WHO Wants High Cigarette Taxes?

    The World Health Organization and World Bank want governments around the world — especially in developing countries — to act as nanny’s and raise taxes on cigarettes by at least 10 percent to discourage people from smoking. A study commissioned by the two organizations, “Tobacco Control in Developing Countries,” claims about 42 million smokers would kick the habit if taxes were raised by 10 percent.

    The WHO/World Bank is especially imperious when it comes to smokers in the developing world, with the authors of the report nothing that since people in the developing world generally have less money, the tax would hit them especially hard and provide a big incentive to stop smoking. As the spokesman for British American Tobacco told the BBC, however, a more likely result would be widespread smuggling of cigarettes. Smuggling and underground economies are already a staple in developing countries (and more power to them), and adding another highly taxed good to the mix would only encourage more smuggling.

    Ultimately, though, as the study puts it the whole point here is control. The WHO thinks people shouldn’t smoke and it is more than willing to use the power of the state to enforce their views about personal behavior.

    An amusing twist to the story was added by Prabhat Jha, co-author of the study, trying to defend against claims by the tobacco industry that raising cigarette taxes would cost jobs. Jha told the BBC, “As people don’t spend money on cigarettes, they will spend money on other goods. They will buy popcorn, they go the movies. These generate alternative jobs and also alternative revenues.”

    The only problem with that picture, aside from using the threat of state-sanction forced to arrive at it, is that the WHO has also been going on over the past couple years about obesity, and it is just a matter of time before it starts to recommend higher taxes on fattening foods like popcorn and sedentary activities like watching movies. After all if we had higher taxes on those, people would spend more time eating granola and jogging on the beach.

    The PR flack for the tobacco companies, Dave Betteridge, got it right when he told the BBC, “It should be for adults only, but provided that you are aware of the health risks — and it is hard to think that there are people who are not aware of these — if you want to smoke then you should be free to smoke.”

Global plea to raise smoking taxes. The BBC, August 9, 2000

Central Planning Is Healthy

    How do you tell if your country has a good health-care system? Does it give individuals few choices over treatment? Does it rely heavily on central planning and rationing of health care? If so, it’s top notch. Anything else falls short of the ideal.

    That, at least, is the distinct impression given by a recent World Health Organization report which ranked the nations of the world by the quality of their health-care system. France’s heavily socialized system came it at number one, while the United States was way down the list at number 37.

    Why? Largely because in the United States, health care spending is done by individuals and corporations rather than the state. To the WHO, if an individual spends $100 out of his or her pocket on health care, that’s a travesty, but if the government taxes a citizen $100 and then spends that money to pay for a doctor visit, that’s the hallmark of a great health care system.

    To WHO it also depends who the health care dollar is spent on. The WHO report includes a measure of “disability-adjusted life expectancy” which is the average number of years a person lives without a serious illness. Essentially that means that to WHO every $1 spent on providing care for people with long-term chronic illnesses is an inefficient expenditure. This is a value judgment there that spending money on the disabled wastes resources that might go to say reducing infant mortality (this is a common value judgment

    The fatal flaw in the United States system is the one area where it excels, according to the WHO report — the United States ranks number one in the world using WHO’s criteria for responsiveness to patients. There aren’t any long waiting lists to receive medical treatment as there are in many countries. The state doesn’t dictate which medications can be prescribed or forbid people over a certain age from having certain treatments. Unfortunately that very element of choice interferes with the ability of the state to plan the “correct” outcomes.

    And central planning is really what constitutes a good health care system for the WHO. An article on the rankings in the Washington Post captured the flavor and intent of the report when it noted the poor ranking given to China’s health care system:

    A generation ago, China emphasized disease prevention and universal primary care. (It was one of the first Third World countries to eradicate smallpox and was famous for its “barefoot doctors.”) With the arrival of a market economy in the 1980s, medical care became financed largely by out-of-pocket payment by consumers. Today it ranks 188th out of 191 nations in the WHO assessment’s “fairness of financing” measure.

    The erosion of organized planning for health may be one reason Chinas’s life expectancy has barely budged in the past 20 years, despite the huge growth in its national wealth, a traditional driver of health improvement, [WHO’s Julio]Frenk said.

    The WHO report and rankings reflect the values of bureacrats who long for the sort of power and control over people’s lives that a country like China exerted at the height of its centralized planning.