Other insurance companies have already had their chance. So have hospitals. And on Thursday, it was doctors' turn to talk to lawmakers about the difficulties of competing against the state's largest health-care network.

A panel of six physicians spent three hours discussing competition with a legislative task force assigned to investigate Intermountain Health Care's dominance in Utah's health-care market.

For five of the six doctors, the theme was largely the same: IHC has a good panel of physicians, is a strong insurance company and runs sound hospitals. But when you combine the three, as IHC has done, the effect is to squeeze out anyone not part of the IHC network.

"It's not that any one of the divisions is inherently bad . . . but together, all three of them with their little nuances and the small amounts of leverage they can provide each other makes for an unfair competitive layout," St. George cardiologist David Boorman told members of the Privately Owned Health Care Organization Task Force.

Craig Armstrong, a Logan pediatrician, agreed. "I have a lot of respect for what they are doing. But I'm concerned about the integration between the hospital, insurance and physicians.

"This integration is slowly but surely causing my practice to suffer," he said.

Newborn babies are the lifeblood of a pediatrician's practice, Armstrong said, and referrals are vital. But with only one, IHC-owned hospital in the Cache Valley and a policy to refer patients to IHC providers, the doctor said he is continually losing out on new patients.

"When you have a large predominant physician group that has strong internal referral processes, it makes it difficult for independent physicians to compete," Armstrong said.

Orthopaedic surgeon Terry Finlayson, also from Cache Valley, expressed similar concerns. IHC has flooded the area with physicians practicing in his field, who then get referrals from other members of IHC's physician and hospital network.

The company's control of patient flow in his area makes it impossible to compete on a level playing field, he said.

"We don't mind competing head-to-head with all other factors being equal . . . but there's no equality," Finlayson said.

Boorman agreed, saying he would have no problem losing patients to IHC physicians who offer a better product or service. But not, he said, "because they have plans that direct patients to them and give them an unfair advantage, especially in a closed community."