High costs of smoking

We agree with the Florida Hospital Association's concern that Florida's budget shortfall will have dramatic impacts on the cost and quality of health care for everyone in our state. The current recession is likely to require additional state budget cuts of about $4 billion next year, even after using federal stimulus money. Much of that loss will be felt by people who need medical care. Patients will either pay more for basic care, or they will find that the care they need is not available to them.

Our state's lawmakers do not have to accept these drastic cuts, because there is a common sense way that they can increase health care funding. Florida ranks close to dead last - 47th in the nation - in cigarette assessments. If the Florida Legislature raised the 34-cents-a-pack assessment on cigarettes by $1, our state would raise a projected $1 billion to help preserve health care for Floridians.

Public opinion polling shows that the people of Florida overwhelmingly support a dollar-a-pack increase - by a margin of 72 to 17 percent in one independent poll. The political cost of inaction - preserving the status quo of cheap cigarettes at the expense of health care for our people - will be much higher.

The direct impacts of state budget cuts will be on Medicaid programs that serve the uninsured, children, pregnant mothers, unemployed Floridians, the disabled and the elderly. Everyone who needs medical treatment will likely see the impact in the coming years.

Florida has an opportunity to protect the health care of 40,000 Floridians on the Medically Needy and Aged/Disabled programs by using tobacco revenues as a dedicated recurring funding source for the program. Each year, these vulnerable citizens are faced with the possibility of losing health care coverage without a dedicated recurring funding source. An increase in the tobacco user fee will do something that past legislatures and governors have been unsuccessful in achieving - securing the health security for thousands of Floridians.

Deep budget cuts will likely mean that basic costs are passed on to those with private insurance. Unfortunately, even those with insurance will be hurt as they find their employers cutting back contributions or offering less coverage.

For example, hospitals are not paid the full cost of providing Medicaid services, and some are paid at only half the cost. When the state cuts rates for hospitals, fewer of the costs are covered. The losses are then passed on to employers and individuals in the form of increased policy fees and premiums.

Despite these tough economic realities, many of Florida's elected leaders still stubbornly resist any discussion of raising assessments on cigarettes. They need to hear from the people of Florida about the terrible consequences of inaction. Giving up $1 billion in a time of dire need for our state's health care system is not the leadership we expect in times of crisis.

This letter to The Tampa Tribune is signed by Larry Archbell, CEO of University Community Hospital; Sue G. Brody, president and CEO, Bayfront Health System; Gary Carnes, president and CEO, All Children's Health System; William S. Dalton, M.D., president, CEO and center director, H. Lee Moffitt Cancer Center; Don Evans, CEO, Helen Ellis Memorial Hospital; Larry Hanan, CEO, University Community Hospital-Carrollwood; Ron Hytoff, president and CEO, Tampa General Hospital; Stephen Klasko, M.D., senior vice president for USF Health; Isaac Mallah, president and CEO, St. Joseph's-Baptist Health Care; Debora Martoccio, CEO, UCH's Long Term Acute Care Hospital-Connerton; Stephen R. Mason, president and CEO, BayCare Health System; Stuart L. Rogel, president and CEO, Tampa Bay Partnership; Brigitte Shaw, CEO, Pepin Heart Hospital and Dr. Kiran C. Patel Research Institute; Norm Stein, CEO and president, University Community Health; William G. Ulbricht, president, St. Anthony's Hospital; and Glenn Waters, president, Morton Plant Mease Health Care.