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Monday, May 01, 2006

More Important Than Money

Michael Waddoups
Utah State Senator, District 6

As chair of the Privately Owned Health Care Organization Task Force, I have spent two years scrutinizing the state of our healthcare system in Utah and in the United States.

The process is like watching a train wreck about to occur.

I have read several recent stories regarding the CEO of United Healthcare and how this insurance company is being investigated by the SEC.

A study by the American Medical Association confirms that health insurers are consolidating market power to the point that they are a virtual monopoly in many areas of the country.

Additionally, I have heard complaints from constituents about a lack of choice in selecting their physicians and where they can receive desperately-needed health care.

They feel they are treated like a number.

Employers are telling me that they cannot deal with the never ending increases of insurance premiums.

And, disturbingly, I have seen examples of what I consider predatory practices of insurance companies and some hospital systems to get rid of competition.

Who will stand up to a system like this? Political freedom means you chart your own destiny. You decide the type of society in which you are willing to live. Are you willing to live under the health care system, as it currently exists?

Some of my more cautious friends have counseled me that it is impossible to stand up to big, powerful industries. I have been pressured to back off. People felt that way about Enron and look at what happened. I have reached the point where I can no longer be silent.

I am in the process of formally communicating with Congress, the Department of Justice, Federal Trade Commission and Health and Human Services. I am calling for state and federal investigations of the business practices of the insurance industry and hospital systems in Utah and in the United States.

I have also met with Utah's Department of Insurance and our Attorney General about potential violations of antitrust provisions in our consumer protection laws. I believe there is evidence that these two large powerful interest groups (the insurance industry and hospital systems) are putting profits before people and that their actions are hurting employers and working families.

Specifically, I believe we have serious problems in the following areas:
  • Business practices at insurance companies and hospital systems similar to what the SEC is investigating at United Healthcare;
  • Potential collusion between insurance companies and hospital systems to prevent competitors from effectively competing against hospitals;
  • Legitimate claims payment issues which hurt consumers; and
  • Potential violation of Utah consumer protection laws.

26 Comments:

Anonymous Anonymous said...

Interesting, I see nothing of the statement made by Sen. Waddoups on NPR last week. The statement reiterated a fear and lack of understanding of the health care business and that he was "in over his head." Sen. Waddoups opened the Pandora's Box, to borrow from President Bush, and now must find long lasting solutions to the problems.

5/01/2006 1:55 PM  
Anonymous Anonymous said...

I also find it intersting that he never mentions the facts that have been uncovered about the industry over the past two years. Why...because they do not validate his claims. He reminds me of an angry child who is not getting his way so he now has to run to other authorities to once again try and prove his point.

5/01/2006 4:04 PM  
Anonymous Anonymous said...

An answer to this question: Are you willing to live under the health care system, as it currently exists?
Yes I am since it is currently the BEST in the Nation.

5/01/2006 4:14 PM  
Anonymous Anonymous said...

Mr. Waddoups,

Why can't you let the task force do the job our elected officals have outlined?

You must be getting alot of money for your campaign from outside interest groups (namely outside insurance companies who want to target our healthy Utah market)!!

Quit wasting precious time and taxpayer money beating a dead horse! You need to step down!

You were once in a position of power in a condo association and messed that up too!

I think you are just trying to make a name for yourself.

Also, if you really cared about the people you say you're speaking for -- you'd let the citizens do the talking! I only see greed and corruption from you and your little political powermongers!

5/01/2006 4:18 PM  
Anonymous Anonymous said...

I've worked in the healthcare industry for over 30 years. Most consumers do not know what their insurance coverage will pay. I encourage Senator Waddoups to thoroughly investigate his constituents complaints. I would venture to say that those complaining either owe money because they went to the wrong facility or physician, or they owe money because they have an 80/20 plan. They complain because they simply have not educated themselves on their policy. Please Senator Waddoups: Don't try to fix what doesn't need fixing. Why would the entire country think Utah has the best healthcare system in place and you don't? Personally, I worry about your intentions.

5/01/2006 4:20 PM  
Anonymous Anonymous said...

Tell me again what hospital board you sit on......are you also concerned about their practices or are you just trying to help take out their competition?

5/01/2006 4:25 PM  
Anonymous Anonymous said...

Senator Waddoups: This collusion you are worried about, is this also something you are concerned about with Blue Cross or are you once again only focused on one insurance provider. I've been insured under health care plans for years, and none of the plans I've participated in, including Blue Cross, have given me full access to any provider. This is not creating a monopoly, its called running a cost effective business. No matter the insurance company, if you choose to go outside of their panel of providers, you end up paying a larger percentage of the cost yourself. This even occurs with my auto insurance. They have specific vendors that I must go to for auto repair in the event of an accident. Are you investigating them too? Here's the deal, the customer purchases insurance from the company of their choice. No one is forcing them to purchase their insurance from a specific company. They can choose who they prefer. Once they've made that selection they understand that there are guidelines to utilizing that insurance. No one hides the fact that purchasing this insurance product requires following their guidelines for maximum coverage. That is part of what should determine the insurance coverage to be selected. If I don't like the panel of doctors or hospitals that this insurance gives me access to, then I purchase a different insurance. If my employer is making this choice for me, that is not the fault of the insurance company, that's the fault of my employer. Ultimately,you get what you pay for. If you want greater access, then purchase a policy that gives you that access. No one has taken away your right to make that choice.

5/01/2006 5:28 PM  
Anonymous Anonymous said...

Senator Waddoups,

As usual your lack of humility is clouding your ability to think rationally. Don't make your personal short-comings the problem of the entire state. In this case you are simply wrong, so give up, please. It's embarrasing.
To the public and your peers you act freindly and genuinely interested, but in reality you are self-centered and ambiguous. Mostly your actions are fluff and a waist of public service. Such as is the case with healthcare, something you have very little experience with. And by the way an "official" committee doesn't give you that. Dont get everyone in healthcare confused with one bad apple. I have met certain big company helathcare exec's and they are honest, hard working people that I feel are helping the public of Utah, something you may not understand. I have also had the pleasure of dealing with people associated with your business and they do not have my best interests in mind, only yours and your moneys'.
So please rally up with your fellow ignoramous Republicans and find something to do that will actually change things for the better in this state. Please stop trying to manipulate the public.

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

Senator Waddoups needs to stop demonizing industries and businesses and realize the rising expense problem nationally is NOT due to Enron type scandals, but rather a system that needs fixing. Escalating utilization, an aging population, over industry regulation, malpractice premiums, defensive medicine, supply costs, pharmaceutical costs, technology improvements, etc. - PROBLEM WON'T BE SOLVED SIMPLY BY LOOKING FOR SOME MYSTERIOUS AND NEFARIOUS ELEMENT.

5/01/2006 5:45 PM  
Anonymous KB said...

Sen. Waddoups,
You are focusing on what is happening instead of why it's happening. Your actions and recommendations to date will cause health care costs in Utah to go up. It's that simple. Your comments show that you see problems but don't really understand why we have those problems in the first place. You are looking at a couple of trees in a forest of millions of acres infested with bugs. You cut down the couple of trees you can see and walk away thinking you've done some good. Had you sprayed the entire forest you could have saved the trees you cut down as well as the rest of the forest. The health care problem is bigger than you alone have the ability to handle. You are going to do more harm than good if your proposals are put into place.
Any one can get the health care they want if they are willing to pay for it. Anyone can choose any doctor they want, under the insurance plans I've seen from IHC or Blue Cross, if they are willing to pay for it. Removing the ability of hospitals to provide less expensive care through group discounts, physician panels, etc will not solve the problem it will only explode the already rising costs of health care.
I, like you, would like to see my health care costs go down. I would like to see everyone have affordable health care. But your actions are not consistent with fixing the problem. I've been reading the minutes to the health care task force. How you can come up with the statements you made about what you've learned from attending those meetings is beyond me. It also seems to be beyond other members of the task force.
I can only assume this is not really about fixing health care. You're comments are not documented. You provide no references to the task force meeting minutes that support your allegations. I'm a very disappointed. I had hoped we had better leadership in this task force than we do.

5/01/2006 5:49 PM  
Anonymous Anonymous said...

Mr. Waddoups needs to be careful about what he is proposing to do. Whether he wants to acknowledge it openly or not, some of his biggest supporters have clear, well-known monopolies in certain medical specialities and areas of the state. They threaten competitors from trying to practice in their territory or specialty area. This is well-known amongst doctors and the medical community - so give those of us who know a break and stop the blind, two-faced allegations. If he proceeds, plenty of skeletons will come out of the closets of his supporters and he will end up cutting off his nose to spite his face. Federal investigations?! Please. If that were to happen many will see to it that investigations are directed to the true monopolies (which are not where Mr. Waddoups thinks they are) and it will lead to the break up of his supporting groups that have 100% of the market in certain communities (and likely his own removal from any position of influence - which he has greatly abused). He should quit while he is behind before he embarrasses himself any further and wastes more of our money.

5/01/2006 7:29 PM  
Anonymous Anonymous said...

I agree that something needs to be done about healthcare. As a provider, there is not one day that passes that I am not frustrated with what an insurance company tries to dictate. Unfortunately, investigating insurance for monopolies is not the answer.

Changing the states current system will not lower prices, expand a persons coverage, or make Mr. Waddoups look any better. In fact, it's likely that the opposite will happen in all accounts.

Rather than state anecdotal evidence (which from a researchers point of view is the least convincing), give us some real evidence from your 'comittee's' research.

If your bone to pick is IHC, how do you refute their claims of millions of dollars of charity care for the people of Utah? Does that charity care hurt Utahns?

If your complaints are elsewhere, show us some evidence from other states where the health care is any different. I lived in the state of Texas for a few years. In a state that claims everything there is better, and different from any other state, their healthcare was almost identical (just the insurances were different).

Thank you for looking into healthcare. But lets look to solve the real problem, not the way it is manifesting.

5/01/2006 9:16 PM  
Anonymous jb said...

Senator - looks like Congress already beat you to the punch on this one. Check out the local community events that have been occuring around the nation on this healthcare issue. Visit the Citizen's Healthcare Work Group

Congress and the President created the Citizen's health care work group to get input on how to change the system. From one national insurance company, to just bolstering current community systems. Be sure to take the Health Care poll. Let your voice be heard on this issue.

5/01/2006 9:38 PM  
Anonymous Anonymous said...

Mr. W. the "train wreck" occurred years ago when physicians began procuring and protecting outrageous salaries and benefit packages. As with any poor managers, the docs got what they deserved. You may want to examine with greater scrutiny the AMA (and the docs) who contribute to you and your interests e.g. Utah Healthcare Coalition or rather health care providers other than IHC a.k.a. the private not for profit integrated health system not presently subject to a 6% or 3% illegal tax on gross receipts intentionally excluded from the coalition on the premise that big business may cause irreparable harm to the coalition free speech/protect the little guy intent (United, Regence, Coventry, and others exempted from the categorization of big business of course). It is common knowledge that big money (organizations exempted from the categorization of big business of course) and large lobbying firms (former Republican National Committee Chief Counsel, former Senior Advisor to U.S. Senator Bill Frist and former Staff Director for the U.S. Senate Subcommittee on Public Health, one of the “The Hill’s (meaning Washington D.C Capitol Hill) Top Lobbyists and Hired Guns” firms) are backing you and the other ignorant lackeys involved. You don’t have to put your head in the trashcan to know it stinks. It is even less advisable to get into the trashcan, wallow around, and return to the business of feigning representation of your constituents without first showering with a good lather or in this case effectively hiding the money. The folks formerly from Sen. Frists’ office are looking for a backward, hillbilly, trusting, blind sheep, inbred, ethnocentric, easily duped population to use as a platform to springboard in to the limelight. Fortunately for us, and unfortunately for your Neolithic, hurly-burly, bullying backers, Utahns are none of the fore mentioned. I understand that you have the ill-fated (and ill-placed) ambition to break onto the national scene, but your ambition is not backed with any fundamental or even reasonable knowledge about the issues you have lovingly embraced. History is replete with examples of overambitious crash and burners (egotistic fiddlers) who bring entire staffs, states, and nations with them. Our health care situation in Utah is not ideal, but may be the best of the healthcare situations in the nation (yes it is a rhyme..catchy huh).

Honest Uncle Abe

5/02/2006 7:45 AM  
Anonymous ckeilman said...

Mr. Waddups. It seems to me that you are just another Democratic bomb thrower, all bluster with no substance. If you could just once back up your claims with some facts, at least then you might have some credibility. You obviously see yourself in the hero role of the David and Goliath ilk. We have a great system here in Utah and although every system can be improved upon, it does not require the dismantling of what is by national accolade the best health care system in the country. If you have any proof at all that insurance companies are in collusion with one another to fix prices, let’s see it. I think you are just wasting the tax payer’s money on a wild goose chase similar to the one Congress is on trying to prove that the oil companies are working together to fix oil prices. It’s been done, there is non, just leave us alone.

5/02/2006 8:21 AM  
Anonymous Anonymous said...

I am amazed at all the people that defend the healthcare system in Utah (and the United States). Even if one believes that Utah has the best healthcare in the nation the system is still broken. The number of uninsured Americans is estimated at over 46 million people. This does not count the millions more that are underinsured or still cannot afford their copayments and therefore cannot access healthcare. The infant mortality in the United States is 36th worldwide and life expectancy is 27th even though we spend more than the rest of the world $4,500 per person (Switzerland #2 at $3,300).
It can be argued whether this committee will be helpful or simply a waste of time and money and provide a distraction to the real issue of the failings of the healthcare system in America. But at least it is one of the few efforts by government to look at the problem (even if not at the central issue).
Healthcare in the U.S. is so unfair and confusing that a significant number of people in the U.S. cannot receive basic healthcare. We need to shift our resources from focusing so much on heroic care of the old and channel some basic universal care to the young.
Perhaps the two most important commodities for our children's success are education and basic healthcare. We attempt to provide basic education to all children why can't we provide basic healthcare?

5/02/2006 10:00 AM  
Anonymous Anonymous said...

I agree. We would do well to return to, or at least consider public health or population based planning and treatment.

5/02/2006 10:25 AM  
Anonymous jb said...

There is no system of healthcare in the United States.

“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.” - The Center for Studying Health System Change began in 1995 to study the impact of HMOs.

The March 2006 article is an excellent commentary on the current healthcare situation in the United States. Three points emerge:
1. Public Perception Matters
2. All Healthcare is Local
3. The Devil is in the Details

Bottom line: The only constant in healthcare is change.

Every insurance business in Utah has been adapting over the years, in fact Regence BlueCross BlueShield of Utah, is the oldest and largest insurer in the state. They have done a pretty good job of adapting since 1942.

Every business runs as a BUSINESS - whether it is for-profit or not-for-profit (that includes advertising, paying CEOs, and scrambling to meet legislative requirements). Every insurance business try's to exploit its niche. Since when has not-for-profit meant one cannot be extremely successful? We need a variety of for-profit and not-for-profit businesses to fulfill the needs in Utah.

5/02/2006 11:24 AM  
Blogger The Senate Site said...

These health care blogs seem to have hit a nerve. Some of the comments here (and here)are a bit acerbic, so here's a reminder:

Thoughtful, policy-oriented discussion is welcome.

Mean-spirited, personal mud slinging is not.

Thanks JB, and several of our anonymous posters for sharing helpful insight while maintaining a respectable level of decorum. You should think about running for the senate.

5/02/2006 12:16 PM  
Anonymous Anonymous said...

What concerns me as a citizen of both the state of Utah and this country is- big business has so much power and money behind them, that to get to the truth is like looking for a needle in a haystack. These big corporations spend small fortunes on promoting what great service they are to the communities, while those who truly provide the great care are the individual providers. And these individual providers have their hands tied by big corporations when they try to provide the highest quality, most affordable, and efficient services to their patients-- It is time that people know what is really going on in healthcare and who is really control the escalating costs- it certainly isn't the little independents!

5/03/2006 10:38 AM  
Anonymous Anonymous said...

as a practicing physician in southern Utah, I had an opportunity to speak with Senator Waddoups last evening. He impressed me as an honest and forthright person, who is truly concerned with what is happening in Utah and the nation with healthcare. He admitted he doesn't have all the answers, but is just beginning to understand the scope of the problem- I have found this type of modesty to be rare in the political arena. On the other hand, our own state representative Dave Clark seems to think we don't have a serious problem and embraces the status quo.

5/03/2006 10:42 AM  
Anonymous Anonymous said...

What’s wrong with calling for an audit and investigation into our healthcare system? Something is wrong and identifying the problems shouldn't be all that bad.

Senator Waddoups should not be blamed for stumbling into a mess, he has nothing to gain.

Since IHC is so anxious to leave their past image behind, the investigation could give them a clean bill of health to go along with their new "squeaky-clean" image, name change and logo. Let them start their new image with purity!

5/03/2006 11:31 AM  
Anonymous Anonymous said...

We are all experiencing anxiety and frustration with regards to this topic. I work in the healthcare field in fact for the exact company criticized at the start of this. We need to step back and let the task force complete their review/investigation and hope that they will come up with some very workable suggestions.

I would ask that any derogatory comments or recommendations from this task force be kept quite until all facts are in order. It does no one any good to get worked up over the issues when the facts are not in order.

I support the state and federal government to investigate any and all health plan, hospital and Providers office. I believe that Intermountain Healthcare has nothing to hide and would hope other health plans; hospitals and providers offices have the same confidence to open their doors to an audit.

5/03/2006 12:01 PM  
Anonymous Anonymous said...

The committee has released its findings in a 101 page document. To access it copy this address and post it in your URL:
http://www.le.state.ut.us/interim/2006/
HealthCareReport/Utah_Report.pdf

Interesting that contrary comments would occur so close to the documents release.

5/08/2006 9:46 AM  
Anonymous Anonymous said...

Sorry that link didn't work. Try this:
http://www.le.state.ut.us/interim/2006/HealthCareReport/index.html

5/08/2006 9:48 AM  
Anonymous CONCERNED CONSTITUENT said...

For the past 2 years you have scrutinized the state of our healthcare system in Utah as the chair of the Privately Owned Health Care Organization Task Force. During this same time period you have been a sitting board member of a for-profit hospital corporation. That is a blatant conflict of interests. You should step down.

5/08/2006 10:32 PM  

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