259174 Charge for harm fees: Alcohol mitigation funding for prevention services and health care impacts

Tuesday, October 30, 2012 : 12:50 PM - 1:10 PM

Bruce Livingston, MPP , Alcohol Justice, San Rafael, CA
Alcohol taxation in the US is 40 years behind tobacco taxation. The charge for harm or mitigation fee approach to alcohol pricing and taxation has great potential. We define the mitigation fee model, describe partial implementation in 21 US states and present case studies of three recent US advocacy campaigns. This alternative to general revenue excise taxes calculates the governmental harm/cost from alcohol use, and applies fee revenue directly to health and public safety programs mitigating harm. Mitigation fees internalize the externalities of consumption: simultaneously raising prices, reducing consumption and harm, and subsidizing alcohol-related non-profit and government programs. A $1.4 billion model fee program was rigorously written into 2009 California legislation. Governmental costs for health, prevention and public safety programs were to be funded by ten cent a drink alcohol fees. A groundbreaking nexus study of San Francisco, California, found $18 million in annual health care and treatment costs, proposing a municipal charge for harm fee of 3-5 cents a drink. Despite extensive advocacy campaigning, both proposals were defeated in November 2010 through a statewide ballot initiative funded by oil, tobacco and alcohol corporations. The initiative created insurmountable two-thirds voting requirements but challenges are underway. In 2011 a health care coalition in Maryland, USA, won an alcohol sales tax increase dedicating revenues to schools, disability services and health care. Mitigation fees and dedicated alcohol taxes poll well and are a good policy alternative, but industry clout is often insurmountable.

Learning Areas:
Public health or related public policy

Learning Objectives:
Design an alcohol mitigation fee model for funding of alcohol-related programs. Describe the five types of health and safety government and agency programs that could be subsidized with a charge for harm fee. List the twenty-one states with alcohol tax or fee subsidies that mitigate harm.

Keywords: Alcohol, Prevention

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: As Executive Director of Alcohol Justice and Master of Public Policy, I bring 25 years of policy analysis and advocacy. I supervised campaigns to limit advertising to youth, expose inappropriate products such as alcopops and alcoholic energy drinks, fight decontrol of liquor sales, and raise taxes and fees on alcohol. I co-authored or supervised numerous evidence-based publications as director of Health Access Foundation, Senior Action Network, California Clean Water Action, and U.S. Environmental Protection Agency.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.