HMO REGULATION: Consumer Advocate Bemoans Oversight Structure
Writing in today's Los Angeles Times, Consumers for Quality Care Director Jamie Court calls the way HMOs are regulated in California a "torpid civil oversight." Court notes that HMOs are currently overseen by a commissioner in the state's Department of Corporations. But this is "a post that carries no accountability to the public, only to the governor and inevitably to the governor's campaign contributors: the HMO industry." He notes that "in the entire 22-year history of state oversight of HMOs, only one fine has been issued against an HMO or a quality-of-care violation." Rather than placing the "regulation of an industry [that is] responsible for the health of 19 millions patients" under the jurisdiction of "a single, unelected individual," Court asserts the task would be better performed by "an elected regulator -- accountable directly to the public -- or a commission that is appointed jointly by the Legislature and the governor."
Gov. Pete Wilson wants to create a Department of Managed Health Care and appoint "a single HMO regulator." But according to Court, this move is "simply a name change, and it will be a placebo" because the managed care department will still be under the Department of Corporations -- "an agency concerned with supporting businesses, not sanctioning them." Court concludes: "The Legislature has 60 days to pass a resolution that short-circuits Wilson's approach, and it must act quickly." But until HMO reform legislation "addresses the chief concern of the public" -- that "'HMOs are in it for the money' and yet they pay no price for their wrongdoing" -- Court says any reform measures will continue to frustrate the public (5/18).