Threat Complicates Reforms, Official Says

The chairman of the commission charged with recommending ways to regulate managed health care voiced disappointment Wednesday that Gov. Pete Wilson has thrust his panel into political controversy by threatening to veto all reform bills.

Chairman Alain Enthoven, a highly regarded health care economist, said he is uncertain whether the advisory panel can now reach consensus and make recommendations as scheduled in January.

“I regret it,” said Enthoven, a Stanford University professor whom Wilson appointed in April to head the advisory Managed Health Care Improvement Task Force.

“I just don’t know what the outcome is going to be,” Enthoven said in an interview. “I am hoping that we can keep our eye on the ball and not get diverted by the swirl of partisan politics.”

In a surprise announcement this week, Wilson said he will veto virtually all of the estimated 100 managed care bills headed his way this session. He told lawmakers to shelve their proposals until January, when the commission is scheduled to deliver its recommendations.

Wilson said his one exception would be a bill that would outlaw so-called “drive-through deliveries,” in which new mothers and their infants must leave hospitals shortly after birth.

The governor complained that the Legislature was attempting to remedy a myriad of managed care issues with disjointed, “piecemeal” responses. In contrast, he said, the commission will provide a more comprehensive and reasoned approach.

Some Democrats and advocates for patients and consumers immediately accused Wilson of using the commission as a political vehicle to kill or delay bills the industry couldn’t scuttle in the Legislature, a tactic they said he had promised not to use.

But the Republican governor’s decision did draw a measure of support Wednesday from one unlikely Democratic source, Senate President Pro Tem Bill Lockyer of Hayward, usually a Wilson opponent on virtually every big issue.

Lockyer characterized Wilson’s threat to veto managed care reforms a “bit unfair” but agreed that “we are legislating in a piecemeal fashion without a more comprehensive and disciplined policy product.”

“As a general matter, taking six months to be thoughtful and try to integrate the work product is not a bad idea,” Lockyer said.

Wilson, meanwhile, was unapologetic. “We will not be ramrodded with bills. We feel the need to be fully deliberative on these bills,” said his spokesman, Sean Walsh. “It would be bad public policy to sign these bills without more analysis.”

Walsh dismissed the complaints of lawmakers and consumer representatives as the “charges and howls” of what he called “special interests.”

The 30-member advisory commission was created by Wilson and the Legislature last year to propose mechanisms to regulate the swiftly expanding managed care industry. Critics said Wilson loaded it with insurance and other industry executives.

In a separate development, Jamie Court, director of Consumers for Quality Care, said managed care reformers are discussing contingency plans to put a health care initiative on next year’s ballot.

“If the legislators won’t deal with the issue, the people will,” said Court.