SACRAMENTO — Taking their campaigns to an audience of doctors Tuesday, Republican gubernatorial candidate Bill Simon Jr. called for "fundamental reform" of health care to benefit physicians, while Gov. Gray Davis cautioned against "wholesale changes."
In back-to-back appearances before the California Medical Assn., Simon decried health maintenance organizations and urged less government involvement in health care. He called for a "market economy" solution to what he described as a "full-fledged crisis."
Davis focused on his support for abortion rights, which he hopes to contrast in the campaign with Simon's opposition to abortion.
While many physicians share the governor's views on abortion, Simon generated an enthusiastic response with his criticism of the health-care bureaucracy and of lawyers who sue physicians.
"We need fundamental reform," Simon said, adding that in his solution, "it will be the doctors and the patients whose input will be most important to me."
For his part, Davis proposed a doctors' "bill of rights" ensuring that insurance companies promptly pay doctors for care they provide and protecting them against unilateral changes in their contracts. A spokesman said the idea isn't yet embodied in legislation.
In a brief news conference after his speech, Davis also endorsed the current health-care system, with some improvements: "If you're talking about wholesale changes in the way health care is delivered in this state, patients better beware."
Some doctors lauded Davis' call for a physicians' bill of rights. And his support of abortion rights could be key in how many physicians vote in the November election. But Dr. John Barr, a diagnostic radiologist from Oakland and a Democrat who described himself as "strongly pro-choice," said, "Simon spoke to issues that resonated."
"What solutions did [Davis] have? More of the same," added Dr. Thomas W. LaGrelius of Torrance. "Simon wants to put patients and doctors back in charge."
Simon's prescription for the health-care system, set forth in a half-hour speech, included "less bureaucracy, trying to restore the patient-doctor relationship, private solutions."
He did not specifically say he was embracing the old fee-for-service system, in which doctors had more control and patients bore more costs. But he suggested that patients pay more for routine visits.
Simon, who has called for a tax reduction, said he would look seriously at raising government payments to physicians who treat people on Medi-Cal, the main state health-care program for the poor, elderly and disabled.
"Medical providers must be paid fairly and adequately for the services they provide," Simon said, adding that doctors who provide care for the needy should receive tax breaks. He also called for medical savings accounts for people whose employers offer health insurance, tax credits for people who buy their own insurance and health-care vouchers for the indigent and workers whose companies don't provide coverage.
Simon also took a slap at trial attorneys who sue doctors for malpractice. To the applause of many physicians in the audience, he vowed to veto legislation changing a 1976 law that caps damages for pain and suffering at $250,000.
After Davis' speech, the governor left open the possibility that he might sign legislation altering the malpractice law, but would offer no specifics: "I'd be opposed to any wholesale changes. I'd be open to some modest improvements. The health-care system is in a fragile state.... I might be open to some modest improvements."
Davis, who spoke for about 15 minutes, cited accomplishments including expanding Healthy Families, a state- and federally funded program for the children of working parents without health insurance. He also pointed to a new Department of Managed Care, which intervenes on behalf of patients who have complaints with health maintenance organizations.
"America left fee-for-service for HMOs because of the staggering cost that was being borne by individuals, the government and the corporate community," Davis said. "I'm not prepared to abandon the HMO model. I still believe it can be improved to provide good quality care and still be fair to the physicians providing that care."