Prop 106: Health Care Freedom

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The pros and cons of Proposition 106, a measure on the general election ballot in November that amends the state constitution in an effort to ensure that no law shall infringe on a person’s freedom to choose the health insurance/system of their choice.

Ted Simons: Good evening and welcome to "Horizon." I'm Ted Simons. Tonight we continue our vote 2010 election coverage with a debate on proposition 106. It's a measure sent to the ballot by state lawmakers. Prop 106 amends the Arizona constitution in an effort to ensure that no laws can be enacted that keep people from choosing the healthcare of their choice. Joining me to talk about the proposition is Dr. Eric Novack, chairman of Arizonans for healthcare freedom, the group supporting prop 106. And Peter Cerchiara, a member of prop 106 endangers your health. That's a group opposing the measure. Good to see you both here.

Eric Novack and Peter Cerchiara: Thank you.

Ted Simons: Eric, let's start with you. Amending the constitution is serious stuff. Why amend the constitution for this?

Eric Novack: Prop 106 does two things. It amends the constitution and says no mandates. You can't force people to buy insurance or fine or penalize them. Second, of course, a healthcare system is legal, people should be able to spend their own money to get access to it. That's it. There's nowhere in the Arizona constitution or any constitution where we have any right to have control over our healthcare. We need healthcare reform and need to ensure that patients and families stay at the center of health and healthcare reform. It's a major step how to get that done.

Ted Simons: Is there a basic right to be in charge of your own healthcare?

Peter Cerchiara: I think the issue of choice is important. However, to posture this initiative as presenting choice is at least misleading. Individuals have a very limited amount of choice today and this proposition will actually reduce choice because it will reduce governmental alternatives and leave the only choice to be determined by large insurance companies and we know where we've gotten today. The reason we've got 40 million, 50 million people uninsured is because the insurance companies have taken us there. This act will actually put in place the opportunity for the insurance companies to consolidate control over what they determine as choice and not allow any individuals. Choice is two sided. You have the choice when you have the freedom to choose something. We know what we have today and this prop will narrow the choice because it will not allow the government to offer or control alternative programs.

Eric Novack: Which isn't true. If tomorrow, the federal government passed an option or access to everyone in the state and prop 106 passed, there's no conflict between the two. All prop 106 is saying, is you can't force you, me or Ted or any of our family members or anybody in the state to purchase the insurance or pay a fine. At the same time, again, if a healthcare service is legal, do you and your organization believe that the government or any other individual should tell an individual that they can't spend their own money to get access to a legal healthcare service?

Peter Cerchiara: I do. Because mandates have proven to be valuable. Government has produced mandates for things like maternity care and mental health equity and those are important mandates to control access to healthcare across the board. So to posture this as providing for a free choice is really more about creating more chaos and reducing choice because it's going to cause -- let me restate that. It's going to cause chaos because regulation is important and we have a history of seeing the fact that the oil companies, investment, mortgage -- we're in the position we're in today because the position that, well, we don't want to control the market and any control is not beneficial. That is contradictory. The point is you do need mandates because mandates protect access for everyone.

Eric Novack: But there's nothing in prop 106 that says that maternity leave can't be a mandate. And autism coverage can't be mandated. What we're saying is you can't mandate a person to perch a private product against their will. The implication of what you're saying, the supporters of the prop 106 is private healthcare industry. The healthcare funded the opposition against it back in 2008. The biggest winners is the private healthcare industry which is why the health insurance lobbyists after getting the mandate in September 2009, said, quote, we won. They're the winners on this. This is the way to take control away from the healthcare industry and put it in the hands the people of Arizona.

Peter Cerchiara: This was an alliance for health system change now health system reform. The barriers to entry were too large. Basically, the control of insurance, it's -- it's a straw dog to call it choice because the only choice individuals have is what the insurance companies determine.

Ted Simons: Let me ask you something, corollary to that point. If now, my choices are pretty much limited to what insurance companies say. Why is that different, better, worse than the government making that decision?

Eric Novack: Remember, that what prop 106 doesn't say is it doesn't prevent the government from offering plans. We can debate the merits or not of doing that and as a physician, I deal with health insurance companies dozens of times a day and the big insurers have no love lost between me and them. We need reform but do we want it resided in the patients and families or in the hands are the politicians? In large part, the health insurance industry who spent the money to get the bill they wanted passed.

Ted Simons: The idea that you have the choice to opt out, can there be substantial healthcare reform at the government level if there's a hole in the dam? Everyone's got to be in or it's not going to work?

Eric Novack: That is what the administration and the people who passed the law in Washington, what the lobbyists who around the town and state, when I say we need to support this for individual liberty for the people in Arizona, at every meeting, the lobbyist for the biggest health insurance company says unless we force everyone in, the thing doesn't work. We have a learning experience in Massachusetts where they have a mandate, where first of all, not everybody is insured. Costs aren't reduced and going up faster than the national average and looking at much more restrictive rationing of care so it doesn't solve the problem that people claim.

Ted Simons: The idea it doesn't solve the problem.

Peter Cerchiara: It doesn't. It doesn't assure quality of care. This prop is going to do nothing to change what the current status is so if you think the current status is fine and gives everybody total freedom, we wouldn't have 40 million, 50 million people unable to get insurance. This bill will prevent insurance steerage. That's basically incentives. If you have a co-pay to steer people to proper or cost effective care, this proposition will say if the government attempts in any of their programs to do that, it will become unlawful.

Eric Novack: That's actually not true.

Peter Cerchiara: That's what we read.

Eric Novack: When the language was written down at the legislature, having spent six months working on the language for prop 106, that was specifically one of the questions and as you know, there was a concern in 2008 with the previous version that the language might damage AHCCCS, the state's Medicaid program. We believe that a safety net healthcare is necessary. One of the questions is that. Can we write language that addresses this issue of saying can we provide incentives so the government program here in Arizona, which is Medicaid, can function like it's meant to? And since we worked down there, the people who run AHCCCS believe there's no issue with them. So I think your organization is misreading that issue.

Peter Cerchiara: The way this prop was written this time, because it failed last time and you're right, AHCCCS was against it, the hospital association was against it. The way they got around it, they grandfathered everybody. Saying right now your programs are fine. But if you create an incentive, a new program element and you create another element that somebody according to the prop is going to say that's a penalty. You're charging me. I don't have to do that because this constitutional change will allow me to say I don't want to participate because it's a penalty.

Ted Simons: We have a minute left. You were going to make a second point?

Peter Cerchiara: Yes, the second point, contrary to Dr. Novack's statement that this isn't driven by the lobbyists and insurance companies, there's an organization that created the templates of this proposition around country for at least 10 to 15 different legislations, called American Legislative Exchange Council, and it's represented by or has members on -- or lobbyists who have created this template. I thought it was interesting, they want to create the beachhead to do a state's rights challenge against the federal healthcare law.

Eric Novack: They took my language, the people in Arizona had the idea they took from it. That's first. And second of all, I encourage everybody out there who is watching to learn on their own. is where people can learn more. This is about simple rights. No mandates. 70% at least don't like and if a healthcare service is legal, we believe people should have the right to spend their own money and I think the majority of Arizona voters will.

Ted Simons: We have both websites on the air and you can go to the website of your choice.


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