Cigarette smoking is the leading cause of preventable disease and death nationwide. Annually, over 32,000 Floridians die from smoking tobacco products. This surpasses the combined mortality rate from automobile accidents, illegal drugs, alcohol abuse, murders and suicides. Despite these risks, an estimated 2 million Floridians continue to smoke tobacco products.

Smoking tobacco is not only deadly, but it is also costly. In Florida alone, health care costs directly related to smoking exceed $10 billion annually. About $1.62 billion of the cost is paid for with taxpayer dollars in the form of Medicaid. To cover the costs of smoking-caused government expenditures, Florida taxpayers pay approximately $840 per household.

Lawmakers — from Tallahassee to Washington, D.C. — should assist individuals in the transition away from cigarettes and toward less harmful alternatives, including heated tobacco products (HTPs). Unlike traditional cigarettes, HTPs do not burn tobacco. Rather, HTPs heat a small amount of tobacco just below the point of combustion, creating an aerosol of nicotine without the smoke. According to the U.S. Food and Drug Administration (FDA), the production of harmful and potentially harmful chemicals is significantly reduced when there is no combustion. Although the health risks are not eliminated, scientific studies show an average 90 to 99% decrease in harmful and potentially harmful constituents, suggesting a complete transition from cigarettes to HTPs would improve the health of tobacco users and reduce societal costs.

The FDA currently recognizes a risk continuum for tobacco products, with cigarettes representing the highest risk. Florida Senate Bill 1418 and House Bill 785 propose excluding heated tobacco products (HTPs) from the statutory definition of “cigarette,” recognizing that non-combustible HTPs warrant different tax treatment than more harmful cigarettes. This judicious approach could mitigate the harms associated with tobacco use and improve public health. HTPs may represent a less harmful alternative, but their market penetration hinges on legislative classification and taxation of these novel products.

Introducing HTPs into the U.S. market and providing incentives in the form of lower taxes compared to those of cigarettes can go a long way toward reducing cigarette use. In Japan, for example, cigarette sales dropped more than 50% during the first 10 years after HTPs were introduced. With the right tax structure and policies, these products could have a similar impact in the U.S.

Florida legislators should seize the opportunity to help more Floridians transition away from cigarettes and toward less harmful forms of tobacco. By implementing a risk-based tax policy for tobacco products, lawmakers can incentivize more adults who smoke tobacco to make the switch to these lower-risk alternatives. Not only would this improve and promote public health for generations to come, but it would also best serve Florida taxpayers by reducing the cost of long-term health care and improving health outcomes for smokers.

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Dominic M. Calabro is president and CEO of Florida TaxWatch.

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Sen. Clay Yarborough’s proposal to fix a long-standing gap in state law that penalizes certain survivors of deaths at the hands of negligent doctors continues to move.

The Appropriations Committee on Health and Human Services is the latest panel to advance SB 734, which Yarborough calls a “clean repeal” of state statute — 768.21(8) — prohibiting adult children and their parents from collecting negligence and non-economic “pain and suffering” damages for medical malpractice.

Yarborough says the current state of play “singled out a narrow group of survivors who cannot recover non-economic damages in the case of a wrongful death due to medical negligence, even though the same damages can be recovered by survivors for a wrongful death that is caused by all other forms of negligence.”

Florida is the only state in the nation with the restriction on its books. Lawmakers passed it in 1990 when the state was trying to rein in increasing medical malpractice costs and attract more doctors to the state.

Yarborough stressed that most doctors do a good job.

“This is in no way a knock against the medical profession or anyone in it because Florida has some of the best health care providers and institutions in the country and beyond. I do not have a statistic to quote, but I will venture to say, we likely have a low single-digit percentage of those in Florida’s health care community that have issues with malpractice or negligence,” Yarborough said, framing his bill as being about “accountability” and “the value of life.”

More than two dozen speakers showed up with passionate cases for or against the legislation.

Opponents made the case that medical malpractice insurance has gotten more expensive and more difficult to procure in the last few years, so the pool of claimants should be expanded.

Tallahassee Memorial Hospital’s Judy Davis, a risk manager, said that “bad, unfortunate outcomes” do happen, but only 1 in 4 of them involve “some degree of negligence.”

“When physicians and hospitals have to pay large sums of money, it does reflect in higher insurance premiums,” Davis said.

Andy Bolin of the Florida Justice Civil Reform Institute said his clients “face the highest medical malpractice premiums” in the U.S. He argued that “infusing” new cases into the system would make that problem worse, and suggested that if the bill must go forward, damages need to be capped.

Associated Industries of Florida’s Adam Basford urged lawmakers to take a “holistic” view of the problem and “mitigate” the impact on providers.

The Florida Chamber’s Carolyn Johnson warned that the bill would increase litigation, insurance rates and health care costs, while decreasing access to care.

Proponents argued that survivors need the opportunity for compensation without caps.

Some told their personal stories of treatment deferred with horrible consequences and no recourse, while their advocates made the larger case for change.

AARP’s Karen Murillo said current law discriminates against older adults, arguing that people are being deprived of justice and rejecting the idea that this class of claimants should be held responsible for reducing liability for medical providers.

Ethan Perez described maltreatment for his grandfather that included injection with hydrogen peroxide, which an autopsy deemed to be “homicide,” but which was protected under current law.

“Civil lawsuits have an opportunity to reveal criminal wrongdoing,” Perez said, adding that his family is “being left without justice” due to the current “inhumane and barbaric” free kill law.

Lauren Korienko said her mother was found dead in a hospital bed, “covered with blood” after a minor surgery because medical professionals let her bleed to death over the course of 24 hours and succumb to septic shock. Her family was aghast to find they lacked recourse and protection under state law that makes Florida a “sanctuary for medical malpractice.”

Darcy McGill, another person who buried her mother after maltreatment, called Florida’s “free kill” law the state’s “dirty little secret.”

“I’ve yet to hear one good reason why my life is less valuable because I’m married and without children,” McGill said.

After the testimony, Senators diverged on whether the bill could work ahead of the bill moving forward.

Republican Sen. Gayle Harrell said the right move wasn’t this bill, but was to empower the Board of Medicine.

Republican Sen. Jason Brodeur said other states had these provisions without caps, so Florida should as well.

Democrat Sen. Darryl Rouson said the passage of the bill would be a “milestone moment” for people without recourse until now.

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Jesse Scheckner of Florida Politics contributed to this report.

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