It's no fun to get your anatomy kicked.
By more than a 2-to-1 margin, senators endorsed a proposal to let patients, not their insurance plans, choose which doctors and hospitals they use. The vote followed an emotional two-hour debate on a separate-but-related bill aimed at diluting IHC's influence.
The bills have the potential to transform how health care is delivered in Utah. Senate Bill 34 would undermine, if not eliminate, health maintenance organizations as we know them; Senate Bill 61 would force IHC to sell its health plans or pay a 3 percent tax on its revenue.
And while it is possible both proposals will be nixed in favor of further study, the fact they have gotten this far is a sign the climate at the Capitol has changed.
Even IHC executives acknowledge they have "heard the message" of lawmakers who say IHC's business model is no longer healthy for Utah.
"I have no doubt our size sneaks up on us once in a while," IHC Vice Chairman Kent Murdock said.
It did not, however, creep up on the Legislature on Friday. More than 1,000 IHC employees, bearing stickers and brandishing signs, showed up to oppose SB 61.
They clogged the Capitol entrance, the hallways and the room where Sen. Michael Waddoups, R-Taylorsville, presented his IHC tax proposal to the public for the first time. When that room was full, the employees crammed into an auditorium to watch the hearing on closed-circuit TV.
They cheered and jeered depending on lawmakers' support or disdain for IHC. But in the actual meeting of the Senate Revenue Taxation Committee, the atmosphere was much more subdued.
And although the committee adjourned without voting on the bill, the panel received plenty of feedback.
Waddoups, his voice quivering slightly, complimented IHC's doctors and hospitals - and its public-relations managers.
But, he argued the company, with its hospitals, physician panels and insurance plans, stifles competition and acts like a for-profit business.
In 2003, IHC collected $137 million more than it spent, suggesting the company would not be crippled by a 3 percent tax, Waddoups said. (The tax would net Utah schools $87 million in 2006 and $101 million the year after.)
He called claims that IHC would have to drastically reduce its charity care "the biggest scare tactic ever," noting that Utah's for-profit hospitals manage to provide as much or more charity care than IHC.
Non-IHC medical providers said IHC's tax-free status lets it lower prices, making it hard for others to compete. And, they said, the company has a history of abusing its power.
Two telling examples came from women who told, through tears, how IHC bill collectors dogged them for payment. One woman said she sold her house to avoid bankruptcy and, to avoid a repeat situation, has dodged hospitalization despite heart problems.
When it was their turn to speak, IHC supporters talked of the company's national reputation as a leader in health care from a quality and cost perspective.
Compared to in-state competitors, IHC's costs are 16 percent lower for hospitalizations and 35 percent lower for outpatient services, Murdock said. And all of the money IHC makes is pumped back into the system. Not so with for-profit hospitals.
If IHC had to suddenly come up with $87 million to $100 million a year in taxes, services would have to be cut or costs would have to go up, he said.
"No one who pays for health care is in favor of this bill," Murdock added.
Midvale Mayor Joann Seghini said penalizing IHC would harm low-income families who rely on its charity care, a concern echoed by others.
Allen Nelson, a trustee and former president of the American Medical Association, wondered why the Legislature would want to blow up one of the most respected health-care systems in the country without at least studying the consequences.
"I urge you first to do no harm," Nelson said.
Opponents of SB 34 made the same recommendation to their Senate colleagues, complaining that an issue as important as this deserved more study.
But the bill passed easily by an 18-8 vote. It now moves to the House.
