| Briefing on this Proposed Ballot Act
"An Act to Protect the Rights of Patients
and to Promote Access to Quality Health Care for all Residents
of the Commonwealth"
1. HEALTH CARE ACCESS AND COVERAGE FOR
ALL MASSACHUSETTS RESIDENTS. The ballot measure mandates that,
not later than July 1, 2002, high-quality, affordable health
coverage be ensured to all Massachusetts residents, in accordance
with six requirements.
Those six requirements are:
- Universal access for all residents and
the elimination of barriers to medical services and medications
- A choice of physician and providers for
patients and clinical freedom for physicians and nurses
- Affordable health coverage ensured for
all residents and limits on expenditure growth
- Protection of quality of patient care and
promotion of medical research and innovation
- Limits on spending on administration and
other non-health purposes
- Prohibition and minimization of incentives
for over and under-care
To devise and propose health care legislation
and policies meeting these six requirements, the ballot measure
creates a special committee of the Massachusetts Legislature
and an associated council of health care providers, advocates,
entities, and citizens, who must complete their work not later
than September 30, 2001. The Legislature must then debate
and enact final legislation by July 1, 2002.
2. PATIENTS’ BILL OF RIGHTS AND PROTECTIONS.
The ballot measure writes into law 10 strong and specific
patient protections. All are effective January 1, 2001, and
are designed to ensure that key decisions affecting the care
of individual patients are made by physicians, nurses and
other health care professionals, and by patients themselves
– not by HMOs or insurance companies.
These provisions are:
- The right of the individual patient to
choose his or her physician, including the right to select
an obstetrician or a gynecologist as a primary care physician
- The right of the individual patient to
continuity of care in the event of a provider leaving the
patient’s health plan
- The right of the individual patient to
see a specialist
- The right of the individual patient to
emergency care when indicated
- The right of the individual patient to
a second opinion from a provider of patient’s choice, and
patient right to appeal if HMO/insurer says care not covered
- The right of the individual patient to
get what he or she has paid for, through a requirement that
HMOs/insurers limit their non-health expenditures (such
as administration and overhead) to not greater than 10 percent
of revenues
- The right of physicians and nurses, in
consultation with their patients, but free from third-party
intervention, to make decisions regarding treatments and
medications
- The rights of physician or other health
care professionals to communicate with patients about the
term of their coverage and to advocate on their behalf
- Prohibition of financial inducements to
reduce, delay or limit medically necessary care and a requirement
that all financial arrangements be publicly disclosed
- Prohibition of HMO/insurer contracts that
allow health care providers to be terminated without cause
3. MORATORIUM ON FOR-PROFIT CONVERSIONS. Additionally,
the ballot measure imposes a moratorium on any conversion
of not-for-profit hospitals, insurers or HMOs to for-profit
status until such time as the six requirements of the universal
health care mandate (see above) have been met. |
