HMO REFORM: Gubernatorial Candidates Check In

      In today's Wall Street Journal/California Edition, gubernatorial candidates Gray Davis (D) and Dan Lungren (R) are asked "how they would react to specific pieces of legislation that have landed on Gov. Pete Wilson's desk." On bills that Sacramento "insiders" say are some of the "toughest calls facing Mr. Wilson," the Journal notes that in many cases Davis and Lungren saw "eye to eye," but "in a few others -- most notably in the area of managed health care -- they simply decided to punt."

HMO Reviews
      On state Assemblywoman Liz Figueroa's (D-Fremont) AB 332, Davis said he is "undecided." Lungren said he would veto the legislation. Figueroa's bill would "require the medical directors of [HMOs] to have a California medical license before they could overturn a doctor's treatment decision." The bill would also prevent HMO reviewers from overturning "a doctor's original treatment decision until they have physically examined the patient."Davis said he supports "the concepts presented in this legislation," but thinks "it is critical that we convene a stakeholder meeting to forge compromise that will work for all interested parties." However, he said he would not want "HMO administrators, insurance executives or other nonmedical personnel" making treatment decisions. Lungren says he favors "the requirement that all medical decisions made by health plans be made by doctors," but that "limiting health plans to only employing California-licensed doctors would deny California patients the expertise of any specialist -- no matter how world-renowned." On the bill's treatment review provision, Lungren said it "might sound good at first, but on any realistic examination, its shortcomings are obvious." Click here to read CHL's coverage of the bill.

Mental Health Parity
      Davis said he would sign state Assemblywoman Helen Thompson's (D-Davis) mental health parity bill. AB 1100 would "require health insurance plans to cover serious mental illness in the same manner as physical illnesses." Lungren, on the other hand, said he is "undecided." Davis said, "The cost to employers is estimated to be minimal, but the cost to society for not providing such coverage is staggering." Lungren said he is "very supportive of efforts to expand the coverage of mental illnesses in health plans," but is "hesitant to commit to this particular measure without a clear understanding of the extent to which its provisions might have the unintended impact of dramatically increasing the cost of health insurance, thereby reducing access to affordable health care" (Benson, 9/23). Click mental health parity to read about the issue, or click here to read CHL's roundup of legislative activity on health care this session.

If I Were Governor...
      Democratic gubernatorial candidate Gray Davis' latest TV ad spot features him telling an audience about the need to "rein in these HMOs." In the ad Davis says: "One of the most important things a governor can do is to rein in these HMOs. And the first thing to accomplish that is to let you choose your doctor. I want to re-establish the doctor-patient relationship. If you're denied care, you ought to have the right to a very rapid appeal. I don't want anyone on the review team that is an accountant, an insurance executive, a financial specialist. They don't know beans about medicine, they're only interested in the bottom line, I want people who are interested in your physical well-being" (Davis ad text).