THE FATAL FLAW OF THE SIN TAX FIX

                            By Jon Carroll

   Taxing cigarettes is fine with me; I don't smoke.  Also, I hate the
marketing practices of cigarette companies, so anything that can be done
to make them squirm is just jake in my book.
   But I do think the administration's reasoning, as expressed by Budget
Director Leon Panetta, is just a little flawed.  Well, a lot flawed.
   Panetta said that a huge tax on cigarettes would be a grand idea for
two reasons.  First, cigarette smoking adversely impacts the health of
American citizens, so the merchants of death might as well pay for it up
front.  Second, high taxes on cigarettes would serve as a disincentive
to smokers, meaning that fewer people would smoke and the nations health
care bills would go down.
   It's number two that bothers me.
   The people who refrain from smoking because of the high cost of
cigarettes are going to live longer.  As they age, they are going to
contract a wide variety of other diseases.  Eventually one of the
diseases will be fatal, although heroic efforts will be made to save the
person anyway.
   In other words: Nonsmokers die too.  In fact, nonsmokers die at
precisely the same rate as smokers, ie: 100 percent.
   And since nonsmokers live longer, they will inevitably put a greater
strain on the health care system.  Someone who dies of Extreme Old
Age at 97 is going to use up a lot more health care bucks than someone
who keels over from a heart attack at 48.
   So if we really wanted to use tax policy to help control the rising
cost of health care, we wouldn't tax cigarettes at all.
   We'd tax vegetables.
   You see what I'm saying.  One of the great problems with our health
care system is that everybody's living longer.  People are gobbling
up prescriptions, getting various limbs and sockets replaced, responding
to advances in physical therapy, just living and living and living.
   Fiscally speaking, all this living is a bad idea.  Fiscally speaking
we need more death.
   I'm not suggesting that be our nation's policy; I'm only exploring
the reality of the matter.
   We should tax vegetables, leotards, walking shoes, meditation tapes,
X-ray equipment.  Hell, we should tax medicine.  Of course, that would
mean that rich people would get better health care, but that's already
true.  And it will never change.
   Whatever safety nets are in place, whatever blessings managed
competition brings to average Americans, the rich will always get the
best doctors.
   Let's look at it another way.  If you ask people how they want to
die, almost inevitably they say that they want to die unexpectedly and
painlessly in their sleep.  The vote is more or less unanimous; it would
be impossible to find an issue on which Americans agree more.
   And yet how much money is being spent trying to make sure that every
American gets to die unexpectedly and painlessly in their sleep?  None.
   Death is hard to think about; I acknowledge that.  But death is the
bottom line of health care.  We all know we want a lot more damn fine
health care, but what do we want it for?  To live longer, or to live
better?
   Longer is not better; we know that.  On the other hand, we have only
one life, and we don't want the government deciding when our longer does
not equal our better.  And so we pretend that nonsmokers don't die; we
pretend that human mortality is a policy matter; we pretend that
suffering and pain were created by the Republicans.
   Nope.  God did it.  Isn't that irritating?

                                Jon Carroll wrote this commentary for
                                the SAN FRANCISCO CHRONICLE.