s if rocketing health costs, an HMO-bashing presidential race, and angry hospitals aren't enough, the local managed care industry also has Question 5 on its crowded plate.
If passed, it would mandate universal care in the state, as well as enact a host of stringent HMO controls and allow anybody to see any doctor. But in the end it's all about HMOs. Though Question 5 has pages of legal language to explain how it would change the health care system, it has become essentially a referendum on managed care. Can you trust HMOs?
HMOs seem to realize public sentiment is against them. Their commercials studiously avoid use of the term HMO, instead featuring hospital executives talking about the havoc that would follow passage of Question 5. One ad has a mountain of red tape falling on a doctor and patient.
The HMOs are pouring big money into the campaign to defeat the measure. In the last two weeks, Blue Cross kicked in $494,811, and was joined by Harvard Pilgrim ($400,000), Health New England ($10,000), and several other large local companies including Tufts, Aetna, and Fallon, according to state campaign finance filings.
The supporters of Question 5 have only $11,568.24 to their name. Their campaign is run by a handful of doctors and nurses, who say they have had enough of the current system. They have no commercials and zero political clout. Yet they are winning, according to recent polls.
It's not unusual for ballot questions to ride high in the polls only to be defeated at the 11th hour by a flood of advertising from the opposition. Indeed, this is what the HMOs have promised. Ultimately they may spend up to $3 million, which would make Question 5 among the most highly financed efforts in state history.
But with just over a week to go, they continue to travel in rough waters. Presidential candidates Al Gore and George W. Bush - the dominant figures of the moment - have both been steadily assailing HMOs and their ''bean counters.'' Generally, polls show, most people are satisfied with their HMOs. But they are frustrated with managed care overall.
It was in this climate that Question 5 was born. It is not so much a detailed policy recipe as a manifesto of ''All That Is Wrong With For-Profit Medicine.'' It lists, in general language, a set of goals and principles for the entire health care system. It would be up to lawmakers to figure out how to achieve those goals.
But most of the public will only see a glowing 64-word question that speaks of guaranteeing ''rights'' and ''coverage for all,'' and criticizes ''for-profit'' medicine. Wedged prominently in the middle of the question is ''HMOs.''
RAJA MISHRA
