Kentucky Health News
The Foundation for a Healthy Kentucky has taken a tougher stance toward tobacco, advocating a $1-a-pack increase in the state cigarette tax as a way to reduce smoking and its health-care costs. Now its CEO says the foundation also favors taxes on sugary drinks as a way to fight obesity, another bad health statistic in which Kentucky is a national leader.
"We think sugar taxes are a good way to go," Ben Chandler, who has headed the foundation for a year and a month, said in an interview with Mark Green, editor of The Lane Report, a Lexington-based business publication.
"You’ve got to figure out a way to get the public to not consume as much sugar," Chandler said. "There isn’t any question that we have a significant obesity problem. And there isn’t any question that it affects the overall health of not only the individuals but the state. And one of the obvious ways to attack that problem is to raise taxes on sugary beverages in particular.
Chandler asked, "Why single out the beverages and not other forms of sugar?" He answered, "These sugary beverages have no other nutritional value. What we’re looking to do is deal with the high-caloric and low-nutritional things. You don’t want things that have high calories and low nutritional value. You would prefer, obviously, high-nutrition and low-calorie."
Chandler, a Versailles Democrat who was state attorney general and then Bluegrass congressman, probably faces a tough fight getting new taxes approved by a state legislature controlled by Republicans, many of them newly elected. Many are also from rural areas, where a shrinking number of farmers still grow a lot of tobacco.
"You hear the argument, for instance, on smoking that tobacco is an economic force in Kentucky and is a positive economically. The costs from smoking far outweigh any kind of economic gain we get from tobacco," Chandler told Green.
"You can’t get an exact figure on it, but I can tell you that the costs are dramatic. For instance, the Campaign for Tobacco-Free Kids estimates that the cost of smoking in the commonwealth of Kentucky is $1.92 billion. And $590 million of that is to the Medicaid program alone. . . . If we were just to get to the national average on smoking, it would mean over 300,000 fewer smokers. It would save taxpayers in the neighborhood of $600 million a year."
The costs aren't just in state and federal spending, Chandler said: "Just as a result of the smoking habit, every household in Kentucky has to pay $1,100 a year more than they otherwise would for health insurance. That’s whether you smoke or not. So that’s an indirect cost. The indirect costs start with loss of productivity and the cost of health insurance."
Under Chandler's predecessor, Susan Zepeda, the foundation more gently promoted various measures to discourage smoking and other bad health behaviors. Now it is being more aggressive.
"We want to move into being active on public policy because we believe the health needle in Kentucky needs to be moved, and we’re not going to do it unless we have strong public policies like the ones I’ve talked about that encourage healthy behaviors," Chandler told Green. "One reason we need to go in that direction is that our budget is about $2 million a year, and it’s just not enough to make the kind of impact we want simply by giving out grants. We’ve got to have a strategy to affect public policy in the state, and that’s what we’re going to try to do."
Chandler added later, "The key to this whole thing is that we’ve got to start focusing on health as opposed to health care. Not to diminish the importance of health care, but if we can have a healthier population on the front end, and if we can invest in policies that cause our population to be healthier, then not only are people going to have more fulfilling lives, but we’re going to help our economy, we’re going to create jobs, and we’re going to help the business climate. We’ve got everything to gain and nothing to lose by taking that position. We just haven’t done a good job of it in this country."
Earlier, he said, "In this country we spend almost all of our money on a rescue system. We wait until people get sick, and then we rescue them. We talk about healthcare all the time, but I have yet to meet a person who wants health care if they can have health. It’s important to have a system that helps people when they’re sick, but it is also the least efficient way to spend your healthcare money. That’s why we spend twice as much per capita in this country as any other country in the world, and our outcomes are, according to the World Health Organization, 37th in the world."
He added later, "What we ought to do is redirect some of that spending to prevention programs. We can do that through the public health departments, for instance. We have 61 public health departments in Kentucky. They need to be the chief health strategists for their communities. Public health departments are underutilized and underfunded, and it’s tremendously important that we utilize them, not just to provide additional clinical services but to actually be the health strategists for their communities."
Chandler said the foundation "has undertaken programs in seven different counties, to bring coalitions together in those counties, schools, governments, hospitals, concerned citizens – anybody who might be interested in joining a coalition – to work to enact healthy policies in that locality. Clinton County, Kentucky, in Appalachia down on the Tennessee line, is a good example. It has enacted policies that allow the school gymnasium to be used by the community after school. Another good policy is complete streets policies: when you’re developing a street, you have to have sidewalks, you have to have bike paths. In other words, being healthy is an easier option that way. Being able to exercise is an easy choice rather than a difficult choice."
Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Media at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.
The Foundation for a Healthy Kentucky has taken a tougher stance toward tobacco, advocating a $1-a-pack increase in the state cigarette tax as a way to reduce smoking and its health-care costs. Now its CEO says the foundation also favors taxes on sugary drinks as a way to fight obesity, another bad health statistic in which Kentucky is a national leader.
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| Ben Chandler |
"You’ve got to figure out a way to get the public to not consume as much sugar," Chandler said. "There isn’t any question that we have a significant obesity problem. And there isn’t any question that it affects the overall health of not only the individuals but the state. And one of the obvious ways to attack that problem is to raise taxes on sugary beverages in particular.
Chandler asked, "Why single out the beverages and not other forms of sugar?" He answered, "These sugary beverages have no other nutritional value. What we’re looking to do is deal with the high-caloric and low-nutritional things. You don’t want things that have high calories and low nutritional value. You would prefer, obviously, high-nutrition and low-calorie."
Chandler, a Versailles Democrat who was state attorney general and then Bluegrass congressman, probably faces a tough fight getting new taxes approved by a state legislature controlled by Republicans, many of them newly elected. Many are also from rural areas, where a shrinking number of farmers still grow a lot of tobacco.
"You hear the argument, for instance, on smoking that tobacco is an economic force in Kentucky and is a positive economically. The costs from smoking far outweigh any kind of economic gain we get from tobacco," Chandler told Green.
"You can’t get an exact figure on it, but I can tell you that the costs are dramatic. For instance, the Campaign for Tobacco-Free Kids estimates that the cost of smoking in the commonwealth of Kentucky is $1.92 billion. And $590 million of that is to the Medicaid program alone. . . . If we were just to get to the national average on smoking, it would mean over 300,000 fewer smokers. It would save taxpayers in the neighborhood of $600 million a year."
The costs aren't just in state and federal spending, Chandler said: "Just as a result of the smoking habit, every household in Kentucky has to pay $1,100 a year more than they otherwise would for health insurance. That’s whether you smoke or not. So that’s an indirect cost. The indirect costs start with loss of productivity and the cost of health insurance."
Under Chandler's predecessor, Susan Zepeda, the foundation more gently promoted various measures to discourage smoking and other bad health behaviors. Now it is being more aggressive.
"We want to move into being active on public policy because we believe the health needle in Kentucky needs to be moved, and we’re not going to do it unless we have strong public policies like the ones I’ve talked about that encourage healthy behaviors," Chandler told Green. "One reason we need to go in that direction is that our budget is about $2 million a year, and it’s just not enough to make the kind of impact we want simply by giving out grants. We’ve got to have a strategy to affect public policy in the state, and that’s what we’re going to try to do."
Chandler added later, "The key to this whole thing is that we’ve got to start focusing on health as opposed to health care. Not to diminish the importance of health care, but if we can have a healthier population on the front end, and if we can invest in policies that cause our population to be healthier, then not only are people going to have more fulfilling lives, but we’re going to help our economy, we’re going to create jobs, and we’re going to help the business climate. We’ve got everything to gain and nothing to lose by taking that position. We just haven’t done a good job of it in this country."
Earlier, he said, "In this country we spend almost all of our money on a rescue system. We wait until people get sick, and then we rescue them. We talk about healthcare all the time, but I have yet to meet a person who wants health care if they can have health. It’s important to have a system that helps people when they’re sick, but it is also the least efficient way to spend your healthcare money. That’s why we spend twice as much per capita in this country as any other country in the world, and our outcomes are, according to the World Health Organization, 37th in the world."
He added later, "What we ought to do is redirect some of that spending to prevention programs. We can do that through the public health departments, for instance. We have 61 public health departments in Kentucky. They need to be the chief health strategists for their communities. Public health departments are underutilized and underfunded, and it’s tremendously important that we utilize them, not just to provide additional clinical services but to actually be the health strategists for their communities."
Chandler said the foundation "has undertaken programs in seven different counties, to bring coalitions together in those counties, schools, governments, hospitals, concerned citizens – anybody who might be interested in joining a coalition – to work to enact healthy policies in that locality. Clinton County, Kentucky, in Appalachia down on the Tennessee line, is a good example. It has enacted policies that allow the school gymnasium to be used by the community after school. Another good policy is complete streets policies: when you’re developing a street, you have to have sidewalks, you have to have bike paths. In other words, being healthy is an easier option that way. Being able to exercise is an easy choice rather than a difficult choice."
Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Media at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.
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