HMO Reform and Propositions 214 and 216

Re your Oct. 7 article on Props. 214 and 216:

If Prop. 216 and Prop. 214 on HMO reform are twins, as the HMO industry contends, then Prop. 216--backed by California’s nurses, Ralph Nader and Prop. 103’s Harvey Rosenfield--is Abel. Able to end HMO abuses, such as the bonuses awarded to doctors for withholding treatment and the unreasonable denial of access to specialists’ care, with new patient safeguards. Prop. 216 can only be amended by two-thirds vote of the Legislature.

Prop. 214 would then be Cain. It is backed by the Service Employees International Union, which has cut sweetheart deals replacing skilled nurses, who provide critical care, with the less skilled workers that SEIU represents. Prop. 214 can be amended with a simple majority vote. If Prop. 214 gets more votes than Prop. 216, the evil twin will have won out over the good one.

JAMIE COURT

Los Angeles

Gov. Pete Wilson recently signed legislation to outlaw gag rules, the central provision of both these measures. The law, created by AB 3013, ensures open communication between doctors and patients and negates the need for the so-called health care reform “gag rule” provisions in Props. 214 and 216.

BARBARA ALBY

Assembly, R-Sacramento

The writer was author of AB 3013.

These labor-sponsored initiatives are designed to save jobs and give health care workers preferential employment status at the expense of saving the county health care delivery system.

Both initiatives contain provisions that essentially end “at will” employment because an additional burden would be placed on hospitals and physician groups to demonstrate “just cause.” For employee terminations under this initiative, employers would have to compile substantial evidence in order to terminate an employee. Discipline for such employee problems as substandard or unsatisfactory performance, lack of conscientiousness, negligence, tardiness, insubordination, etc., is not enumerated in the initiative. The result is that these performance-related problems are not included in their definition of “just case.”

Prop. 216 would levy a heavy tax on the county for entering into public/private partnerships where it can be demonstrated that the private sector can provide the service less expensively than county government.

JIM LOTT

Senior Vice President for Policy Development and Advocacy

Healthcare Assn. of So. Calif.