Health Care
Tucson, Arizona — Among propositions expected to be on the ballot this fall in Arizona is the Freedom of Choice in Health Care Act, an amendment to the state constitution which forbids the legislature to pass any law that would “restrict a person's freedom of choice of private health care systems or private plans of any type…interfere with a person's or entity's right to pay directly for lawful medical services,… impose a penalty or fine, of any type, for choosing to obtain or decline health care coverage or…any particular health care system or plan.”
A citizens' initiative put forth by a group called Medical Choice For Arizona, led by Phoenix area physicians Eric Novack and Jeffrey Singer and 2006 Proposition 207 (Private Property Rights Protection Act) director Lori Klein, the Freedom of Choice in Health Care Act's stated objective is to preserve individuals' right to purchase or not purchase health care services or health insurance plans. In effect, it would make socialized or so-called “single-payer” healthcare, favored by many on the far Left, unconstitutional in Arizona. It does not rule out voucher or universal tax-credit systems, nor does it restrict funding or even expansion of residual-welfare programs such as AHCCCS (Arizona Health Care Cost Containment System), the state's Medicaid program.
In its late May e-mailed campaign update, the campaign reported that as of the beginning of June it was ninety thousand signatures short of its three hundred thousand signature goal and on schedule to collect the remainder well in advance of the 3 July filing deadline. Arizona requires signatures equal to fifteen percent of the votes cast for governor in the last election, approximately two hundred thirty thousand signatures in 2008, to put a constitutional amendment on the ballot by initiative.
According to early polling reported on by Healthy News Service, 71% of polled voters support this measure. The Freedom of Choice in Health Care Act is seemingly written to ensure very broad support at the expense of allowing proponents of government-financed health care considerable leeway. For example, the Healthy Arizona Coalition's initiative to expand the state Kids' Care program to middle-income families, which failed for lack of funding, would likely have been constitutional even after the passage of the Freedom of Choice in Health Care Act. So far, unlike the Arizona Civil Rights Initiative or 2006's Private Property Rights Protection Act , no organized opposition has emerged.
Nevertheless, the Act, if passed, will be a significant speed bump for populists and ideologues who favor adoption of Canada-style single-payer health care. As such schemes would be unconstitutional, their passage would require a separate constitutional amendment striking the Freedom of Choice in Health Care Act, allowing for more thorough discussion of the causes of and solutions for the state's health care problems. Economists nearly uniformly ascribe the United States's healthcare troubles to coverage mandates, which in a sense forbid the purchase of inexpensive insurance or the sale of policies with riders for individuals with preexisting conditions, and the tax code, which ties insurance to employment and encourages purchase of problematic “comprehensive care” plans that insulate consumers from prices. Although the view is popular among citizens and politicians, that greedy insurance companies or the free market itself are the source of trouble is not a view with much support from those who study healthcare economics. Thus the slow, deliberate debate about single-payer that passage of the Freedom of Choice in Health Care Act would necessitate could only benefit free-marketeers like Klein, Novack, and Singer. It is more likely that legislators will simply opt for health-care reforms that do not entail the forbidden mandates and bureaucratic control of care decisions.
The effect passage of the Freedom of Choice in Health Care Act would have on Federal health insurance programs is unclear. If the measure passes, Congressional attempts to impose Canada-style nationalized healthcare payment or the sweeping Federal insurance mandates favored by Barack Obama will likely set off the first major federalism fight in recent US history. Although the Court favors a cautious, limited-government reading of the Constitution today more than any time since the “Switch In Time” response to Franklin Roosevelt's infamous court-packing scheme, there remain but two firm textualists, Clarence Thomas and Antonin Scalia, on the bench, and three justices: Breyer, Ginsburg, and Stevens, are downright hostile to a doctrine of enumerated powers, with Breyer declaring in his book Active Liberty that consequences and political philosophy should outweigh the letter of the law. Although purchase of medical services or health insurance is not ordinarily interstate commerce and the Constitution itself gives no grounds for Federal preemption of health care matters, were the Freedom of Choice in Health Care Act to be enacted by Arizona voters and were Congress to violate it, that the courts would side with Arizonans is far from a shoo-in. We can nevertheless expect that Washington will treat passage of the Act as a message to be taken very seriously.
Sources:
Medical Choice for Arizona
Eric Novack, May Campaign Update, Medical Choice for Arizona
Medical Freedom Initiative Launched in Arizona; Supported by 71 Percent of Voters, Healthy News Service
Howard Fischer, State-funded health care measure falls off ballot, East Valley Tribune