sin taxes and mortality rates

Actions Create Consequences

Amidst the theatrics, serious as they are, on Capitol Hill, I see the most discouraging news this week as declining mortality rates around Lake Erie—and across the United States.

Twenty years ago I made tongue-in-cheek suggestions that the U.S. diet was probably our most enduring and effective legacy against China because it was abound to increase diabetes rates. It was insensitive but accurate for a country with such a huge population and little investment in health care, my less insulin. My observation about the rates was correct but I suspect it resulted from our companies marketing Amur’can food like Kentucky Fried Chicken, which the Chinese adore.

Sadly, the Post article this week reminds us that diabetes is deadly in this country as well, as is stroke and lung cancer.

I remain so surprised when I see anyone smoking today as the Surgeon General’s report on cigarettes and lung cancer, something so sensitive they released the findings on a Saturday to prevent throwing the NYSE off kilter, was fully 60 years ago. We know, we know, we know that smoking creates lung cancer which is often deadly.

Then, of course, we also know about the opioid addiction, the increase in women drinking to levels matching male counterparts, and on and on and on. Suicides are a national crisis.

These are established causal conditions, thus preventable.

Less clear cause-and-effects relate to other chronic illnesses growing precepitiously, such as memory-based impairments, obesity, Parkinson’s, and other cancers. Of course the genetic component of these illnesses is crucial but the number of cases are growing, especially in poorer communities where problems are so pervasive.

Now we get to the crux of the article: political decisions in Ohio, northwest Pennsylvania, and western New York have tended to favour lessening deterents to consumption patterns, thus contributing to these problems.

The article specifically notes lower taxes, for example, on cigarettes. ‘Sin taxes’ were not deployed only to raise revenue when they began decades ago but to discourage consumption because of the associated cost.

The links to our current turmoil in Washington are two primary ones. Providing health care to patients suffering from any of these conditions is extraordinarily expensive over a lifetime. In an economically depressed area such as western New York, a substantial portion of those afflicted are on Medicaid.

Medicaid is one of those programs that is controversial in our federal budget. I doubt, however, it will decrease regardless of political grandstanding because its benefits span the political spectrum, if not geographical one. Those wo cannot afford to see a private physician rely on this federal system often to make it through decades of their lives.

Obamacare, so hated under that title but beloved when called the Affordable Care Act, has been crucial to improving the options for those in these depressed areas. But, this cost of the program is high, even with subscribers paying some premiums. Medicaid becomes crucial to the lowest income levels to get doctors and hospitals paid. The Women & Children’s (WIC) support for food is also important but a pittance of the federal expenditures, even if it attracts politicians’ ire. Those needing these assistance programs are the folks who survive have little option without well paying jobs, whether they are Swedish-Americans in Jamestown, African-Americans in Erie, or fifth generation farm labourers.

The life expectancies in these areas diminish coincident with consumption of life-shortening products resulting from desperation, boredom, and increased affordability. The mental health issues so precipitously driving many of these consumption problems remain unaddressed assess to mental health professionals becomes ever more remote.

All of this combines with a downturn in job opportunities, educational achievement, hopelessness, and the resulting spiral of addictions which contribute to deaths at ages far younger than the average of 78.

The Post article focused on Ashtabula, Ohio, but it could have been discussing Laredo, Bishop, or Pine Bluff.

I don’t have a magic wand to fix it; I most definitely wish I did. I recognise that consumption is a personal choice, a concept we cherish above virtually everything else in this country, evidenced by our adoration of the Second Amendment. I understand in a democracy we go with the will of the people; you see me harp about it daily. But, I cannot help but wonder if higher consumption taxes, which I recognise is a regressive tax which hits the poorest hardest, wouldn’t be better.

What do you think? I genuinely would like to hear your thoughts as Congress, on both sides of the Hill and the political chasm, is ignoring this for things that seem to me rather pointless.

It was a spectacular morning on the Creek as the Power Boat Show kicks off today. I simply wish the sunrise was earlier as this reminds we have a long winter ahead.

Thank you for reading Actions Create Consequences. I hope you may consider a subscription as it supports this work but I welcome you reading and circulating this and any other column. I do this to increase civil engagement as I said 11 months ago today when I kicked off.

Be well and be safe. FIN

Lauren weber, Dan Diamond, and Dan Keating, ‘How Red-State Politics are Shaving Years off American Lives’, washingtonpost.com, 3 October 2023, retrieved at https://www.washingtonpost.com/health/interactive/2023/republican-politics-south-midwest-life-expectancy/?itid=hp-top-table-main_p001_f001