Wednesday, November 10, 1999

Mexico’s ruling party
holds its first primary

Bullet The issue: The ruling Institutional Revolutionary Party held its first presidential primary in its 70-year history.
Bullet Our view: The election drew a large turnout and may have strengthened the party for the general election.

FOR the first time in its 70-year domination of Mexican politics, the Institutional Revolutionary Party (PRI) has held a primary election to determine its presidential candidate to succeed President Ernesto Zedillo. The results are being viewed as pumping new life into the party, which had seemed in danger of losing the presidency.

Mexicans responded enthusiastically to the unprecedented opportunity offered by the primary, turning out in much greater strength than had been predicted -- 9.5 million voters compared with the expected 6.5 million.

The primary winner, Francisco Labastida, is a former minister of the interior and agriculture who appeared to have the support of the party establishment.

Since the PRI's founding in 1929, the incumbent president has always chosen the party's presidential candidate. That method of selection was intended to ensure stability following a decade of revolutionary violence.

But the PRI's popular support has waned in recent years. The primary was seen as an attempt to revitalize the party. If the turnout was any indication, it worked.

There were fears that Labastida's closest rival, Roberto Madrazo, would bolt the party if he lost. That would have sounded a sour note and perhaps defeated the purpose of the election. But Madrazo decided to remain in the PRI, thereby averting what could have been a disastrous split.

Although there were allegations that both Labastida and Madrazo had engaged in questionable tactics in the primary election campaign, the vote count seemed to be fair. After a long history of official cheating, that is encouraging.

The PRI primary contrasted with the disarray of the opposition, which has failed to come to terms on a primary of its own. Unless the opposition parties manage to resolve their difference, their strength will be divided in the general election, which is scheduled for July 2, 2000.

The strongest opposition candidate appears to be Vicente Fox of the conservative National Action Party. Making his third bid for the presidency is the mayor of Mexico City, Cuauhtemoc Cardenas, the nominee of the liberal Party of the Democratic Revolution.

Mexico is suffering from poverty, rampant crime and corruption and a smoldering revolt in the south. It might benefit by the ouster of the PRI, which has been in office too long. But the primary appears to have rejuvenated the party while the opposition fritters away its chances.

The United States has to be concerned about conditions in its southern neighbor; the smuggling of illegal aliens and illegal drugs across the border are obvious concerns. On the positive side, trade with Mexico is flourishing under the North American Free Trade Agreement.

A stable, democratic and prosperous Mexico is in this country's interest. Mexico's choice of an able, honest president is crucial to achieving those goals.


Health-care decisions

Bullet The issue: America's second-largest health maintenance organization will let physicians and patients make treatment decisions.
Bullet Our view: Other insurers should defer to doctors on decisions regarding care of their patients.

MANY physicians and patients have been incensed by health-maintenance organizations intervening in health-care decisions. The controversy has triggered federal legislation that would delegate such decisions to independent panels.

Now, however, the nation's second-largest health insurer has promised to give doctors the final word. Other insurers should consider taking the same step.

HMO officials have argued that their intervention has prevented large increases in health costs. But Minneapolis-based United Health Group found it was spending $100 million a year to review questionable treatments and then approving 99 percent of them. The chief result of the reviews was to infuriate doctors and patients.

United, which insures 14.5 million people, has decided to phase in new rules to return decision-making power to physicians. The company will review decisions afterward and urge doctors not to exceed certain averages. On rare occasions, it may drop doctors from its network of approved physicians when persuasion has not worked.

The two major health insurers in Hawaii, Kaiser Permanente and Hawaii Medical Service Association, rely on doctors to make treatment decisions. Kaiser, which has an integrated system, has always relied on doctors' judgment. Clifford Cisco, HMSA's senior vice president, says his organization has gradually reduced the requirement of prior authorization.

United's shift still was greeted enthusiastically by Dr. Arleen Jouxson-Meyers, president of the Hawaii Coalition for Health. She says disagreement between physicians and insurers "has been the biggest beef against managed health care all this time, that people who are not physicians have the last say in what is done or not done for patients."

Health-care insurers in Hawaii should recognize United's new policy as appropriately giving doctors and patients the ultimate decisions on treatment. If they are not already doing so, health-care insurers should confine themselves to actuarial calculations.

Published by Liberty Newspapers Limited Partnership

Rupert E. Phillips, CEO

John M. Flanagan, Editor & Publisher

David Shapiro, Managing Editor

Diane Yukihiro Chang, Senior Editor & Editorial Page Editor

Frank Bridgewater & Michael Rovner, Assistant Managing Editors

A.A. Smyser, Contributing Editor

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