Supporters of Proposition 216, a California ballot initiative aimed at curbing healthcare abuses, launched a $4 million campaign with full-page advertisements in major state newspapers last week.
The ads, featuring stories of HMO enrollees who became critically ill or died because they allegedly were denied care, appeared in the Los Angeles Times, the West Coast edition of the New York Times and other newspapers.
Proposition 216, called the Patient Protection Act, will appear on the November ballot. It is co-sponsored by the Foundation for Taxpayer and Consumer Rights, a Ralph Nader-backed organization, and the California Nurses Association.
It calls for sweeping curbs on managed care and healthcare system downsizing, including taxes on mergers, on hospitals that eliminate beds, and on "excessive" executive compensation.
Among other things, according to the ads, the measure "outlaws bonuses to doctors for withholding treatment, bans `gag rules' restricting physicians and nurses from discussing treatment options with patients (and) establishes safe staffing levels for hospitals and nursing homes."
The measure also "restricts the provision of patient care by inadequately trained personnel, ends denial of recommended medical treatment...(and) requires written explanation and qualified second opinion for denial of claims," the ads say.
They also say the initiative "establishes a self-funded independent consumer watchdog group, requires industry disclosure of safety and financial data, bans the sale of your private medical records without your permission (and) requires detailed justification for increases in your premiums."
The measure will be funded by penalties placed on "excessive HMO executive pay and multibillion-dollar mergers," according to the ads. Those fees also will flow to safety-net providers, proponents say.
But the ads are "littered with inaccuracies," said a campaign coordinator at Taxpayers Against Higher Health Costs, a coalition including providers, businesses and HMOs opposed to the measure.
The ads claim HMOs will spend $15 million to defeat Proposition 216. And Elaine Burn, a staff worker at the Foundation for Taxpayer and Consumer Rights, said the group's research indicates HMOs could spend as much as $50 million.
But Janet Maira, a spokeswoman for the provider-business-HMO coalition, said that's a "grotesque exaggeration." She said opponents, aided by the media consulting firm of Goddard Claussen/First Tuesday, plan to spend $7.5 million. Goddard Claussen created the "Harry and Louise" television ads financed by the health insurance industry to fight the Clinton health reform plan.
Several provisions of the initiative-including the "gag clause" measure-ban practices that are already illegal in the state, Maira said. Other provisions, such as requiring a second opinion when care is denied for any reason, would "gridlock the system" and cause healthcare costs to skyrocket, she said.
The measure's provisions "are so complicated, they have implications even their authors don't understand," Maira charged.
C. Duane Dauner, president of the California Healthcare Association, said both Proposition 216 and a similar measure, Proposition 214, would "impose millions of dollars in unnecessary costs on both public and private hospitals in California."
The measures also would increase hospitals' legal liability and invite malpractice lawsuits, he said.
Opponents also cite a state legislative analyst's report that the measure would cost state and local governments "hundreds of millions of dollars annually."