HMO REFORM: Davis’ Plan Leave Patients Feeling Pain

      In a San Diego Union Tribune op-ed, Jamie Court, director of Santa Monica-based Consumers for Quality Care, blasts Gov. Gray Davis' HMO reform proposal, arguing that "HMO reform is turning into a debate over tort deform, a long-sought agenda item of the insurance industry." He argues that the proposal "will either create a two-tiered system -- public officials having more remedies than those they serve -- or eviscerate legal rights for public employees, individual purchasers and those on Medicare and Medicaid." Taking aim at the "substantial harm" clause, Court also asserts that too many Californians would be left with little legal recourse since their injuries would not fit into the narrowly-defined right to sue threshold outlined in the proposal. Court also decries the proposal's attempt to limit HMOs' responsibility in covering damages patients seek to recover from their injuries when doctors and medical groups are unable to pay. He notes that "tort reform threatens to overshadow the need for patient's rights" in Congress as well. Citing a recently denied request by "patients victimized by HMOs and without a remedy" to meet with the governor, while he took time to meet with HMO executives "behind closed doors," Court asserts that "those with cash clout" have the most influence over health care reform. Court concludes that "if these patients cannot get an audience with their governor, at least they should have their day in court" (8/25).