Task force puts IHC under the microscope

Nelson paraded a bevy of statistics before the task force members and standing-room-only crowd of public onlookers, including referencing a survey performed by a law firm that took a sampling of bankruptcy records from 2003.

While bankruptcy actions showed an average of debt to IHC as $3,330, IHC was only one of 19 creditors on average, Nelson said.

Those cases where debt to IHC was more than 50 percent of the total amount owed represented only 1 percent of the sampling's cases, he added.

"Our belief and hope is that through our charity care, we prevent bankruptcies."

Nelson and others pointed to the $67 million in charity care delivered last year in 147,000 cases and its support or operation of 15 community clinics in Utah.

That reference did draw a pointed question from Rep. Bradley Last, R-St. George, who wondered aloud who really pays for IHC's "charity" care.

"One of the things that drives people really nuts about IHC is charity care," he said, adding that he had experienced a 54 percent increase in his health insurance costs. "Who is paying for charity care?"

That brought a concession by IHC chairman Merrill Gappmayer, who told Last, "You're right. IHC doesn't pay for charity care. . . . Everyone in this room is paying for charity care."

Early questions also centered on the effectiveness of an integrated health-care model, such as IHC — providing doctors, delivery of health-care services and insurance — contrasted to other providers that don't have that business structure.

Jack Towsley, vice president of HCA's Mountainstar, operating six hospitals in Utah from Brigham City to Payson, said it would be a misstep for task force members to assume that quality of care and cost containment only accompany integrated models.

Pointing out that Mountainstar forfeited $41 million in uncollected funds in 2004 while paying $25 million in taxes, Towsley said task force members need to ask themselves if the size of IHC produces benefit or harm to the public interest in health-care delivery.

"We don't employ physicians and we don't have our own insurance plan, but I would put our quality of care up against IHC any day."

While the debate over IHC will certainly continue for months to come, the Senate chairman of the task force, Michael Waddoups, R-Taylorsville, stressed that the fact-finding is not in a punitive vein.

"IHC has proven they merit that tax exemption," said Waddoups, who was the architect of the session's firestorm with his SB61, which proposed to level a gross receipts tax on IHC.

"The purpose of this task force is not to look at taking that tax exemption away. But I became convinced there are some areas that merited being looked at it."

Those areas will likely receive more discussion in the task force's next meeting, scheduled in June.

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E-mail: amyjoi@desnews.com