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Physician activism behind measure to bring freedom of health care choice
Arizona proposal lost by less than 9,000 votes, or four-tenths of 1%, during the general election.
Although Arizona’s Proposition 101 failed (click here to read related article), the 2-year journey to get the it to the ballot underscores the importance of physician activism in health care.
“I believe with absolute certainty that the system in which medicine is practiced is just as important as the care that we can provide,” Novack told Orthopedics Today. “I think that principles matter. If we advocate for the rights of our patients and their freedom to be in charge of their health and health care, then everyone who seeks good care and those who provide care will win in the end.”
Proposition 101
As part of the 2008 general election, Arizona voters decided the fate of the proposition, the Freedom of Choice in Health Care Act. The measure was sponsored by Medical Choice for Arizona; Novack is the group’s chairman.
The proposal would have amended the state constitution to include the following rights:
- to choose private health care;
- to spend one’s own money for legal medical services; and
- to opt out of a government-run health care plan without penalty.
Novack said that the measure would have ensured the people of Arizona a seat at the table during future health care reform discussions.
“With Proposition 101, we were saying that the cornerstone of health care reform must be the preservation and protection of rights of people to be in control of their own health and health care,” he said. “[We] need to build health care reform from these rights, because if we do not protect them, they will be sacrificed on the altar of health care reform.”
Close vote
The proposition failed by less than 9,000 out of approximately 2.1 million votes. Novack said that the opposition — funded entirely by groups that have government contracts for health care services — outspent the supporters five-to-one, and that the state’s governor was the spokesperson against the proposition.
“Most people, including those in health care, are not aware that these basic rights are being threatened in every statehouse and in Washington,” Novack said. “Given the intensity of the opposition, it is remarkable that Proposition 101 went from concept to ballot and received over 1 million votes in 18 months.”
Possible effects
The Arizona Health Care Cost Containment System (AHCCCS), the state’s only Medicaid agency, warned the public about possible unintended consequences of the proposition. Although Novack, backed by several independent legal opinions, said that the proposition would not impact the AHCCCS, the agency said that the vague wording of the measure could lead to changes to the program that would cost the state billions.
“AHCCCS did not advocate for or against the proposition,” Rainey Daye Holloway, chief public information officer for AHCCCS, told Orthopedics Today. “As a state agency, we have a fiscal responsibility that anytime something could have a monetary impact on the agency and cost tax payers money, we have to educate the public about what could be, and that is simply what AHCCCS did.”
Novack said that the close vote showed that the concepts of the proposal resonated with the public. His group is working on the language of the proposition and is continuing to look for ways to educate the public and physicians about the importance of acting to protect basic health care rights.
“Remarkably, in none of the 50 state constitutions or the federal Constitution, is there a right for you to be in control of your own health and health care,” he said.
“While some of the founders were against the Bill of Rights, everyone is happy that we have it today. … There are people in nearly every state proposing to take away some or all of those rights. Frankly, the tragedy in medicine — and even in organized orthopedics — has been a willingness to sacrifice basic principles, patient autonomy and individual liberty for the short-term gain of a few extra dollars.”
Editor’s note:
A representative from the Arizona state government was not available for comment at press time.
For more information:
- Rainey Daye Holloway can be reached at AHCCCS, 801 East Jefferson, Phoenix, AZ 85034; 602-417-4000; e-mail: Rainey.Holloway@azahcccs.gov.
- Eric Novack, MD, can be reached at Phoenix Orthopaedic Consultants, P.C., 5605 West Eugie #111, Glendale, AZ 85304; e-mail: ericnovack@mac.com.
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