that the Pro M50 ad was "unfair."

    Of course it is an argument over semantics, but the semantics did not stem from the Oregonian, but from the M50 ad. If the proponents of M50 are going to claim that a particular revenue stream is "fair", I don't this it is at all out of bounds for an "ad watch" to point out that no positive argument about "fair" is actually made.

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