September 2000

The Massachusetts Health Care
Reform Ballot Question

by Paul K. Ling, PhD

The current campaign in Massachusetts represents one of the major points of opposition to the health insurance and managed care industries domination of health and mental health. The campaign is to pass Ballot Question 5. Question 5 will have immense impact on both state and local politics. When endorsed by the voters on November 7, Question 5 will mandate universal health coverage for all residents of the Commonwealth by July 2002, implement a moratorium on for-profit acquisition of nonprofit systems, and will enact a sweeping managed care reform package that will take effect on January 1, 2001.                

The ballot question is the creation of the Ad Hoc Committee to Defend Health Care. As a grassroots organization the Ad Hoc Committee is unique in the country. It is a tightly knit group that combines the power of elite and rank and file doctors, organized nursing in the form of Massachusetts Nursing Association, and the mental health community in the form of the Consortium for Psychotherapy and Advocates for Quality Care.  Nobel Peace Prize laureate, Bernard Lown, MD is the Ad Hoc’s chairman and founder.

The Ad Hoc Committee to Defend Health Care first drew national attention in December of 1997 when its statement of principle, “A Call to Action” was published in the Journal of the American Medical Association.  Simultaneous to the “Call to Action” the Ad Hoc Committee reenacted the Boston Tea Party as protest to the erosion of the doctor-patient relationship under the influence of for-profit health care.  Town meetings at Boston’s Faneuil Hall in 1997 and 1998 further solidified the core groups making up the committee and clarified our thinking. We realized that as effective as our public protests against the HMOs and the for-profit mentality were, the only way of forcing real change and reform was to by-pass the politicians and put the question directly to the voters.

1999 was spent in formulating the ballot initiative and in collecting over 100,000 signatures from registered voters. It was a truly Herculean effort that tested the mettle of the group. The HMO industry did not believe we could possibly accomplish this task and were astonished when we made the necessary number of signatures.

Due the fact that the Ad Hoc Committee to Defend Health Care is a nonprofit educational corporation, tax law required that we form a new group to carry on this political endeavor.  The Coalition for Health Care (CHC) was founded as our overt political entity. The Ad Hoc became one block of votes in a larger coalition. Throughout the first half of 2000, our adversaries threw everything they had against us from white paper, scholarly studies indicating the ballot would destroy the existing HMO system to state house forums decrying our efforts as wild-eyed and poorly conceived.

By June, public option and focus group studies commissioned by our opponents indicated that despite their maneuvering, the ballot question would nonetheless be overwhelmingly approved by the voters. In early July, we were presented with our latest challenge. We where told that the Massachusetts legislature would pass an HMO reform package, if we withdrew our ballot initiative. This gambit on the part of the HMO lobbyists and state house powers failed.  The Governor Cellucci signed the legislative HMO reform package, which had languished in conference committees for over four years, into law. The Secretary of State of the Commonwealth, acting as a defender of the state constitution affirmed that there was no way in which the ballot question could be withdrawn.  It officially became Question 5. However, the political power play did succeed in shattering the Coalition for Health Care. Some CHC members decided it was politically expedient to declare victory and call it day. The core groups of the Ad Hoc Committee unanimously decided to carry on the fight for Question 5. Our new political arm is “Defend Health-Yes on 5”.

As a mental health profession I am deeply honored to be part of this effort. What is in Question 5 for the mental health community? In addition to the worthy goal of universal health care, our Patient Bill of Rights gives the patient back the right to choose there mental health professional. It would also transform HMOs as we know them by limiting their “administrative” expense to ten percent on the premium dollar. The moratorium on for-profits has obvious implications in view of the fact that most insurance plans use mental health carve outs such as UBH or Magellan.

As of September 2, 2000, the Boston Herald’s polling indicated that over 70% of registered voters intended to vote yes on Question 5. Needless to say we have the HMOs, the Massachusetts Legislature, and Lobbyists very worried.  We expect the opposition to pour in $5 to 10 million in paid TV to try and stop us. We need all the help we can get from activists from other states. We are depending on grassroots support win on Election Day.  The Ad Hoc Committee to Defend Health Care address is 649 Massachusetts Avenue, Cambridge, MA 02139. Its phone number is (617) 576-7741. Please feel free to contact me at (617) 472-3125 or PKLing@aol.com. Come November 7, we expect all eyes to turn to Massachusetts.

Paul K Ling, PhD is a clinical psychologist in Massachusetts and an early member of the NCMHPC.

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