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Arizona Medical Freedom to Choose, Proposition 101 (2008)

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Proposition 101, known by its supporters as Medical Choice for Arizona or the Freedom to Choose Act, appeared on the November 4, 2008 ballot in Arizona as a citizen-initiated constitutional amendment, where it was defeated.

The supporters said their goal in putting the initiative forward was to "prevent socialized medicine or further heavy regulation of medical care and health insurance" in the state. Titled "Arizona - Freedom of Choice in Health Care Act" and advanced by Medical Choice for Arizona, the measure aims to prevent "many of the abuses associated with socialized medicine and restricting its form to either residual welfare or a voucher system."[1]

In the wake of Prop 101's defeat, its supporters are pushing the Arizona Health Insurance Reform Amendment (2010), intended for the November 2010 ballot.

Election results

Arizona Medical Freedom to Choose
ResultVotesPercentage
Defeatedd No1,057,19950.2%
Yes 1,048,512 49.8%

Results according to the Arizona Secretary of State.[2]

Text of measure

The descriptive ballot title that appeared on the ballot said:

"Prohibits laws that: restrict person's choice of private health care systems or private plans; interfere with person's or entity's right to pay directly for lawful medical services; impose a penalty or fine for choosing to obtain or decline health care coverage or for participatin in any health care system or plan.

A "yes" vote shall have the effect of prohibiting laws that restrict a person's choice of private health care systems or private plans, interfere with a person or an entity's right to pay for lawful medical services, and impose a penalty or fine for choosing to obtain or decline health care coverage or for participation in any health care system or plan. Yes.

A "no" vote shall have the effect of retaining the current law regarding a person or entity's health care choices. No."

Supporters

The sponsor of Proposition 101 was Medical Choice for Arizona. The group's chairman, Eric Novack, is a practicing orthopedic surgeon.[3]

Other supporters included Americans for Prosperity, Former U.S. Deputy Secretary of Agriculture John R. Norton, The Arizona Chiropractic Society, and The Arizona Dental Association. [3] In October, nationally syndicated columnist George Will wrote in favor of the measure saying it "could shape the health care debate that will arrest or accelerate the nation's slide into statism."

Supporting arguments

Notable arguments that were made in favor of Proposition 101 included:

  • Keeps patients in control of their health care.
  • Protects people from having their health care choices dictated by government-appointed bureaucrats.
  • Preserves our rights to seek second opinions, choose alternative care, and keep our medical records private.
  • Makes patient freedom the top priority in health care reform.[3]
  • It creates a constitutional amendment that lays the groundwork for a solution to the health-care crisis.

Perspective of NTU

The National Taxpayers Union said, "Proposition 101 would protect an individual’s choice to pursue private health care coverage. It would also prevent fines from being levied on individuals who decline health care coverage. Proponents believe that the “Freedom of Choice in Health Care Act” would avoid the impositions on personal freedom that are common in socialized health care systems.

Donors in favor of Prop 101

Through October 20, the supporters of Proposition 101 raised about $560,000 to support their campaign.[4]

Opposition

The Arizona Coalition for a State and National Health Plan opposed Proposition 101. The group is chaired by two MDs, Jonathan B. Weisbuch and Mary Ellen Bradshaw.[3]

Additional opponents included Governor Janet Napolitano, medical providers such as the Arizona Hospital and Healthcare Association and the Arizona Academy of Family Physicians, and business leaders such as WestMarc and approximately a dozen chambers of commerce.

State Rep. Phil Lopes, representing Legislative District 27 (central, west and southwest Tucson), and George Pauk, a member of Physicians for a National Health Program published editorial page columns arguing against 101.[5]

Opposing arguments

Notable arguments that were made against Proposition 101 included:

  • A constitutional amendment limiting future legislation is dangerous. No one can predict what laws may be needed to improve the health of Arizonans.
  • The proposed amendment will not assure one's freedom to choose a personal physician, but will prevent the state from creating a system assuring everyone access to the care they require.
  • Arizonans who now rely on Medicare or Medicaid could lose coverage.
  • The proposition's goal, to prevent abuses associated with "socialized" medicine, is irrational. The only "socialized" medical programs in the US are the Veterans Health System, the Indian Health Service, and military medical services. None abuse the private sector. Socialized systems are funded by the Government. They provide services in government facilities by professionals who work for the U.S. Public Health Service.
  • Passage of a constitutional amendment in Arizona would limit legislative options. It will increase the abuses that private practitioners, hospitals, and patients now suffer from private insurance carriers. The industry dictates reimbursement, determines the services patients receive, and dictates who shall be granted or denied access to care.[3]
  • The language of the amendment is ambiguous or "murky" which could lead to the courts having to do the final interpretation on what it means.[6]

Donors to opposition

Through October 20, the opponents of Proposition 101 raised about $1,015,000 to support their opposition campaign.[4] Larger donors to this campaign were:

  • Greater Phoenix Chamber of Commerce, $830,000.[4]
  • University Physicians Health Plans of Tucson, $175,000.

AHCCCS Controversy and Litigation

Anthony Rodgers, the director of the Arizona Health Care Cost Containment System (AHCCCS), distributed a letter on September 17 which said that Proposition 101 is written in a way that could open the door to litigation that could harm the AHCCCS program by requiring a switch from a managed care model to a fee-for-service model. Such a switch could increase state costs by up to $2 billion per year, he argues. AHCCCS is Arizona's indigent health care program.

The author of the amendment, Jeff Singer, called the argument "totally bogus."The intent of the amendment is to block the state from forcing all Arizonans into an AHCCCS-type model and prohibiting other insurance models. [7]

A lawsuit against AHCCCS was filed on Friday, October 4th, 2008 alleging that the letter constituted illegal lobbying against the proposition. AHCCCS denied the charges.

Head of AHCCCS cleared

Maricopa County Superior Court Judge Kenneth Mangum ruled on October 29 that the memo sent out by Rodgers did not violate Arizona's law that prohibits public agencies from spending funds to influence the outcome of an election. The judge said that the memo that was the basis for the lawsuit, instead, constitutes a permissible form of education. [4]

Path to the ballot

On Thursday, August 7, Deputy Secretary of State Kevin Tyne said Thursday that a random check of the signatures submitted for the measure indicated that it does not have the 230,047 valid names necessary to qualify for the Nov. 4 ballot.

Jeff Singer, a key supporter of Proposition 101 responded by saying, "There are a lot more signatures that we believe are valid." The supporting group intends to hire an attorney to file a lawsuit against the determination that insufficient signatures were filed.

Maricopa County Superior Court Judge Mark Aceto ruled Aug. 14, 2008, that 22 signatures originally declared invalid on the petitions for Proposition 101 should be counted. Those 22 were from a random sample of 5 percent of all names checked by the Maricopa County Recorder's Office.

Those 22 names extrapolate out to 440 more signatures which now have to be considered valid. And that is enough to show that the petition drive collected at least 95 percent of the 230,047 signatures necessary - the point at which the measure by laws should go to a 100% validity check. The state did not have time to do that check, instead they decided to put the measure on the ballot.

Deputy County Attorney Colleen Connor said the 22 names in question all had either the wrong date or an incomplete date on which each person signed the petitions. Connor said state law specifically requires Purcell not to count these.

But Aceto said all he legally has to conclude is that there is evidence of the date the petition actually was signed and that each signer was a registered voter on that date.

For example, one petition was listed as being signed "8/08/08.

Andrew Chavez, owner of Petition Partners, the firm hired by backers of the initiative, testified that was not possible as the petitions were turned in to the Secretary of State's Office before the July 3, 2008 deadline. And Chavez noted that dates listed for signatures above and below the one questioned all showed "4/8/08.

There also were some signatures collected in January where the signer listed the year as 2007, before the petitions were even on the street.

See also

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