A state House panel voted Tuesday to allow Arizonans to opt out of any new national health care plan adopted by Congress.
HCR2014 would constitutionally overrule any law or regulation that would compel any individual or company to participate in any health care system. That would bar not only mandatory enrollment but any fines against those who refuse to enroll.
It also would guarantee that individuals have the right to purchase health care services above and beyond anything provided by the government or private insurance. And it would bar the government from penalizing doctors who provide - and charge for - those services.
The measure, which now goes to the full House following the 6-3 party-line vote of the Republican-controlled Committee on Health and Human Services, is modeled after Proposition 101, which was narrowly defeated by voters last year. But House Speaker Kirk Adams, R-Mesa, a proponent of this measure, said the 2008 initiative was killed following "a powerful campaign of distortion" by foes.
Adams also said the wording of this measure is clearer and that he believes voters will approve the plan this time when it appears on the 2010 ballot.
Christie Herrera, who works for the American Legislative Exchange Council, said approval is necessary to preclude the kind of "socialized medicine" being considered in Washington that exists in some other countries.
But even attorney Clint Bolick of the Goldwater Institute, who supports HCR2014, conceded that if this measure becomes part of the state constitution, it would set the stage for a legal fight with the federal government over any "single payor" plan Congress might approve, whether before or after the 2010 election.
"It will set up a federalism clash," Bolick said. He said attorneys for Arizona will have to argue in court that the rights of the state and the rights of individuals to make their own health care choices trump any right of Congress to enact this kind of health care plan.
Eric Novack, a Phoenix orthopedic surgeon who crafted the unsuccessful 2008 initiative, told committee members they should be alarmed about what some members of Congress are considering.
"Make no mistake: The very ability for everyone in this room and your families to seek out the kind of health care you believe is best is under direct assault," he said. "And the risk that you will lose control over your health and health care has never been greater."
Rep. Nancy Barto, R-Phoenix, who is sponsoring the legislation, said the aim is "to prevent the state or other government entities from forcing residents to be subject to the practice of medicine by government."
While there has been talk of some sort of national health care plan, there is no actual proposal that is ready for congressional debate. But Barto said that does not delay the need for lawmakers here to be proactive to ensure that whatever eventually is enacted does not interfere with the rights of Arizonans.
Barto acknowledged that nothing in this proposal actually does anything to address the problems of the high cost of health care. Instead, she cited various other measures making their way through the Legislature that sponsors say would decrease the cost of health insurance.
Rep. David Bradley, D-Tucson, said he appreciates those efforts.
"But always there's someone left behind - always," he said. And Bradley said those who can't afford health insurance show up in emergency rooms when they get sick, many unable to pay their bills, passing along the costs to others.
Bradley also complained that this bill takes one possible solution off the table, at least in Arizona. He said before lawmakers do that, they need to focus on the most important factor: What works best for patients.
"Our life expectancy, we're at 24th," he said, citing statistics from the World Health Organization. By contrast, Bradley said, Canada and the United Kingdom, which have government-controlled plans, are 12th and 14th, respectively.
And Bradley said the United States leads health spending as a percentage of gross domestic product, versus Canada at 18th and the United Kingdom at 41st.
Adams, however, said those numbers ignore how real people are affected. The House speaker said he has an aunt in Alberta, Canada, who has been waiting for months to have a procedure performed.
Not all the talk about a government-run or government-regulated universal health care system has been on the national level.
Rep. Phil Lopes, D-Tucson, has crafted his own version of such a plan at the state level that would require every resident to enroll in a government-run plan and pay into the system based on income. That provision in HB2188, which has not received a hearing, directly conflicts with what is in HCR2014.
But Lopes' proposal would allow individuals who want specialized care not provided in the state plan to use their own money to obtain it.
Lopes, who voted against Barto's proposal, defended the concept.
"It's like being compelled to pay primary property taxes even though you don't have any kids in the public schools," he said. "It's for the collective good."