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Gregory L. Schneider

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Gregory L. Schneider

Gregory L. Schneider, Ph.D.is a senior fellow with the Flint Hills Center for Public Policy, a Wichita, Kansas-based organization. He is also an associate professor of history at Emporia State University, alsoin Kansas. He has written and edited three books on the history of conservatism and has published book reviews and articles in a variety of national publications, including the Weekly Standard, Claremont Review of Books, and The American Conservative. In 1999 he was featured in Reason Magazine for his book on the student group Young Americans for Freedom.

Schneider has been a opinion columnist for the Topeka Capital-Journal. He received his PhD in history from the University of Illinois at Chicago, an MA in history from Ohio University and a BA in International Relations from Drake University.


Friday, October 3, 2008

Wall Street Crisis Could Produce Health Care Reforms 

By Gregory Schneider

The recent news from Wall Street concerning the government’s plan to bail out financial markets and stick taxpayers with the bill has made it difficult, if not impossible, for the advocates of universal health coverage to fulfill their goals. Democratic presidential candidate Barack Obama recently said that some of his plans for spending would have to be curtailed if, as expected, the bailout of Wall Street passes Congress. The money just won’t be there.

For those Americans without health insurance who were counting on at the least some discussion of the issue during the campaign and some action for universal health insurance should Obama win in November, the deflation in the credit bubble was too deeply and personally felt. With the government assuming such a vast quantity of private market debt, it appears unlikely that health care reform funded by government will be possible.

But not all hope is lost for a different type of health care reform. The Wall Street/government fiasco should convince many Americans that it is high time to get the financial ship in order, not only in New York and Washington, but in their own households as well. Last year the media reported that for the first time since the Great Depression Americans had a negative savings rate. It is high time we reverse course.

Health care reform which is not predicated on expanding government’s role, but rather promoting individual responsibility is best. The creation of a true market for health insurance and consumer health care, would point the best way towards both lowering the number of uninsured in the country as well as the costs of health care.

One way to do this is to change the tax structure which favors the employer-sponsored insurance the majority of Americans still receive. Employers receive the tax benefit for purchasing insurance for their employees. Many Americans who find themselves uninsured or without employer sponsored insurance could find themselves with insurance if they were to receive the tax benefit accorded employers.

Senator John McCain, the Republican candidate for president, has offered a plan whereby a tax credit of $2500 for an individual and $5000 for a family is given which would allow people to purchase private health insurance. McCain has also suggested allowing the purchase of health insurance across state lines so that individuals in high cost states could purchase cheaper insurance products offered in other states. This would not undercut the regulations in each state—the insurance commissioner of a state like Kansas would still be responsible for the soundness of the insurance product. But it would allow for a more competitive marketplace which should lower costs.

Second, encouraging the use of health savings accounts (HSAs) by employers or through the individual marketplace would provide greater individual control over health care costs and allow Americans to build up savings which would be used towards future health care expenses.

There are other ways to reduce health care costs and to increase the number of insured without creating a universal health care system. Wall Street’s recent crisis and the response by government need not end reforms of a vital sector of our economy. Rather it should point the way to the prudent and measured reforms which will revitalize the health care sector while government spending is focused on other priorities.

Friday, August 1, 2008

A Paradigm Shift for Health Care 

By Gregory L. Schneider

Categories:  Insurance Regulation, Kansas

The manner in which people receive their health insurance in America is changing. In the past sixty years employers provided the majority of Americans with health insurance and in return employers received a tax deduction for doing so. Employer sponsored insurance (ESI) was the norm during a period after World War II when American corporations were huge employers and American industry was dominant. By the end of the 1940s close to two-thirds of those insured received their health insurance from their employers.

Today the statistics are quite different. Only 54 percent of Americans receive insurance from their employers and another 26 percent receive health insurance from government programs. An additional 16 percent of all Americans are uninsured and only about 5 percent pay for coverage as individuals, according to date from the Kaiser Family Foundation.

The decline of ESI insurance and the growing importance of government sponsored health insurance has been one of the bigger stories dominating the debate about health care. If government now insures, through Medicare and Medicaid, more than 25 percent of the population and if large employers such as General Motors, are struggling to pay health insurance costs (about $1,500 of every GM vehicle sold goes to health care costs for retirees), then, some say, we need national health insurance in order to be competitive in a global marketplace.

There is another way. The cost of government funded health care is on the rise and expected to consume 19 percent of Gross Domestic Product (GDP) by 2082 (federal spending on health care currently is 4 percent of GDP). Total spending on health care already amounts to 16 percent of GDP. If Americans want to have higher taxes and cuts in spending on other priorities, such as defense, to pay for health care, then we can continue on such a path. If we want government to spend on other priorities and keep taxes low, we cannot take such a path.

How about a new paradigm altogether? If big employers continue to slash workforces and small businesses continue to have difficulties paying for health insurance, why not empower individuals to pay for their own health care and increase the numbers of those who pay for health insurance on their own? In time such practices would encourage the recipients of government assistance to purchase health insurance in the marketplace. What this new paradigm would constitute is the creation of a true market for health care, something which doesn't exist now.

The easy criticism of such a plan is that it costs too much. Individuals have to pay for what their employer would have kicked in for their insurance. They also do not receive the tax deduction for doing so. How could an individual with a family afford health insurance?

The easy answer to this is to restack the decks in a way which favors individual consumers of health care rather than the providers of health insurance and the providers of health care (doctors and hospitals). Give a tax deduction comparable to ESI-based insurance to those who pay individually. Maximize the existing laws which favor the creation of Health Savings Accounts (HSAs) and provide needed incentives for individuals to subscribe to them.

Make health insurance actual insurance. It used to operate this way. Most individuals had insurance to protect them from accident, surgeries, hospitalization and other catastrophes. The typical health policy did not pay for doctor visits or routine expenses. If an individual paid for routine health expenses themselves rather than have a third party payer (government or an insurance company) pay for them, they might use their health care more responsibly, take better care of themselves and make healthier choices when it comes to diet, exercise, and smoking cessation, for example.

How do we know this? When something is individually owned it is better cared for than when something is shared in common. Think about it. When you pay for something yourself, whether it is a car, shelter or something else, you will take care of how you use it since it is a personal investment. When you don't own something you don't take care of it. This is called the tragedy of the commons and while it is a theory which has been applied mainly to the difference between individual landowning vs. the exploitation of lands held in common by the public, it fits health care well. Incentives matter and if a market existed in health care which empowered individuals to take better care of themselves, receive benefits for doing so and lessen the cost of health care, wouldn't that be worth pursuing?

If we sought the above reforms we would create a huge paradigm shift in health care in America. Costs would go down, health care would be controlled by individuals rather than by third parties, and a market would be created. This might reverse the above percentages of those who receive their health care from employers and government-wouldn't it be great if those numbers were 5 percent rather than 75 percent as they are now? Government funded care would be saved for the truly needy and for those individuals who have no ability to care for themselves.

Paradigm shifts are not wishful thinking. They can and do occur. It is high time we start thinking and applying such a shift to health care.

Wednesday, July 2, 2008

Lessons from the "Robber Barrons" Era 

By Gregory L. Schneider

In his book The Myth of the Robber Barons (1996), Burton Folsom eviscerates the idea that capitalists exploited the people during the industrial revolution--and provides some inspiration for health care reform.

The theme of business-as-exploitation developed as a result of the Great Depression of the 1930s, a time when businessmen were not held in high esteem. It was also a result of Matthew Josephson’s book The Robber Barons (1934) which first applied the old medieval term to individuals like John D. Rockefeller, Jay Gould and Andrew Carnegie.

Folsom shows how problematic the term is for a description of all businessmen during the industrial era. Some deservedly exploited the public good, bilking stock owners, the American Treasury and exploiting labor to make huge profits which were not subject to taxation or their firms to regulation. They were political entrepreneurs and they produced a shoddy product at a higher price than the true market entrepreneurs Folsom profiles in the book.

The market entrepreneurs produced a product at less cost and delivered superior service to their customers. They were innovators and they legitimately benefited from the rewards of doing business right. They did not look for political favors nor did they seek the help of government to build their firms and market their products. They include, in Folsom’s interpretation, Great Northern railroad builder James J. Hill (the only western railroad built without government land grants and the only major railroad never to go into bankruptcy); Andrew Carnegie; and Rockefeller of Standard Oil, who produced kerosene so cheaply that “only the rich could afford to use candles.”

I was thinking of how much our current health care system bears resemblance to Folsom’s apt distinction between political and market entrepreneurship. On the one hand we have a health insurance system which rests on public and private insurance with the pricing mechanism determined by the Medicare system. In other words, there is no true market for health care because the price is not set by market forces, but rather by third parties who control the market and do so, as much as anything else, because of a system politicized by government entry into health care in the 1960s with the creation of Medicare and Medicaid.

What needs to be done instead is to create an actual health care market, a pricing mechanism that is transparent and depends on consumer demand for services and the institutionalization of reforms which would empower individuals to take control over their own health care and health care spending rather than leaving it to the political entrepreneurs in insurance companies and government.

It is possible to have a market in health care. Plastic surgeons charge a price for their procedures (some also take insurance and Medicaid patients); Lasik eye surgery pricing is known up front as well.

Wouldn’t it be nice to know what the price of a procedure is when you receive it? If insurance truly acted as insurance—subsidizing risk and paying for catastrophe such as extended medical needs, surgery, hospitalization and other expensive items.

It could work. As Folsom’s book shows, there were innovative market entrepreneurs who took risks, profited, plowed the profits back into their firms and developed even better and more efficient services and products. If it worked for steel, oil and railroads (among other things); there is no reason why such a market can’t work for health care as well.

Thursday, June 5, 2008

The Benefits of Retail Health Clinics 

By Gregory L. Schneider

Categories:  Kansas, Retail Clinics

Sarah McIntosh, my colleague at the Flint Hills Center for Public Policy, offers Kansans a review of retail health clinics, in a policy paper, Adding Health Care to Your Shopping List: The Emergency of In-Store Clinics (PDF). It discusses the origins of these clinics, their benefits, objections to them, and consumer responses.

Friday, May 30, 2008

Your Cigarettes or Your Job? 

Turnpike authority says "no smokers"

By Gregory Schneider

Categories:  Kansas

Some of the more despised people in America are not BIG OIL executives or even the grandstanding politicians who spend most of their time scolding them about what the price of gasoline should be. BIG GOVERNMENT is not despised either despite the impact it has on individual liberties and on your pocketbook. BIG TOBACCO is not even the enemy anymore. Remember, they paid off BIG GOVERNMENT and BIG TORT LITIGATORS and admitted their guilt. Now they are free to go. Even BIG FAST FOOD and BIG INSURANCE COMPANIES cannot draw the ire of most Americans these days.

No, the most despised people in America are the little smokers, who are forced to huddle in dark corners to puff away while people shun them as if they were Gollum eating grubses and wormses deep in the Misty Mountains while plotting to steal the ring back from Frodo. They can no longer smoke (in most states—Kansas is still somewhat sensible) within fifteen feet of a building as if some small plume of smoke may waft through the double-paned security glass, drift up forty floors and kill some poor government office worker finding out ways to further hinder smokers from puffing away in public.

Now we have a story posted on the Kansas Health Institute website discussing how the Kansas Turnpike Authority board will no longer hire smokers as a way of reducing health care costs. The turnpike authority is a public and private company and Michael Johnston, the Authority president, was quoted saying that employees who smoked used more health care (and drove up health care costs) to the point where health care was now costing the Authority about 10 percent of its revenue.

It is perfectly understandable that Johnston wants to reduce health care costs but he is going about it the wrong way. The story relates how “everyone who is hired by the KTA must sign an affidavit stating that neither they nor their spouse are tobacco users. Once hired, they must consent to random drug tests that in addition to screening for illegal substances detect nicotine.” Drug tests to detect illegal substances are understandable from a law enforcement perspective, but tests which detect a legal product, one funded heavily by BIG GOVERNMENT agricultural subsidies?

A more prudent policy to lower health care costs to employees of the Turnpike would be to give them control over their own health care. We need policies designed to move us away from the archaic employer-sponsored insurance of the past (where costs are borne by the employer who also receives the tax benefit for providing health insurance) to one which empowers the individual consumer to make their own choices regarding health care (and receives the tax benefit for doing so). If the employee paid for their own health care—let’s say through a Health Savings Account—and continued to smoke, then the burden of paying for the habit in medical terms would fall on that individual. Costs of health care would probably decrease as the individual would be able to see the impact of smoking on the increased costs of their own health care and (probably) take action to cease smoking. These policies would put the Turnpike Authority on the fast lane of lowering health care costs.

Friday, May 2, 2008

Insurance Mandates: Causing a New Problem 

By Gregory Schneider

Categories:  Insurance Regulation, Kansas

One reason for the high cost of insurance lies in the mandates governing the insurers. Mandates are politically inspired and government-backed add-ons to insurance which raise the cost of insurance for everyone and blocks access for those without insurance.

The Council for Affordable Health Insurance (CAHI) has studied health insurance mandates in the fifty states. As of 2006, states had more than 1,800 mandated benefits requiring insurers to provide coverage for treatments ranging from mental illness, maternity or any number of other maladies. In this year’s session the Kansas legislature heard testimony to provide a mandate for bariatric surgery.

A 1999 study by economists Gail Jensen and Michael Morrisey of the Health Insurance Association of America showed that "as many as one in four individuals who are without coverage are uninsured because of the cost of health insurance mandates."

What is the problem with mandates? It forces insurance companies to provide benefits for people who don’t want them and yet are still forced to pay for them. "Mandating benefits," according to CAHI, "is like saying to someone in the market for a new car, if you can’t afford a Lexus loaded with options, you have to walk. Having that Lexus would be nice . . . but drivers with less money can find many other affordable options, whereas when the price of health insurance soars, few other options exist."

In CAHI’s study of the states, Kansas falls somewhere in the middle of the pack when it comes to mandates. Kansas has thirty-seven insurance mandates, eighteen catalogued as benefits and five for covered persons. Out of the eighteen benefit mandates only five are mandated by fewer than half the states (bone mass measurement, diabetes self-management, mastectomy, mastectomy stay, maternity). Out of that group only bone mass measurement is mandated by fewer than fifteen states.

The thirty-seven insurance mandates make Kansas about average. Idaho, as of 2007, had 16 mandates (on the low end) while Minnesota had 63.

Mandates are costly and too many mandates make health insurance more expensive thereby contributing to problems with access. One way to improve the situation is to allow the purchase of health insurance across state lines. If Idaho has fewer mandates than Kansas, then allow an average 30 year old male to purchase health insurance in Idaho (provided it meets the requirements of the Kansas Department of Insurance as a product salable in the state) to help lower his costs.

Such a situation will not work for everyone. Some individuals, due to preexisting conditions or chronic diseases, will not be able to purchase health insurance. There will always be a need for a safety net of public care for such individuals. But it might just work for those struggling to purchase health insurance in states where mandates have made such insurance more costly.

Friday, April 4, 2008

It’s Not Just Your Health, It’s Your Freedom 

By Gregory Schneider

The title of these comments—shamelessly borrowed from a Mr. Goodwrench ad campaign of a few years back--is indicative of where we should be headed in the health care debate as the end of the Kansas legislative session draws to a close. Health care reform should be concerned with creating a system which promotes personal freedom, choice and fiscal sanity designed to improve health care for everyone.

Health care has been hotly debated the past month in Topeka and the compromise solution being proffered in both the House and the Senate, subject to the inevitable reconciliation between the two bodies which will be worked out in April, is not in the best interest of maintaining free choice and expansion of consumer-driven alternatives. Rather the Kansas legislature is on the verge of expanding the state’s role in health care in a manner damaging to fiscal responsibility and consumer choice.

Last year the Kansas House agreed to a compromise bill—Senate Bill 11—which empowered the Kansas Health Policy Authority (KHPA) to explore a number of reform options and to report back to the Governor and Legislature by November 1, 2007. The KHPA was asked to consider consumer-driven alternatives as part of its package of reforms; however, it failed to consider any and failed to include leading advocates of such reforms in its deliberations.

The major stumbling block, aside from the smoking ban and increased taxes, was the idea of premium assistance. Premium assistance was a measure introduced as part of SB 11 by Senator Jim Barnett (R-Emporia) to assist in the purchase of private insurance for individuals under 100% of the Federal Poverty Line (around $22,000 per year in income). It was to be phased in, beginning in 2009, to help those under 50% FPL (around $11,000 income) to purchase private health insurance. At least that’s what many legislators understood premium assistance to mean.

What it meant for the KHPA was something different—an expansion of Medicaid to cover those individuals under 100% FPL not currently covered by Kansas Medicaid (which only provides coverage to those 35% or less FPL). The fiscal note on the proposed expansion of premium assistance was too large for many legislators to consider; in the Senate, lawmakers stripped premium assistance from their bill (SB 541) in favor of an expansion of HealthWave to 250% FPL (to fund children whose parents make under $44,000 yearly income). The problem with this is it does nothing to help low income Kansans and expands Medicaid for the middle class population.

The bills are not nearly considering enough of the consumer-driven alternatives to more government run health care. How can needy individuals purchase private insurance which is cost effective and allows for them to take control over their own health care spending? There are cost effective insurance products, such as Health Savings Accounts (HSAs) and Section 125 cafeteria plans which could do this without inevitably expanding the government’s role in health care.

The original House bill (HB 2934) introduced in February by Rep. Jeff Colyer (R-Overland Park) contained many of these provisions and some are still alive in SB 81. But we need more action on these measures or the government’s role in health care will expand; in the end that affects not only the health care of Kansans but their freedom as well.

Friday, March 7, 2008

Private Hospitals, Sensible Prices 

By Gregory Schneider

Go into your doctor’s office and ask the price of an office visit. They may be able to tell you what they charge for an office visit (that is, what the discounted price of a visit is after the insurance company is billed for services). The doctor doesn’t set the price for services--the third-party payer establishes the price. If you were paying cash or using a health savings account--in other words paying for services rendered at the time of service--a doctor may be able to negotiate a price with you, saving expenses and hassles by not dealing with the paperwork required by Medicaid, Medicare or insurance companies. 

One way to lower costs of health care would be to rearrange the stacked deck in favor of third-party payers and free up individual consumption of health care. Health Savings Accounts are a powerful tool to do this as is the rewriting of the federal tax code to allow individuals the ability to deduct their health care expenses to the levels businesses are currently allowed.

But another way to reduce costs was discussed in the February 24, 2008 story in the Wichita Eagle. Galichia Heart Hospital, a private hospital specializing in heart-related diseases, has decided to charge a flat fee of $10,000 for a common open heart procedure. Galichia CEO Steve Harris said, “We’re very serious about presenting cost-effective products and options for our community. . . .This isn’t just a good rate. It’s a world-class rate.”

Indeed it is. Consider that the two largest hospitals in Wichita, which have exclusive contracts with insurance providers, charge as much as $35,000 for open heart surgery. Galichia is hoping to attract individuals without insurance, to reach out to those who are cost-conscious and to attract medical tourists from abroad, particularly England and Canada where waiting lists for surgeries in their socialized medical systems are the norm.

Galichia as a private surgical hospital has some advantages over other providers when it comes to offering the lower rate. They are outside the Medicare and private insurance pricing structure. They don’t have to see Medicare patients as other hospitals are required to do. They also are not required to charge for services based on the provider-insurance company contract. This gives them the advantage to be able to charge what they want for a service.

Regular hospitals are required by law to accept all patients, regardless of ability to pay. Galichia is not. As a private surgical heart hospital they accept the patients they want and base their acceptance on the ability to pay.

By reducing the costs of the basic open heart surgery procedure they have opened up a necessary discussion in the pricing of health care. If Galichia can do this much more efficiently and at a lower cost, why can’t the government and private insurance systems promote a more price sensitive, consumer-driven health plan which promotes lower costs, price transparency and allows individuals to choose for themselves where they go for procedures? If Medicaid patients could be included in such a reform of the basic way health care is funded and individuals are insured, costs would go down.

The recognition that cost is the main concern of most Americans when it comes to health care, especially when it comes to costs of health insurance, is a positive outcome of the national discussion on health care that has raged in the past year’s presidential campaign. Too often, however, the perceived solution is that we need more government run health care. Universal health care funded by the government (or a reform of the mixed system which currently exists with greater government inducements for individuals to purchase health insurance) has been the proposed solution.

The solution may be much simpler. Reduce the costs providers and insurance companies charge, empower individual consumers, create price transparency, reform the tax code to allow individual purchasers of health care to receive the full deduction corporations receive for offering health benefits—all of these are ways in which to reenergize health insurance and to prevent increased costs from bankrupting Americans and hurting the competitiveness of American business.

Even Canadians recognize the benefits outlined above. According to Canadian Rick Baker, who connects clients in Canada with surgical hospitals in the United States, “The solution to America’s health care problems is (for) people to find a way to negotiate good prices.” It would be nice to have more American politicians recognize this as a solution rather than focusing on universal coverage. Costs come first and they can come down, but it will take a major restructuring of our health care system. Galichia has shown one way to do this; let’s see if other providers can follow.

Thursday, February 21, 2008

Employer-Based System is Dying 

By Gregory Schneider

In this election year, we will hear a lot about plans for health care reform. From a philosophical and economic perspective the plans which focus on empowering the consumer and developing a true market in health care are the best. The plans which focus on creating more government bureaucracy and impediments to market based reforms are the worst. Why would this be the case?

The biggest stumbling block in health care is the fact that a true marketplace for health services does not exist. In fact one can argue that since the creation of employer-sponsored health insurance during World War II, such a market has never existed. As a result of favorable tax rulings the employer who provides health insurance receives the tax benefit for doing so. If you are fortunate (and most Americans were until recently) to receive such insurance from an employer, it was a good benefit for you and a terrific tax benefit for your employer.

However the changing nature of the economy has left fewer Americans working for large corporations which provide health insurance. The growing costs of insuring employees has forced many firms—especially small businesses employing twenty or fewer employees—to stop providing insurance to their employees. Individual contract employees and the self-employed market also are hurt by rising costs of insurance coverage. When individuals purchase insurance they do not receive any tax benefit for doing so. The entire cost of their health insurance is borne by them without any tax deductibility.

Meanwhile, unrelated to the market for insurance, health care costs have grown tremendously over the past thirty years. Part of the explanation for this lies in the fact that technological changes in health care have led to some major advances in the treatment and curing of disease. The United States has the best health care system in the world and technological advances are a big reason why.

But another cost driver has been government entering the health care system. Much like government support for education, government entry into health care with the creation of Medicare and Medicaid in 1965 has led to staggering inflation in medical costs. Medicare and Medicaid replaced charitable health care, in many situations, with government funded care. Medicare’s reimbursement rate for doctors has also impacted the private insurance market.

What we have is not a market system at all. We have a government system which funds nearly half of all health care in the country and which some politicians, sensing the mood which grips the electorate this year over growing health care costs, wish to expand. What certain politicians believe we need is a universal health insurance system funded by government. They say this would solve all our problems.

Private insurance based on an employer-funded model is no better when it comes to market forces. This insurance model is dying. Similar in many ways to Social Security, it was predicated on an industrial economic model no longer prevalent in American life. One can see this most aptly in the Detroit automakers’ desire to eschew their "corporate responsibility" to continue paying for the costly health insurance of workers, and especially pensioners. The bigger corporations favor a universal government model since they would benefit by having government take this responsibility from them. However, most Americans today work for small firms or are self-employed. The old model of employer-based health insurance is not long sustainable.

The best solution for health care is to create a true marketplace for health care insurance and services. Some reforms have already been enacted, such as Health Savings Accounts, individually owned insurance accounts which place the control of health care spending back in the hands of the consumer rather than a third party payer. While HSAs have grown in recent years few insurance companies market them as much as they should. They offer the best hope for small businesses to be able to provide insurance to their employees while reducing the costs of insurance and the costs of health care as well.

Other ways of reforming health care include tax code changes which allow individuals (and families) to deduct the costs of their health care insurance under federal tax law. President Bush recommended this in his State of the Union address in 2006 yet nothing has come of this in Congress. Finally, allow health insurance to be portable from job to job and from state to state. Auto and life insurance are portable—why is health insurance so heavily regulated? Reforms of the insurance market including ending community rating and guaranteed issue would also contribute to a stronger marketplace for health care.

The old governmental solutions have failed everywhere they have been tried. Yet in America we seem to be rushing headlong towards such a model. What we need in health care, as we need in elementary and secondary education, is a true marketplace, the power of choice which will improve health care, lower costs and improve efficiencies.

Friday, February 15, 2008

Smoking Bans, Taxes, and Liberty 

By Gregory L. Schneider

In November 2007 the Kansas Health Policy Authority (KHPA) published its 21-point reform plan to reform health care in Kansas. Now that the legislative session has begun, there has been some movement towards the implementation of the reforms. A group of senators introduced a smoking ban for consideration in the legislature, the first of a projected three bills to be submitted on the recommendation of the KHPA.

Senate Bill 493 bans smoking in public areas and "any place of employment." Many states have passed smoking bans as a way of signifying their commitment to prevent the hazards of second-hand smoke from impacting other people who come into contact with smokers at restaurants, bars or other public areas.

But consider this, especially if you run your own business and have a stake in providing services to consumers. A ban on smoking in a bar or restaurant may cost you business. A ban on smoking in state-owned casinos created by legislation in last year’s session and endorsed by the governor as a revenue enhancer for Kansas may wind up actually costing the state revenue. There are many Indian nation casinos in Kansas and Oklahoma which are but a few hours from big metropolitan areas such as Wichita and Kansas City. The Indian casinos won’t be affected by the state ban. If the state bans smoking in public buildings, what is to stop many Kansans from crossing the border in order to have a smoke while gambling?

The bigger issue involved with the ban concerns individual liberty. When it comes to consumption of a legal product, individuals should have the right to make their own choices regarding their own lives, even if others consider them to be poor choices. If a business owner wants to serve people who smoke, as well as those who don’t, that’s the business owner’s choice. Why is it the government’s business who smokes in a private establishment? People who don’t want to be around smoking can choose to take their money to establishments which ban smoking by choice.

Government wants to remove all risk from individual lives and they do so in the most hypocritical way possible--reducing smoking saves money in health care costs they say (which can then be spent on something else). The government then proposes a tax increase on cigarettes to fund health care reforms. Cost is the biggest issue being focused on in this debate. Recently some doctors in Britain were reported to suggest that lifelong smokers with chronic diseases related to smoking and elderly patients who need liver transplants after drinking liquor their entire lives might be better off being denied treatment. Is this what we can expect when costs trump compassion?

The smoking ban is another blow to the responsible choices of those who are free to smoke tobacco (since it is legal) but are constrained in doing so because of the purported impact of second hand smoke on the health of others. The smoking ban is yet another step on the road to the nanny state and another stake in the heart of individual liberty.

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