GUBERNATORIAL ELECTIONS: HMO Reform Catches Fire
Candidates in the upcoming gubernatorial election are emphasizing HMO reform as "[s]igns of the public's sour mood toward managed care are everywhere," the Los Angeles Times reports. The three leading Democratic gubernatorial candidates -- Al Checchi, U.S Rep. Jane Harman and Lt. Gov. Gray Davis -- "support legislation that would give HMO patients the right to sue their health plans ... for medical malpractice." Harman and Checchi are the more "vocal" critics of managed care, while Davis "is often more conservative." Harman is backing unrestricted provider choice, "requiring HMOs to pay for second opinions" and disclosure of criteria for treatment decisions. Checchi is also pushing to "require plans to fully disclose information about all available medical treatments, 'not just those that are the least expensive." Davis is campaigning on "HMO issues affecting women," criticizing "so-called drive-through mastectomies" and emphasizing the need for pregnant women to be allowed to continue to see the same doctor when their employers switch health plans. However, Davis would "allow HMO patients to seek outside second opinions only in the case of life-threatening medical conditions."
Where Dan Stands
Meanwhile, the "presumptive Republican nominee," state Attorney General Dan Lungren, is pushing for "marketplace reforms" instead of directly attacking the industry. "I think that HMOs stand in the shoes of the physician ... and ought to be required to have both obligations and responsibilities," he said. Lungren said he supports the "intent" of the measure to allow HMO enrollees to sue their plan, but declined "to say if he would sign it." Additionally, all four candidates "support transferring oversight of HMOs from the Department of Corporations to another agency." Checchi, Davis and Harman support allowing patients to process appeals through an independent review board, while Lungren supports the idea only if "determinations are made by medical personnel."
Tapping Into Anger
According to state Republican Party Chair Michael Schroeder, only juvenile crime can match managed care as an issue that "generates not only concern but a real depth of anger." He said, "Managed care has reached a critical mass in California, where if people are not in a managed care plan themselves, they have family or friends who are and they've heard some complaint." Drew Altman, executive director of the Kaiser Family Foundation, which is not affiliated with Kaiser Permanente, said that the candidates who are campaigning on HMO issues "are tapping into a very real public anxiety about change occurring in the health system and managed care." Bill Carrick, Harman's campaign manager, said, "I think we have yet to see this issue reach its full maturity. It's going to be a very big issue over time" (Olmos, 5/31).