Oversight of Managed Care

* In response to Jamie Court’s May 18 commentary: Managed care is the most highly politicized policy issue in the country. Politicians of all stripes see it as an easy “hot button” issue. Special interests see it as a way of advancing their own agenda in the name of “consumer” protections. Why would we want to fuel this trend by making the head of a new state managed-care agency an elected official or a politically appointed board?

California needs a new agency dedicated to managed-care oversight, with expanded clinical and consumer assistance staff and with a system of binding external review in place to ensure fair grievance and appeal processes. What it does not need is more politics. Let’s get on with the business of creating a strong regulatory agency with an appointed head accountable to the new governor.

BEAU CARTER, Exec. Dir.

Integrated Healthcare Assn.

Pleasanton, Calif.

* Paul Conrad (“Dr. Kevorkian and Associates,” May 18), Court and Daniel V. Jones (whose freeway suicide was televised) should know the differences between health maintenance organizations and managed care before becoming critics or activists.

HMOs (like Kaiser Permanente) are distinctly different from managed care systems. The former meet Court’s description as a “setting where health care is the primary focus,” while the latter restrict access to health care via gatekeepers, to control costs.

Gov. Pete Wilson has taken appropriate action by renaming the state regulator of HMOs the regulator of “managed care.” Presumably this new designation will allow oversight and enforcement of both managed care and HMOs. A step in the right direction.

MALCOLM McDOUGALL

Yorba Linda