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The Tax On Twinkies

Notes from an emergency room doctor: Good health is far more a consequence of good personal choices than good luck. Insurance companies have long been aware of that and that's why they impose costly surcharges on people with poor health habits, like smokers.

Fancy mathematics has calculated the medical cost of smoking to be more than two bucks per pack. I guess someone simply divided the number of packs of cigarettes smoked into the cost of treating lung cancer, emphysema, and other smoking related diseases. But a pack of cigarettes probably has far greater costs than that. No one can accurately measure the value of more than 400,000 lives lost in smoking related deaths per year. And how do you calculate how many houses, factories, and forests burn to the ground due to a smoldering cigarette? You can't.

Insurance industry practice has been to make an individual responsible for his own bad habits by charging more to those that choose to incur greater risks. Unfortunately, not everyone is insured, it's impossible to monitor personal habits, and the surcharge that insurance companies charge doesn't accurately assess the real costs to society, like those mentioned above.

Now that congress is contemplating taking over the job that insurance companies now do - paying the medical bills - they're also busy targeting the sources of bad health. During the recent debate over the health consequences of cigarette use, an RJR Tobacco executive told congress that just as nicotine was addictive, "any enjoyable activity was addictive," even eating sweets.

Rep. Henry Waxman countered. "You and I know," he said, "Twinkies don't kill a single American a year. The difference between cigarettes and Twinkies ... is death."

Well, simplistically Rep. Waxman is right - "Twinkies" don't cause death. But smoking a few cigarettes won't kill you either. What the government needs to focus on is a total picture of health risk. I like the government's idea of taxing those things associated with bad health. They're busy with tobacco now but alcohol could be taxed far more too. The health tax on a bottle of alcohol should not only cover alcohol related diseases like cirrhosis and liver cancer but should factor in the cost and consequences of all those drunk driving accidents, and stunted newborns who suffer from fetal alcohol syndrome.

But alcohol and tobacco are easy targets. Americans are at great risk of cardiovascular disease because of our eating habits. Why not a tax on the cholesterol content of food or the fat content of meat and milk. A quart of non-fat milk should be cheaper than whole milk, not only to encourage a healthier diet but pay for the health costs of a bad one. And, of course, we should tax Twinkies. You, and I, and Congressman Waxman know that though "Twinkies don't kill," they're not "health food" either.

The government could go beyond the pale and subsidize the good as well as taxing the bad. Fruit and vegetables could be cheaper. Home exercise equipment and health club memberships could be bought tax free. If the television is on more than four hours a day, tax it.

The best of all situations would be if government didn't have to interfere in our personal choices. But we have become a society where individual responsibility is passť. Most people don't want to pay for or admit responsibility for their nasty habits. So, maybe we all need to be led a little toward the right path.

Because elected officials are so dependent on special interest contributions to stay in office, they ought to create an independent authority to make those difficult "health tax" decisions. I'd call it "The Supreme Court of What's Good For Us." It would decide what the real health costs are of all our consumptions and habits and tax them accordingly. However, if they do create such a court, I will decline any appointment. There's no way Dr. Pollack would vote to increase the tax on ice cream, pizza, chocolate, and a good white zinfandel.