Posted on September 15, 2008

No on Prop. 101: It's a false pitch that blocks reform


By Phil Lopes and George Pauk
Tucson Citizen
Guest Opinion: Health Care Choice
Published: 09.15.2008

When Arizona voters cast their ballots this November, one of the questions they face is whether to vote yes or no on Proposition 101, the misnamed Freedom of Choice in Health Care Act. They should definitely vote no.

Prop. 101 is a constitutional amendment that would forbid restrictions on “a person’s freedom of choice of private health care systems or private plans of any type.”

Sounds like more freedom, doesn’t it? In fact, Prop. 101 protects the private health insurance industry.

Its passage would give the industry a privileged place in our state’s basic law. The result would be less freedom for average Arizonans, not more.

Remember, this is the industry that diverts about 31 cents of every health care dollar toward administrative costs, including big payouts for shareholder profits, marketing expenses and outlandish executive salaries.

Prop. 101 would limit Arizonans’ choices to plans offered by these private insurers, and it would block any steps toward badly needed health care reform.
Let’s step back for a moment and ask: What kind of choices do people want in health care?

They want access to comprehensive, affordable, high-quality care. They want to choose their health practitioner. They want to choose their hospital or other service delivery site.

Under our current health insurance system, Arizonans have none of these choices.

The U.S. Census Bureau reported last month that 45.7 million Americans - including 1.2 million Arizonans - lacked health insurance in 2007.

Employer-sponsored coverage continues to shrink, as do employee health benefits. Access to care, and availability of care, especially in rural areas, is diminishing.

The Commonwealth Fund, a research group, estimates that another 25 million people were “underinsured” last year - i.e., they had insurance but still wouldn’t be able to afford care in the event of a serious illness or injury.

Health insurers are further restricting what they cover - what they’ll pay for and what they won’t - and they increasingly impose big deductibles and co-pays.

They are also constantly changing their lists of “in-network” doctors and hospitals.

Choice of doctor or hospital? What a quaint idea! Just see what happens when you go “out of network.”

Thus, in the name of “freedom” and “choice,” Prop. 101 would give us neither. It would further push Arizonans into the iron grip of an industry that is failing us - an industry in which many put profits above the delivery of sorely needed health care.

There are many potential unintended consequences of Prop. 101.

For instance, if the Arizona Department of Insurance determines that a particular health insurance carrier does not meet set criteria for fiscal solvency and wants to bar it from offering unsound policies, the department would be prohibited from doing so if only one person in the state wanted to purchase this policy.

Wouldn’t it be better if every resident were guaranteed comprehensive, high-quality health care - at least as good as what is offered to our state employees?

If each person could choose his own health practitioner, hospital or clinic (working within our private delivery system), allowing continuity of care, better follow-ups and fewer medical errors?

Wouldn’t it be better if our state’s residents didn’t have to worry about crushing medical bills because they knew a social insurance fund would cover the costs? If every Arizonan were in one big pool, spreading the risk more equitably?

If health care costs were controlled by, for example, bulk purchasing of drugs and medical supplies?

Such a plan exists: the Arizona Health Security Act. Its enactment by our Legislature would go a long way toward curing our state’s health care ills.

It’s practical, fair and eminently realistic.

But take note: The passage of Prop. 101 would prevent Arizonans from choosing that better path, among others. And it’s being bankrolled by at least $434,000 - mainly from business interests, much of it from out-of-state.

In a recent newspaper interview, Dr. Eric Novack, a Phoenix-based orthopedic surgeon and leading proponent of the measure, conceded that Prop. 101 would constitutionally preclude “certain options.”

So the real aim is to preclude certain choices, Dr. Novack?

Arizona voters should not be deceived. They should vote “no” on Prop. 101.

State Rep. Phil Lopes represents Legislative District 27 (central, west and southwest Tucson), is leader of the House Democrats and is the sponsor of the Arizona Health Security Act. George Pauk is an internal medicine physician in Phoenix and a member of Physicians for a National Health Program (