Arbitration: Is health-care 'fix' unhealthy for patients?

It either:

a) will help fix an ailing health care system, or

b) is so unjust that Thomas Jefferson is probably rolling in his grave.

That's how the rhetoric is shaping up around Intermountain Health Care's decision to push arbitration instead of litigation to solve medical malpractice disputes. The arguments for and against mandatory binding arbitration include horror stories on both sides — as well as plenty of hyperbole, dueling experts and conjecture quoted as fact.

No wonder, then, that the arbitration controversy is both heated and hard to get a handle on. The issue is escalating, with a state legislator looking to repeal a 2003 state law that lets doctors turn away patients who don't sign agreements to arbitrate disputes.

IHC and other health-care providers, the Utah Medical Association and the Chamber of Commerce line up on one side, bringing in big guns like former Gov. Norm Bangerter in a group called Arbitration Alliance. On the other side are several vocal malpractice plaintiffs' attorneys, Patients Against Mandatory Medical Arbitration (PAMMA), some unions and the AARP.

In the middle are the elusive facts.

Both sides say logic and research support them. Sit with either camp for an hour and it's easy to be seduced by their arguments — and even feel their pain.

Here, on the one hand, is trial attorney Clark Newhall delivering an impassioned speech about the injustices of mandatory arbitration. He jumps up and down, breathing hard, and you worry that he'll have a heart attack right in front of you.

Later, you interview IHC Physician Group director and surgeon Dr. Linda Leckman and find her candid and humorous, even self-deprecating. She shows you a Far Side cartoon: two deer, standing upright, one with a bull's-eye printed on his chest. "Bummer of a birthmark, Hal," reads the caption. IHC, she says, is taking the heat for a growing move to medical arbitration.

It's a target IHC pinned on its own chest, though. The Utah Medical Insurance Association, a physician-owned malpractice insurance company, says that half of its covered obstetricians and plastic surgeons and nearly that many of its general and orthopedic surgeons already require patients to sign arbitration agreements. UMIA promotes that with a 5 percent malpractice premium discount for those who require arbitration agreements. But it is 250 IHC-employed physicians who decided — as a bloc — to require mandatory binding arbitration.