UP Medics: On Taxes and Transes

The Sin Tax Bill, House Bill No. 5727 and Senate Bill No. 3249, is an act restructuring the excise tax on alcohol and tobacco products. The bill aims to discourage alcohol and tobacco consumption, especially among the poor and the young; reduce health care costs from tobacco and alcohol use; and raise revenue for the universal health care budget. A small percentage would also fund alternative livelihood for tobacco farmers.

Makes sense? Let me make it real for you: For a liter of beer, add P25; for a pack of cigarettes, add P14-30. So if I want to buy San Mig Light (P38/can) from the nearest convenience store, I’d have to pay around P46 (roughly 3 cans per liter = P25/3), and for a pack of Marlboro (P39), that’s P69. Would I buy? Sure! Why not? It’s not like I drink everyday, and I’m fine with just one can. Oh, and I don’t smoke. So what do I care about this bill?

Good question.

Everyday, I bombard myself with medical facts, diseases, drugs; I basically eat my transes! At the end of the day, I just don’t want to think anymore. I don’t want to care. And there lies the problem.

I want to be a doctor because I want to be the change I wish to see in the world. Well, here’s a change—care. This issue, it’s more than me. It’s for my future patients. We all know how smoking and alcohol are risk factors for so many diseases. This bill could be the answer to this health problem.

A study was published in Psychological Science (February 2010), showing the effects of sin tax on junk food on buying behavior. The researchers wanted to know if adding sin tax on junk food (e.g. chips and soda) were more effective in reducing overall calories purchased, than adding a subsidy on healthy food (e.g. fruits and vegetables). Results? Sin tax was more effective. When junk food was taxed, participants of the study bought healthy food instead. On the other hand, when healthy food was subsidized, participants bought healthy food and junk food. The money they saved from the subsidized healthy food was used to buy junk food. Sin tax decreased overall calories purchased, while subsidy increased it.

Why is this so? I’d like to explain it in two simple concepts, reinforcement and punishment.

In operant conditioning, reinforcement aims to increase a behavior by either presenting a positive stimulus (positive reinforcement) or removing a negative one (negative reinforcement), while punishment aims to decrease a behavior by presenting a negative stimulus (positive punishment) or removing a positive one (negative punishment). In the study above, healthy food subsidy is a form of negative reinforcement (reduce cost), while junk food sin tax is a form of positive punishment (additional cost). Which is more effective? Negative reinforcement is shown to give immediate results but only in the short term. What is the goal of the sin tax bill on alcohol and tobacco? Basically to decrease its consumption. Is this short term or long term? Long term of course. So the logical move would then be to use positive punishment: decrease behavior with negative stimulus. Hello sin tax.

So yes, I agree with DOH in advocating the sin tax bill, because it is first, and foremost, a health bill. It’s anti-cancer because it can decrease tobacco and alcohol consumption, which can lead to lung and liver cancer.

I also agree with raising revenue for the universal health care budget. Gabriela representative, Emmi de Jesus, on the other hand, disagrees. In her speech (June 13, 2012) she stated, “…The fundamental question is not the lack of revenues, but the improper allocation of resources.” Be as that may, the sin tax bill would still fulfill its main goal of discouraging tobacco and alcohol consumption. She further argued, “…It is politically and socially anomalous to seek revenues from people’s vices…” But isn’t it more socially anomalous if the government let thousands of Filipinos die from not passing the sin tax bill?

The sin tax bill is a psychologically sound health bill that will benefit many. Lives will be saved, and money raised will fund the country’s health programs. Many have spoken their minds about it; some are for it, while some are against it. How about you? What is your say on this issue? Fellow med students, before you go back to your transes, spare a little brainpower and think, not just about tomorrow’s exam, but also your patients’ tomorrow.

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