IT’S APPALLING THAT South Carolina was one of five states that
didn’t spend a penny of its cigarette lawsuit settlement money on
smoking prevention and cessation programs this year.
But it’s difficult to criticize the Legislature for diverting the
money to more immediate needs, such as keeping Medicaid solvent.
When you get yourself into a situation where you must choose between
providing medical care to someone who’s going to die without it and
providing programs that will keep people from eventually developing
medical problems that demand care, even the most responsible
government (or individual) is going to make the decision to
temporarily forego those preventive measures.
What is disturbing — and what needs to be criticized — is that
our state’s failure to fight smoking is not simply a reaction to
tight budget times.
When the state was rolling in money, our Legislature never
adequately funded smoking prevention programs. We’ve never spent
more than $2 million a year to try to keep kids from smoking, or to
help people stop once they’ve started, even though we used our share
of the tobacco settlement money to set up a $440 million trust fund
and the Centers for Disease Control says South Carolina needs to be
spending $24 million to $62 million each year in anti-smoking
efforts.
Yet it is indisputable that such expenditures are smart
investments. Studies show that we can cut the number of teen smokers
in half, and even reduce adult smoking, with aggressive media
campaigns. The payoff comes in reducing the huge amounts of money
taxpayers spend to provide medical care for people who have diseases
caused by smoking. Every household in South Carolina is paying $485
a year in taxes to provide medical care for people who have diseases
caused by smoking. The total tab for smoking-caused illnesses in our
state is $854 million a year — with $307 million of that covered by
the taxpayer-funded Medicaid program.
What’s even more disturbing — and what demands even more
criticism — is the fact that this short-sighted approach to public
policy is not limited to smoking. Our state has never taken
seriously enough the need to invest in any kind of prevention
program. We’ve never invested enough in prison-based education and
drug-treatment programs to steer criminals into jobs instead of more
crime when they’re released. We’ve never spent enough on public
education and job-training to make sure kids can get good jobs and
stay out of trouble to begin with. We’ve never spent enough on early
childhood programs to make sure kids are ready to learn when they go
to school — and thus able to take advantage of the education
programs that help them lead productive lives.
We know that this approach is going to cost us more in the long
run: The lack of an adequately educated population means there are
fewer good jobs in the state, which means we have to spend more to
provide Medicaid and other services for people who don’t have jobs,
and we have to spend inordinate amounts of money on prisons for
those who turn to crime.
This isn’t a radical concept. To the contrary, it’s the stuff
that the sage cliches your mom taught you are made of: A stitch in
time saves nine; an ounce of prevention is worth a pound of cure.
Cliches become cliches because they speak universal truths. As
individuals, most of us would be a lot better off if we followed
Mom’s advice more often. Society is no different.