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Second opinion
This is an archived article that was published on sltrib.com in 2005, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.

In diagnosing a clearly complicated medical case, it is often a good idea to seek a second opinion.

In considering deceptively complicated medical legislation, it is always a good idea to have an informed opinion.

Whether through enlightenment or through intimidation, state Senate backers of bills that would have significantly changed the way the giant Intermountain Health Care does business in Utah have apparently thought enough about the unforeseeable ramifications of their proposals to send the matter to a study committee.

It's not that the sword no longer dangles over IHC's unique, to Utah, practice of merging health insurance and health care under a single, supposedly more protective, umbrella. Sen. Michael Waddoups' revised Senate Bill 61 still breaks up those two functions effective July 1, 2008.

But the review committee now envisioned - six senators, nine House members and $105,000 in budget authority - would still have time to pull the emergency brake if it decides that train needs to be stopped. Or, more likely, rerouted.

Waddoups' approach has been a break-up-the-Yankees attitude that presumes that the merger of insurance company with hospital network is an inherently anti-competitive arrangement that hurts patients a lot and hurts health care providers that aren't on IHC's team even more.

A companion bill, sponsored by Sen. Chris Buttars, would have demanded that all of those insured by IHC, or by anyone else, have the choice to roam to “any willing provider” of health care rather than be confined to approved networks of hospitals and doctors.

But it wasn't all that long ago that the problem with health care in the United States was said to be too much choice. Patients freely sought all manner of care for real and imagined maladies, because they were insulated from the cost by employer-subsidized insurance. Doctors readily ordered every imaginable test and scan, sometimes at added profit to their own practices, because the patient wasn't paying and because they were afraid of being sued for a lack of due diligence.

The answer, of which IHC is a globally admired example, was supposed to be an integration of insurer and provider that truly managed a person's health care.

We are told, mostly by people who work for IHC, that IHC's approach works. We are told, mostly by people who practice outside IHC's network, that it doesn't. Thus the need for the Legislature to go out and hire experts who don't have a dog in this fight.

Having forcefully expressed their views on the matter, Waddoups, Buttars and their allies don't qualify for that description any more than IHC's officials do.

But, as they used to say on TV, the truth is out there.

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