IN MY VIEW: Senate Cigarette Tax Proposal is Not a Sensible Way to Fund Children's Health Care, But is a Big Win for Big Insurance

The proposed 61 cents per pack increase in the cigarette tax to raise funds to support the State Children's Health Insurance Program (SCHIP) appears quite likely to be enacted by Congress. President Bush has threatened to veto the bill, and although this may be a first, I am on the same side of the issue and hope that he does follow through with the veto.

This is no way to fund children's health insurance. You don't make children's health insurance dependent on the continued consumption of cigarettes. You don't create a reliance on high levels of smoking in order to provide health insurance to our nation's children. You don't create a situation where we have to hope that smokers continue to smoke because otherwise, we will lose necessary funding to provide health insurance for children.

What this proposal does is to take away any incentive for Congress to do anything that might jeopardize the program by substantially reducing smoking rates or cigarette consumption. What the anti-smoking groups are doing by supporting this proposal is inadvertently putting a death knell into any meaningful federal legislation to decrease youth or adult smoking.

Ironically, the Campaign for Tobacco-Free Kids (TFK) might be shooting itself in the foot by supporting the cigarette tax proposal. If it is enacted into law, it may actually make Congress less likely to pass the FDA tobacco legislation that TFK so desperately desires. Because the Campaign has spewed out so much propaganda indicating that the FDA legislation would greatly reduce smoking (I believe the exact opposite is true), legislators are likely to think that passage of the FDA legislation would reduce smoking and thus jeopardize the SCHIP program's funding. This would require finding an alternative funding source, which would be politically undesirable, or not funding the program - which could also be a political liability. At very least, the creation of a federal dependence on cigarette tax revenues is likely to lead to a watering down of the already weak legislation.

The real story behind the proposed cigarette tax increase is not any desire to protect health. Instead, it turns out that this is simply a way of avoiding what could have been a mechanism for funding the program - reducing federal subsidies to health insurers. As a MarketWatch article points out, the real beneficiaries of the tax proposal are: "Humana Inc., UnitedHealth Group, Aetna Inc., Healthspring Inc., Tenet Healthcare Corp., and Cigna Corp."

Instead of asking Big Insurance to bear the burden of providing health insurance to poor children, Congress is poised to ask smokers (who in general are poorer than the rest of the population) to fund the program. And it is in fact the poorest smokers who will be hurt most by the proposal.

This is all about politics, not health. Anti-smoking groups which are supporting this proposal are simply playing a political game. They are not promoting the public's health. Any proposal that makes a vital public health program entirely dependent upon continued high rates of smoking is not, ultimately, a way to promote the public's health. Any proposal that removes all incentive for the federal government to take any action to reduce smoking is not a way to promote the public's health.

There has to be a better, more sensible way of funding children's health insurance. Unfortunately, largely because of the actions of anti-smoking groups, we're not going to find that way.