Downsizing state government has become both a political and economic imperative. A number of states have garnered much national attention for their efforts at improving performance and government downsizing. The New Governor's Commission on Government Performance has pointed to Texas and North Carolina as models for the Commission's work. Other states that have been highlighted in the briefing materials for the Governor's Performance Commission include: Louisiana, South Carolina, Wisconsin and Iowa.

The 1995 Oklahoma Welfare Reform Act (HB1673) enacted the following changes:

I. Comparable Managed Care entities shall be subject to comparable standards.

Comments: Committee members recognized that PPOs are essentially unregulated while HMOs are heavily regulated. Since both entities represent to the consumer a select panel of physicians and hospitals, for example, both should be held to some basic quality standards. The group found this logic unassailable and strongly supported the above recommendation.