Can You Persuade Me to Support S-CHIP?

I pose this as a direct challenge to the community: can you persuade me to support the recently vetoed bill to expand S-CHIP?  Support for this bill, and for an attempt to override the President’s veto, is nearly universal here.  Despite that, I intend to challenge the community to justify this to me. 

It is not truly important for you to bother to do this.  I am only one person, and few people share my opinion.  Further, whether or not you agree with me, this is very advantageous political theater, and undermining it by seriously questioning its foundations has disadvantages.  That being said, I’ll make my case, and I’ll even give you reason to believe you can succeed in converting me.

My objection to the S-CHIP expansion has nothing to do with actually expanding S-CHIP.  Generally speaking, as most of you know, I oppose government expansion and spending.  But in this case, I honestly don’t care.  Providing more health care to children, particularly poorer children, is enough of a good that I’m willing to accept the bad of more government for it, under the right circumstances.  If the government is going to spend one more dollar, I think this is a good place to spend it.  I believe that it genuinely benefits American society.

In this case, I am simply horrified at the way we intend to pay for it.  We intend to pay for this expansion of S-CHIP by increasing the federal tax on cigarettes from $0.39 to $1.00, an increase of over 150%.

My first objection is that there is simply no moral case that I can fathom why smokers and smokers alone should bear the costs of our providing more health care to children.  I have not yet seen anyone so much as attempt to make one, so I will assume this to be true.  Of course, if you want to argue that the moral responsibility for this is solely that of smokers, I’ll listen.

My second objection is that this is something which will cause significant harm to primarily poor Americans, and which will not achieve hoped-for benefits.  This case is more detail-specific.

The first contention is that smokers inflict a high financial cost on society, our government, and our health care system.  Therefore, increasing their financial costs is deserved.  But the data does not support this.  Economic studies have shown repeatedly that smoking decreases overall health care costs in the long term.  In addition, we also can determine that smokers bear 77% of all smoking-related costs directly, leaving less than one quarter of the costs of smoking to be borne by other entities. 

The remaining 23% of smoking-related costs are borne by the public.  But those costs are offset by currently enacted cigarette taxes and the Master Settlement Agreement between tobacco producers and state governments, which provides over $206 billion to offset public costs.  Meanwhile, the Congressional Research Service determined in 1994 that cigarette taxes already offset the public costs of smoking.  In 1994, the average pack of cigarettes in America cost an additional $0.50 in state and federal taxes.  Today, those taxes are $1.46 for the average pack.  Which means it is safe to say that smokers already pay quite a bit more than their actual costs to the public.

Even if that wasn’t true, this much worse fact is: this is a tax on poor people.  This data is not in dispute.  Nearly one third of Americans below the poverty level are smokers, compared with less than a quarter of those above the poverty level.  Over half of all smokers are from households in the bottom two quintiles of income.  And this is not only an indicator of current smokers, but of future smokers: children whose families earn less than $20,000 a year are 90% more likely to start smoking than children whose families earn more than $50,000.

Further, tobacco taxes are literally the most regressive form of taxation possible to fund S-CHIP expansion.  This led The Tax Foundation to conclude that “no other federal tax hurts the poor more than the cigarette tax.”  Their study demonstates that the costs for the poorest 20% of taxpayers of an increase in the tobacco tax would be $249 a year, while for the wealthiest 20% of taxpayers, the costs would be $291.  Compare this to an increase in the income tax, which would cost the poorest 20% of Americans $7 a year, and the richest 20% $1,277.

The most often cited reason why increasing tobacco taxes is considered a good thing is because it ostensibly reduces smoking.  Yet, that data is deeply suspect.  As I diaried here before, cigarette taxes in Washington State, which has the third highest cigarette tax in the nation, resulted in an overall increase in tobacco sales.  Doubling the cigarette tax over the last decade has not reduced the overall number of smokers in America – 50 million Americans smoked then and smoke now. 

It is hard for me to imagine the argument that can trump this data.  Clearly, tobacco tax increases have already exceeded the public costs of smoking.  Clearly, there are severe limits to the ability of tobacco tax increases to decrease smoking.  And clearly, this is an extraordinarily regressive tax which will mostly affect the poor, and effect the poor a great deal.  We are suggesting nothing more than helping more poor children by making millions of poor Americans much poorer.  But I have been wrong before.

I was recently persuaded to support hate crimes legislation.  I was a lifelong opponent of such laws.  It is my belief that there is nothing at all worse about a crime based on bias than a crime based on greed or anger.  But it was pointed out to me that many hate crimes are not considered crimes at all.  Tucker Carlson can casually state that he beat up a gay man for making a pass at him.  If that was an excuse for a beating, then tens of thousands of men in bars across America would be being pummelled as I write.  But in too many places, those assaults are not considered “crimes”.  And hate crime laws can be an important act of changing that, and bringing justice to those who would otherwise get no justice at all.

So, give it a shot.  Explain to me why this bill is something worth fighting for, instead of something that does nothing more than to make me be ashamed to be a Democrat.


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  1. …this will appear at Daily Kos tomorrow, and if you don’t mind my asking, I hope you’ll help me promote it there too.  This is important.  This goes to why poor people don’t vote much, and why they don’t vote for Democrats much either.  If we are the party of the poor, we need to act more like it.

    My thanks to Armando, who called me out and made me feel the pressure to try to lead on this, and to andgarden, who convinced me to write it.

    • Turkana on October 13, 2007 at 07:45

    because i think it should be taxed, mercilessly; however, it’s not the best way to fund s-chip. to the degree that the sin tax cuts down on smoking, that will also reduce the revenue for s-chip, which doesn’t make sense. i’d rather we funded it by other means- such as an increased tax on known libertarians!

    • robodd on October 13, 2007 at 08:03

    and your argument is a variant on this. Until there is a truly progressive tax policy, there will always been inequities in who pays for what and how.

    There does not need to be a direct correlation between a good policy and how it is paid for.

  2. The hour makes it difficult for me to give my best shot, but I’ll see if I can get somewhere.

    So, we’re talking about the bill we have, and not the bill we wish we had. That’s actually a good thing, but before we discuss the tobacco tax I think we have to consider why it is such a good thing to cover more children. So let’s take that part step-by-step:

    First, children are innocent. Full stop. They are not responsible for their parents’ income level.

    My inclination is to say that the next step is the obvious point that every American is entitled to a basic level of care. But I don’t know if you’ll agree with that. So let me make a pragmatic argument.

    People without insurance visit the emergency room when they need urgent care. But the definition of urgent care has changed as few people are able to afford regular visits to their family doctor. That includes children, and pediatricians are not free or even cheap.

    So people end up visiting emergency rooms for issues that would not, normally, be considered urgent. When that happens, the doctor you need to treat, say, your collapsed lung, might be distracted, overworked, and otherwise engaged. That’s bad.

    So, we need to regularize these kids. It would actually be good to get everyone free access to a basic level of care. But this will be an incremental process, as universal healthcare is still something of a bogeyman. (Full disclosure: my father is a doctor, and he is just finally coming around to this because of the obvious inefficiencies of the insurance companies).

    I don’t know if that’s enough for you, but it’s the best I can crank out at 2AM on a Saturday.

    Next, we move to the tobacco tax.

  3. I guess the same sort of argument is made by drivers who buy gas. Why should drivers pay a gas tax that is used for supporting mass transit and bike lanes and not just roads.

    Shouldn’t bicyclists be taxed or use fee to support creation and maintenance of bike lanes? Shouldn’t bus riders and subway riders pay the full cost of the ticket?

    I’m certain more than a few libertarians would argue that they should bare the full cost of their preferred form of transportation. That sort of argument is raised every time a light rail or commuter rail project is proposed or Amtrak comes around asking for help.

    I’m also certain more than a few libertarians would argue that all corporate subsidies should be done away with – such as tax payer support for the FAA to run the air traffic control systems.

    Unfortunately or fortunately, the tax system in the United States is broken and isn’t going to be fixed easily, if at all. In some ways, it may be easier to repair our Constitution than to overhaul our tax system, especially when some may feel the idea of taxation is inherently unfair as a concept.

    So, while Dennis Kucinich wouldn’t vote for the S-CHIP legislation because it left out children of legal immigrants, you would not pass S-CHIP because of the way it is funded. While I think both of these positions are laudable, I also believe they are, when it comes to practicality, too idealistic.

    I think health care is something we, as a society, should provide for all children regardless of how much their parents or guardians can afford. Therefore, I am willing to see this as the next step toward meeting that goal and am also willing to put aside my pure ideology and vote for the override of the veto.

    Both the extent of the coverage and the funding mechanism needs to be improved, but it is a good next step and, for that reason, I would encourage you to support it.

    As the writers of the Constitution promised to follow up with a Bill of Rights, if I were in a position to, I too would follow up with a promise to revisit both the coverage and the funding if you would join me in the veto override.

    Plus, it would be politically good to demonstrate to Mr. Bush that he vetoed it for the wrong reason(s).

  4. …honestly, if I were to take a shot at how I really feel about it, since the tax is not confiscatory, or even remotely so, I wouldn’t assign it the same ethical weight.  Nobody who wants to smoke is going to have to quit.  Little kids get better medical care.  It’s inequitable, somewhat regressive, and representative of a grotesque refusal to honestly discuss the cost and funding of a real social safety net.  Little kids get medical care, and nobody has to quit smoking.  What’s not to love?

    As a standing DA, I have to wonder about the moral frame of smokers having lower long term medical costs.  People who smoke die sooner, it is true, and are probably a cheaper deal than long term geriatric care, chemo and all.  Massive coronaries are practically free, from the perspective of the state.  While I don’t priviledge the state to extend lives, neither do I wish to count their reduction a net good to the commonweal, necessarily. 

    I can’t help on the ashamed to be a democrat thing though 🙁 

  5. If you do, support S-CHIP.

    If you think I should have died at 14 due to bad poor working class health care doctors, then support it, they almost killed me.

    That’s all I got to say about this, and all I ever will.

    Support S-CHIP, for the working class poor.

    • oculus on October 13, 2007 at 19:15

    previously financed?

    • pico on October 13, 2007 at 19:34

    cigarette taxes in Washington State, which has the third highest cigarette tax in the nation, resulted in an overall increase in tobacco sales.

    According to the article, there was in increase in tobacco sales despite the raised taxes, which is quite different than how you worded it (I doubt it was intentional: you’ve written this as if the tax actually led to the increase, but there’s no evidence for that).

    Doubling the cigarette tax over the last decade has not reduced the overall number of smokers in America – 50 million Americans smoked then and smoke now.

    So statistically speaking, there was a drop in the percentage of Americans who smoke.

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