We all pay to cover the cost of tobacco-related disease

By Michael J. Pramenko

“Knowing is not enough; we must apply.
Willing is not enough; we must do.”
— Johann Wolfgang Von Goethe

This fall, Colorado voters will have ample opportunity to consider, discuss, and vote on matters pertaining to health care. With respect to Amendment 69, there are simply too many questions left unanswered for me to comment for or against this proposal to overhaul Colorado’s health care system. 

On the other hand, plenty of evidence and hard facts support Initiative 143. It would increase Colorado’s tobacco tax and use the funds to help reduce health care expenditures for the rest of us well into the future. 

According to the National Institute for Health Care Management Foundation, 5 percent of the population accounts for 50 percent of overall health care spending.  In fact, 1 percent of the population accounts for 23 percent of overall spending. Where do you fit in? Indeed, the healthy among us are paying an ever increasing price for the unhealthy.

My recent columns have emphasized what we need to do as patients to help address the massive cost of health care in the United States. We can’t fix this problem without addressing the major causes of chronic disease: obesity, alcohol, and tobacco.

While we can’t live forever, we can certainly live healthier lives while we are here. And, as a country that does tax everyone to help fund healthcare for the masses, we have a responsibility to the medical “safety net.” Medicare is the best example.  And, commercial insurance operates in a similar fashion. Insurance companies, with or without the Affordable Care Act, need a pool of healthy patients to help fund the medical costs for the sick and chronically ill.

Libertarian, Republican, Democrat, Independent — we all have skin in this game. 

Now you have an opportunity, based on factual experience in public health and population health, to effect real change. Together, by increasing the tax on tobacco in Colorado, we can reduce the use of tobacco and improve the health of the population.  In addition, the initiative specifically spells out how the tax dollars would be utilized. Here are some highlights that pay large dividends well into the future:

■ Of the $315 million in projected first year revenue, $92 million would be spent on research at Colorado facilities. This would include research into treatments for cancer prevention, heart and lung disease, Alzheimer’s disease, and youth mental health. 

■ $48 million to fund unmet medical and mental health needs for Colorado veterans.

■ $17 million to provide student debt repayment and training for medical professionals serving rural and underserved areas of Colorado. 

■ $54 million would be spent on Centers for Disease Control prevention recommendations for funding tobacco education, prevention, and cessation programs.

Initiative 143 will appropriately fund population health measures by taxing unhealthy behavior.  It will raise the tobacco tax in Colorado such that our tax ranks 11th in the nation versus our current standing at 38th.

We fund our roads, in a large part, with user fees. The more you use the roads, the more you pay to maintain them. In order to address rising costs, health care funding requires similar techniques. So here’s your chance to get a return on the extra $700 every Colorado household pays to cover the cost of tobacco related disease. Raise the tax on tobacco.  Vote yes on Initiative 143.

Michael J. Pramenko M.D. is the executive director of Primary Care Partners. He is chairman of the board of Monument Health and is a past president of the Colorado Medical Society.


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The good doctor did not include the elderly (65 +) using the highest percentage of health care costs according to AHRQ.gov which is expected to rise with baby boomers ageing. A recent study by John Hopkins researchers report medical errors as the third leading cause of death. Another shocking report by WHO predicts 70 percent increase in cancer over the 18 years.
1/2 of the population spends little or nothing on health care, AHRQ.gov.
Let’s give the tax money back to the people - Obama care is failing, SS and disability are running out of money, bad economy, roads and bridges, 20 trillion national debt, homelessness and education all want to raise your taxes to fix our many problems. Our money problems can’t be fixed by taxing soda and tobacco. We need to quit giving our taxes to big business, give it to the many hurting families. 50 special interest groups sponsored this petition and expect a piece of the pie. Those t.v. anti smoking ads will increase and 32 million for youth behavior health services could mean so much more. Veterans won’t benefit as they claim, loosely. Give the money back to the people please.

you want to help the youth? Build a rec-center - best investment ever if you would just use the tobacco tax money. T.v. anti smoking ads versus exercise and good clean fun and keep them active.

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