Wider Medical, Dental Choices Fail At Ballot

Health initiatives

Washington voters Tuesday rejected a move to expand the choice of doctors available under health plans.

They also defeated another health-related measure, a proposal to allow dental hygienists to practice on their own.

The health-care measure, Initiative 673, would have required health plans to cover the services of any provider offering treatment covered by the plan. The campaign pitted managed-care companies against “alternative providers,” largely chiropractors.

Initiative 678 would have permitted trained hygienists - the people who scrape and clean teeth - to ply their trade independent of dentists. Opponents, mostly dentists, said dental health would suffer.

With 66 percent of precincts reporting, the managed-care initiative failed 67 percent to 33 percent. The hygienist proposal lost 52 percent to 48 percent.

Initiative 673 would have allowed managed-care patients to keep their doctors when they changed jobs or health plans. The measure also barred health plans from excluding the services of any willing health-care provider - from nurse practitioners and chiropractors to optometrists and naturopaths - if the plan covered their specialties.

It also would have required managed-care companies to better explain what they do and do not cover, and to disclose how much of their revenue went into treatment as opposed to administrative salaries and other costs.

Managed-care companies, which poured nearly $1.8 million into the opposition campaign, said they needed to be able to limit choices of providers in order to hold down costs.

Backers, largely chiropractors, spent about $400,000 trying to convince voters that an unfettered choice of providers is a basic right of healthcare consumers - a right that would not increase costs.

Hygienists, who for years waged a losing struggle for their cause at the Legislature, spent about $400,000 on their campaign for the right to practice without dentists’ supervision. Allowing hygienists to operate independently would improve access to dental care without threatening patient health, they said.

Foes, largely dentists, spent about $630,000 to defeat the proposal. In 11th-hour television ads, they contended dental health would suffer because hygienists are not trained to spot problems requiring a dentist’s expertise.