HMOs and Arbitration

I was surprised to see The Times’ March 11 editorial against my bill, AB 1751, which would prevent HMOs from forcing patients into binding arbitration as a condition of getting health care, thus thwarting legislation signed by Gov. Gray Davis last year that allows patients to sue their HMOs for denial or delay of critical care.

When you opine that there is “no broad political support” for my bill, what can you possibly mean? The coalition of patients and consumers that supported the entire package of HMO reforms last year may not be “political,” but it was sufficient to point out the deficiencies in the system. Gov. Davis did not seek or support the reforms last year at the beginning. They were the work of legislators who turned 72 disparate bills into a package of desperately needed reforms, which we then patiently worked with (and pushed) the governor to shape.

Arbitration, even with the few additional due process protections Sen. Richard Polanco proposes, is still deficient. Arbitrators, whose firms and livelihoods depend on the few HMOs that hire them, make decisions that are not reviewable by a court, are not public and do not have precedential value. The patient is stuck with the decision. Arbitration can still be chosen by the patient under my bill, but HMOs are terrified that patients who have been harmed might understand that the system is not really set up to vindicate a patient’s right for redress, it’s just set up to save the HMOs money, like every other procedural rule they impose.

SHEILA JAMES KUEHL, Chair

Assembly Judiciary Committee