HMO REFORM: Imholz Mixes It Up with CAHP Over Plan
California HMOs' recently announced reform package is insufficient to meet the needs of managed care enrollees, according to consumer advocate Betsy Imholz. She said if "the HMOs' plan was to regain consumer confidence and win over health reform-minded legislators, it failed." The Journal of Commerce reports that Imholz, the West Coast regional director for Consumers Union, said the California Association of Health Plans' proposed independent review process fails to hold "HMOs responsible for refusing medical treatment to patients," and that her group "supports legislation that would empower patients to seek legal recourse as they can do in some other states such as Texas." CAHP spokesperson Cory Black explained that the group did not propose a right-to-sue provision because according to a Kaiser Family Foundation survey, "patients want a right of appeal through independent review more than the right to sue," reinforcing the CAHP's position that "liability is the wrong answer to a real problem." CAHP President Walter Zelman added, "Perhaps what we are offering is a 75% solution. But we believe it is the most important 75% and the other 25% may be fraught with considerable risk and cost for all." Imholz countered, "[T]he broad statements sounded good, but when you get down to the specifics, my concern is that we won't be on the same page. The devil's in the details; Mr. Zelman's speech was long on theory but short on specifics" (Lent, 5/10).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.