I hope April is treating you kindly this year and that it's not exhibiting its usual cruelty. If it is, though, at least you have this week's Capitol Action Weekly to take your mind off of everything else.

This past week was a quiet one in terms of reader feedback. Remember that I love to hear from you -- whether it's just a note to say hello, a letter to the editor, or a desire to be featured in the Reader Spotlight, our latest feature which I hope you're enjoying. All that and a chance to promote yourself or your business via advertising! Simply reply to this e-mail for more info on any of the above.

Have a great week, and may your lilacs bloom to their fullest potential this month.

-Gabe

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The quality of health care for millions of Californians, long a simmering political and social issue, is about to take center stage in the Capitol. And while education reform is a notion supported generally by the vast majority of Californians, the questions surrounding the health care system are many and complex and not easily defined in quick sound bites. As a political issue, health care is enormously complex, pitting powerful special interests against one another. Insurers, doctors, corporations -- all will be major players in the looming political wars in which the needs of the average person are likely to be lost in the shuffle.

The most crucial questions are these: Should a disgruntled patient be allowed to sue a health management organization, or HMO, for questionable treatment? Who should make the final decisions regarding treatment -- a doctor or an HMO administrator? Should HMOs cover mental disease and contraception? Which state agency should regulate HMOs? Should it be the Department of Corporations, the traditional regulator; the Department of Insurance, the state Health Services Department or some other agency, perhaps a new entity whose sole responsiblity would be to track HMOs? Should there be an official state ombudsman to field complaints about HMOs? How should health coverage be provided to the millions of people who have no health insurance?

These questions are basic, far from resolved and fraught with the potential for costly, bitter political infighting. Ultimately, if the Legislature can't resolve them, they could wind up on the statewide ballot.

The cornerstone of the HMO battle is all but certain to focus on a patient's right to sue. Consumer groups and their allies in the trial lawyer community favor expansion of HMO suits; the HMOs, clearly, oppose it. Legislation that would extend the right to sue already is being crafted in the Senate and is likely to have its first major hearings this month.

Lawyers and consumer groups, with the governorship and both houses of the Legislature in the hands of Democrats for the first time in 16 years, believe that major changes in the way HMOs operate will be approved this year. Former Republican Gov. Pete Wilson vetoed HMO bills approved by the Democrat-ruled Legislature, but this year the Democrats, the traditional ally of the trial lawyers, believe the result may be different.

During his campaign, Davis promised to overhaul HMOs, but he provided few specifics then. He still hasn't, and the fundamental question for HMO reformers is what Davis will sign and what he will reject. Thus far, true to form, Davis has been vague and offered few clues.

The problem of those who have no health insurance also will receive attention. A recent University of California study found that more than seven million Californians had no coverage, including many people who earn too much to qualify for MediCal -- the state-federal health program for the poor -- and those who lost coverage through the changes in welfare eligibility laws that went into effect during the past two years. What happens to them?

California has long been in the forefront of the continuing transition of health care from the traditional fee-for-service to managed care, and anything this state does is likely to influence the way other states attack the issue.

The focus comes back to Davis: What will he do?

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