The health care industry is changing rapidly, and some of those changes could be dangerous to your health. That's why we need Proposition 214, the HMO Patient Rights Initiative. All of us, especially those of us who depend on health care the most--seniors, cancer patients, adults and children with disabilities--must be certain that our health insurance will be there when we need it.

Proposition 214:

• Prohibits written and unwritten gag rules that keep doctors from telling patients about the care they need.
• Protects doctors, nurses, nursing home aides, paramedics and other health care givers from intimidation when they speak out on behalf of patients.
• Prohibits financial incentives for withholding care patients need.
• Requires insurers to disclose guidelines for denying care and to give patients a second opinion--including a physical examination--before denying care recommended by the patient's doctor.
• Forces HMOs and insurers to disclose how much they spend on patient care and how much is spent on executive salaries and corporate overhead.
• Requires that hospitals and nursing homes have safe levels of staffing.
• Prohibits the sale of your medical records without your permission.
• Will be enforced by existing state agencies and without new taxes.

Gag rules on doctors and nurses are wrong. Intimidation of caregivers is wrong. Bonuses for denying care that people need are wrong. Secret guidelines for denying care are wrong. Unsafe staffing in hospitals and nursing homes is wrong.

It is dangerous for everyone if HMOs and health insurers worry more about making money than they do about your health when they make decisions about your care.

If you get sick, you have a right to know what care you need, and you have a right to get the care your insurance premiums have paid for.

You should not have to worry whether your doctor is afraid of retaliation for referring you to a specialist or whether nursing home aides fear being punished for speaking up for their patients.

You should not have to worry that your health plan could drop your doctor for no reason.

You should not need to be afraid your doctor is being paid a bonus for denying you the care you need.

You should know how much of your insurance premium is spent on actual patient care and how much on bureaucratic overhead and executive salaries.

Is it important to contain costs to keep health care affordable? Yes.

Should cost controls be used as an excuse to deny patients the treatments they need just because administrators for HMOs and insurers think it will cost them too much money? Never.

214 will be enforced by existing agencies, minimizing enforcement costs. And those costs are necessary in order to make sure the rights of patients are safeguarded.

Proposition 214 is a decision about life and death. Please consider carefully and join us in voting yes on Proposition 214.

MARY TUCKER
Chair, State Legislative Committee
American Association of Retired Persons

LOIS SALISBURY
Executive Director, Children Now

LAURA REMSON MITCHELL
Issues Coordinator, National Multiple Sclerosis
Society, California Chapters