Why Fight a Sin Tax to Aid Child Health?

It’s a no-brainer. Increase the tax on cigarettes and use the revenue to pay for health care for the 10 million kids currently uninsured. When conservative Republican Orrin Hatch and liberal Democrat Ted Kennedy teamed up to make that proposal, I thought that at last we were on the way to sound health care. It just makes such perfect sense.

Cigarette smoking costs the government $50 billion in additional health costs and kills 400,000 people a year. Increasing the cigarette tax is the most effective way to undermine the growing popularity of smoking among the young, since studies have demonstrated that boosting the price of cigarettes leads to a comparable cut in teenage smoking.

So hiking the federal cigarette tax by 43 cents a pack as Hatch and Kennedy propose would save lives, cut government spending and raise $30 billion over the next five years. To appease fiscal conservatives, the two senators proposed allocating $10 billion for deficit reduction while sending the remaining $20 billion to the states willing to pay for health care for the children of the working poor who are not now covered.

For the heartless in the crowd, let me remind that we are not talking here of ministering to the needs of people on welfare, since they are already covered by Medicaid. No, these are the children of those who work hard day in and out in low paying jobs that carry no medical insurance and who can’t afford to purchase coverage on their own. As Hatch put it: “One of every three children in this country is uninsured . . . and we must help these working poor families who are frantic about what to do with their children.”

Hatch points out that the working poor are confronted with “a choice between dropping employment to get Medicaid eligibility or staying employed and getting no health insurance.” Since he would rather have those people stay off welfare and keep working, he terms the bill “the most conservative thing in the world.”

This is the sort of incremental improvement in the health care system that the Republicans claimed to favor when they rose up en masse to kill Hillary Rodham Clinton’s proposed overhaul. They argued then that the national scandal of 40 million uninsured Americans could be dealt with through far less sweeping measures. Yet the Republican leadership is now venomous in its opposition to this very limited and sensible approach to the problem.

At first, Hatch had seven other Republicans on his side, and given the near unanimous support of Democrats, it looked like the bill would pass. But under relentless pressure from Republican leader Trent Lott and the tobacco lobby, Hatch is left with only three allies on his side of the aisle.

The mood of the Republican congressional leadership is so ideologically obtuse as to doom even this modest first step down the path of responsibility. They would rather kill people than raise taxes. As Arlen Specter, the sometimes reasonable Republican senator from Pennsylvania, put it last week in predicting failure for the Hatch/Kennedy bill, “I frankly have doubts we would pass a bill to tax organized crime.”

Fortunately the public does not share this ideological obsession, and support for an increase in tobacco taxes to finance health care is widespread. This is a battle that can and should be won if only the insular hypocrisy and callousness of senators, themselves covered by taxpayer supported health care, would stand exposed. Hatch reports that these very senators claim that it is hard for them to get by and wonders, “If it’s difficult for us who earn $134,000, what is it like for people to work for $25,000 a year?” Many of the senators are millionaires--they must regard their salary as pocket change.

How can we in good conscience guarantee health care for fat-cat senators while denying it to the children of the working poor? The failure to provide for the well-being of the productive generation of the future is as shortsighted as neglecting the maintenance of industrial machinery. It is also absurdly wasteful when kids show up in emergency rooms for conditions that should have been treated earlier, far less expensively, through health maintenance programs that every other industrial society regards as a birthright.

Why should any child be denied health care because her parents don’t earn enough? Whose interests can it possibly serve for infections to run amok? At a time when the Republican leadership in Congress proposes handing the super-rich an enormous break on capital gains and estate taxes, how dare they claim that funding health care for kids through an increase in cigarette taxes is fiscally irresponsible?