enator Edward M. Kennedy said yesterday that he would support controversial ballot Question 5, which would mandate universal health coverage and a host of far-reaching health care reforms, giving the embattled measure a boost a week before Election Day.
Kennedy, considered by many to be the nation's leading liberal health-care lawmaker, said Question 5 fits with his lifetime political mission of establishing universal health care. He said a yes vote here may spur other states to adopt similar policies.
''It will carry beyond our borders,'' he said in an interview from the campaign trail. ''Massachusetts has led the nation on many health care issues. ... It's time for us to lead again.
''My position is that I intend to vote for it,'' said Kennedy.
With health maintenance organizations in the midst of a high-spending political ad campaign that has eroded Question 5's once-dominant support in polls, Kennedy's endorsement comes at a crucial time. An Oct. 24-26 Boston Globe/WBZ-TV poll found that 50 percent of 400 likely voters surveyed supported Question 5, with 25 percent against it, and 25 percent undecided or unwilling to answer.
Kennedy will not campaign on behalf of Question 5, said his staff. His energies will be focused on his reelection campaign, in which he has a sizable lead over GOP challenger Jack E. Robinson. Kennedy's support of Question 5 came only after inquiries by the Globe.
Kennedy's position pits him against the majority of the state's medical establishment, the same establishment he has relentlessly championed on Capitol Hill. Most health plans, hospital and doctors groups, and health care advocates have come out against Question 5.
The Massachusetts Nurses Association is the largest group that supports the ballot question. But most of the funding for the Yes On Five campaign has come from individual nurses and doctors. They have been outspent about 25 to 1, and have yet to air any campaign ads. Instead, they hope some of the public's uneasiness with HMOs translates into yes votes.
Larry Rasky, head of the No on 5 effort, said, ''Given the senator's national agenda, it's not surprising that he'd feel compelled to vote for Question 5. The fact that he's not campaigning for Question 5 should be an indication of all the problems that it would create.''
Rasky also noted that the majority of newspaper editorial boards in Massachusetts have written against the ballot measure.
Question 5 is perhaps the most far-reaching health care proposal in a generation. It would mandate universal care by July 2002, enact a set of stringent HMO reforms, allow patients to pick the doctor of their choice, temporarily ban the entry of for-profit health companies into Massachusetts, and prohibit HMOs from spending more than 10 percent of their revenues on administrative costs and executive salaries.
Opponents argue that the measure is so radical, the health care system would be thrown into turmoil, with HMOs struggling to survive, thousands of patients losing insurance, and health costs skyrocketing. Some lawmakers on Beacon Hill are making plans to substantially alter Question 5 if it passes.
Kennedy said he was unmoved by these arguments.
''I understand some of their concerns but it seems to me that the overall objective is compelling,'' he said.
The local HMO industry's campaign against Question 5 features ads that show a shower of red tape falling on a doctor and patient. In another ad, well-known patient care advocate Dr. Mitchell T. Rabkin, president-emeritus of Beth Israel Deaconess Medical Center, denounces the ballot measure.
Rabkin and Kennedy are longtime political allies, and Kennedy said he disagreed with his friend while maintaining respect for him. As for the HMOs' ad blitz, Kennedy said it was no different than aggressive campaigns the insurance industry has run against national initiatives he has sponsored.
''I'm not surprised they're against it,'' said Kennedy of the ad campaign, which could cost HMOs up to $3 million.
The theme of universal health care has been a constant in Kennedy's 38 years on Capitol Hill. He favors a Canadian-style single-payer system, in which the government would pay for all health costs. But he has largely abandoned that, at least legislatively, instead taking an incremental approach that involves adding children and the near-elderly to government-run health insurance programs.
''In a perfect world, it would be a single-payer system. But we don't have a perfect world, so we're moving incrementally,'' he said.
Absent a national movement toward universal care, a state initiative like Question 5 could be the next best approach, said Kennedy.
''I think that there's nothing that would give the issue of health care for all a push than a resounding vote by the people of Massachusetts,'' he said.
