HMO POLITICS: Reform Becoming Key Issue In Gov. Races
U.S. Rep. Glenn Poshard, the Democratic nominee in the Illinois gubernatorial campaign, last week "laid out a broad legislative platform for HMO reform to give people more choice of physicians and guarantee full emergency room reimbursements." The Chicago Sun-Times reports that Poshard was "sketchy on details" but said "HMOs need to provide better coverage so members can seek treatment from family doctors, regardless of whether they are in or out of a network." Poshard also opposes "gag rules" in HMO physician contracts. Secretary of State George Ryan, the Republican nominee, is currently drafting an HMO "platform," a spokesperson said. Ryan supports banning "gag rules" and mandating "emergency room coverage similar to what Poshard proposes and improved methods to allow independent arbiters to decide claim disputes." The Sun-Times notes that Poshard's call for HMO reform followed the newspaper's report last week "on state data showing a 54% jump in complaints against HMOs" by consumers (McKinney, 6/15). A separate piece in the Sun-Times notes that "[t]he rising tide of complaints is likely to define one of the major themes of this year's gubernatorial campaign and force a deadlocked General Assembly to find middle ground on HMO reform -- something it couldn't do this spring" (McKinney, 6/15).
Two Democrats seeking their party's nomination in the fall governor's race are backing "civil liability for HMOs." Lt. Gov. Buddy MacKay (D) believes the state "need[s] a law that says patients and doctors ought to make the decisions about the quality of health care here in the state of Florida, not insurance company accountants, not HMO accountants." State Sen. Rick Dantzler (D), MacKay's opponent, said "if a treatment or a procedure is denied, then you are going to have an opportunity to hold that HMO or that managed care company accountable." Dantzler's "campaign offers a toll-free number to log HMO complaints."
The St. Petersburg Times reports that the Democrats' HMO reform proposals "worry" the health care industry more than those articulated by Republican candidate Jeb Bush. The Times notes that Bush's "proposals generally amount to modest tinkering with existing laws and giving consumers more information about HMOs." Bush also backs the creation of medical savings accounts (Smith, 6/15).
Ohio And Maryland
Managed care reform is also cropping up in the Ohio and Maryland gubernatorial races. In Ohio, Democrat Lee Fisher has proposed a plan "[m]odeled after a Patients' Bill of Rights being promoted by President Clinton." His plan "calls for greater access to more doctors, the right to appeal an HMO's decision to deny care to an impartial tribunal, and freedom to sue HMOs if their decision to deny care harms a patient." Fisher's Republican opponent, Secretary of State Bob Taft, "endorsed portions of the Fisher plan and said he agrees there is a need for a Patient Bill of Rights" (Theis, Cincinnati Enquirer, 6/12). In Maryland, two candidates challenging incumbent Gov. Parris Glendening in the Democratic primary are pushing HMO reform. Last week, Eileen Rehrmann said "she supports legislative efforts to discipline medical directors of HMOs for inappropriate medical-care decisions." And Rehrmann is backing the "creation of an advocacy office in the state health department to help patients cope with conflicts with their HMOs." The other Democrat, businessman Raymond Schoenke, "has tapped into the issue by running ads in Baltimore touting his support for giving members of HMOs more freedom to pick their physicians" (Waldron, Baltimore Sun, 6/11).