Under the terms of the 1998 “Master Settlement Agreement” of
that suit, the states collectively have since received in excess of two hundred
billion dollars: $200,000,000,000!
That money continues to flow at astonishing levels: during the current fiscal year, the states
will derive approximately $7 billion from the settlement. Massachusetts alone will get over $200
million.
What continues to astonish, as well, is the harm caused by
tobacco: smoking will kill more than 480,000 Americans and smoking-related
illnesses will necessitate health care spending of approximately $170 billion
this year.
In Massachusetts, 16.6% of adults still indulge in the
nicotine habit. That number ties us with
New York as the states with the 11th lowest smoking rate in the
U.S. Utah has the lowest rate, 10.3%, and Kentucky the highest, 26.5%
Here’s something we chin-rubbers of the political persuasion
seldom consider: the debt all Massachusetts taxpayers owe to Scott Harshbarger,
our attorney general from 1991 through 1998.
Harshbarger was in the coterie of attorneys general who conceived
of and organized the suit versus the tobacco companies and helped to turn the
case into a juggernaut by bringing so many other AGs on board.
As discussed in a previous post, we at Preti Strategies once
had a client, Dr. Robert Berger, who wanted to use a relatively small portion
of the state’s tobacco settlement dollars, one time only, on a clinical trial of
the effectiveness of lung volume reduction surgery. See:
http://pretiminahan.blogspot.com/2016/01/it-proved-impossible-to-do-what-doctor.html
That proposal failed due mainly to the opposition of those
wanting to spend the lion’s share of those dollars on smoking prevention and
cessation programs. We had no choice but
to drop the idea and move on.
The overall debate on how best to use the settlement in
Massachusetts, however, has never ended.
One on side have been the governor and a majority of
legislators, who each year have favored putting most of the money in the
state’s general fund, where it can help defray the enormous and ever-growing
costs of running the Medicaid program.
On the other side have been the Centers for Disease Control
(CDC), the Tobacco Free Kids organization, and an assortment of well-grounded, passionate health
advocacy groups, who want tens of millions taken from the settlement every year
and spent directly on smoking prevention and cessation.
The CDC says Massachusetts should be spending roughly $67
million a year on prevention/cessation.
Advocates use the CDC number as a rallying point every budget
season (February through June) on Beacon Hill.
In the current state budget, $3.9 million is set aside for
prevention/cessation, only 5.8% of what the CDC says is required to protect the
citizens of Massachusetts, especially children, from cigarettes and other tobacco
products.
Over the years, Massachusetts has spent as much as $50
million on prevention/cessation (FY 2001) and as little as $2.5 million (FY
2004).
When Governor Charlie Baker filed his proposed FY 17 state
budget this week, he level funded prevention/cessation at $3,866,096. Neither the House nor the
Senate, I predict, will change that figure much when they take their turns at bat in the budget
formation contest.
Here’s a concluding bit of relevant data: in Gov. Baker’s FY 17 budget, total spending
on MassHealth, the name we give to Medicaid hereabouts, is pegged at $15.4 billion, which is nearly
40% --and by far the largest single spending category -- of his $39.6 billion
budget
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