HMO REFORMS: Positive Changes Could Go Farther

      Noting "[w]hat a difference a governor makes," an editorial in Wednesday's San Jose Mercury News lauds Gov. Gray Davis for "applying to health care reform his philosophy that change should be incremental -- and should balance the interests of business and consumers." Under former Gov. Pete Wilson, "[n]o one reined in the excesses of the managed care industry [and little] effort was made to coordinate legislation," states the editorial, adding that Wilson vetoed "practically everything" passed by the Legislature. The piece concludes that with this week's reforms, "everything changed" (9/29).
      A Santa Rosa Press-Democrat editorial cautiously agrees, calling the package "ambitious" and "a political victory for the governor." But the editors warn that the legislation fails to address the main problem with managed care -- rising costs. "While these HMO protections are welcome, the celebration cannot ignore that Californians have not faced up to the coming impacts of higher costs," the editorial notes, adding, "If anything, these necessary reforms only add to the cost build-up." Pointing to several local hospitals that are on the verge of closure due to financial problems and other providers struggling to stay afloat, the piece predicts that "[p]eople who can afford [health care] are going to pay more, and the people who can't are going to see their access ... diminished." It concludes, "Politics being what it is, it's easier to criticize HMOs than deal with solutions that require all of us to sacrifice" (9/29).
      An editorial in today's Sacramento Bee also reservedly praises state lawmakers and Davis, stating: "Leave aside the details: the 21 bills signed by the governor will improve the confidence of the 20 million Californians enrolled in various health plans. What's more, legislators can no longer campaign against the [HMO] system -- unless they wish to campaign against themselves." The Bee argues, however, that "Davis and the legislators have falsely framed that issue. The governor knows -- or by now certainly should -- that virtually every health plan in the state delegates medical decisions to doctors and their medical groups, not to bean counters. HMOs are not micromanaging every last decision and reversing some to make more money. The real system is much more decentralized and complex" (9/30).