he standoff between Tufts Health Plan and Partners HealthCare Systems could not have come at a worse time for corporate interests trying to defeat a doctor-driven ballot initiative to reform health care in Massachusetts.
All the scare tactics that millions of dollars in political advertising can buy are not working on an electorate that need look no further than the daily headlines to see the folly of maintaining the chaos that is the status quo:
Harvard Pilgrim Health Care drops thousands of seniors and raises premiums for everyone else.
Beth Israel guts psychiatric services and promises more cutbacks.
Partners bars the doors of Mass. General and Brigham and Women's hospitals to subscribers of Tufts Health Plan.
Overwhelmed emergency rooms divert patients to distant hospitals.
Massachusetts's HMOs have spent more than $3 million to defeat Question 5. For that kind of money, you'd think one of their political consultants might have warned them against alienating subscribers to the third largest HMO in the state a week before the vote. Partners claims its hospitals and physicians lost $42 million treating Tufts patients last year. Unless Tufts agrees to a 27 percent increase in reimbursement rates in the first year of a new three-year deal, Partners has threatened to stop treating Tufts patients on April 1.
It is no wonder that well-salaried administrators at Partners and Tufts are scrambling, albeit belatedly, to mend that rift before voters go to the polls and take out their resentment at being used as pawns in a reimbursement war between insurers and providers. Question 5 would require HMOs to spend at least 90 percent of premiums on patient care, prohibit HMOs from paying doctors to withhold treatment, allow patients to choose their own physicians, and extend health care coverage to the 636,000 residents of Massachusetts without health insurance by July 2002. Goodbye bloated bureaucracy.
Opponents of Question 5 would have voters believe that passage of the initiative, drafted and supported by doctors, nurses, and other health care providers on the front lines, would make things worse. But what study do the HMOs cite to support their contention that passage would cripple the state's economy and burden individuals? An ''independent'' study by the Massachusetts Taxpayers Foundation.
In October, the MTF concluded that passage would cost taxpayers $1.8 billion and result in an average 43 percent increase in health care premiums. The problem is that the MTF, an executive of which appears in TV ads attacking the initiative, is not independent. The group contributed more than $5,000 in staff time and expenses to the ''No on 5 Coalition.''
A voter might reasonably ask how, in the midst of a fiscal crisis that saw the state's largest HMO placed in state receivership earlier this year, insurers can afford to divert millions of dollars from patient care to this political campaign. Secretary of State William Galvin is asking, too, but the election will be long over before we determine what we now suspect: that all this lobbying is a violation of the nonprofit status of HMOs.
The battle over Question 5 is unfolding during an open enrollment period for many HMOs in Massachusetts. The fevered competition for subscribers is being waged by people who seem to have forgotten that hawking health care as though it were a product sold at Wal-Mart is what got them into trouble in the first place. It is not possible to turn on a car radio without hearing the folksy voice of Charles Baker relating the reassuring tale of his son's brush with asthma and his recovery at the hands of physicians from Harvard Pilgrim Health Care.
I'm certain Massachusetts voters are pleased that little Charlie Baker's condition has stabilized. They only wish the same for the health care system.
Eileen McNamara's e-mail address is mcnamara@globe.com.
