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PHOENIX — Two doctors launched an initiative drive Tuesday to preclude lawmakers, or even voters, from ever requiring Arizonans to buy health insurance.

The proposed amendment to the Arizona Constitution would bar approval of any law "that restricts a person's freedom of choice of private health-care systems or private plans of any type."

The measure, if approved by voters next year, would prohibit the state from imposing any penalty or fine on anyone because of the type of insurance he buys, or if he chooses not to buy coverage at all.

Backers have until July 3 to get 230,047 valid petition signatures to put the issue on next year's general election ballot.

The initiative, if successful, could undermine a separate petition drive being organized by Healthy Arizona.

That Tucson-based group, which successfully pushed a 2004 initiative to expand eligibility for government-provided health care, is preparing an initiative to provide insurance for all state residents, its Web site says. And the group says premiums would be based on each person's ability to pay.

Any constitutional measure, if approved, would trump any statutory change, whether it's enacted by lawmakers or voters.

Claudia Ellquist, a member of the Healthy Arizona committee, refused on Tuesday to provide details of what the group's initiative contains, or even say whether it would mandate insurance coverage.

"We're waiting on this poll to see how we're going to nuance this," Ellquist said. "In another couple of weeks, we'll have our initiative in front of people. Perhaps there'll be no conflict at all; perhaps people will see a conflict and have to choose."

Jeffrey Singer, a Phoenix surgeon, said he and colleague Eric Novack proposed the initiative because states are pushing ahead with their own universal-health-care plans in the absence of federal action.

Massachusetts, for example, requires all people to buy insurance or face a fine. California Gov. Arnold Schwarzenegger is proposing a similar program there.

An aide to Arizona Gov. Janet Napolitano said her health-care proposal, to be given to legislators in January, calls for no mandatory health insurance. But Singer said his measure is necessary to ensure nothing of that kind ever is approved here.

Singer said he's not against health insurance as a matter of choice. But he said government mandates have a way of producing unintended consequences that end up limiting the options patients have to get care.

"We just want to make sure that whatever ends up happening … won't be able to restrict people's freedom of choice regarding whether or not they want to participate in a particular plan," he said.

One particular concern, Singer said, would be provisions to bar individuals from directly paying for health care.

The precedent, he said, exists in Canada: If that country's health program won't pay for a particular treatment or test, doctors are legally precluded from performing it, even if the patient has the money to pay for it.

"Wealthy Canadians fly down to Phoenix all the time and get elective surgery rather than wait on line two years in Canada," he said. "We don't want that to happen in Arizona."

And Singer said the initiative also would protect the right of patients to obtain prescriptions or alternative types of medical care not covered by insurance.

For example, he said a patient may be unable to get an insurer to pay for a specific pain reliever that proves effective because it's not on the company's "formulary" of approved medications. Singer said that individual now has, and should continue to keep, the right to buy the more effective drug with his own funds.

And he said people sometimes opt for alternative medical treatments that aren't covered.

"I'm not going to say I'm advocating that," Singer said. "But these are personal choices."

He stressed that the measure would not force insurers to cover any specific medications or treatments. Those issues, he said, are covered by contracts between a policyholder and an insurer.

Singer is no stranger to taking issues directly to the ballot.

He was one of the architects of a 1996 measure to allow doctors to prescribe marijuana and otherwise controlled or illegal drugs to terminally and seriously ill patients. That measure passed, as did a ratification two years later after legislators tinkered with it.

However, threats by federal drug agents to prosecute doctors here have so far kept them from actually writing prescriptions.

Novack has a weekly radio program in Phoenix.

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