By Michael Waddoups
Utah State Senator, District 6
This past week* marked a milestone in Utah's health-care system. The Privately Owned Health Care Organization Task Force
packed up and headed home.
The 14-member task force, which I co-chaired with Rep. David Clark, was formed two years ago to study issues relating to competition and business practices in Utah's health-care market.
Specifically, it was asked to assess whether or not Intermountain Healthcare, the state's largest provider of health care and commercial health insurance plans, uses its size and dominance to restrict competition.
Task force members found that the answer depends on one's perspective. We studied the issue extensively. We asked questions, demanded answers and took some important steps to ensure Utah's health-care system operates with fairness.
Undoubtedly, the question of competition is critical. It's essential to fostering a health-care system where quality improves, innovation is encouraged and prices are modified as a result of normal market forces. One expert hired to review the situation for the task force concluded that Utah's health-care system provides vigorous competition with good quality care at reasonable prices. Some disagreed. A number of organizations and individuals (including the Utah Medical Association, the Utah Ambulatory Surgery Center Association, competing insurers and hospital systems) provided testimony regarding errors and flaws with the consultant's result.
Probably more significant, we were presented with a petition signed by more than 3,000 members of Utah working families calling for more choice.
The task force's work did little to quell the disparate voices, but it did raise awareness of many important health issues, including
- rising costs,
- the uninsured,
- tax advantages and
- charity care.
Most important, the legislative oversight provided by the task force resulted in the implementation of several important, positive changes for Utah consumers — most notably:
- Improved medical billing practices — IHC announced its commitment to refrain from using court proceedings whenever possible to collect unpaid medical bills and reducing interest rates on unpaid bills.
- Expansion of health insurance networks — IHC announced it will offer a health plan that will allow any qualified physician or health-care facility to participate in the plan's network.
- Elimination of an anti-competitive activity — the line between hospital and insurance inside IHC has been fuzzy, providing the organization an advantage. The task force compelled IHC to establish organizational systems that formally separated hospital and health insurance functions, especially in contract negotiations with competitors. However, predatory practices are still being alleged.
These important, long-term changes will ease the strain carried by many struggling to pay their medical bills. They'll also provide a measure of equity to the state's physicians and insurance companies.
I commend Intermountain Healthcare for its active cooperation. A number of medical providers, insurance companies and consumer advocates exhibited courage by articulating different viewpoints.
Finally, I honor my fellow task force members for their diligent efforts. Now the Legislature must work to give consumers information on health-care pricing and quality and allow them to choose the best doctor and facility for their care, regardless of insurance coverage.
I plan on introducing legislation to support patient choice. Utah patients feel that the sanctity of the doctor-patient relationship is being violated by "big corporate health interests."
The task force made significant strides toward improving and understanding our state's complex health system. Our committee will carry that invaluable knowledge with us into the legislative session. It will serve us well as we work to ensure that all Utahns have access to the highest quality of health care at the most reasonable prices.* Note: I wrote this op-ed piece weeks ago; it was finally published in yesterday's Deseret Morning News.