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Right to Health Care Work in Massachusetts.
Health Care for Massachusetts Campaign (HC MASS)
Health Care Insurance for Massachusetts
Constitutional Initiative Petition
ATTORNEY GENERAL'S SUMMARY OF NO. 03-09
This proposed constitutional amendment would impose an obligation and duty on the state Legislature and executive officials, on behalf of the Commonwealth, to enact and implement laws to ensure that no Massachusetts resident lacks health insurance that is comprehensive, affordable, equitably financed, and covers all medically necessary preventive, acute and chronic health care and mental health care services, prescription drugs and devices.
PETITION FOR A CONSTITUTIONAL AMENDMENT RELATIVE TO THE PROVISION OF HEALTH INSURANCE
SECTION 1: The People of the Commonwealth of Massachusetts hereby declare it necessary and expedient to alter the Constitution by the adoption of the following Article of Amendment:
Upon ratification of this amendment and thereafter, it shall be the obligation and duty(1) of the Legislature and executive officials, on behalf of the Commonwealth, to enact and implement such laws as will ensure that no Massachusetts resident lacks(2) comprehensive(3), affordable(4) and equitably financed(5) health insurance coverage(6) for all medically necessary(7) preventive, acute and chronic health care and mental health care services, prescription drugs and devices(8).
(1) This mirrors the language of the Article of the Massachusetts State Constitution that the Supreme Judicial Court held created an enforceable right to a public K-12 education for every child in the Commonwealth.
(2) Goes to the issue of universality of coverage, without which we cannot improve quality of care, improve the health status of all Massachusetts residents, contain costs, prevent cost shifting or simplify the system.
(3) Implies a broad benefit package that is essential to getting the best care and health outcomes for the resources invested in the care provided.
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EXPLANATION OF RELATION TO RIGHT TO HEALTH CARE
Thare are several reasons behind the specific language that was adopted, specifically in regard to the "Right to Health Care".
The drafters believed that creating a right to health care was not sufficient to in fact guarantee that everyone would get the health care they needed. We chose instead to establish a right to access to affordable, comprehensive coverage for specified health and mental health care benefits that would guarantee access to that care.*1
Massachusetts legal precedent distinguishes between a fundamental right that vests in the individual and an aggregate societal right that the government has an obligation to protect by enacting the necessary laws.
A fundamental right to health care given, Massachusetts legal precedent, would result in an endless set of suits by any individual who felt that they were denied care for any reason. For example, if the Legislature (or the people by referendum) enacted a universal insurance program, they could not place any limits on elective, cosmetic surgery without being sued.
The committee chose the aggregate societal right path because there is clear legal precedent which was very effective in forcing massive reforms to the public education system here without creating the problem of endless individual suits.
Finally, however erroneously, there is a widespread belief that people in Massachusetts already have a right to health*2 care since they cannot, under state and federal law, be denied care if they come to a hospital. From a legal standpoint that is technically correct, however, that was not the kind of health care any of us were interested in promoting. We therefore chose to focus instead on access to affordable health insurance with a minimum benefit package to ensure real access to quality care.
All the original signers strongly believe that everyone has a right to quality health care or they wouldn't be bothering to support this in the first place. Perhaps, as an attorney, I am overly sensitive to the legal implications of using the word right in Massachusetts, which may be unique in how its courts interpret the word.
The choice of words has no political agenda behind it and if the goal was to avoid mobilizing powerful opponents we have been unsuccessful.
The only political strategy we chose was to establish the principle that everyone in Massachusetts have access to affordable comprehensive health coverage first and then negotiate how that principle was to be achieved. That has neutralized some opposition and concerned some allies who advocate for specific solutions whether single payer or employer mandate or something else.
We have found this proposal to have been very effective in mobilizing support across a broad variety of groups including many low-income neighborhoods and communities of color. We were able to collect almost 90,000 signatures from 343 of the 351 cities and towns in the state over a 7 week period. Many were collected by social equity groups from Springfield, Worcester, Fall River and New Bedford - four of our poorest cities.
Contributed by Barbara Waters Roop, PhD, JD, Co-Chair
The Committee for Health Care for Massachusetts
1 Interesting point. This is a concern of other organizations supporting the Right to Health Care also.
2 This has also been somewhat an noted issue in other states, at least insofar as state legislators have argued that everyone already has such a right. Clearly, as Dr. Roop also notes this is an entirely erroneous concept and most state organizations have decided to combat this just as they do the many other myths created and nourished by the insurance industry's PR machine.
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