Entomologists claim that the cockroach is one tough bug to eradicate. People throughout history have suffered from pestilence it transmits. Even today, the roach is an unwelcome intruder in homes and businesses. From the standpoint of workers' compensation reform, much the same can be said for oft-reviled outpatient surgery centers, whose political influence in Sacramento, and perhaps beyond, continues to annoy those who would continue to reform the system.

Their methods are both aggressive and well financed, as records with the Secretary of State's Office attest. Over the past several years, the centers have poured millions of dollars into lobbying and campaign expenses. Most recently, they helped establish the "Pharmacists and Physicians Alliance," a lobbying coalition that successfully bottled up SB 292 (Speier) in the Assembly Appropriations Committee. That bill would have placed repackaged drugs dispensed by doctors within the pharmacy fee schedule. Former Assembly Insurance Committee Chairman Tom Calderon works for them as a consultant. The Alliance also supported AB 681 (Vargas), a bill that would have postponed implementation of the new official medical fee schedule, which was strongly supported by orthopedic surgeons, the group largely viewed as taking the biggest cut when the new schedule is adopted.

The surgery centers, like any other good business, find the need to diversify during these tough economic times. For example, West Coast Surgery Center Management LLC, a significant contributor to the Democratic Party and numerous Democratic candidates for the legislature, is also the proud parent of California Pharmacy Management LLC, at least according to the Secretary of State's records. California Pharmacy Management, in turn, was a major funder of the Alliance. Pacific Hospital of Long Beach, reportedly also Tom Calderon's client, is also part of the West Coast Surgery Center operation.

West Coast Surgery Center LLC and Tom Calderon, through his consulting firm, also have not been bashful about contributing to the campaign of Lt. Gov. Cruz Bustamante, leading candidate for the Democratic nomination for Insurance Commissioner.

Candidates Calderon and John Garamendi also benefited from the Center's largesse during their campaigns for Commissioner in 2002. It seems as long as the money isn't coming from the insurance industry, it doesn't matter.

That may be about to change. It is one thing to do, as so many interests in Sacramento do, and "invest" in access. It is quite another to distinguish yourself by bringing down the entire system. Yet that appears to be exactly what these groups are willing to do through the "Worker Empowerment Act," the initiatives that have been filed for title and summary that would in essence bring an end to the workers' compensation system as we know it. The applicants' attorneys are distancing themselves from these initiatives, as is organized labor. In the meantime, the business community is gearing up for a major battle at the polls in November. Not the environment that lends itself to a robust debate of lingering issues after the enactment of SB 899 (Poochigian), is it?

So the question is whether these groups are willing to take one of these initiatives to the ballot in hopes that the attorneys and labor will be forced to support them. Or perhaps the agenda is more simple. Given the relationship the Speaker of the Assembly has with the surgery centers, perhaps they are the leverage he needs to extract concessions from the business community and unwind parts of SB 899. It is simply too soon to tell, although it is safe to say that whether it is the Speaker or a candidate for Insurance Commissioner, being associated with these public policy pests eventually will cause the bright light of public scrutiny to be focused on them and their allies.

And, as we all know, roaches hate sunlight.