Budget bill compromises health, savings
As Wisconsin lawmakers put the final touches on a compromise state budget, one item we hope will get closer attention is the massive proposed cut in one of the state's most successful - and financially smart - health programs: The tobacco control...
As Wisconsin lawmakers put the final touches on a compromise state budget, one item we hope will get closer attention is the massive proposed cut in one of the state's most successful - and financially smart - health programs: The tobacco control program.
At the outset, we should note that we expect this program to be cut and bear its share of the state's fiscal pain. But tobacco control is being cut 40 percent - eight times the average size cut most other programs face.
This is counterproductive - even counterintuitive - in almost every way.
Even smokers will tell you they hope their kids never start using tobacco. Youth prevention programs are a smart investment for public health, and when adequately funded and paired with significant tobacco tax increases, we've seen positive results for Wisconsin kids and young adults. Since the tobacco control program began operating in 2000, high school smoking has dropped by 36 percent. But 21 percent of Wisconsin high school students still smoke. Now, more than ever, we need to ensure funding for youth prevention - there is clearly more work to be done.
The state is levying $500 million annually in tobacco taxes. This budget proposes to levy another $300 million in new tobacco taxes - about a third of which are paid by low income people.
To us in health care, the tobacco tax is a powerful motivator; when prices rise, tobacco users rethink their addiction and are truly open to quitting. But virtually every state has learned that for a tobacco tax increase to be truly effective, it must be accompanied by a funded, multi-tiered approach to help tobacco users quit. If it isn't, it's strictly a regressive tax on tobacco users, which is one of the concerns many Democrats had about raising the tax in the first place.
But what's even harder to comprehend is why lawmakers are cutting a program that, in the end, saves money. For every smoker who quits, Wisconsin sees a $1,600 savings in health care costs. Smoking-related diseases are the single largest cost to the state Medicaid program, which lawmakers are trying to cut by $500 million. So why are we cutting a program that actually helps reduce Medicaid spending?
Finally, the effort is badly underfunded already. The program has faced budget cuts in the past to help balance the state budget. Funding is now below one-fourth of what experts at the Centers for Disease Control recommend to battle the burden of tobacco in Wisconsin - and to counter the $276 million a year Big Tobacco spends marketing its products in our state.
This cut is a crippling blow to the effort.
Wisconsin's tobacco control program has been highly successful. It's helped drive down smoking rates in middle schools by 65 percent and adult smoking by 22 percent. The number of retailers found to be selling tobacco to minors is low - and infractions are rare.
Unfortunately, we have very clear data that shows when states cut these programs dramatically, progress stops. In fact, dramatic cuts to tobacco prevention efforts have reversed progress in every case.
This is a program that saves lives. It saves taxpayers' money. It is politically popular. It is excellent health care policy.
We strongly urge lawmakers to reconsider at least part of the cut the tobacco control program faces. And we're hoping that Gov. Jim Doyle, who has been a strong tobacco control advocate, can remind lawmakers of our shared vision of healthier people and healthier balance books.
We're ready to face our share of the cuts. But the proposed cut is unsustainable.
Maureen Busalacchi is executive director of Smoke Free Wisconsin.