MANAGED CARE: Becomes Hot-Button Election Issue
Public disaffection with managed care and a popular call to reform the health care system will be key issues in this fall's midterm elections, according to political and industry analysts quoted in the New York Times. The Times notes that "candidates in primaries and general elections for governor and Congress" -- especially in key states like New York, California, Texas and Florida -- "are promoting access to more doctors, a right to appeal [HMOs'] decisions on restricting care to impartial tribunals, and freedom to sue the organizations for malpractice" (Kilborn, 5/17). "There's no question that patients' rights and HMO reform will be the key political issues this election," said Democratic pollster Mark Mellman. The Christian Science Monitor reports that "some experts even predict it will dominate the next presidential campaign" (Marks, 5/18).
GOP Not To Be Outdone
Today's Wall Street Journal reports that Democratic party leaders and labor unions are pushing Democratic candidates to take up the managed care reform issue, forcing the issue for Republicans. Many in the Republican leadership stress the need for the party to push its own managed care agenda. "If we don't, we could well get steamrolled in November," said Rep. Lindsey Graham (R-SC). In fact, a Republican bill may be introduced in the House as early as this week. It "is expected to contain some consumer protections as well as steps aimed at making insurance more affordable for small businesses" (McGinley, 5/18). Frank Luntz, a Republican pollster, said most voters do not want massive government intrusion into health care, but public "[s]upport for setting minimum standards is a mile wide and a mile deep." Michael Schroeder, chair of the California Republican Party, said of the managed care issue: "The one thing the California Republican Party will not do is defend the status quo because we do not believe the status quo is defensible" (New York Times, 5/17). Some Republicans remain skeptical about the need for reform, like Rep. John Linder (R-GA), head of the House GOP re-election effort. "Managed care isn't a silver bullet," Linder said (Wall Street Journal, 5/18). But Gene Bolger of the Republican-friendly polling firm Public Opinion Strategies, said, "If you see Democrats winning with it ... you're going to see it catch fire" (New York Times, 5/17).
It's The Economy, Stupid
Experts quoted by the Christian Science Monitor contend that the strong performance of the U.S. economy may be "mask[ing] the deterioration of the health care system." Bill McInturff, a partner at Public Opinion Strategies, said: "There's every evidence that if, and when, the economy declines, health care will become a surrogate measure to talk about economic recovery, just as it did in 1992."
The Business Angle
The Christian Science Monitor reports that the HMO industry is not happy with either party's reform proposals, and industry "leaders contend that they're already responding to the public's fears and that legislation is unnecessary" (5/18). Mark Merritt, vice president for strategic planning and public affairs for the American Association of Health Plans, said, "The politics of health care tend to change at the end, when people say, 'Hey, this legislation may cost me my health insurance or I may have to pay an extra $400 a year just to help this politician have an easier re-election'" (Wall Street Journal, 5/18). AAHP President Karen Ignagni said of managed care reform supporters: "The bottom line is that they're trying to take us back to the old-style system that was too costly. The people who are going to be penalized are the working families -- the very people these politicians say they're out to protect" (Christian Science Monitor, 5/18).
Case In Point
Today's Louisville Courier-Journal notes that "[a]ll three Democratic contenders for the seat of retiring U.S. Sen. Wendell Ford [D] ... have run advertisements saying they favor requiring HMOs to allow people to choose their own doctors." One of the candidates, Charlie Owen, said: "If you make it possible to sue HMOs, you're going to do away with a lot of the most egregious decisions made by accountants instead of by doctors." The Courier-Journal also notes that the two Democrats seeking to challenge incumbent Rep. Anne Northup (R) in Kentucky's 3rd congressional district also support HMO reform. One candidate, Virginia Woodward, "has proposed a 'Health Plan Bill of Rights,'" while the other, former state Attorney General Chris Gorman, said: "HMO abuse has run rampant. ... Medical decisions must be patient-driven, not profit-driven" (Quinlan, 5/18).