Utah Senate Bill 61 with the Substitutes

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Utah senate bill 61 has different purposes that IHC health plans is on the hook for that you may or may not wish for depending on what side of the table you sit on.

I've decided to wait for the dust to settle before I addressed this issue with you. In part I have had mixed feelings about this bill. Any potential rate increase possibility I would and do fight. I have also seen this type of struggle before with other insurance carriers in other states and witnessed "the closed door maneuvers". It is frustrating to me to see what goes on and that the general public isn't included fully on all facts. So I want to get some issues addressed here and point out some facts to encourage awareness of the good the bad and the ugly. I don't want to sway you with my opinion but rather to expose you to some things much more deeper than what you hear in the paper or on the news channel.

Date of Facts

The original Senate Bill 61 proposed a 3% sales tax on all IHC gross receipts. This money was to be earmarked for school funding.

On 2/11/05 IHC Health Plans and Intermountain Health Care were allotted two hours for a Pre-Hearing to present arguments against this Senate Bill 61. I requested a 5 minute presentation but was blocked. The time was already determined to be allotted to large employers, high ranking IHC executives, and hospital administrators. Apparently their voice was considered to be more weight...in the small time allotted. I disagreed in principle because all of my clients are either small employers or individual policy holders. Arrogance on my part for demanding to be heard? Perhaps, but I felt I had a responsibility to represent my people.

On 2/11/05 at the end of the hearing Senate Bill 61 had a substitute adoption that would prohibit IHC from owning or having a controlling interest in a health insurance company. The substitute bill was introduced with no time for testimony from anyone. The committee therefore moved to adjourn the meeting, with no votes, until 4:00 p.m. on Monday, February 14th.

On 2/16/05 Senate Bill 61 will soon be presented on the Senate floor. The substitute bill will require IHC to divest itself of IHC Health Plans as of January 1, 2007.

On 2/25/05 I was informed by IHC Executives that Senate Bill 61 is all but Dead. Apparently there is going to be a committee appointed to analyze all the facts. IHC Health Plans and Intermountain Health Care have agreed to cooperate.

The Good (my opinion)

The 3% tax isn't happening which IHC would definitely pass onto policy holders. I particularly have a issue with this which I will discuss in the ugly.

IHC Health Plans and Intermountain Health Care "heard" and "understood" the discontent that a good part of the Utah community has for them. They now want to focus on understanding the community needs better. At least that was what was told to me at a focus group I was asked to attend on 2/22/05. Interestingly enough IHC seemed confident that Senate Bill 61 would be defeated before the actual occurrence. In this meeting it became very evident that there are very hard feelings towards IHC in general expressed from other members in the broker community that attended. But there were also feelings of great amount of gratitude and examples of life saving medical treatments. I walked away from the meeting feeling that IHC Health Plans understood that there needs to be more "ownership" taken to resolve issues. I was dismayed and offended somewhat when the IHC representative would ask me "Do you think your clients will understand" this and that of basic insurance scenarios. It has been my experience that the "client" is often more intelligent about what their insurance needs are. I generally pride myself in educating those of you that aren't sure about concepts.

The Bad (my opinion)

Red tape committee created to address the disadvantages and advantages of breaking up IHC. I say "Red Tape" because I don't believe anything will be done soon or in a manner that will benefit Utah in general.

Yes IHC can be credited for keeping insurance rates low because they claim to have the most effective doctor contracts anywhere. Well, talk to most IHC doctors and they complain about being overworked and under paid. Has any ground been made to better Utahans in general with this committee? I would hope so.

The Ugly (my opinion)

Why is the "patient" and "policy holder" always caught in the middle of these struggles? I get so disturbed over this at times I wonder if I need to see a physiologist to determine if I have multiple personalities. Why multiple personality? Well in any given day I go through the following personality changes. One minute I am praising IHC to clients when they do good and deliver in many cases life saving medical treatments. Those of you know who I am talking about. IHC does deliver, on the most part, above average medical treatment. So my one personality wants to defend IHC in that respects. My other personality that resembles a "bull dog" comes out when IHC wants to penalize a client in "rate increases" or use scare tactics of...."if this house bill goes into effect we'll just pass it on in rate increases"... What in the world does that have to do with the client? There are other areas to cut costs and give back to the community. Yes IHC builds 52 million dollar hospital nearly every year but what about using some of that money to lower premiums! Then my other personality of a white dove comes out when I am able to say to new and old clients that their rates are the some of the lowest in the state. In the national average I can testify that the IHC plan designs we have in this state with the rates are some of the best when compared to other states with other benefits that I manage. My raging rhino personality comes out when I am treated rudely by either IHC Health Plan insurance company or Intermountain Health Care hospital. Hey.....I think I should be thanked by IHC insurance that I care about my customers enough to call up there every day to resolve issues in their behalf! I also feel that I should be thanked that I elected to use a Intermountain Health Care hospital rather than one of their competitors from Mountain Star Health hospital chain. Right? Some of you know exactly what I am getting at. So is Senate Bill 34 "Patient Access Reform" (Any Willing Provider) such a bad proposal from that standpoint? Should IHC prove and open their books to Utah governmental authorities that it will affect policy holder premiums with the passage of the bill? Has that even been asked yet?? NO!! If it is found to be true than shouldn't the bill be amended in such a manner to allow "patient access" within reason as to not affect premium rates?

IHC boosts on what it does for the community in hospital constructions, new equipment, etc. I think we can all be thankful for that. We have the facilities now so can we move on and address keeping premiums low? If you (IHC) must divest yourself of profits to claim "non-profit status" to build these facilities than lets give some back to the community partners and use the rest to lower premiums!

Well, after some soul searching, sleepless nights, hitting my punching bag and nearly running to my physiologist to see how I can keep from the insanity of all of this (which by the way mental health coverage in this state is awful) I came to a conclusion. I remember my old Economics professor Michael Laracca and the many heated debates he inflicted on his students to drive home one conclusion. Government interference in the private sector should be for the benefit of its citizens. Period. I think Senate Bill 61 failed to deliver what Utahans need most. Better reform on how people can get approved for a insurance policy. Better reform on what your premiums can be increased by each year. Better reform on patients rights.....Better reform on specific coverage's such as mental health, disease treatment, etc. Better regulatory evaluations of all insurance companies that claim they are non-profits. So many difficulties in life could had been avoided if taking "ownership" of issues was a rule rather than a courtesy. Look what happened to Humana insurance company that waived their "proud and strong" flag chanting the motto of "my way or hit the highway" approach. They were busted up. Rates got more competitive because of market competition but hospital quality care dropped significantly.

Contact your Senator with your opinions.

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Michael Oliphant
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