Cook County’s Sweetened Beverage Tax of November 2016 – It’s A Matter of Choice!

In early November of 2016 the Cook County Board passed a one cent per ounce tax on sweetened beverages. Almost from the day the ordinance was passed, organizations from the beverage industry and small business have publicly opposed the tax. There were organized protests in front of the County Building on June 27, 2017. At the last minute, the Illinois Retail Merchants Association, which is affiliated with the Illinois Beverage Association, filed an appeal asking for a Temporary Restraining Order against collecting the tax.

As the battle lines between purveyors of Sweetened Beverages (SB) and the County government became drawn, one might question the wisdom of such a tax. The County position in favor of the tax was supported by every health related public interest organization. Sugar has been a part of dietary intake since the eighteenth century, but was used mostly as a “spice” until its production was more recently made easier and some cane sugar substitutes became readily available (including beet sugar). Like most spices, sugar has no documented intrinsic nutritional value. The nutritional labels on foods have no “recommended daily intake”, because the Food and Drug Administration hasn’t found one. However, several organizations worldwide have suggested that there is a level that should not be exceeded. They have suggested that a child of 7-10 years consume no more than 25 (20-30) gm daily[1]. The American Heart Association suggests that a woman take in approximately that amount, and that the average man take in no more than 36 gm.[2]

There have been multiple scientific reports that suggest increasing sugar intake is associated with obesity and its complications:

  • Diabetes
  • Hypertension
  • Heart Disease
  • Some Cancers
  • Arthritis

Thus, any initiative that will help dissuade people from consuming SB should help improve the public’s health. One estimate is that approximately a third of of the nation’s health care spending is related to complications of consumption of excess sugar.[3]

These observations would suggest that in addition to generating revenue by a tax, there would likely be a reduction of demand for sugar sweetened beverages. The reduction of demand should lead to enormous Public Health Benefits, potentially associated with a reduction in health care costs to the county upwards of $400,000,000.00 annually[4]. The cost reduction would likely take several years to realize, but should help decrease County costs over time that would result in a potential reduction in other taxes. One should understand that this type of tax is one of choice. Those who buy beverages that have added sugar or artificial sweeteners pay the tax. Those who substitute water, milk, or pure juices don’t pay it. Because it is a choice tax it is not inherently discriminatory. In fact, in one community the lower income residents had a greater decrease in SSB consumption than those with higher incomes, although in both income groups consumption decreased.

Overall, the Cook County SBT makes sense. Those selling these drinks claim that their business will be adversely affected. They will still make profits, perhaps a little less. This seems like a small price to pay for the potential public health benefits that disincentivizing SSB consumption should provide

Footnotes:
[1] A 12 ounce bottle of Sugar Sweetened Beverage provides between 30-39 gm of sugar (Aproximately 40%more than the recommended maximum).
[2] One Teaspoon of granulated sugar contains approximately 4 gm of sugar. (thus 6 tsp = 24 gm)
[3] Forbes Magazine in 2013 quoting a Credit Suisse report: https://www.forbes.com/sites/danmunro/2013/10/27/sugar-linked-to-1-trillion-in-u-s-healthcare-spending/#175314cb6ad1 accessed 7/3/2017
[4] Cook County Budgets $1,600,000,000.00 for Health Fund

About Ted

Edward B. J. (Ted) Winslow received an MD from the Faculty of Medicine of the University of British Columbia in Vancouver and an MBA by the Kellogg School of Northwestern University. Before getting his MBA, Ted practiced Cardiology and Internal Medicine at several Chicago institutions (University of Illinois, Veterans West Side, Illinois Masonic, Northwestern Memorial and Evanston Northwestern Healthcare – each one at a time). As a practicing physician, Ted has had experience in managing a medical practice, and implementing the adoption of electronic medical record systems
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