Tax hike is about life and death, not beer and soda

In the next six weeks you are not going to be able to kick a pile of moose poop in Maine without some of it hitting a person on the street asking if you are fed up with high taxes. When you answer, “Hell, yes,” they will then ask if you want to sign a petition to veto a recent increase in Maine taxes on beer, wine, sodas, some other sweetened drinks, and health insurance claims. Then you should answer, “Hell, no,” because the real cost of rolling back those taxes will be to deprive about 18,000 Mainers of health insurance.

That’s right, the petition is not just about the issue of whether you want these new taxes repealed. Rather, it is about the profoundly difficult question of whether you are willing to deprive 18,000 people of their health insurance in order to repeal those taxes.

The health insurance in question is DirigoChoice, subsidized insurance offered by state government primarily to small employers. About 700 such employers currently purchase insurance through DirigoChoice for some 18,000 enrollees, at a cost of about $50 million annually out of our collective pockets for the subsidies. DirigoChoice is part of why Maine, alone among New England states, has seen its ranks of uninsured residents decrease in the past few years, and why it has one of the lowest rates of uninsured in the United States.

These new taxes were passed during the last session of the Legislature because the previous funding mechanism for DirigoChoice (an assessment against Maine health insurance companies) was a constant source of controversy and legal claims.

Unfortunately, there is no funding proposal for insuring the uninsured that is not going to tick off a lot of us because every proposal will require taxpayer support. In choosing what to tax in order to expand insurance, the only question is whose soda is going to be flattened.

The biggest component of the new taxes to support DirigoChoice is a 1.8 percent tax on health insurance claims ultimately paid by businesses for those of us with employer-funded health insurance.

If those 18,000 people do not have health insurance, when they get sick and cannot pay their medical bills those unpaid bills are going to be passed on to people with health insurance in the form of higher medical bills for the insured. That’s a hidden tax we are all paying now. A tax on the insured to help keep those 18,000 people healthy, rather than a hidden cost passed on to all of us when they get sick, seems to me like a rational investment of our money.

Other taxes to pay for steps toward universal health insurance should ideally be on nonessential consumer items, and things that in their own way can contribute to higher health care costs. A tax on beer, wine, soda and other sugared drinks meets both of those criteria. Alcohol-related crime and disease cost Maine’s economy more than $1 billion a year, and sugared soda is a direct cause of people being overweight and obese.

I have friends and family in the legitimate businesses of selling them; they are not responsible for those effects, and I am sorry the burden of the new taxes falls on their businesses disproportionately. But those products impose their own “taxes” on us already by the impact their excessive use has on our collective and individual health. Taxes that help mitigate that impact by insuring the uninsured seem less unfair than new taxes somewhere else.

Some will argue a veto of the new taxes will not kill DirigoChoice, but rather force the Legislature to find a new funding source. Given Dirigo politics in Augusta, and the departure of DirigoChoice “obstetrician” Gov. John Baldacci from office in 2010, that argument seems either hopeful, hollow or both.

The new taxes apparently amount to 3 cents per can of beer in a six-pack, 7 cents on a bottle of wine, and 7 cents on a 20-ounce can of soda. Think of it this way: That’s not a tax you are paying, that’s a mammogram you just helped give someone. If you’re willing to do that, then a few cents a drink might go down a lot easier than 18,000 people without health insurance. That is especially true when you consider that people without health insurance die younger, are less likely to get their diabetes and high blood pressure cared for, and are less likely to survive cancer. You might think this is about beer, soda and taxes, but it is really, in some cases, about life and death.

That is the real point here: If you look at all of this as just a new tax, it not only tastes lousy but you also want to hack the tax back up. On the other hand, if you consider it as sweet relief for thousands of Maine families, maybe we can swallow hard and agree that, of all the lousy options, this one tastes the least bad.

If you still hate the new taxes, consider them motivation for us all to get about the tough work of reining in health care costs, and getting us all healthier so we cost less to insure. Those are petitions we should all happily sign, but we should not sign the one to veto the new health insurance funding mechanism for 18,000 of our neighbors, friends and families.

Erik Steele, D.O., a physician in Bangor, is chief medical officer of Eastern Maine Healthcare Systems and is on the staff of several hospital emergency rooms in the region.