Prop. 45: A foe drew personal attacks

As a surgeon, I weigh in on political issues whenever they impact me and my patients, and when I think I can shed additional light on the matter.

That was the case this year when I became a vocal opponent of Proposition 45, which would have given the state’s Insurance Commissioner unprecedented new powers over health care decisions. Fortunately, voters rejected that initiative by a near 20-point margin, sending a clear signal that it was fundamentally unsound public policy.

The rejection of Proposition 45 was a vote of confidence in the state’s newly established health exchange, Covered California.

Some would suggest at this point to pack up the resounding victory and move on. But now that the dust has had weeks to settle, and knowing full-well that issues like these tend to spring up time and again in the most unlikely of places, I think it’s important to underscore what the wholesale rejection of Proposition 45 really meant.

Also, having proponents of the ballot measure personally attack me, my physician colleagues, nurses, health care providers and even Minority Leader Nancy Pelosi for expressing our grave concerns about the policy, I feel it is even more important to clearly explain why newspaper editorial boards from across the state and nearly 60 percent of California voters opposed Proposition 45.

First and foremost, the rejection of Proposition 45 was a vote of confidence in the state’s newly established health exchange, Covered California. In the past year alone, the exchange enrolled 3.4 million people and cut the state’s uninsured rate in half, remarkable progress that has made California a model of health care reform in America. They also negotiated competitive rates and benefits on behalf of consumers and small businesses.

That’s why many of the national architects of the Affordable Care Act, including Leader Pelosi were vocal opponents to the measure. That’s also why groups that care deeply about insuring the uninsured, like the California NAACP and the Service Employees International Union (and more than 250 other respected groups and organizations) opposed the initiative.

And voters from across the political spectrum, whether they support Obamacare or not, rejected the measure because few believed that adding another layer of bureaucracy on top of the newly established health reform would be helpful.

The California Medical Association joined other physicians, nurses groups and health care providers from across California in opposing the measure because it was so poorly and loosely drafted that we believed it could interfere with treatment decisions best left to doctors and their patients.

Add to that the conflicts of interest that were not disclosed, and the fact that the initiative’s sponsors wrote in provisions that would allow them to make tens of millions more through legal challenges to health care reform policies, and voters called it for what it was – a deeply flawed and undesirable policy.

In the aftermath of elections, some try to spin their losses and blame it on factors outside of their control. In this case, the voters spoke loud and clear, rejecting a measure motivated by self interest to primarily benefit the people who wrote it.
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Ed’s Note: Dr. John Maa is on the Board of Directors of the San Francisco Medical Society.