‘Health Czar’ Powers Under 186

* Open your election umbrellas! If the Aug. 26 commentary on Prop. 186 about a supposed “health czar” is any indication, a deluge of lies will be poured onto us by an anti-186 campaign that will spend any amount of your insurance premiums to defeat health reform.

I know a little bit about the section of the initiative dealing with the commissioner’s powers that was attacked by Sally Pipes’ column--I helped write it. * Pipes’ article says that the commissioner is empowered to “tell doctors what procedures they can perform.” It is utterly false. The act states that all Californians have a right to “medically appropriate” care. If your doctor says it is needed, it will be paid for, with no insurance company bureaucrat with an eye to profits second-guessing your doctor’s decision.

The only limit upon the care paid for is in section 24045. If there is no “medical indication,” then it isn’t covered.

* The health commissioner is subject to more checks and balances than the CEO of any insurer. By statute, the commissioner must consult with a board of medical experts on any decision that has to do with care. Pipes left out the references to the advisory board in her quotes from 186. Pipes also “forgot” to mention the fully independent Health Care Consumer Council established by 186. She also “forgot” about the regional advocate, whose sole job is to report to the consumers in each community about how the system is working for them.

* Section 2500(d) of Prop. 186 states: “Californians should be guaranteed the freedom to choose their own doctor or health care provider.” Pipes baldly says that “ ‘the patient’s provider of choice’ will probably be a . . . primary care provider.” Where does the act say that? Nowhere.

Finally, missing from Pipes’ article is why 186 grants power to the commissioner. The drafters didn’t want the commissioner to be able to blame anyone else if things weren’t working as well as they should. ED HOWARD

Santa Monica

* In the Aug. 24 article, “Getting a Jump on Health Care,” there were numerous misleading statements. :

False statement: “In any case, Prop. 186 sets an absolute maximum of 4% on administrative costs.” Fact: A 4% administrative overhead is fantasy. The Department of Education has a 15% overhead and the California Lottery has a 16.6% overhead. Does anyone truly believe that state-run health care will only be 4%?

False statement: “All premiums, all deductibles, all caps on expenditures and most co-payments and out-of-pocket expenses would disappear.” Fact: The initiative allows the health commissioner to add additional co-payments or require full payment for some services if the system lacks funds.

False statement: “Businesses would benefit because the new payroll tax would be less than their current health-insurance costs.” Fact: Currently 20% of the state’s businesses do not provide health coverage. For these businesses the additional taxes will be harmful. Many businesses will be forced to cut employee wages, fire employees or raise the prices of goods and services.

DAVID KNOWLES, Lead Republican

Assembly Health Committee

R-Placerville