Extending Health Care security to seniors and kids

By William R. "Bill" Orton

We are entering a "post-HMO" world, where the future of health care needs new definitions. We must make some big decisions, so that seniors and children are able to go to the doctor and have access to prescription drugs.

As insurance companies shifted to the HMO model as the way to control the bottom line, this became the way that most people received health care.

Now, HMOs are dying. They have competed brutally against one another. They are no longer able to hold down costs, as the drug companies are charging too much, capitation has stagnated care and mergers, consolidations and squeeze-outs. have gutted the concept of competition.

California is at a point where our lawmakers must now ask: What comes next?

"Capitation" and "Authorizations" and the idea that doctors are simply workers within a company will not hold up.

• It's time that we begin a grand debate on what path the state should follow to make sure that children all have the chance to see a doctor.

• I think it's time that we explore how best to provide health care security for our seniors and disabled, so that we are not held hostage to an HMO world, where fewer and fewer companies are able to bargain for higher and higher costs and deliver less and less service.

• The debate cannot be entirely among the insiders, for while there must be experts ready to lead and guide debate, this is a societal discussion. Everyone must be a part of this.

It was state legislation (written by a gentleman named Barry Keene) that outlined the "paradigm" of the HMO. It is time now to see what next needs to be crafted. We need to be ahead of the curve on this one. Too much is at stake to leave it to chance.