f voters approve a ballot question on Nov. 7 that would require universal health coverage, Massachusetts health costs would skyrocket by between $2.8 billion and $5.6 billion, according to a study released yesterday.
The dire analysis was prepared by the Massachusetts Taxpayers Foundation, and is the latest evidence that a wide array of interests - HMOs, hospitals, businesses, even health care activists - are concerned that Question 5, the health care initiative, will pass, pushing the state's health care system into uncharted waters.
By all accounts, the ballot question is radical, perhaps the furthest-reaching piece of public policy to ever appear on a Massachusetts ballot. In addition to universal coverage, it would allow patients to seek care from any doctor and would enact a temporary ban on all for-profit medicine, as well as strict HMO controls.
But it does not spell out how these things would be achieved, leaving it mostly to the Legislature. Question 5 is more a manifesto of general principles, whose basic tenet is hostility to profit-driven medicine.
Recent polling shows that Massachusetts residents support the measure by a significant margin. But HMOs are in the midst of a multimillion-dollar ad campaign against the question, with commercials featuring a shower of red tape falling on a doctor and patient.
The study paints a chaotic picture of life after Question 5, with HMOs dissolving, health premiums skyrocketing, and thousands forced to give up health insurance.
''These cost increases are staggering and would send a tidal wave through the state's health care system. Everyone in the Commonwealth would feel the impact,'' said Michael J. Widmer, president of the Massachusetts Taxpayer Foundation.
But supporters of Question 5, a small group of doctors and nurses, said this doomsday scenario is overblown.
''There have been several studies done that show that if we can trim administrative costs by about 25 percent, we could insure every Massachusetts citizen without raising premiums by a dime,'' said Andre Guillemin, campaign director of ''Yes On 5.''
Guillemin cited a recent study jointly authored by the Access and Affordability Monitoring Project at Boston University's School of Public Health and Washington-based health consultants Lewin and Associates. It found that universal coverage would save the state money in the long run. Another recent study, commissioned by area HMOs, found that passage of Question 5 would result in only a 4 to 10 percent increase in HMO premiums, far less than the predictions of yesterday's study.
The ''Yes on 5'' advocates, who are being significantly outspent by opponents, are counting on a general atmosphere of hostility toward HMOs to buoy their cause. Also to their advantage, agreed both sides, is the wording of the actual ballot question. It is 64 words long; the ''yes'' vote is couched in optimistic language; the ''no'' vote is simply the status quo.
Excerpts from yesterday's analysis will likely find their way into the TV and radio spots now being run by the ''No on 5'' forces, which are bankrolled by HMOs. The analysis is based on information supplied by those HMOs.
It predicts that the massive costs created by Question 5 would be shouldered by all sectors of society: big businesses, who would pay more to cover their employees; local governments, who would lose money for public programs in order to cover government workers; and hospitals, who would get lower Medicaid reimbursements from the state.
Ultimately, predicts the study, the state may enact steep tax increases to offset all these costs. The most drastic consequence, the study predicts, would be the death of HMOs, which would lose the ability to control costs by Question 5's mandate that patients be able to go outside HMO doctor networks at will.
''It provides patient freedom to roam where ever they want,'' said Widmer. ''It would mean the end of HMOs as we know them.''
