Nader Urges Support for HMO Curbs

Chastising HMOs for “excessive greed” and for interfering in the relationships between doctors and patients, consumer activist Ralph Nader on Tuesday said tough new state regulations are needed to keep the managed care industry in check.

Nader is backing Proposition 216, which is one of two anti-HMO ballot measures on the Nov. 5 statewide ballot and which is trailing in the polls.

Supporters of the measure are hoping to gather some momentum by launching a series of radio and newspaper advertisements this week and TV ads featuring Nader within the next few weeks.

Proposition 216 and a similar but competing measure, Proposition 214, are being widely watched by health care experts and legislators across the nation as a measure of the public’s attitudes toward managed care.

The two measures share a number of similar provisions, such as requiring second opinions when medical treatments are denied by health maintenance organizations or related medical groups. But Proposition 216 proposes sterner regulations, such as “greed taxes” on health care mergers and on “excessive” compensation for health care executives.

Opponents, however, say the measures would sharply raise medical costs and impose overregulation of the health care industry, and are union-backed efforts to protect jobs.

Speaking at a news conference in Santa Monica, Nader said the California measures have become “the main battleground in health care today” in the ongoing national debate over the growing influence of large managed care companies over medicine.

Nader, joined by a hospital nurse, attacked HMOs for “practicing medicine without a license.” He contended that doctors’ decisions are being overridden by health plan administrators “who haven’t even seen the patients.” With them was a Simi Valley insurance broker who portrayed himself as an HMO victim whose wife died of cancer.

A frequent complaint of physicians who work for HMOs is that their treatment decisions are sometimes overturned by managed care administrators who are only vaguely familiar with the patient’s history and medical problems. Supporters of managed care, however, say that such oversight is the very backbone of the industry’s efforts to cut medical costs by reducing unnecessary medical treatments that may also be potentially harmful to patients.

Nader predicted that the issue of who is in charge of making medical decisions--doctors or managed care administrators--”will become a second battlefront in the debate over the growth of big hospital chains and HMOs.”

Proposition 216’s principal backers are the California Nurses Assn., a nurses’ union that has been harshly critical of HMOs, and Consumers for Quality Care, a Nader-affiliated organization headed by Harvey Rosenfield, author of the Proposition 103 auto insurance reforms.