Competing Propositions Confuse Some Health Issues

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Of all the propositions voters will be asked to decide Nov. 7, few are more confusing than 200 and 204.

This despite the fact that both purport to take the same money Arizona's $3 billion share of a 1998 settlement between numerous states and the nation's tobacco manufacturers and spend it on the same thing: health insurance for those who can't afford it.

One factor complicating the issue is a difference of opinion over what happens if both 200 and 204 pass. Some say if both pass, the one with the most votes prevails. Others say if both pass, the whole mess will end up in court.

To further complicate the issue, some heavy political hitters, including Gov. Jane Hull and Maricopa County Sheriff Joe Arpaio are weighing in, and various health organizations and alliances have chosen sides as well.

Proposition 200 Healthy Children Healthy Families would use $40 million of the $120 million Arizona will receive annually from the tobacco settlement to provide health insurance for 40,000 uninsured working family members. It would allocate the rest of the tobacco money for hospice care; for preventive screening for cancer, heart and lung disease and strokes; to assure that children start school healthy and ready to learn; and for a health insurance program for children.

Proposition 204 Healthy Arizona 2 is a replay of an initiative overwhelmingly passed in 1996 but never funded by the Arizona Legislature. It would combine $59 million in annual tobacco revenues with federal funds to provide health coverage to most of the state's 100,000 working poor.

Under 204, the rest of the settlement money would go to six established programs, including Women, Infant and Children; child abuse prevention; health care for young mothers and children; medical research that has lost federal funding; teen pregnancy prevention; and rural health education.

Those who support 200 include the state's nursing association and hospitals, as well as Gov. Jane Hull, grocery store magnate and former gubernatorial candidate Eddie Basha, and Maricopa County Sheriff Joe Arpaio. They argue that it uses the tobacco money as it was intended, for health purposes and toward children's public health and prevention programs.

Supporters of 204, while not the big political names backing 200, are health care professionals, many who run small clinics. Eve Shapiro, speaking for the 1,100 physicians who are members of the Pima County Medical Society, said 204 offers the simplest solution for lack of access to health insurance.

Meanwhile, Dr. Kent Campbell, dean of the College of Public Health at the University of Arizona, has been studying both initiatives from an objective point of view. Campbell argues that voters should ignore the side programs that each initiative would fund, and focus rather on which initiative gives the most people the easiest access to health care.

While both sides present compelling arguments, he thinks that 204 "more clearly, efficiently and accountably works to promote the public health of Arizona. It addresses the central biggest health problem in Arizona coverage and access to health care."

Arizona Common Cause encourages voters who are unsure to vote "yes" on both 200 and 204, rather than splitting their votes and risking defeat of both measures.

State Treasurer Carol Springer of Prescott, on the other hand, said she thinks both propositions should be defeated.

Springer thinks 200 creates too many new programs, not to mention a seven-person health commission with no oversight. And she opposes 204 because she fears it will triple the size of the state's health care program for the poor, while also leading to future cost increases the state will have to bear.

One thing is for sure: only Texas has a higher rate of uninsured residents than Arizona. Supporters of both 200 and 204 view the money from the tobacco settlement as the best opportunity to change that.

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