Tax the recliners. Televisions and computers, too. Tax books; if we’re reading, we’re not exercising. Spending a wintry afternoon curled with a novel is an “unhealthy lifestyle choice.”

We’re kidding, of course. Taxing Mainers for unhealthy choices is far from frivolity, though, since the Blue Ribbon Commission on Dirigo Health has now recommended several “sin taxes” to offset the program’s $57 million cost.

Smokers would pay 50 cents more per pack. Snacks, beer, wine, soft drinks and syrups would also be taxed, with all revenue going to Dirigo. Like shadowy figures from film noir, these items have become the “usual suspects” of negative public health.

Gov. John Baldacci credited the panel – locally represented by Chamber of Commerce chief Chip Morrison and Realtor Barbara Trafton – for reaching “agreement” on Dirigo reforms.

Uneasy consensus is a more accurate description, we’d say. With the eight-page report are the commission’s votes on the various recommendations; most were “agreed” by majority vote, with few points earning unanimous support.

The dissension inside the commission highlights a national trend: when it comes to the reducing health care costs, nobody has a winning idea. But hopeful signs are prevalent that honest-to-goodness results are coming.

President George W. Bush made health insurance a key part of his recent State of the Union address, and a bipartisan group of senators, earlier this month, announced the Health Partnership Act, which would fund state-level health insurance initiatives, perhaps as incubators for future federal legislation.

States such as Massachusetts, Vermont and California are pursuing aggressive programs to insure their uninsured, reflecting the reality that – as the dean of the University of Virginia Medical School, Arthur Garson, opined last week – “health care…is rapidly becoming the No. 1 domestic issue for voters.”

Compared to these initiatives, four-year-old Dirigo Health is gray at the temples. Maine is now alongside these insurance experiments, all searching for the “magic bullet” to penetrate the secrets of reducing health care costs.

The Dirigo report contains several positive steps. Altering Dirigo’s funding away from the controversial assessment on insurers called the “Savings Offset Payment” is smart; so is insisting on developing public repositories of data on actual medical costs, to spur “informed purchasing.”

Public dissemination of medical costs could inject some market forces into health care, which is a founding principle of Dirigo.

Sin taxes are a tired concept, however. The governor has already targeted cigarettes for a $1-per-pack tax in his biannual budget; similar Dirigo surcharges would further cement these policies as extortion, shredding whatever vestiges of “protecting public health” they have left.

During his campaign, Gov. Baldacci admitted Dirigo needed change. He’s been handed a decent blueprint, during his final term when politics are irrelevant.

Dirigo is not a total failure, yet, and the chance remains to make it the national model it was always heralded to be. It’s high time to fix the damned thing.

Just leave our recliners alone.


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