PacifiCare Leading Donors in Fight Against 2 Initiatives

PacifiCare Health Systems Inc. has made the biggest contribution yet--$130,000--to a health industry-backed campaign to defeat two ballot initiatives aimed at making significant changes in the state’s managed-care business.

The giant Cypress-based health maintenance organization donated nearly half of the nearly $278,000 raised by Taxpayers Against Higher Health Costs in the three months ended June 30. A company spokesman said the company expects to donate at least $170,000 more to the cause, but other HMOs are likely to catch up in their donation levels.

The campaign is taking aim at Propositions 214 and 216, which would outlaw gag rules in managed-care contracts that prevent a doctor from telling a patient about a treatment not covered by the patient’s health plan. Both would also require a health plan to give reasons for denying care.

One difference between them, among several, is that Proposition 216 would levy taxes on HMO mergers and chief executives’ salaries to pay for county emergency care. PacifiCare, for instance, would be required to pay a 1% tax on its $2.1-billion bid to buy its longtime Orange County rival, FHP International Corp.

The campaign’s most visible effort so far has been a television commercial that began airing last week. The 30-second spot depicts a mock interview between a news reporter and two identical twins--respectively representing Proposition 214 and Proposition 216--which quickly degenerates into the twins’ argument over the merits of their proposals.

Jamie Court, a Proposition 216 supporter, said the ad campaign trivializes a “matter of life and death for Californians who are arbitrarily denied care.” He noted how, in the past year, the company denied chickenpox vaccinations to members until regulators insisted on them.

Ben Singer, a PacifiCare spokesman, said the company always strives to provide good health care, and defended the company’s policy on chickenpox vaccinations. At the time, the company’s temporary recommendation against the vaccinations came after medical experts had questioned the effectiveness of the shots, he said.

He also said the company and the rest of the California HMO industry opposes the measures because they believe the ballot measures would drive up health care costs. Both measures, for example, would require mandatory staffing levels at hospitals and clinics, he said.