hey seem to have nothing going for them. Supporters of the health care initiative known as Question 5 count a meager $4,433 to their name.
What's more, the health care industry and the state's biggest employers are lined up against them. And scores of key allies have abandoned the cause - or worse, begun to fight against it.
And yet this ragtag group of consumer activists and physicians is winning big, according to a University of Massachusetts poll.
The survey, conducted in late September by UMass Poll, shows that 72 percent of voters support Question 5 on the November ballot, which would guarantee universal health care coverage for all state residents. Only 16 percent said they opposed the initiative, reflecting a public hunger for health care reform.
For opponents, who argue that Question 5 will drive up the cost and destroy the quality of health care in Massachusetts, the poll results are jarring. For months, they hoped the campaign would never even happen, and, though they are well-funded, they are getting a late start in fighting back.
''We're terrified,'' said Larry Rasky, chairman of the PR firm The Rasky/Baerlein Group, which is running the ''No on 5'' campaign.
The ''No'' side's attempt to eliminate this gap began in earnest with a radio ad campaign Wednesday, and a television ad blitz Thursday. Rasky said it has purchased numerous commerical slots on local network affiliates every day for the next 10 days, with plans to extend the ads to Election Day. He said the ''No On 5'' group anticipates spending about $3 million on advertising and about $1 million on other types of outreach.
Rasky believes that voters have not yet focused on the ballot question and that it's too soon to draw conclusions from poll results, which are bound to have ''very soft numbers'' this far from the November election. But he acknowledged that the health care industry, despite its huge financial advantages in the Question 5 fight, is worried that it's doing too little too late.
The public is sour on HMOs. Both presidential candidates are trumpeting reform of the system. Question 5, while only 64 words long, features a ''yes'' option couched in optimistic terms. The ''no'' side is characterized as the status quo.
And in a particularly intriguing finding, UMass pollsters found that even those voters with health insurance and who are satisfied with their medical care support the ballot measure, which would usher in the most radical restructuring of the state's health care system in a generation. Among voters with health insurance, 70 percent supported Question 5.
''They know they have good health care, they want to extend it to others, and they want to lock it in - even if the government has to make up the cost difference,'' said Lou DiNatale, director of UMass Poll. ''With such a strong level of support, the opponents have a long way to go.''
Polls taken by each side mirror the UMass results.
The ''No On 5'' group found earlier this year that 72 percent of those polled answered `yes' to a question similar to the one that will appear on the ballot. ''There isn't reason to think it's moved since then,'' Rasky said.
Another poll, paid for by a single physician member of the relatively impoverished ''Yes on 5'' coalition, found the number to be 80 percent.
Rasky's group has hired national media consultant Winner/Wagner & Mandabach of California to try to overcome these odds. The firm cut its teeth defeating ballot measures in California, considered the ballot question capital of the nation.
The ''No'' TV and radio spots will not explain the details of the question, but will keep it simple by planting seeds of fear about the impact if it passes.
In one spot, a male announcer asks ''What's being said about Ballot Question 5?'' He and a female announcer answer by quoting newspapers and political organizations calling the question ''pure folly,'' ''badly flawed'' and ''would cost taxpayers billions.'' In another TV ad, red tape falls from the sky onto a doctor examining a female patient.
The spots feature the tag line ''It's bad medicine for Massachusetts.''
The ''Yes on Five'' forces will likely be outspent 1,000-to-1 by the end of the month. They are hoping the 113,000 signatures they collected to get the question on the ballot will translate into a grass-roots network that will counteract the media onslaught in the coming days.
''We are planning to use the grass-roots network that we have in place, which includes thousands of doctors and nurses,'' said Andre Guillemin, campaign director for ''Yes on 5,'' which is based in North Quincy.
The wording of Question 5 will likely aid Guillemin's side. And Rasky said he regrets that his side did little to influence its drafting, which was done by the state a ttorney g eneral's office, with input mostly from the ''Yes on 5'' side.
Registered voters will also be given an extensive 13-page explanation covering the arguments of each side, though both sides expressed doubts that it would be read.
Though Question 5 is short, its impact on the state's health care system could be massive. It would mandate universal health care coverage by July 2002, leaving the details to the L egislature. It would also ban all for-profit health care companies until universal coverage was in place.
It would also require HMOs to spend at least 90 percent of their budget on patient care, setting a 10 percent limit on advertising, management, and executive salaries. HMO patients would be able to pick any doctor; if the doctor is outside the HMO's network the patient would pay a small fee. In addition, it would enact a set of HMO controls similar to the Patient Bill of Rights passed on Beacon Hill this summer.
That bill of rights was the L egislature's answer to Question 5. In fact, the majority of the groups that ran the Question 5 signature campaign abandoned the ballot question after the Patient Bill of Rights passed. They contend that the L egislature's HMO fix is good enough.
But a small group of dissident doctors and nurses continued the campaign. Rasky said that the health care industry failed to fight Question 5 early on. ''I think everybody thought they could dodge the bullet,'' he said.
HMO reforms languished on Beacon Hill for three years; legislators passed them only after Question 5 garnered enough signatures to get on the ballot. Now legislators, who would be forced by Question 5 to craft sweeping reforms that most of them oppose, are leaning on their constituents to oppose the ballot question.
''I was surprised and disappointed to read that a respected organization such as the Massachusetts League of Women Voters is continuing to support Question 5,'' wrote state Senator Richard T. Moore, an Uxbridge Democrat who chairs the Senate's Health Care Committee, in a letter to the group. ''... passage of this measure is likely to result in health coverage for fewer Massachusetts residents rather than for all Massachusetts residents.''
