IT IS one of the most ubiquitous taxes we pay, now levied on virtually everything we buy, sell, and use. The tax accounts for 30 percent of the price of a stepladder and over 95 percent of the price of childhood vaccines. It is responsible for one-quarter of the price of a ride on a Long Island tour bus and one-third of the price of a small airplane. It will soon cost large municipalities as much as they spend on fire or sanitation services.
Some call it a safety tax, but its exact relationship to safety is mysterious. It is paid on many items that are risky to use, like ski lifts and hedge trimmers, but it weighs even more heavily on other items whose whole purpose is to make life safer. It adds only a few cents to a pack of cigarettes, but it adds more to the price of a football helmet than the cost of making it. The tax falls especially hard on prescription drugs, doctors, surgeons, and all things medical. Because of the tax, you cannot deliver a baby with medical assistance in Monroe County, Alabama. You cannot buy several contraceptives certified to be safe and effective by the Food and Drug Administration (FDA), even though available substitutes are more dangerous or less effective. If you have the stomach upset known as hyperemesis, you cannot buy the pill that is certified as safe and effective against it. The tax has orphaned various drugs that are invaluable for treating rare but serious diseases. It is assessed against every family that has a baby, in the