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Fizzy Math: Tax Soda to Pay for Health Care and Prevention

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Why tax soda? Obesity is expensive and soda is cheap.

To be sure, a lot of factors contribute to obesity, including enormous restaurant meals and the couch-potato syndrome. But sugary soft drinks are the only beverage or food that has been shown to increase the risk of obesity. And obesity, in turn, promotes heart disease, diabetes, cancer, and other expensive-to-treat diseases. All told, Americans spend about $90 billion a year in direct medical costs related to obesity, of which half is paid with Medicare and Medicaid taxpayer dollars.

In other words, Americans are already taxed by soda. Out of every paycheck, and on every April 15, we're each paying to treat diseases promoted by the overconsumption of these uniquely worthless beverages.

What was once a rare treat is now the default drink for many, particularly young people. Our 2005 analysis of soda consumption showed that teenage boys who drink soft drinks consume an average of three 12-ounce cans and girls an average of two 12-ounce cans. One in 10 boys who drinks soft drinks consumes five-and-a-half 12-ounce cans a day, or about 800 calories worth. It's not the only reason, but the increase in soda consumption since the 1970s certainly helps explain why obesity rates have tripled in teens.

We all need food, but no one needs soda. Soda is basically liquid candy, providing empty excess calories without needed nutrients. (The same is true for "fruit drinks" with little juice, so-called "energy drinks" like Red Bull, "sports drinks" like Gatorade, or gimmicky products like VitaminWater.) Besides promoting obesity and disease, soft drinks displace real foods with redeeming health-promoting properties. In fact, in the 1970s, teens drank about twice as much milk as soda. By the 1990s, teens drank twice as much soda as milk. That trend has been reinforced not only by the ubiquitous availability of soft drinks and the ballooning sizes of containers, but also by economics: soda keeps getting cheaper compared to real food.

To some critics, soda taxes are a radical new idea. "We can't live anymore," bemoaned Fox News' Sean Hannity. I don't know if he lives in New York or whether he drinks soda, but if he does, he already pays soda taxes, perhaps without knowing. New York is one of two dozen states that levy small taxes--usually just special sales taxes--on soft drinks or snack foods. Arkansas, California, West Virginia and the city of Chicago are others that do. Those taxes are designed solely to raise revenue and the revenues aren't earmarked for health programs, but they've been around for a while.

Congress should do it differently. A federal excise tax on non-diet soft drinks of one cent per 12-ounce can would raise $1.5 billion per year, and might reduce consumption by 1 percent. A tax of one cent per ounce--as has been suggested by New York City Health Commissioner Tom Frieden (since named to head the Centers for Disease Control and Prevention) and Yale obesity expert Kelly Brownell--would raise about $16 billion a year. That kind of a tax would reduce consumption by more than 10 percent and help reverse the obesity epidemic.

Others will claim that a soda tax is regressive. That's true as far it goes, but don't look for this argument from anti-poverty advocates. If we're using soda tax revenues to help pay for expanded health care coverage and for prevention, lower-income Americans will enjoy the biggest share of the benefit.

Members of Congress crafting health care reform legislation have a difficult job ahead of them. Among other things they have to raise $1.2 trillion over the next 10 years. A tax on soft drinks might get a tenth of the way there. Raising excise taxes (which have been eroded by more than one-third since they were last raised in 1991) on alcoholic beverages could get you another tenth of the way there. But unlike payroll taxes, income taxes, or taxes on employer-sponsored health benefits, a soda tax itself would promote health and reduce health care costs. True conservatives should join liberals in seeing the value in that, even if Sean Hannity doesn't.

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