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Wednesday, April 26, 2006

In Defense of the Health Care Task Force

By Senator Michael Waddoups
Senate Chair of the Privately Owned Health Care Organization Task Force

The local news has started to report on some of my actions relating to a looming health care problem in Utah and the United States.

The Deseret Morning News story tried to spin them into some kind of end run - a condemnation of the work of the Privately Owned Health Care Organization Task Force. That is not how I see it.

The KSL story was even worse - they reported Senator Davis and I feel the task force is failing.

That is not accurate.

The task force is meeting the challenge of gathering information, and dealing with it in a responsible, deliberative manner. When the facts are in, rational decisions will be made and we'll propose legislation that will result in better healthcare for our communities. My actions were no condemnation of the task force. The task force is doing its job.

That said, we need to be clear that we are on the verge of a serious national crisis and we all need to do what we can to find solutions. My actions are warranted, absolutely necessary, and probably overdue. They in no way circumvent the work of our task force.

I felt Linda Fantin’s story was straightforward and substantially accurate.

64 Comments:

Anonymous Jonathan P. said...

Senator Waddoups, the problem I see with your comments is their timing. You have had a significant and important role in creating and managing the Taskforce. I wish you'd let it finish its course before you begin calling for State Attorney General and Federal investigations, otherwise your own credibility and that of the Taskforce is under questions (hence the need for you to reply to concerns raised in the D-News and KSL yesterday).

Everybody knows we have huge problems in healthcare - on a national basis, not just in Utah. It doesn't take a rocket scientist (or a bunch of new investigations) to figure that out! What it does take is for people to work together to figure out the solutions. I'd hoped you were one of those people. I'd like to challenge you to try that approach for a few years. It certainly doesn't seem to be your approach at the moment.

4/27/2006 10:21 AM  
Anonymous Anonymous said...

Senator

I disagree with Jonathan P. I think you are being a leader.

And being a leader means you often take a beating when you propose something which upsets the vested interests.

The Task Force is bogging down. You are being numbed into inaction by the very forces you seek to change. And that is by design, and you know it.

To change the landscape in Utah, we need more people like you, not less. We need more leaders to step to the plate, not shrink from duty. It would be easy to wash your hands of this issue and focus on other less controversial ones.

But I, for one, give you great credit for being steadfast and strong.

4/27/2006 11:37 AM  
Anonymous Jonathan P. said...

While I agree with what "Anonymous" said about needing good leadership, leadership doesn't necessarily mean being the first one to jump off a cliff. Effective leaders bring others along to a better place and work together for a common purpose.

If the Taskforce is "bogging down", who better to fix it than a "leader" - especially one who is the Co-Chair?! And since in Sen. Waddoups' own words he contradicts himself, I'm not sure what he as a "leader" really believes. In one breath he said: "I don’t think we’ve accomplished anything (in the Taskforce). In fact, I’m seeing the problem is even bigger than I envisioned a year ago."

Then after being questioned about his call for additional investigations while the Taskforce is still in progress he said: "The task force is meeting the challenge of gathering information, and dealing with it in a responsible, deliberative manner. When the facts are in, rational decisions will be made and we'll propose legislation that will result in better healthcare for our communities. My actions were no condemnation of the task force. The task force is doing its job."

So which is it Senator? If you want to lead, give the people a rational reason and plan to follow. As I see it, we already have that. See the Taskforce through, make recommendations, and take those to the next legislative session and as appropriate to healthcare stakeholders directly.

4/27/2006 12:39 PM  
Anonymous Anonymous said...

I find it interesting that Senator Waddoup's gave a donation to a local Jr. High School, the check was from Regence/Blue Cross. Is it not a conflict of interest that the Senator has, being that Regence/Blue Cross is funding the coalition? Just wondering.

4/27/2006 2:20 PM  
Anonymous Anonymous said...

Senator Waddaoups, I am pretty sure you have already made up your mind and are using the process to get where you want to go. Otherwise, why not let the taskforce finish what you have entrusted them to do? I ask that you look into your motives and realize what is so apparent for many others, you have made a decision and will not allow reasons, information, or the opinions of others to change your mind. It is so scary, a little power in the hands of small minds can do a lot of damage.

4/27/2006 2:20 PM  
Anonymous Anonymous said...

I wonder, Senator, if you are simply not dipslaying frustration about the fact that the Task Force appears to not be heading in a direction that will have huge negative impact on, for whatever reason (and I think you and I both know what that is), what appears to be your "mortal enemy" Intermountain Healthcare.

I wonder why, if you are so concerned about the "national health care crisis" you are not addressing the fact that Utah, by many national accounts, represents a model environment for health care delivery. I wonder why you are not talking about why Utahns pay less in health care costs than any other state in the country. I wonder why you are not talking about the fact that Intermountain's costs are lower than any other provider in the state. I wonder why you don't seem to recognize that if Utah were a market better suited to HCA's business model, Utahns would almost certainly be paying more for healthcare.

Perhaps it is because you have become so consumed with the idea that Intermountain Healthcare is the problem, and not the solution, that you are blinded by the realities that are staring you right in the face. Is Utah's healthcare market perfect? No. Is it a lot better than the rest of the nation? Yes.

Intermountain Healthcare is nationally recognized by their industry, by national lawmakers, and by nearly every other person who has a stake in the debate as being the model for efficiency, best practice health care delivery, and cost.

My question to you is while you claim to be concerned about the healthcare availability and delivery to the citizens of Utah, why don't you admit what most of us already know? You are more concerned with taking down Intermountain, regardless of the affect it has on the health care market, than you are in what is best for Utah.

You already have a health care system in place in Utah that legislators from 49 other states would be thrilled to be able to present to their electorates. Why would you possibly want to tamper with it? What is your percentage, senator?

4/27/2006 2:21 PM  
Blogger J. Allen said...

I have to agree with jonathan p. Senator. I've always struggled with the motivations of your involvement in this issue considering you are on the board of a hospital which is a competitor with IHC, whose practices are in question in all this.(please forgive me and correct me if I am wrong). I do want to give you the benefit of the doubt and assume that as a lawmaker your motives are honorable, but I must agree that your statements over the last couple days appear very condradictory. This is making it very difficult for me to give you the benefit of doubt and assume that you are not motivated by self-or special-interest rather than the good of the people of Utah.

4/27/2006 2:22 PM  
Anonymous Anonymous said...

My frustration with this entire review is the lack of transparency to the physician owned entities that are crying that the healthcare industry is broken. Shouldn't this discussion also include the huge conflict of interest in a physician owning centers that provide the services being prescribed by said physician. I think the patient might want to question why a physician is suggesting particular testing or surgical intervention. Is the testing really needed or is it just being prescribed because the physican hasn't paid the rent on his high priced Imaging or Surgical center. Is this being reviewed or questioned? Why is it that this task force's main agenda is to see what can be done to stop IHC from succeeding. The nation recognizes this company as one who is doing things right and are trying to emulate their practices. However, our own state is trying to use government intervention to stop a successful community focused organization from succeeding because its competitors have to raise the bar of their own organization to be able to compete. If they succeed with their agenda, we all lose.

4/27/2006 2:31 PM  
Anonymous Anonymous said...

Senator Waddoups, As has been stated. There is a National Healthcare Crisis and all though the cost for healthcare continues to rise why is there such a huge emphasis on fixing a wheel that is not broken here in Utah. Utah has one of the lowest costs for the delivery of healthcare in the nation. I agree totally with what is being reported by the media. It appears from what has been recently uncovered that the real motivation behind the commission is to benifit the insurance company's and not the public. You are so focused in on Utah that you haven't even looked at what other states are doing which is; they are trying to model what is already being done in Utah. I'm sure as the public becomes more educated to these issues they like myself will realize that some of our elected officals are motivated by something other then what would be in the best interest of the public.......Jerry

4/27/2006 2:33 PM  
Anonymous Anonymous said...

IHC snuffs out competition and treats people like dogs.

4/27/2006 2:37 PM  
Anonymous Anonymous said...

"IHC snuffs out competition and treats people like dogs."

Not in an attempt to lend any creedence to this statement, but I wonder if people would be happier to pay more for their healthcare because "at least the competition now gets their fair share of the market." I dare say not.

4/27/2006 2:46 PM  
Anonymous Anonymous said...

Could it be possible that IHC only snuffs out competition because they deliver excellent services. What i do not understand is how anybody in Utah would want to get rid of the best healthcare in the country. The whole task force has been put together all because Senator Waddoups has personal feelings about IHC. I also feel that his recent comments are in fact due to the task force finding facts that are contrary to what Senator Wadsoups was hoping for. It is blatantly obvious. No matter what happens with the task force or any federal investigation, Senator Waddoups would still fight against IHC.

4/27/2006 2:53 PM  
Anonymous Marie said...

http://www.le.state.ut.us/~2005/bills/sbillint/sb0061s05.htm

Could someone please clarify for me if this is the same Task Force that was organized as a result of SB61 passed through the 2005 Legislative Session?

I'm trying to understand how/why there are contributions from BCBS being made to a Legislative Task Force. Anyway, here's what I sent out in an email during that legislative session, regarding this bill:

The task force is essentially going to be set up to look at the tax exempt status of IHC, as most if not all of the competitors to this health care organization are for profit and do not qualify for tax exempt status. IHC does actually have for profit divisions, and therefore pays taxes. Initially the bill was hoping to collect a 3% of gross receipts tax. This meant that 3% of every dollar that was charged for any service would be taxed, not after expenses from those services were considered, but the gross amount. The substitutions have whittled it down.

There is a feeling of resentment from competitors who are for profit that IHC is able to maintain tax exempt status, and will argue that they provide similar services that ought to qualify them for this status. If you consider that taxes become a part of your cost factor when you are trying to make a profit, without this liability you can then become "more competitve". Thus the arguement that IHC has an unfair advantage in the market. Personally, I don't think it is unfair, as any business who is willing to comply with the tax exempt requirements may qualify. But I can see businesswise the frustration.

SO politically, you have a group of unhappy businesses who are also hoping for a tax exempt status. However, granting this would cost tax revenue. But if you take away the one thorn in the side of these businesses, a competitor's tax exempt status, you no longer have the opposition of these businesses AND you gain more tax revenue from forcing a company into for profit business instead of their non-profit structure. Win-Win, right?

And who, in the end, is going to fund this change? How do businesses recover their tax liability? In the cost of their products or services. So the legislature, in name of good business practice, can then raise the tax burden to their constituents without even raising "personal taxes". Sneaky.

Now, if IHC isn't playing by the rules, and they are not actually eligible for tax exempt status, I think it is right, then, to persue action to remove the tax exempt status. However, a $400K task force is simply not the venue. Because after you spend the $400k, you're still going to have to spend the budget of the district attorney or appropriate division to persue the matter.

I am learning through this process that many times an issue is used in vain to hide the politics of the underlying issue. Sometimes, you will oppose or support the banner issue, but underneath it is possibly something contrary to your beliefs. Or even a more solid base for the initial issue. Isn't politics exciting? I liked this definition from merriamwebster.com: 3 a : political affairs or business; especially : competition between competing interest groups or individuals for power and leadership (as in a government) b : political life especially as a principal activity or profession c : political activities characterized by artful and often dishonest practices

4/27/2006 3:03 PM  
Anonymous K Burt said...

Senator Waddoups...
your comments make it sound like you and your committee's goal is to solve health care problems in America.
how arrogant and completely unrealistic and bordering on psychotic for you to believe such a thing.

4/27/2006 3:11 PM  
Anonymous JB said...

In the tribune article, which you claimed was pretty fair, it states:
“Both lawmakers [Senator Waddoups and Senator Davis] cited recent news stories about consolidation and billion-dollar profits in the health insurance industry as the impetus for their call to action.”

What I don’t understand; however, is if you want to help America’s insurance problem, shouldn’t you be running for congress? You were elected to a state position, so to help America’s insurance problems, you’re going to bring down successful Utah based companies? It just doesn’t make sense. If IHC Health Plans goes under, isn’t more consolidation and profit taking going to occur as national for-profit companies try to buy it?

I think you are mistaken in assuming that Utah’s health care companies are the cause of health care “consolidation and billion-dollar profiteering” in the United States. It’s non sequitur to assume that profiteering on a national level means profiteering is a common occurance in Utah.

Of course, I recognize that you are a sly politician – I mean, you remember your SB61, the original one with the 3% tax on IHC? You started it out by saying; “I want to break up IHC.” Then later you changed your tune, “Oh, I was just forcing IHC to the table.” Such flip-flopping makes me distrust every move you make, you appear pestered with ulterior motives. What is this Senator really trying to accomplish?

Will you please take the time to explain in detail why your actions are warranted and absolutely necessary? Just because there are mega billion dollar insurance companies in the United States does not mean you should badger successful Utah based businesses.

4/27/2006 3:26 PM  
Anonymous Anonymous said...

Senator Waddoups,

Let's go back to school: "In economics, a monopoly (from the Greek monos, one + polein, to sell) is defined as a persistent market situation where there is only one provider of a kind of product or service."
Blue Cross Blue Shield, who have provided you with a nice board position at one of their hospitals, has more money and more resources than IHC ever did. I actually have them for insurance. They practice the same thing IHC does. They have a panel of doctors. If you don't use that panel care costs more. Blue Cross could give IHC a run for it's money if it wanted to. But why bother when they can get a pony boy in the legislature to pass a law for them so they can keep charging large sums of money for health care.
With all this talk about transparency I think it's time your real modivations become transparent. It's not about really fixing a problem. If it was you would being looking at trying to fix health care in general and wouldn't have started with trying to destroy the company who is a direct competitor of the company for which you sit on the board. It's about who's backing you and your own political goals.
Your stunt was about publicity and now you're sorry because it back fired on you.

4/27/2006 7:08 PM  
Blogger West Jordan Voter said...

Good grief!!! Do we really have to put up with Waddoups 'til 2008?! Isn't there some way to fire him? Impeach him? Put a sock in his mouth???

4/28/2006 11:42 AM  
Anonymous jb said...

This response was prepared as a reply to Senator Waddoups article posted on this site April 27th at 1:39 PM titled More Important Than Money. Today when I went to post my reply, it appears he removed his article.
********************************************************************************************************************************************

Your new approach still reeks of a hidden agenda. Perhaps your title should be revised, “More Important Than Money, but Mostly Money”

How fascinating, after just two years of studying an issue you think you have all the answers. Regence BlueCross BlueShield, the oldest and largest health insurance company in Utah, has been around since 1942 and is still trying to figure out the answers and they continue to adapt their business model to fit their niche.

We know your hidden agenda Senator – it has been apparent from your first private meeting with an IHC executive telling, not asking, him to get rid of his insurance business. You want IHC broken up. And now you’re trying to claim you care about the healthcare in the United States.

For anyone interested in a balanced review of healthcare in America please check out this very well written article: A Decade of Tracking Health System Change written by Paul B. Ginsburg and Cara S. Lesser. http://www.hschange.com/CONTENT/821/

They focus on three points:
1- Public Perception Matters
2- All Health Care is Local
3- The Devil is in the Details

The report mentions, not specifically, some of the issues occurring here in Utah and also nationally.

The public is very important with regards to healthcare issues as they drive demand for certain types of products. Although we talk of a national healthcare system, no such thing actually exists. “Indeed, while we speak of the “American health system,” what we actually have is a collection of highly local health care systems—many of which are so fragmented that it is a misnomer to call them a “system” at all.” http://www.hschange.com/CONTENT/821/

The devil, of course, is in the details. Especially in regards to the special interest groups that Senator Waddoups champions (namely the non-IHC hospital board on which he sits). The Senator’s purpose is to break up IHC to help physician-operated facilities earn more money. From the above-mentioned article we read:

“Facing stagnant reimbursement rates for professional services, many physicians have turned to investments in specialty hospitals and outpatient surgery centers to supplement their income. These ventures have created new competition for traditional acute care hospitals and challenged longstanding relationships between hospitals and physicians.” http://www.hschange.com/CONTENT/821/

While I sympathize with the physicians on their lack of money, as it were. The physicians search for more money and their desire to provide more services within their own offices makes them a direct competitor with hospital systems – creating a duplication of expensive machines and services in one geographic area. This higher concentration, in many cases of imaging and diagnostic machines, has been shown to increase costs for the area.

Bottom-line: The Senator’s whole approach is focused on busting up a successful Utah based business instead of seeking true solutions for healthcare. And that is why his work on this issue cannot be constructive, unbiased, and viewed as a good-hearted gesture to curb healthcare costs.

Senator Waddoups, if you really want to help the healthcare issue in the state of Utah. You could better spend your time on lowering the number of uninsured and reforming malpractice insurance (lawsuits of physicians). Those two issues would have an immediate impact on the cost of services and the income of physicians.

4/28/2006 12:29 PM  
Anonymous Anonymous said...

I am extremely dissapointed that the seantor that is supposed to represent me, as a West Jordan voter, has failed to listen to the voices of his constituents. He needs to represent the people. Really, his personal opinion doesn't matter. He needs to listen to the people and make decisions that are based on the voices in the community represents- not a hospital in West Valley. I really wish that we didn't have to keep him office through 2008. I personally will do all I can to make sure that he is not re-elected next round...

4/28/2006 12:56 PM  
Blogger The Senate Site said...

Thanks for your comments JB.

Senator Waddoups postponed his most recent blog because he didn't want to dilute today's discussion on the proposed BLM rail spur to Skull Valley.

Look for his post this weekend, or early next week.

RC

4/28/2006 1:33 PM  
Blogger FG said...

I do not have a problem with IHC if in fact they will allow patients to choose where they want to go for their health care be it physician or facility. Blue Cross Blue Shield is the same. They are indeed trying to block access to health care by controlling where the patient can and cannot go. Lets not be fooled and think that this is only being done by Inter Mountain Health (IHC). Mountain Star (Formerly Columbia or HCA) is doing the same trying to build exclusivity arrangements with Blue Cross and Altius insurance plans to limit where patients can go. When ever you have a situation where the hospital and insurance plans limit your choice of providers (both doctors and facilities) you are going to have problems. I do not know Senator Wadduops but I think there are problems with hospitals in this State blocking access for patiens in fear of loosing money. If indeed Intermountain Health Care(IHC) and Mountain Star (HCA) are nationally acclaimed and superior in their fields then let them compete on an even playing field and let the people of Utah choose for themselves. Release the Health Plans and have open access. I pay my monthly premiums so let me choose the doctor and facility of my choice. IHC, HCA, or some one else. Thank You Senator Wadduops

4/28/2006 2:00 PM  
Anonymous Anonymous said...

I am writing as a concerned citizen as well as physician. We as Americans and citizens of the state of Utah ought to have the right to chose when it comes to healthcare. We ought to be able to choose the facility and health care providers that we feel will provide the most effective, efficient, high quality care available. Currently big corporate medicine is depriving us of these rights. Their bottom line is control and profit, despite the fact that some maintain non-profit status. It seems that every conversation I have had with this non-profit organization about improving quality and access in our local facility ends up in a discussion about how this would cut into their bottom line. This particular mega-corporation claims to own the biggest business in Southern Utah but gives nothing back to the community in the way tax base.

I have noticed my personal health insurance premiums quadruple over the same 11 year period that my reimbursement as a physician has decreased by over 50%. Something is wrong with this picture. I haven’t seen improved access and quality for patients over this time, but see millions of these health care dollars being spent 6 and 7 digit bonuses for CEO’s, false advertising and self-interest lobbying. I have witnessed hundreds of examples when patient care was limited or compromised because certain insurers did not allow access to other better qualified providers or facilities based on their monopolistic interests. In many situations, the care rendered was far more costly than better care that could have been provided outside these tangled webs of networks. In fact, a recent high ranking executive of one of the major players in Utah was forced to pay for his cancer care out of pocket and then lost his job for seeking better care outside of his major health corporation network.

One of these major healthcare conglomerates controls the major insurance company, major hospital chain and employs a large number of healthcare providers. They are said to be more powerful than the State of Utah, in that even though there is substantial evidence that they commit more Medicaid fraud in Utah than any other entity, an official in governor Leavitt’s office has told me on many occasions that the State of Utah does not have the resources to successfully prosecute the obviously guilty mega corporation.

I urge you to take an active roll in promoting legislation that will ensure patient choice and access as well as put the health care dollars back into the arena of providing healthcare rather than huge CEO salaries and bonuses, big scale marketing and lobbying, and other non-beneficial areas. I urge you to support legislators who are risking their careers to pass such legislation despite attacks from the mega corporations that spend our health care dollars on promoting their best interests rather than improving quality, choice and access to care.

4/28/2006 2:33 PM  
Anonymous Anonymous said...

Senator Waddoups- thank you for all your efforts on behalf of the people! It makes me feel sick inside to read some of the comments that totally miss what your efforts are about!
The comment that claims you were contradicting yourself is not only ridiculous, but again clearly demonstrates their own ignorance. For anyone to think that the huge profits of insurance companies and hospital systems do not effect the patient/consumer is not only naive but scary! If there is nothing unethical going on, there should be nothing to fear. But the responses that have come out since your call to action are a sign to me that they do have something they fear being exposed. I wish you were a representative of my area- I would not only vote for you again and again, I would advise everyone I associate with to do the same! (I will advise everyone I know in your district to support you and encourage others to do the same!) we need more proactive representatives who are not afraid to stand up for the smaller businesses and individuals! THANK YOU SENATOR WADDOUPS!

4/28/2006 3:28 PM  
Anonymous Anonymous said...

I am not only extremely disappointed, but amazed at the negative responses to Senator Waddoups! Senator- I applaud you and your efforts to support the small business owners and individuals who are the ones paying the costs for healthcare abuse in our state and our country! It is incredible to me that anyone can think that the huge profits and continued expansions of these health insurance companies and hospital systems do not directly effect the patient and consumers! WHen was the last time health insurance premiums went down? or coverage increased without increase in premium? yet, not only do these companies continue to have huge profits, the profits get bigger year over year--AND the consumer costs go up each year! If their profits were at a normal rate and even maintained that rate of profitability- it would look a little different, but they are greedy and the consumer has no choice- pay the higher amounts for less coverage or go without is the only choices they are given. And, as we all know, there are many who do go without because they cannot afford it. THe system is not only broken, it is shattered! Drastic measures are needed, and consumers need to speak out. WIth the help of representatives that support us, we can.
THANK YOU SENATOR WADDOUPS!! I only wish you were my representative- but know this, I will advise everyone I know in your district to vote for you and support you in these efforts!

4/28/2006 3:38 PM  
Anonymous Anonymous said...

I find it interesting that the argument that always talks about patients wanting more choices in their healthcare options also seems to believe that lower cost is also an option at the same time. It's like saying everyone should have access to a Porsche but only be required to pay the cost of a Camry. More choices means more cost. Pure and simple. If IHC Health Plans, or any other insurance provider for that matter, let every one of its subscribers go to whatever hospital they wanted, see whatever doctor they wanted, and have any procedure performed that they wished at any time, the cost would be extraordinary. More choices means higher cost, lower costs mean fewer choices. There is no way around this.

You can call IHC's tactics strong-arming, bullying, or whatever short sighted label you wish to slap on it, but the reality is that they are doing what they can to keep costs down, while improving the care available. So some poor, unfortunate doctors can't have everything they want. Cry me a river. IHC is playing within a system that was not of their own creation. This is modern day health care people. Get used to it. Personally I'd rather pay less than feel like the national healthcare giants are getting a fair share in our market. Poor HCA, poor Blue Cross. What is a healthcare giant to do when they have to compete with a not-for-profit that is more interested in quality than in lining the pockets of their shareholders?

If Waddoups is really interested in investigating an organization that is "gaming" the system at the expense of the people of Utah (which anyone with half a brain knows he's not), how about looking into Questar?

4/28/2006 3:45 PM  
Anonymous jb said...

In reference to Anonymous, who if they would have put some indicator of who they were, the reader could easily reference their statements. It is the Anonymous about 4 comments up who discussed open access to all physicians as some sort of right:

The purpose of an HMO is directability. If you can guarantee a group of doctors that they will have patients, then you can negotiate a lower rate with them.

For example, in Pennsylvania the Amish have negotiated with local hospitals. They made three statements: 1) They would only seek services from those local hospitals, 2) no one from the Amish community would file a lawsuit against the hospitals, and 3) the Amish would pay in cash for all services.

Because of this arrangement, the Amish pay 1/3 – yes, that is one-third - what other groups pay for their services at the same hospitals. Why? 1) Because they have promised the hospital that they will only use those facilities, that means guaranteed business. 2) The Amish will not be charged a lawsuit premium. And 3) The Amish will not be charged a billing premium because everything will be paid in cash.

Being able to direct patients to a certain group of physicians is the basic premise of an HMO plan.

Blue Cross operates HMO, POS, and Open Access plans, Altius operates HMO plans, and IHC Health Plans operates HMO, POS, and Open Access plans.

Which plans cost less? The answer is HMO plans. POS and Open Access plans will always cost more because of the uncertainty in where the consumer will go.

You can choose where you want to go for services, but it will cost you if you go outside an HMO network. Encouraging consumers to stay in-network is how HMOs work. That was by design to lower costs.

An interesting side note, because of consumer demand, both Regence BlueCross and BlueShield and IHC Health Plans have begun to offer Open Access plans. They are expensive, but if the consumer wants to pay more, such open access plans are available.

HMO = Health Maintenance Organization (directability for lower cost, smaller physician panel)
POS = Point of Service (better in-network rates than out-of-network rates, larger physician panel)
Open Access (you pay the same percentage of the bill no matter which doctor you visit, any physician)

Once again, if Senator Waddoups wants to help the healthcare situation in Utah, he must look at:
1 - lowering the number of uninsured (a larger group of insured individuals results in lower premiums over all), and
2 - regulating lawsuits against physicians (there would be no lawsuit premium and physicians could get lower malpractice insurance, thus increasing their bottom line).

4/28/2006 6:48 PM  
Anonymous Anonymous said...

I applaud Sen. Waddoups for calling for investigations...you don't have to sit on the Task Force for any length of time to figure out more serious inquiries are needed to halt monopolistic health care situations. As a physician who has worked with surgical patients in the mega-HMO in Utah, I have seen first hand how the incentive to perform excellent work drops off when surgical patients cannot choose to go elsewhere. Some physicians perform excellent work because that is what is proper...some however perform adequately to avoid the internal quality assurance flags (I have chaired these QA committees)...but perform no more than is necessary to be considered "adequate", not excellent (You don't need that special touch with a captive audience). Competition is the only key to forcing "adequate" physicians to become excellent physicians. You have to have to threat of losing surgical patients before some physicians will improve. I know this statement may be inflammatory, but it is absolutely correct, not politically correct.

4/28/2006 10:13 PM  
Anonymous Anonymous said...

KCPW Interview: "I am not even saying IHC is part of the problem - other than the fact that they are part of the health delivery system in this country. And the system itself is sick."

4/29/2006 11:16 PM  
Anonymous Anonymous said...

http://www.hschange.com/CONTENT/821/ “Indeed, while we speak of the “American health system,” what we actually have is a collection of highly local health care systems—many of which are so fragmented that it is a misnomer to call them a “system” at all.”

4/30/2006 10:45 PM  
Anonymous Clark Newhall MD JD said...

Clark Newhall MD JD--
I am dismayed at the lengthy rejoinders by someone who prefers to remain anonymous. Much of what I read sounds like an apologia for IHC. The "facts" that anonymous cites in his screed are nothing more than IHC propaganda-- they are not Facts in any real sense of the word. The observation that Utah has a healthy population owes nothing to IHC healthcare. The proposition that healthcare in Utah is less expensive (thanks to IHC) than elsewhere is demonstrably false on its face. The assertion that Sen. Waddoups' is failing in an attempt to inquire into the IHC monopoly is a circular argument---it is IHC's intransigience and refusal to provide real information that leads to frustration of the attempt to delve into the monopoly's practices. Unfortunately, Sen. Waddoups' task force lacks subpoena power apparently. Only the force of law will pry the facts out of IHC.

5/01/2006 3:15 PM  
Anonymous Clark Newhall MD JD said...

Remember forced medical arbitration? IHC told thousands of its customers they would have to agree to arbitration in the case of malpractice. If they didn’t agree, IHC would withdraw their medical care. That was in November 2003. Prompted by a 5% discount on their malpractice insurance, few non-IHC doctors would see patients who didn’t sign. One lady with chronic illness asked what she should do when she couldn’t find a doctor that didn’t require her signature. The Utah Medical Association told her she would just have to “drop dead.”
Loud protests from affected patients obliged legislators to repeal the one year old law allowing forced arbitration agreements. Perhaps you, like many other outraged citizens, breathed a sigh of relief. Perhaps you thought that, for once, the little guy won against a moneyed special interest. Perhaps you treasured your constitutional right to go to court, even if you never would exercise that right. Perhaps you thought that forced arbitration was dead and gone.
Perhaps you were kidding yourself. If you thought forced medical arbitration was dead and gone, think again. Clever trial lawyers working for the biggest Utah malpractice insurer have created several new ways to force you to arbitration if you EVER signed an arbitration agreement, even if you signed it because you had no choice.
Thanks to these clever defense trial lawyers and a wrong-headed Utah supreme court decision, that arbitration agreement can deprive you of your right to a judge and jury of your peers. More than two years after the law was changed to forbid forced arbitration, you can still be held to mandatory malpractice arbitration. All because of an agreement that that you had no choice in signing, that you had no input in writing, that was forced on you when you were vulnerable and needed medical care, and that you have probably forgotten all about.
How could this happen? The legislature spoke. Shouldn’t that be the final word? It turns out that if you ever signed an arbitration agreement, that agreement may still be in effect. If you haven’t followed the cumbersome process required to rescind the agreement, clever insurance company trial lawyers will use it to deny you the right to judge and jury.
Unfortunately for you, they may have Federal law on their side. Federal law trumps conflicting state laws and Federal law protects an arbitration agreement involving interstate commerce. So IHC and the insurance company lawyers point out the universal characteristics of US medical care (everybody uses some health care product made outside Utah’s boundaries) and voila, Utah’s legislature can’t invalidate the forced arbitration agreements.
Some judges buy this argument. The Utah supreme court has not weighed in on the question. But make no mistake—if you thought forced medical arbitration was dead, think again.
Here’s how to preserve your right to judge and jury if you suffer malpractice in the future. Don’t think it can’t happen to you---100,000 hospitalized Americans die of malpractice each year, many more than die in highway accidents. Before it happens, write a letter to all your doctors and all your health insurers and all the hospitals you use. Send the letter certified mail with a return receipt. Keep a copy of the letter with the names of every addressee. When the return receipts come back, staple them to the copy. If you have an IHC arbitration agreement, you need a copy of your agreement, because the boilerplate changed several times in a few months, making it hard to know where to send your letter.
Of course, if you believe you will never suffer malpractice, or you are convinced you would never sue for a medical mistake that injured you, then please ignore this advice. And good luck to you. You will need it.

5/01/2006 3:17 PM  
Anonymous Clark Newhall MD JD said...

Can the leopard change its spots?
I have noticed a number of billboards sprouting up along I-15 touting the name change for IHC’s insurance arm to “Selecthealth.” Moreover, although my family only has one IHC insurance policy, we were blessed with not one but two letters explaining that the name change should not alarm us, because “we are still an integrated subsidiary of Intermountain Healthcare.” Whew! I was so worried for a moment that IHC might have changed its spots and become a kinder, gentler version of the Intermountain Health Care that clogged Utah’s courts with the 10,321 lawsuits it filed in 2004 (latest statistics available from Administrative Office of the Courts. Compare that with 1,741 personal injury lawsuits.)
Seriously though, how much does it cost to send hundreds of thousands of letters, each with a slick 12 page brochure? How much for umpteen billboards for a few months? How much to change the stationery, the forms, the official names, the managerial coffee cups, the giveaways? How much to hire the PR flacks to flog the new name? How much to hire the creative geniuses that came up with this stunning new moniker? My guess is that it’s at least one or two megabucks (that’s millions, not thousands.) For the same money, let’s say two million dollars, IHC—oops, Selecthealth—could have bought decent health insurance for about 550 uninsured people for a year. But I guess you don’t argue with a leopard that wants to change its spots.

5/01/2006 3:19 PM  
Anonymous Clark Newhall MD JD said...

With reference to a "lawsuit premium" mentioned by JB--I suggest that the writer familiarize himself or herself with the facts about medical malpractice before speaking to the issue. A recent book "The Myth of Medical Malpractice" by Tom Baker (available on amazon for $15) lays out the facts, among which are the following: there are more than 100,000 deaths annually in hospitals from medical malpractice (called "adverse events"); the cost of medical malpractice premiums is about 60 cents for every One Hundred Dollars of health care spending; Compared to the number of people injured by malpractice, lawsuits by injured malpractice victims are very rare (a few percent) and large verdicts that are actually paid are even rarer; the cost of malpractice insurance averages 7% of practice income for ObGyn physicians, and much less (about half that) for other doctors. The ObGyn pays more because he or she has the capability of killing or maiming two people (mother and child) with one mistake.
So--before spouting more medical industry propaganda about "lawsuit premiums", JB, let me suggest that you read a book.

5/01/2006 3:30 PM  
Blogger LaRee Miller said...

By looking at all the anonymous remarks made above you can tell “whistle blowing” is not a popular form of behavior within the health care industry. Senator Waddoups must be on to something if he is requesting for investigations to be conducted by both state and federal agencies.

Recently Dr. Donald Berwick, president of the Institute for Healthcare Improvement said, “Why does the myth persist that the United States is the best performing health system in the world? It’s almost counter-cultural to claim otherwise. The U.S. system still relies too heavily on new technologies and hi-tech tests that sometimes drive up the cost of care with out improving overall health.”

In last week’s Time Magazine’s article on healthcare Dr. Berwick stated: “My wife was hospitalized with a rare spinal-cord problem. No day passed, not one, without a medication error. Tests were repeated, data misread, information lost. And this was at a top hospital. The errors were not rare; they were the norm.”

Forbes Magazine reported last June that medical errors cost Americans $500 billion a year in avoidable medical expenses – approximately 30% of all health care cost. The annual cost to employers per insured workers of medical errors is $2,000!

Unfortunately bad medicine still prevails while medical insures and the professions spend millions of dollars to defend bad medicine rather than advance and promote good medicine. It’s all about profits over patient safety.

5/01/2006 4:19 PM  
Anonymous Clark Newhall MD JD said...

re the comment of "anonymous" that follows:
"I have noticed my personal health insurance premiums quadruple over the same 11 year period that my reimbursement as a physician has decreased by over 50%."
I would be interested in seeing som proof of that proposition. When I practiced as an ER doc, I made 250-300,000 annually for what amounted to a 36 hour week. Pretty good pay compared with the amount most folks get paid. Notably, the insurance premiums that doctors have paid for their malpractice insurance have increased at a SLOWER rate than the rate of increase in health insurance. And doctors still get about 20% of the money spent on helath care int he US, the same proportion they got about 15 years ago. So where's the beef?

5/01/2006 4:37 PM  
Anonymous Anonymous said...

I thnik healthcare is outrageously expensive. But if we are going to start throwing around executive salaries and company profits as the cause, why don't we add up all the salaries of doctors in the state and then compare that to all the fat bonuses of healthcare executives and see where the most potential is to cut costs. I know many doctors who make more money than the CEOs of these companies and want us to believe that they are the servants of the community. There are a handful of highly paid healthcare executives in this state (and they are paid too much) but there are a couple thousand Drs. who are paid to much.

5/01/2006 4:46 PM  
Anonymous jb said...

Thank you Clark Newhall MD JD, I will check out the book.

By the way, perhaps you should spell check before you post, it will make you look a little more credible.

5/01/2006 9:54 PM  
Anonymous Anonymous said...

It is not lost on me that the forces of IHC seek and destroy. They detect negative comments, they seek out the person making those comments, and then they systematically destroy the messenger.

Looks at some of these posts. IHC has set out for years to destroy anyone who challenges them.

They are equivalent to the Chinese communists in Tiannamen Square. Protest, and you'll be run over by a tank.

Senator, keep it up. This is the bottom line for me: at this rate, and on our present path, we'll have one health insurance company in the state and one chain of hospitals. Now I'm sure the guys at IHC drool over that prospect, but as consumers we'll be screwed.

5/02/2006 10:04 AM  
Anonymous Anonymous said...

Please take time to review these articles (below):

4/24/2006 (CHIPS)
CHIPS Network

AMA Study Shows Limited Competition Among Health Insurance Companies
In the largest study of its kind, a new American Medical Association (AMA) report finds a steep decline in competition in the nation's health insurance market.

In the largest study of its kind, a new American Medical Association (AMA) report finds a steep decline in competition in the nation's health insurance markets.
"The remarkable reduction in the number of competing health plans is troubling for doctors and patients, as competition drives innovation and efficiency in the health care system," said AMA board member J. James Rohack, MD. "Most alarmingly, in the combined HMO and PPO markets, 95 percent of metropolitan areas have few competing health insurers."
In addition, the study found that in 95 percent of markets, a single insurer had a market share of 30 percent or greater, and in 56 percent of the markets, a single insurer had a market share of 50 percent or greater. The AMA report, Competition in Health Insurance: A Comprehensive Study of U.S. Markets, analyzed 294 metropolitan health insurance markets against an index used by federal regulators for measuring market concentration. According to the federal index, markets that are highly concentrated have few competing health insurers.
"Patients do not appear to be benefiting from the consolidation of health insurance markets," said Dr. Rohack. "Health insurers are posting historically high profit margins, yet patient health insurance premiums continue to rise without an expansion of benefits."
The AMA findings must be viewed in the context of the unprecedented consolidation of the health insurance market. Between 1995 and 2005, there were more than 400 mergers involving health insurers and managed care organizations, according to a researcher of merger and acquisition trends in the health care industry.
"Given the troubling trends in health insurance nationwide, federal regulators need to take a hard look at whether patients are being harmed as mergers and takeovers reduce the number of competing health insurers," said Dr. Rohack. "When it is difficult for a new insurer to enter a market with few dominant health plans, patients can be charged high prices without the threat of competition to keep insurers in check."

Loss of Competition Is Seen in Health Insurance Industry

By ROBERT PEAR
Published: April 30, 2006 (New York Times)
WASHINGTON, April 29 — Federal investigators have found that a handful of companies account for a growing share of the health insurance policies sold to small businesses in most states, leaving consumers with fewer options and higher costs.
The Government Accountability Office, an investigative arm of Congress, said that the largest insurer had 43 percent of the market for small group coverage in a typical state, up from 33 percent in 2002. In nine states, the largest carrier — a Blue Cross and Blue Shield company — has more than 50 percent.
Small businesses and doctors also report a steep decline in competition in health insurance markets, a problem Congress is trying to address.
Within two weeks, the Senate plans to take up legislation that would make it easier for small businesses to band together and buy health insurance through trade associations and chambers of commerce. The main purpose of the bill, strongly supported by President Bush, is to make coverage more affordable.
In the face of soaring health costs, small businesses have struggled to find affordable insurance for their employees. The legislation would set uniform federal standards for insurance products that have long been regulated by the states. The standards would supersede state laws requiring coverage of specific services like cancer screenings in the individual and group markets.
The House has passed similar legislation several times. The prospect of a Senate vote has touched off a battle between small businesses, which contend that state requirements drive up costs, and consumer groups, which see them as indispensable protection for patients.
Paul B. Ginsburg, president of the Center for Studying Health System Change, a nonpartisan research institute, said: "There is a strong trend toward more concentration in health insurance in local markets. Being large seems to be more important than ever. Small plans are losing market share to large plans."
Senator Olympia J. Snowe, Republican of Maine, chairwoman of the Committee on Small Business, said the concentration of markets meant that "small businesses have extremely limited choices when seeking health insurance for employees."
In Maine, Ms. Snowe said, Blue Cross and Blue Shield carriers have 63 percent of the small group insurance market, up from 39 percent in 2002, and the five largest carriers have 98 percent.
Trade and professional groups can help members obtain insurance, but they cannot offer a uniform national product because the coverage must meet each state's standards.
The Census Bureau estimates 45.8 million Americans have no health insurance. More than half of uninsured workers are self-employed or working in businesses with 50 or fewer employees.
In a study of 294 metropolitan areas, the American Medical Association found a "remarkable reduction in the number of competing health plans." In 95 percent of those regions, a single insurer had at least 30 percent of the market, and in 56 percent of the areas, a single insurer had a share of 50 percent or more.
Karen M. Ignagni, president of America's Health Insurance Plans, a trade group for the industry, said, "There certainly have been some large insurance company mergers in the last few years." But, she said, "The data do not show a link between concentration of insurance markets and rising health care costs."
The National Association of Realtors and the National Federation of Independent Business are leading the campaign for federal legislation.
Todd A. Stottlemyer, president of the federation, said that health insurance was "the No. 1 concern of small business owners." Under the legislation, he said, small businesses could pool their buying power and obtain coverage at rates like those available to Fortune 500 companies.
But the legislation has formidable foes, including AARP, the American Cancer Society and the American Diabetes Association.
In advertisements, those groups say the Senate bill undermines state laws that "require insurance companies to cover such vital benefits as cancer screening, mental health services, diabetes supplies and education, and well-child care."
Daniel E. Smith, a vice president of the American Cancer Society, said: "We are all for increasing access to insurance, but not if it means degrading the quality of coverage for people who already have it. The Senate bill is beyond repair."
William D. Novelli, chief executive of AARP, said, "The bill would make it much harder for older workers to get health insurance, or even to get a job." Insurers, he said, could more easily raise premiums for small businesses that employ older workers with high health costs.
The bill's sponsor, Senator Michael B. Enzi, Republican of Wyoming, said it would "preserve the primary role of the states" in regulating insurance.
But in a letter to the Senate this week, the attorneys general of 38 states expressed "strong opposition." They said it would "erode state oversight of health insurance plans and eliminate consumer protections."
In New York, the insurance superintendent, Howard Mills, said the legislation could cause havoc by pre-empting a state law requiring insurers to set rates for small businesses and individuals without regard to age, sex, health status or occupation.
Mr. Mills said it would undermine the Healthy New York program, championed by Gov. George E. Pataki as a way to provide affordable coverage to small businesses and uninsured workers. Healthier people would seek coverage through the "small business health plans" envisioned by Congress, he said, while sick people would stay in the state program and face higher premiums.

Consider the following :
1. Why are hospitals afraid of competition?
2. Insurance companies state that it is necessary to restrict or limit access and choice in order to keep health care costs down, yet what they are not telling you is that by doing this their profits and income continue to rise. When was the last time you saw your insurance premiums decrease and/or your benefits increase? Insurance companies don't just make a steady profit- their profits increase year after year.
3. Why do we have to ask for legislation in order to have transparency of actual revenue and profit and uncompensated care costs?
4. Shouldn't the public be outraged at the huge profits, bonuses, etc. that they are paying for, yet have no choice in the matter and while millions remain uninsured/underinsured because they can't afford it?

People should be applauding Senators Waddoups and Davis for taking on the status quo which is killing this country and the State of Utah!! We are in this mess because of our leaders allowing the status quo!!

Senators- PLEASE DON'T GIVE UP BECAUSE OF THE NAY SAYERS IN THIS BLOG!! THEY ARE MOST LIKELY AFFILIATED IN SOME WAY WITH THE BIG INSURANCES OR HEALTH SYSTEMS! WE THE PEOPLE NEED YOU!

5/02/2006 10:15 AM  
Anonymous Anonymous said...

As a wokrking person I have to juggle all of my costs. Between the increase at the pump and my insurance premiums I do not know what to do. IHC is spending at least hundreds of thousands of dollars on their new PR campaign for their new name "Select Health", why don't they give patients a real choice? The SEC is investigating United Healthcare for stock option illegality that gave their CEO $1.6 billion. How could anybody be upset with Senator Waddoups?

5/02/2006 10:29 AM  
Anonymous jb said...

Did you know: one of the current proposals before Congress is to create one national health insurance company? How would you insure every American?

Fill out the Healthcare poll at the Citizens healthcare work group website

5/02/2006 10:51 AM  
Anonymous Anonymous said...

In the New York Times of April 30th Robert Perr wrote an article "loss of Comeptition is seen in Health Insurance Industry".
Here is the lead paragraph, "Federal Investigator here found that a handful of companies account for a growing share of the heath insureance policies sold to small buisness, leaving consumers with fewer options and higher costs."
Senator Waddops and Senator Davis are on the right track.

5/02/2006 10:56 AM  
Anonymous Anonymous said...

IHC's choice of their new health plan name is a joke-- they are all about LIMITING choice! shame on you IHC!

5/02/2006 1:21 PM  
Anonymous Anonymous said...

The federal investigation of insurance monopolies is long overdue! These monopolies are destroying small business and something needs to be done now!

5/02/2006 1:23 PM  
Anonymous Anonymous said...

The Commonwealth Fund, a non-partisan organization that studies health care, found that 41% of non-elderly American adults with income between $20k and $40k are without health care insurance for all or part of 2005, which is up 28% from 2001. Given the $100billion profit made by insurance companies last year, it is high time insurances are investigated as called for by Senator Waddoups and Senator Davis! I was impressed that they were joined by the Utah Medical Association, National Federation of Independent Business and the Utah Ambulatory Surgery Center Association-- it reflects that there is an urgent problem. Other members of the Task Force need to stop fiddling around and be agents of change.

5/02/2006 1:28 PM  
Anonymous Anonymous said...

As I read the paper, watch TV or drive my car and listen to the radio, I am becoming aware of a very expensive ad campaign mounted by IHC to advance their new names. What is the real reason behind the name changes? Are they trying to distance themselves from the bad press of IHC? First they changed the name of their organization, now they are changing the name of their healthplan. If only they would put as much energy to opening up their panels and network so people from Utah could truly "select" their own doctors and facilities for care. Why are they behind the efforts to attack Senator Waddoups and Senator Davis? The Attorney General should begin an immediate investigation to determine if there is collusion between hospital systems and insurances.

5/02/2006 1:38 PM  
Anonymous Anonymous said...

People are watching the Health Care Task Force... Those members who are connected with IHC are especially being watched..........those who have commitments to IHC, will be revealed via internet soon.................. How can task force members with ties to IHC, be objective in their investigation??????

5/02/2006 1:42 PM  
Anonymous Mark Fotheringham said...

RE: Clark Newhall's rant at 3:17 on 5/1/2006

The Utah Medical Association has never told anyone officially to "drop dead." Mr. Newhall may be the only one we've ever considered saying it to, but even he will get a courteous response from the staff of the Association when he calls. I suspect the anecdote quoted is a tall tale that gets taller with each telling. When it was first related by Mr. Newhall years ago, I personally interviewed each member of the UMA staff and was assured that no one ever said such a thing to anyone. These are good people with whom I have a good relationship and they would really have no reason to lie about it to me (I can't fire anyone, nor would I want to). If anyone did say it and subsequently lied to me about it for some unknown reason, let me assure Mr. Newhall (again) along with the other readers of this blog that the sentiment to drop dead is not an official UMA stance towards anyone, even the most rabid of trail attorneys.

During the year when arbitration agreements could be required by doctors, there was never a time when even a majority of physicians in any specialty were requiring them, according to the Utah Medical Insurance Association. Most physicians were reluctant to even bring up the possibility of medical injury and lawsuits at the outset of care, so they did not take the option of requiring the agreements. In other words, the lady claiming an inability to find a doctor who did not require the agreement must not have looked very hard. It made for compelling legislative testimony, however, despite the dubious veracity.

Dr. Newhall and I have completely different opinions as to the advisablity of using arbitration agreements in health care. I have no qualms at all about avoiding the courts should I have a dispute with a treating physician and have fearlessly signed such agreements for myself and my family in the past and will in the future as well. My reasons are many, but best left to another forum as the arguments both for and against arbitration have been hashed and rehashed so often now as to become rote.

Now let's shift gears back to the actual subject of this blog.

When you include all the players and payers, and all the voices that are involved in the health care game, it’s easy amidst all the clamour to drown out the fact that where health care actually happens is in the meeting of a sick or injured patient with his or her doctor.

To greatly simplify this discussion, you might consider anything that artificially or without good cause interferes with that nexus “a bad thing.”

What Senators Waddoups and Davis are suggesting and what they are hearing from their constituents is that there is too much interference, and that perhaps there are players who are more focused on the fortunes to be made than on facilitating the patient-physician encounter. Time and again, Senator Waddoups has reiterated that he was NOT speaking specifically of IHC but of the general U.S. health care environment where patient choice is getting lost in the scramble of exclusive contracts and managed care.

Giving patients a choice of health care providers is good for everyone. It stimulates innovation and greater attention to quality and service and efficiency in healthcare. If the review called for by Senators Waddoups and Davis helps to increase the choices patients have, it will be well worth the time and effort involved.

Access to care is the issue. Cost has been the dominant issue for too long and the pendulum has swung too far, so that in many instances the efforts to contain costs now seem to cost more than the care that is being contained. And make no mistake; it is too often care that is being contained, not just costs.

Too many patients have no access at all and even those who have coverage are too often restricted from getting the care they need from the provider they would choose if given the chance.

This is a topic that deserves further investigation, and if such an evaluation can help the pendulum to swing back even a little toward greater access to needed care, then the physicians of the Utah are all for it.

Mark Fotheringham
Utah Medical Association

5/02/2006 1:53 PM  
Anonymous Anonymous said...

I have a few questions
1. How much business does Zion's
Bank receive from IHC?
2. Which legislators have recently received contracts from IHC who serve on the Task Force?
3. Which members of the Task Force serve on IHC Boards?
4. When will the Task Force take on the monopolies?

5/02/2006 4:56 PM  
Anonymous Anonymous said...

The insurance industry is ripping the U.S. consumers off left and right. From Katrina to shortchanging us on healthcare coverage. It is disgusting. The article in the New York Times by Robert Peer underscores that a monopoly does exist and we need to have it broken up. I wan a true choice to select my physician and the facility where I have care.

5/02/2006 5:02 PM  
Blogger RH said...

Why is the task force membership so secret? What are you ashamed of? Or hiding? That is cowardice.

5/03/2006 1:53 PM  
Anonymous Stephanie R said...

In response to some of the many rants I read above. I am not a doctor, nor have a degree of any kind. But I am a constituant, with a family. I work in the healthcare industry in Utah and have worked for both United Health care and Intermountain Healthcare. I will not hide that fact. What I find interesting about some of your "facts" is that you continue to conveniently leave out all the good that IHC does here in Utah AND parts of Idaho. We have alot of uninsured & underinsured people that live in our good state. And when they can't pay their copays and deductibles, we find a way to help them pay their bills. As someone who processes many charity applications I can assure you Intermountain Healthcare gives millions of dollars a year in free healthcare. Do we hook up a lie detector to the patients to be sure they aren't lying about their financial status? NO. If you all are so set on seeing IHC loose their tax excempt status...are you willing to start picking up that 10 million dollar tab to provide those people with free healthcare? I personally thought our state tax was large enough. I also see the billing process of all insurance companies and how quick they are to pay thier bills. Do you know why Blue Cross Blue Shield shows such heavy profits? On average they take twice as long to pay their bills. Select Health pays an average of 30 days faster than any other insurance company (including Medicare) and they pay at higher rates. What does this mean? They spend less time trying to get out of thier responsibilities, and more time providing better patient care.
In regards to creating a national health care system. How many of you have actually seen this sort of creation in action? When you have a non emergency dr visit you can call and schedule an appointment and get in usually with in the week right? How would you like to wait in line for weeks? The reason we pay higher costs in America for our healthcare than other countries is because we like the convenience - ultimatley the instant gratification. What about the 1/2 hour you may wait in an IHC ER to see a doctor, versus the 3 hours wait in a non-IHC hospital elsewhere in the state, how much longer will the wait be under a national healthcare plan? Why so quick to assume the problems lie in the one not paying taxes? What is Senator Waddoups solution to cover the loss of all that charity care were IHC to loose thier tax exempt status? Intermountain Healthcare is not what is broken.

5/03/2006 2:31 PM  
Anonymous Anonymous said...

You can find the members of the task force on the Utah legislature's website. Enter this web address and then click on Committee Membership. This info is public knowledge, not a secret.
http://www.le.state.ut.us/asp/interim/Commit.asp?Year=2005&Com=TSKPOH

5/03/2006 5:32 PM  
Blogger Branton Richter said...

Branton Richter, DDS

As a children's dentist in Utah county, I have seen many kids without adequate insurance coverage, as well as many more without any coverage. With health care costs increasing and health insurance premiums always on the rise, it is definately in every child's (and adult's) best interest to do what must be done to lower insurance premiums and lower health costs. I'm no economist, but I do know that by increasing access and availability to care, by providing every patient (myself and my children included - as patients) with more choice of which doctor they can go to and which facility they can have their surgery or any other inpatient/outpatient care provided at, then the doctors providing inferior care (whether they be at IHC or any other facility) will have to step it up a notch and provide better care at a lower cost. This is what Ambulatory Surgery Centers (ASCs) and Senators Waddoups and Davis seek to accomplish. PRESS ON, SENATORS!!! Competition has long been a basic American principle. If healthy competition is stamped out (as IHC and many other big businesses nationwide have continually tried - and sometimes succeeded - to do), costs go up, access goes down and we all suffer.

I'm young and building a new office building that is not inexpensive. It is not in my pocketbook's best interest as a Doctor to say "Let's lower costs of health care." However, I am an ethical person and believe that all children should be able to have the best possible oral health and the greatest access to care. Dental Caries (cavities) is the most prevalent disease in Children in the United States, far surpassing #2 Asthma. Dental pain is the most common reason children miss school. Don't we all want our kids to have healthy mouths, free of pain and discomfort? Increase a patient's right to choose the doctor they wish to go to and where they can have surgical care provided and every patient is benefitted -- Don't you want that benefit the next time you're a patient?

br.

5/03/2006 9:30 PM  
Anonymous Anonymous said...

As an MD in the community for many years, I have seen the erosion of physicians' control of their own destiny and the destiny of their patients' health. Many reasons could be cited, including physician naivety, administrative overhead of insurance carriers, business interests excited about the physician naivety and disinterest, legal pressures including malpractice, oppressive regulation by governmental entities, insurance company administrative bonuses, insurance company stock dividend at the sacrifice of healthcare, etc.

Perhaps the most alarming trend has been the loss of the doctor patient relationship in all of this entangled mess. Physicians do know what is best for their patients. That includes disentangling them from the morass we are currently in. Now that enlightened physicians are taking the initiative to practice in ASC’s and threaten the establishment (hospital and insurance carrier) the status quo is being disrupted. Older and often non-refurbished and dilapidated hospitals that have invested minimal capital into their physical plant and even less in their personnel are now trying to spiff up and improve their image with name changes and facelifts. In medical care, beauty truly is more than skin-deep. Physicians know and care more about how the medical system should work just as they know and care more about how the body should work than someone wearing suit and tie.

5/03/2006 10:20 PM  
Anonymous Clark Newhall MD JD said...

To the Editor
I noted your report on Sen. Waddoups's visit to St. George with interest.
As usual, the "malpractice reform" whipping boy was pulled out by the
medical industry. Let's talk facts. Number 1-- the cost of medical
malpractice insurance is only 60 cents out of every one hundred dollars
spent on health care. If malpractice litigation was completely eliminated
and every doctor and hospital was free to do anything to any patient, there
would be no change in health care costs. Number 2--the most costly problem
in medical malpractice is not the insurance, it is the cost of the
ever-increasing deaths and injuries from the malpractice itself. In 1999,
the National Academy of Sciences reported that there were as many as 100,000
people who died each year from hospital malpractice ("preventable adverse
events" in hospital doubletalk.) That is twice as many as highway traffic
deaths in the same year. Deaths have not decreased; current estimates of
malpractice deaths go up to 250,000 annually. No one knows the true figure.
The medical industry has not cared enough about malpractice to do anything
except bury its head in the sand and point its finger at the victims. The
estimated cost of these deaths and injuries, in lost productivity and
increased healthcare costs, is about $300 billion annually. Number
3--doctors polled by Harvard Medical School themselves experienced a 30
percent rate of being a victim of malpractice in hospitals. You probably
have an even higher risk. It is only luck that you may escape without
injury. Number 4--if you are a mapractice victim, you have only ONE
remedy--see a lawyer. The medical industry will not give you an apology,
will not give you an explanation, will not pay your future medical bills,
will not reimburse your lost time and work. You can see a lawyer or drop the
whole thing. Most people choose the latter: only about 1% of malpractice
victims ever sue. Even fewer get any money. None ever get the truth from
the medical industry.

5/04/2006 10:33 AM  
Anonymous Anonymous said...

There are many posts on here that express an interest for patient choice. Let’s encourage and support Waddoups who is taking a stand to make the necessary changes for you, the patient, to be able to choose!

5/04/2006 10:34 AM  
Anonymous Anonymous said...

On Wednesday, April 12, 2006 The Wall Street Journal stated, "The real health insurance problem in America today isn't lack of coverage per se; it's the inability of insurers to offer affordable policies in many states". Waddoups is trying to ensure that insurance companies are doing everything they can to offer patient affordable healthcare.

5/04/2006 10:56 AM  
Anonymous Anonymous said...

The insurance industry made appproximately $100 billion in profits this past year. Hospitals are experiencing significant profits and are in a major building boom. In a post-Enron environment I have become just a bit skeptical on some of their assertions and actions.

5/04/2006 10:58 AM  
Anonymous Anonymous said...

Doesn't it bother anyone else that there are people being denied quality and affordable healthcare and yet insurance companies and hospitals are making huge profits? This is why Waddoups called for the investigations. If the hospitals and insurance companies have nothing to hide then why the push back?

5/04/2006 11:02 AM  
Anonymous Anonymous said...

I wish other elected officals would take bold steps to represent the interests of their constituents. Thank you senators Waddoups and Davis!

5/04/2006 11:25 AM  
Anonymous Anonymous said...

I wish other elected officals would take bold steps to represent the interests of their constituents. Thank you senators Waddoups and Davis!

5/04/2006 11:25 AM  
Anonymous Anonymous said...

The economist report is now posted. I'm sure Sen. Waddoups will now want to apologize to IHC.
http://www.le.state.ut.us/interim/2006/HealthCareReport/index.html

5/05/2006 1:16 PM  
Anonymous John P. Kolb, Jr. said...

The rumor is that IHC has done nothing wrong, that this is a capitalistic society and we better just leave IHC alone. The fear with many in Utah is ‘who wants to take on the big guy with all the power to put you out of business and make life tough on you?’ I could spend time expressing who I am and what I have done in life, but I really don’t think it matters at this point. Health care in America, along with standards and the quality of life for the majority of hard-working citizens, has decayed at an increasing rate since the nineties. During the last two years, I have been very involved with Snow Canyon Clinic in Ivins, Utah. Only recently have I begun to understand the dynamics of how the physicians need to be on call, who gives approvals for imaging, who gets paneled and who ends up getting special treatment from the press. As they say, money talks, especially when you can control what you pay and what you return for services rendered. I have watched the power plays and the political ploys within the legislative body along with the business community’s blindness to what IHC calls a non-profit organization. Yes, I am upset, but not a fool. Is there a need for this process? Yes. Will I need a hospital some day? Yes, and the only player in town is IHC, so I better not be too hard on them.

The positive action in a free market is the ability to compete, provide quality care and service to those in need that have the insurance or cash to pay. Albert Einstein stated, “If it does not have a price, then it does not have a value!” In cases of emergency, life or death, we need to take care of all those that are unable to provide for themselves and IHC does an excellent job in that arena.

I would be more than willing to express my concerns to any committee or members of said committee that would be willing to listen.


John P. Kolb, Jr.
President / CEO
Snow Canyon Clinic
272 East Center Street
Ivins, Utah 84738
435.986.2397

5/09/2006 4:00 PM  

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