From Deseret News archives:

New Utah fight finds IHC in eye of storm

Senate bill attacks the provider's near-monopoly

Published: Monday, Jan. 24, 2005 12:22 a.m. MST
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It will be doctors against doctors in a fight poised to unfold on Capitol Hill, pitting health-care giant Intermountain Health Care against other medical professionals who allege IHC's near-monopoly drives good physicians out of business and compromises efficient medical care for Utah residents.

Sen. Parley Hellewell, R-Orem, is sponsoring SB34, which would allow Utahns to go to any medical provider of their choice, as long as the provider is willing to accept 95 percent of the insurance plan's reimbursement rate.

The premise of the bill goes against restrictions inherent in health maintenance organizations that limit consumers to doctors and hospitals they have agreed to cover.

Seven states have passed what is commonly called an "Any Willing Provider" law, and close to two dozen states have some variation of the concept, which has gained momentum since the U.S. Supreme Court upheld a Kentucky provision in 2003.

Supporters say turning health care into a truly competitive market will result in better service, decreased costs and more equity for doctors struggling to maintain or establish a practice.

Critics say such a mandate would do the reverse, resulting in decreased ability to manage costs and to ensure that doctors are properly qualified.

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Whatever the truth, both sides are gearing up for war in the hallways and committee rooms of the Legislature, where it is predicted the dispute will rival last year's mandatory arbitration controversy. In that battle, IHC was in the hot seat for forcing patients to waive their rights to a lawsuit as a condition for receiving medical care.

A compromise was reached, making such agreements voluntary, but IHC is once again in the crosshairs of critics who say it is too powerful, squeezing out qualified physicians and forcing patients to patronize clinics and doctors not of their choice.

"Why not let patients vote with their feet and decide where to go?" said Dr. Wendell Gibby, one of the primary forces in support of HB34. "This is really a fundamental issue that is reasonable because it is about agency, the ability to choose."

Supporters such as Gibby say they have seen many qualified doctors compromised in their practices because IHC refused to include them on their panel of accepted physicians. In addition, they say, patients have suffered medical complications because they delayed treatment because they could not immediately access IHC providers.

IHC spokesman Daron Crowley said the measure is ill-informed, relying on numbers that don't tell the whole story about the potential economic impact of what the proposal will bring.

While IHC enjoys a good share of the market, it still only insures 19 percent of Utahns and does not enjoy the monopoly critics allege exists, he said.

The Utah Hospital Association and the Utah Health Insurance Association have lined up against the bill, with patients' rights groups squarely on the other side.

SB34 has yet to have a public debate this session, but both sides are promising a a fight.


E-mail: amyjoi@desnews.com

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