Opinion: It’s Time To Raise Excise Tax On Alcohol

(joseph a/Flickr CC)

(joseph a/Flickr CC)

On Friday, Massachusetts State Rep. Kay Khan, a Newton Democrat and Chair of the Joint Committee on Children, Families, and Persons with Disabilities filed a bill that would raise the excise tax on alcohol. (The bill isn’t online yet, says a spokesperson, but here’s the language from last year’s bill, which is identically worded.)

Our guest bloggers, Maryanne Frangules, executive director of the Massachusetts Organization for Addiction Recovery, and John McGahan, president and CEO of the Gavin Foundation, Inc., argue here that the measure is badly needed to support addiction treatment and recovery services.

By Maryanne Frangules and John McGahan

Two years after voters repealed the sales tax on alcohol, which funded addiction treatment and prevention programs, the Massachusetts Health Council reported that alcohol abuse is more prevalent in Massachusetts than the U.S. on average, and emergency room visits (especially in eastern Massachusetts) for drug abuse surpassed that of other much larger metropolitan areas in 2011, including New York, Chicago and Detroit. In fact, Massachusetts ranked first — at a rate of four times the national average — for emergency room visits involving heroin.

These are not categories of achievement for which Massachusetts wants to lead the nation.

We have a drug and alcohol addiction epidemic in Massachusetts, and we need to get serious about prevention, treatment and recovery. The human and economic toll of alcohol and drug addiction are not sustainable for a healthy, civil society.

While the Legislature and Governor Patrick have supported funding for addiction services during the recession and its aftermath, we now face another fiscal year of lower revenues, reductions in spending for vital health programs and perhaps mid-year cuts to public health services, including addiction treatment.

It makes sense to invest in addiction prevention, treatment, and recovery services.  Otherwise our families continue to pay for the mounting social and economic costs of emergency room visits, law enforcement, court, and incarceration. Continue reading

Health Care And The Fiscal Cliff Deal

Harvard professor and author John E. McDonough

Harvard professor and author John E. McDonough

I don’t know about you but I never want to hear about the “fiscal cliff” ever again.

But for true wonks who wish to close the loop on what actually emerged from that final, chaotic and infuriating flurry of legislative wrangling earlier this week, here’s John McDonough, this town’s go-to guy for level-headed health care analysis, offering details in The Boston Globe.

Aside from the major fix to doctors’ Medicare payments (the deal prevents a 30% drop in physician fees) McDonough notes some other items that you probably heard nothing about:

There are 29 Medicare and other health related sections in all. Here are some of the big ones:

–The big “pay-for” cuts $10.5B from Medicare hospital payments to recoup over-payments to hospitals.
–Payment adjustments for End Stage Renal Disease (ESRD) will save $4.9B.
–Rebasing payments for Disproportionate Share Hospitals (DSH) will save $4.2B.
–Rejiggering the coding intensity between Medicare Advantage and Medicare fee-for-service will save $2.5B.
–$1.8B will be saved from reduced payments for certain therapies provided on the same day.
–Eliminating the Medicare Improvement Fund will save $1.7B.
–Throw in a bunch of smaller items less than $1B in savings, and we end up with only a net $1.7B increase in spending over 10 years.

Repeal Of Alcohol Tax Will Boost Morbidity And Mortality, Expert Says

John Kelly, associate director of the Center for Addiction Medicine at Mass. General Hospital, says repeal of the alcohol tax will cost lives

Now that Massachusetts voters have repealed the 6.25% tax on alcohol (depriving the state of about $110 million in revenue that was funding alcohol treatment programs) what will happen next?

Well, aside from making its liquor-industry backers very happy, the tax rollback will certainly fuel consumption of alcoholic beverages, which will lead to an increase in drinking-related deaths, accidents and other harms to society, according to John Kelly, associate director of the Center for Addiction Medicine at Massachusetts General Hospital.

Indeed, on Monday, the medical journal, The Lancet, published a study that found alcohol to be the most dangerous drug — surpassing heroin, cocaine, esctasy and others in terms of the harms it can inflict on society.

One of the simplest, and best known tactics in public health (and one that has been used effectively in tobacco-prevention strategies) is to raise taxes on products you want the public to avoid, Kelly says. The relationship between price and consumption is “very robust,” he says. Slap an extra tax on beer, and people reduce their drinking; repeal the tax, they reach for that Rolling Rock again.

But there’s a public health cost, Kelly says: For every one liter of alcohol that the population consumes per capita, there’s a corresponding increase in mortality of 1%. The deaths attributable to alcohol abuse are well documented in numerous studies, he notes.

It’s unclear whether the state will tap other funding streams to pay for alcohol treatment programs, or if the programs will simply be eliminated. Still, Kelly says, if taxpayers think they’re saving money in the long run, they’re wrong. That’s because all of us will still be covering the cost of emergency room visits, road accidents, alcohol-related cancers, loss of productivity in the workplace and other social problems that alcohol abuse can create.