Doctors, consumer groups oppose tobacco tax initiative

The California Medical Assn. and others say that under the hospital-sponsored proposal, tax revenue would not be distributed fairly.

By Mike Norbut, AMNews staff. Dec. 12, 2005.

California physicians and consumer groups are taking an unfamiliar stand in the fight against tobacco. They have announced their opposition to an initiative campaign that proposes to levy a $1.50 tax per pack of cigarettes.

Their opposition is not related to the tax, but how the initiative proposes to spend the resulting revenue. While nearly two-thirds of the money would be earmarked to protect emergency care in California, opponents worry the funds would not be divided justly among the state's hospitals.

"We need to look at how to get the most benefit for California's citizens out of this unique opportunity," said Jack Lewin, MD, executive vice president and CEO of the California Medical Assn. "There isn't another way we're going to raise that money, so we need to spend it strategically."

Emergency care has become a source of contentious debate in California over the last few years, as more hospitals are forced to close their doors due to escalating losses from uncompensated care. Nine hospitals across the state closed in 2004, according to the initiative sponsors, which are led by the California Hospital Assn.

Opponents say that rather than going to the hospitals most in need of subsidies, the funds generated by the tax would be spread among a larger group of facilities, many of which already would have been compensated for care. In essence, some hospitals would be reimbursed twice for emergency services, they said.

"The money raised by the $1.50 tax invariably would go to the hospitals that need it the least," said Anthony Wright, executive director of the consumer advocacy group Health Access California. "A great majority would go to double-pay hospitals."