The top House Democrat fired the first salvo Tuesday at a ballot measure designed to stop lawmakers from limiting the health care choices of Arizonans.
House Minority Leader Phil Lopes, D-Tucson, said voters should reject an initiative being pushed by some doctors and others to constitutionally prohibit forced enrollment in either private or government-run health insurance programs. The measure also would bar any law which limits an individual's choice of doctors.
"They are trying to protect the system that I think everybody, most people, think is broken," Lopes said.
Lopes has more than a passing interest in the issue: If voters adopt the measure in November it could undermine his plan for a kind of universal health care in Arizona where everyone participates or pays.
But Jeff Singer, a Phoenix surgeon and one of the architects of the initiative, said the measure is not aimed at any specific plan or concept. Nor is it aimed at halting what he said is necessary reform of health care.
"We just want to make sure that whatever kind of health care reform is ultimately instituted, that it doesn't infringe upon the rights of people to make their own decisions regarding what kind of plan they want to be in, or if they want to be in a plan, what kind of health care they want, what kind of doctor they want, whether they want alternative care, whatever," he said.
Singer said what he and backers of the initiative fear is "unintended consequences" of the push to revamp how health care is provided in Arizona - and in the country.
What Lopes envisions is a single health insurer in Arizona: the state.
"It takes all the $35 billion we're spending now and puts it in one pot to assure that everybody in the state has health services," he said.
That includes not only what government is spending but also what is being paid by companies and individuals who buy insurance. And that, he said, requires all Arizonans to enroll "and kick in."
That clearly would be forbidden under the terms of the initiative. If approved it would bar the passage of any law, by the Legislature or voters, "that restricts a person's freedom of choice of private health-care systems or private plans of any type."
Singer said the state could not enact any plan that barred individuals from paying for their own health care.
He said that's the Canadian system where doctors are legally precluded from providing particular treatment or tests not covered by the national system. The result, said Singer, is Canadians who have the money come to the United States for care.
Lopes said his program would have no such restrictions. He said it would be like the Arizona Health Care Cost Containment System, the state' program for insuring those below the federal poverty level, but for everyone.
"You've got a list of physicians or a list of hospitals where you could go," Lopes said.
He said that "possibly" would mean Arizonans with private coverage do not get to keep their current doctor. But Lopes said he believes most physicians will sign up because the plan will be "the only game in town."
Lopes also said the state program would not cover every possible procedure.
"Just like every commercial insurance company out there, there's a set of benefits," he said. Lopes predicted providing all Arizonans with the same package now available to state employees.
"Now that doesn't include everything," he said. "But it includes the lion's share of what people need."
Those who want services not provided under the state plan still would have the ability to obtain them - with their own money.
Singer compared the initiative to the First Amendment to the U.S. Constitution which limits the ability of government to infringe on individual rights. "It's to protect us against things that we don't want to see happen," he said.