• An interventional radiologist in Ogden says he has to refer citizens to Salt Lake City, Davis, Cache or Box Elder counties because he is not allowed on an IHC panel and no other doctors provide the type of specialized care he and his partner offer.

"Patients should not have to travel tens or hundreds of miles simply because the qualified provider nearby is excluded from their insurer's panel," he said.

• Dr. Ron Clark, an orthopedic surgeon who left Utah in 1999, said IHC's leased network of its doctors and other services dominates the market and if a physician is not part of that network, it's "economic suicide."

"While Utahns may think that IHC is a great economic value, its anti-physician policies will ultimately leave Utah with only the least capable doctors who don't mind making 50 percent of what they're worth."

Clark, who said he knows of six other orthopedic surgeons who have left Utah in the past six years because of IHC's "tyrannical reign" said he was able to double his salary by relocating to the Midwest.

So are Any Willing Provider laws about rich doctors getting richer and patients getting more choice — at the expense of spiraling health care costs?

It depends on who you ask.

Managed care providers in Kentucky challenged that state's Any Willing Provider laws, leaving it for the U.S. Supreme Court to decide if the measures go against a federal act that prohibits state laws as they relate to employee benefit plans.

In their argument, echoed at the Utah Legislature, AWP critics said the laws ultimately will deny consumers the benefit of cost-reducing arrangements with providers.

Managed care providers, by closing the doors to other practitioners, assert that the high volume of guaranteed patients drives down costs.

If the doors swing open, volume isn't guaranteed and the costs of health care will go up, they say.

A Federal Trade Commission report from July 2004 backs that concern, saying the laws could have anti-competition effects and harm consumers.

Kentucky's AWP laws, which were challenged two years ago, have been on the books for more than a decade.

While both sides of the Utah issue throw numbers about like candy in a parade — making opposite claims about the law and its effect on costs — in Kentucky, at least, the jury is still out.

"The data we have is inconclusive," said Chris Corbin, the deputy executive director for the Kentucky Office of Insurance. "Whether it has decreased or increased the cost of health care is unknown."

Spokesman Daron Cowley says while many think SB34 is specifically aimed at IHC, it is a measure that affects all providers.

"This is an issue that applies to all of health care in Utah, which is why the Utah Hospital Association and the Utah Insurance Association and nearly all the business community is against this," he said. "Although we think IHC would benefit from this legislation, we think it is bad public policy," because it would increase costs, he said.

But Dr. Dale Sundwall, one of the most outspoken supporters of SB34, believes the "open doors" fostered by AWPs would encourage competition. "If patients have the opportunity to choose their physician and facility, don't you think they would consider costs in the equation?"

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E-mail: amyjoi@desnews.com