Reform Urged as Rx for HMOs

As a tactic that resonates with voters, HMO-bashing is a no-brainer this political season.

Signs of the public's sour mood toward managed care are everywhere--and political consultants and candidates have not missed them.

Audiences cheered Helen Hunt's expletive-powered diatribe against HMOs in the movie "As Good as It Gets." Millions of television viewers watched in horror as a man unfurled an anti-HMO banner on a Los Angeles freeway ramp before fatally shooting himself. And a 36-year-old newspaper publisher in Massachusetts who killed himself left a suicide note describing his struggles to get treatment from his HMO for depression.

So it's not surprising that the three leading Democrats running for California's gubernatorial nomination are calling for tough reforms for health maintenance organizations. All support legislation that would give HMO patients the right to sue their health plans--not just doctors--for medical malpractice. And they favor giving patients the right to appeal HMO decisions to an independent review board.

"Medical decisions should be made by doctors, not accountants," Al Checchi says in a TV ad.

"HMOs must start putting people ahead of insurance company profits," insists an ad by Rep. Jane Harman, a doctor's daughter whose brother is a Kaiser Permanente oncologist. Harman says she belongs to an HMO, as do rival Democrat Lt. Gov. Gray Davis and the presumptive Republican nominee, state Atty. Gen. Dan Lungren. Checchi is not a member of one.

Davis, in campaign speeches, has highlighted HMO issues affecting women, expressing concern about so-called drive-through mastectomies and the need for pregnant women to be able to continue seeing their doctors even when their employers switch health plans.

Lungren has hinted that he too supports the right of HMO patients to sue.

"I may be the only person in the room who's ever sued an HMO," Lungren said in a speech to physicians in April. He told how, as a private attorney in 1977, he represented a patient who nearly died because of poor medical care from her Southern California HMO.

'A Real Depth of Anger' Among Public

Four years after President Clinton's sweeping plan fizzled, health care reform is again a hot political issue. Opinion polls show that concern about the state of health care in this country ranks near the top of issues on the public's mind.