Health-care panel fizzles after 2 years and $300K

Task force on Utah's insurance and HMOs agrees on nothing
By Linda Fantin The Salt Lake Tribune
Article Last Updated:11/14/2006 01:33:08 AM MST

We met. We learned. We adjourned. That is the self-assessment of a health-care task force that spent two years and $300,000 dissecting Utah's health-care system. But don't expect to see it in print. The Privately Owned Health Care Organization Task Force concluded its business Monday without so much as a memo detailing what lawmakers did with their time and your money. Which is not to say they did nothing. Task force members logged more than 63 hours in 21 meetings, gathering information about the fairness and affordability of Utah's health care and insurance markets. They provided doctors, patients and advocates for the uninsured a public forum for voicing frustrations, including concerns about the dominance and business tactics of Intermountain Healthcare. In doing so, they nudged the health-care giant to soften its debt-collection tactics, open its networks to more physicians, and work more amicably with competitors. But mostly, task force members disagreed over the direction of the task force and lamented its lack of focus. Monday was no exception. Lawmakers spent more than an hour debating the wording of a few innocuous conclusions to a draft report that would have outlined the areas of study and stated the obvious: Health care in Utah is complicated, many issues remain unresolved, and the task force can't agree on any solutions. At one point, House Speaker Greg Curtis, R-Sandy, agreed to vote for another lawmaker's substitute motion - or was it a substitute substitute motion? - if it would end the task force's existence. Sen. Michael Waddoups, a Taylorsville Republican who co-chaired the task force, said the failure to agree on a final analysis was indicative of the complexity of the problems at hand, in Utah and nationally.

"I make no apologies for this task force," Waddoups said. "We met frequently. We studied a lot of issues that were difficult to understand and get our arms around . . . and I'm the first to say we don't completely understand them even today. "It would have been wonderful to come out of this task force with a perfect system, but no one expected us to do that." The Legislature does, however, expect a progress report; the statute that created the task force requires a final written report to two interim committees. The group did draft a report, a seven-page memo summarizing the topics tackled by the task force:

* Competition in Utah health-care markets;

* Tax exemptions for charitable health-care organizations;

* A law that guarantees access to rural health care.

But the memo contained no conclusions or recommendations, and that disappointed some members, especially Waddoups. So he offered a couple of amendments. One said that information presented to the task force was "general in nature and not conclusive as to any recommended changes needed to our health-care delivery system," noting individual lawmakers should pursue "any remedy they feel is necessary." It was rejected without a vote. The other, after numerous revisions, said: "Although some health-care systems have made efforts to change some of the perceived problems that precipitated the formation of the task force, issues related to patient choice, access to affordable care, and a level playing field for competition still persist in the view of some." It was voted down, as was the memo absent the amendments. Rep. Rebecca Lockhart, a nurse from Provo, said the panel had an obligation to come to some conclusion, "even if it says we can't agree." "The Legislature deserves to be told what we did," she added. As for recriminations from the rest of the Legislature, Rep. Jim Dunnigan, a task force member from Taylorsville, said he isn't worried, but added, "The ambiguity will hurt us." Divisiveness has plagued the panel from the get-go. Two years ago, the Legislature created the task force in a compromise with Intermountain, the target of two bills. The first, carried by conservative Sen. Chris Buttars of West Jordan, would have allowed patients to choose doctors and hospitals outside their insurance network without penalty, undercutting Intermountain's managed-care model. The other, sponsored by Waddoups, would have taxed the gross receipts of Intermountain to address complaints that the HMO exploits its tax-exempt status to undercut competitors. Both bills were dropped in favor of a 15-member task force that was promptly populated by lawmakers who were beset by conflicts of interest and, depending on their loyalties, appeared biased for or against Intermountain. At one point, 11 of the 15 legislators who sit on the panel had some affiliation with the health-care industry. That could explain the mixed response to a $297,000 independent study that, to the chagrin of Intermountain's critics, determined the company's ownership of insurance plans, hospitals and physicians helps - not hurts - competition. The consultant, David Argue of Economists Incorporated, also cautioned the Legislature against meddling in the marketplace. The report was met with skepticism by consumer advocates and some task force members. Many of its conclusions were refuted by a Regence Blue Cross Blue Shield consultant. Yet it remains the most defining record of the task force's work, and that is fine with Intermountain. "It was very fair and open and informative. It was an excellent opportunity to respond to questions and to tell our side of the story," said vice president and general counsel Douglas Hammer. On Monday, Hammer said hiring Argue was "the best decision" the task force made. As it turns out, it was the only one, too. lfantin@sltrib.com

By the numbers Privately owned health-care organization task force

* 15: Lawmakers on panel

* 59: Key speakers

* 84: Handouts

* 3,801: Minutes met

* 29,447: Words generated in meeting minutes

* 300,000: Dollars spent

* 0: Progress reports to the Legislature