Tobacco tax is needed for health care

One way or another, California needs to find more doctors to treat lowincome residents. The best way to accomplish that goal is to pass a $2-a-pack tobacco tax hike on the November 2016 ballot.

It’s meaningless to provide health care insurance to millions of low-income Californians if they can’t find a doctor who will see them and provide preventive treatment. Preventive care is what lowers the state’s costs for providing health care to the needy.

By law, hospitals can’t turn indigent people away when they need to see a doctor. But Republicans to date have refused to sign on to legislation seeking increased funding to improve the state’s Medi-Cal rates for doctors, which are among the lowest in the nation. The governor’s special session on health care is ongoing and will start up again Tuesday, but don’t hold your breath waiting for the tax to pass.

This is not consistent with conservative values. Unless the state pays doctors enough for them to accept Medi-Cal patients, poor people will continue going to ERs for care, usually after illness has grown serious. This is the most expensive way imaginable for taxpayers to foot the bill for treatment.

The tobacco tax increase would provide more than $1 billion a year, 80 percent of which would go to the state’s health care programs. enough to keep doctors from losing money every time they see a MediCal patient. Routine checkups help physicians identify health problems such as diabetes and arthritis before they become chronic.

The Centers for Disease Control and Prevention estimates that 14 million people living in California have at least one chronic condition, and more than half of that group has multiple conditions. The cost of treating chronic diseases in California is $37 billion every year, or roughly 40 percent of the state’s total health care expenditures.

If doctors could identify at-risk patients before their problems became chronic, the money spent providing routine coverage would save taxpayers billions in the long run.

California hasn’t increased the tobacco tax since 1998, even though lung cancer kills 40,000 people in the state every year. It’s the No. 1 cause of preventable death. Thirtyfour states have cigarette taxes higher than California’s. The national average is $1.63 per pack, close to double California’s tax.

The state has tried to raise the tax. Most recently, a 2012 ballot measure to raise the tax by $2.60 a pack lost by just four-tenths of a percentage point. The tobacco industry poured nearly $50 million into a campaign to defeat it, arguing it was a regressive tax that would only create a black market for cigarettes.

Recent polling shows that Californians support the concept of a tobacco tax by more than 2-1, and supporters anticipating a ballot vote are raising millions to counter the deeppocketed opposition.

Besides financing badly needed rate increases for doctors accepting MediCal patients, raising the tobacco tax will discourage people from taking up the deadly habit. If the Legislature won’t act, voters will need to do it themselves.