Ben Chandler |
"The poor health of the commonwealth is one of the main things that's holding our economy back," Chandler said, telling the Interim Joint Committee on Health and Welfare that among the 50 states, Kentucky's population is 26th but its economy is 45th.
Kentucky has a relatively low cigarette tax, 60 cents a pack, and the highest smoking rate in the nation, 26 percent of adults, as well as the highest death rate from cancer. "If there's anything that needs dealing with, it's that," Chandler said. "Doing something about this smoking problem is absolutely critical to the future of this state . . . . Businesses are not going to locate here if they don't have a healthy workforce."
Republican Sen. Tom Buford of Nicholasville called for a larger increase than Chandler, "Even to a $1.60 a pack is probably not going to provide us the result that we would like to have," Buford said. But he added, "I don't know if the will is there." Alluding to the late-January filing deadline for legislative elections, he said, "I can tell you February the first if there's a chance for tax reform."
Republican Sen. Tom Buford of Nicholasville called for a larger increase than Chandler, "Even to a $1.60 a pack is probably not going to provide us the result that we would like to have," Buford said. But he added, "I don't know if the will is there." Alluding to the late-January filing deadline for legislative elections, he said, "I can tell you February the first if there's a chance for tax reform."
Critics of a tobacco-tax increase have said it would penalize lower-income people, who are more likely to smoke. Chandler told the House-Senate committee that a big increase is needed to push them into quitting.
"You have to raise the tax by $1 or more to get the health benefits," he said. "Otherwise, it's just an added tax burden on the poor." He said cigarette companies would counter an increase of 30 to 40 cents a pack with discount coupons.
Asked where he would spend the money, Chandler, a former congressman and state attorney general, said some should be spent to discourage Kentuckians from smoking.
"We have a very good, in many respects, health-care system, but it's a rescue system," he said. "And people don't want to talk about this, but . . . we spend money largely, for the most part, on health care, to rescue people who are already sick. And we ought to spend a bigger portion . . . on health, as opposed to health care."
Referring to a smoking ban, which she supports, Sen. Julie Raque Adams of Louisville, the committee co-chair, said, "It's not really a freedom issue because every one of us pays out of pocket for those costs."
Chandler told the committee, "We have to focus on promoting policy changes that lead to healthier outcomes by addressing the things that cause poor health in the first place. . . . now have a rescue system."
Appalachian Kentucky continues to be the least healthy region of the state, and the disparity is increasing, Chandler said.
"While all of Kentucky lags behind the nation as a whole, it's generally people living in more rural Eastern counties with more challenging health issues," he said. "The latest numbers show that the health disparities between Central Appalachia and the rest of the nation, or even the rest of Appalachia, are large. And they're continuing to grow."
For example, he said the national death rate from heart disease "declined nearly 58 percent from 1980 to 2014, but not in Eastern Kentucky. In Owsley County, cardiovascular disease mortality actually increased over that 34-year period."
Another big Kentucky health problem is obesity. Chandler said, "Some of the evidence-based programs that help reduce obesity include making the healthy choice the easiest choice by replacing sugary drinks and snacks in school and government vending machines with healthier options, such as fruit and water; increasing the tax on sugary drinks; passing policies that require new streets to be walkable and bikeable; building sidewalks, walking trails, playgrounds and other places where residents can safely engage in physical activity; and adopting policies that enable farmers' markets to thrive."
A video of Chandler's testimony is on the KET website.
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