Wednesday February 27, 2013

There are a few bills moving through the legislature that not only need a public airing but also need more public input. One is the so-called Death with Dignity bill.

When this bill was first crafted it was a thoughtful response to an issue. People wanted to have the ability to end their lives when they felt it was time and they wanted the means to do so. That meant having the ability to obtain a prescription for a drug that could end things. I have mixed feelings about this bill because I have dealt with this issue as directly as possible on a number of occasions.

I am still not sure if the legislature should even consider passing a bill that allows for someone to legally take their own life. In its original form, the bill was something that had sensible safeguards such as requiring a person to make two requests for the lethal drugs and to be deemed not depressed or mentally impaired.

Then the political process turned things upside down. Senators Peter Galbraith, D-Townshend, and Robert Hartwell, D Manchester Center, decided they wanted the bill to pass no matter what and they crafted what they thought was a sensible political solution. The problem was that, in this case, their political solution took away safeguards and turned it from a patient choice bill to a bill that protects doctors who prescribe lethal doses of drugs.

It is now a different bill, more correctly called the Doctor Protection Act. It was originally 22 pages and now it is one page. That speaks for itself. There are times when political compromise just does not make sense and this is one of those times. If a politician reworks a bill so that it has little connection to the original, then they have moved from dealing with the issue to trying to win the political game at all costs. It just doesn't pass the smell test.

Then there is the Sugar Sweetened Beverage (SSB) Tax bill. The proposal is to put a penny an ounce tax on beverages such as Coke, Pepsi, Mountain Dew and others at the processing level. It would add to the cost of the beverages and that is the point. All studies, including those conducted at the Rudd Center at Yale, indicate that such a tax will reduce consumption.

Consider some facts posted by the Alliance for A Healthier Vermont. "For children, each extra can or glass of SSB consumed per day increases their chance of becoming obese by 60 percent. People who drink 1-2 servings a day of SSBs are 26 percent more likely to develop type 2 diabetes than people who drink 0-1 serving a month."

They continue to note that, "Overweight and obesity contribute to 14 to 20 percent of all cancer deaths and have been associated with increased risk for several common cancers including colon, esophagus, kidney, endometrial and breast cancer in postmenopausal women. Children who consume more soft drinks, relative to milk and 100 percent fruit juice, have a greater risk of developing dental caries as they grew older." And if all that is not enough to convince a sensible person that SSB consumption is a problem, what is the average12-19 year old teenage boy who is drinking 109 gallons of SSBs a year doing to his chances of becoming a healthy adult?

This country is in the midst of an obesity epidemic and a reasonable person might think that anything to help cut down on that epidemic would be welcome. But this is the land of the free market and that means that profit is more important than health. That is the message that the Vermont Retail Grocers Association is sending and it is the same message that Governor Shumlin is sending.

The SSB bill died in the House Health Care Committee last Friday. That may have been a good thing because it was linked to unconscionable subsidy cuts in 2014 health care exchange programs. The issue is not dead, and if there is enough public pressure it might be possible for legislators to find a way to resurrect the SSB bill.

Just in case you are looking for another reason to support the SSB tax consider the cost sharing subsidies that the House Health Committee recommended for people on VHAP and Catamount insurance who will be moved into the new health care exchanges in January 2014. Most people will see their out of pocket costs skyrocket and that means they will either not buy insurance or have a massive heart attack when they find out how much it will cost them to actually use their insurance.

The Rudd Center estimates that the SSB tax would generate $27million,which is far more than is needed to ensure that the estimated 30,000 people transitioning from Catamount and VHAP into the Exchange don't see their premiums and deductibles increase dramatically.

If you want more information about these issues and want to become more involved contact me.

Richard Davis is a registered nurse and executive director of Vermont Citizens Campaign for Health. He writes from Guilford and welcomes comments at rbdav@comcast.net.