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Charge for harm: Alcohol and health care in The City

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Here is a tip: San Francisco is about to charge alcohol wholesalers for a portion of the health care costs of alcohol consumption. In concept, a “charge for harm” is a pretty sensible idea. If you knock down a stop sign with your car, it seems reasonable to charge you to fix it. Our American sense of fair play is that if you hurt someone, you should pay your share of the damages.

The proposed San Francisco Alcohol Mitigation Fee would charge alcohol wholesalers and a few other businesses for alcohol-related harm. The City Controller’s Office has conservatively calculated $17.7 million in city agency costs for health care and inebriate emergency medical transport. This includes $10.1 million in unreimbursed community substance abuse services and $4 million in emergency medical service transports by the fire department. San Francisco General Hospital, the Sobering Center, Mobility Assistance and Jail Medical Detoxification incur other alcohol-related costs.

The Alcohol Mitigation Fee will be assessed to wholesalers and distributors of alcohol to San Francisco. These are largely the owners of the beverage and beer trucks that blanket the morning streets to replenish the retailers, restaurants, hotels and bars. The nickel a drink equivalent charge will no doubt be passed through to stores and bars, and consumers could see an increase of a nickel, dime or slightly more. When that happens, it is hard to believe that the jolly booze businesses will be hurt, as their profit margins will stay up.

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Diageo (a London-based distilled spirits giant) is running a flush statewide campaign against alcohol harm mitigation fees, but may not hold sway at San Francisco’s City Hall. The City is running on fumes, and recovering costs from an alcohol fee could provide some fuel. While it is true that a small group of inebriates cost The City an extraordinary amount of money, the new fee will be a sustainable source of funding for focusing and coordinating the services that can deal with the most dysfunctional clients.

We all pay for the costs of alcoholism: drunken incidents that lead to violence and medical issues from alcohol use. Supervisor John Avalos’ mitigation fee shifts a portion of the cost burden from the general taxpayer to a small group of wholesalers who can be efficiently assessed for their contribution to the party.

Also in this net will be wine stores that directly receive products (such as Plumpjack —  enough said), big box stores that have their own suppliers, and microbreweries and brewpubs for the beers produced and sold on-site. A nickel or dime a drink at a microbrew is not going to break the bank when the price of a local brew is pushing a five-spot.

<p>California has had a recycling fee on bottles for decades, and it hasn’t killed the alcohol and beverage industry. A “charge for harm” on beer, wine and spirits at the point of first sale in San Francisco is long overdue. In waste management, it’s called a “tipping fee” for hauling garbage to a dump. It’s time for alcohol wholesalers to pay a fair tip for alcohol-related health care services.
 
Bruce Lee Livingston is executive director of Marin Institute (and a San Francisco resident).



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