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Show Hingkley Journal of Politics 2005 tection of a patient's right to privacy, this provision of the arbitration agreement prevents the public from ever learning the identities of IHC physicians who potentially practice bad medicine in that they have been repeatedly accused or convicted of malpractice. However, IHC will be able to closely track the outcome of arbitration proceedings. The information gathered could be used by IHC to improve its defense strategies while patients will be denied access to information to prepare for their own cases. For example, if an arbiter on the approved list leans in IHC's direction repeatedly when deciding a case, the patient will not have access to this information while IHC will. 8. Arbitration agreement automatically renews itself: The IHC contract automatically renews each year unless the patient cancels the agreement before the renewal date. Once IHC receives a signature for treatment, the agreement does not end. IHC makes renewal automatic each year. The only way to get out of the agreement is for the patient to contact IHC and follow their procedures to cancel the agreement. Upon termination of the agreement the patient is asked to go elsewhere for medical help. 9. Patients are coerced into signing IHC arbitration agreements: In most cases, patients are part of employee/employer health plans. This means that they are less able to change their health plan unless their employer switches all employees over to a new health plan. In rural areas and in other high specialty areas many times there are no other alternatives. It is more than likely that a patient who refuses to sign the agreement must choose no treatment at all. Without other options available to the patient, his or her ability to choose is severely limited. Policy Impact While the passage of S.B. 138 drew little public attention, IHC's implementation of their mandatory arbitration agreement did. Whether the public understood the fine points of the legislation is doubtful. However, the one-sided nature of the bill soon became evident. In late November of 2003, IHC bailed out over 170,000 letters to Utah citizens in Bountiful and Salt Lake City announcing that patients would be Squired to sign the arbitration agreement before receiving Medical care. They were told that if they refused to sign the agreement they would have to go elsewhere for medical care. Certainly, the way in which IHC presented arbitration, and ^e details of their agreement, were thought unethical by many, even by those within the health care community. Scott barton, an Ob-Gyn at Old Farm Obstetrics and Gynecology in Salt Lake City, said, "It's unfortunate that IHC made this come to a head. I don't know if IHC took enough time to e*plain it [arbitration] to their patients" (Hamilton 2004a, B01). Even R. Chet Loftis, UMA General Counsel, in an e-mail to legislators wrote, "We believe that it is unfortunate that IHC chose to introduce arbitration to its patients in the way that it did" (2004). Thousands of consumers were surprised and even outraged when they learned the details of the agreement. As a KSL editorial noted, "Last year, you'll recall, lawmakers passed a bill to allow mandatory medical arbitration. To say the public didn't buy it is an understatement. The outcry was loud and determined" ("Medical Arbitration" 2004). In a poll conducted January 18, 2004, by the Salt Lake Tribune, the subjects were asked: "Should health care providers be allowed to require arbitration of disputes over possible medical malpractice and prohibit lawsuits as a condition of treatment?" 56.3 percent responded "No," 34.8 percent responded "Yes," and 8.9 percent responded "Don't know" ("Should Health Care" 2004). In addition, a Dan Jones and Associates poll conducted 27 Dec 2003-3 Jan 2004, asked: "In general, do you favor or oppose patients signing binding arbitration agreements before being treated by a doctor or hospital?" Similar results were found, as 22 percent responded that they were strongly in favor, 17 percent responded that they were somewhat in favor, and 38 percent indicated strong opposition to arbitration agreements (Collins 2004, A01). Policy Evaluation: a Legislative Correction In the weeks leading up to the 2004 legislative session the debate heated up. Sides were formed, including groups such as Patients Against Mandatory Medical Arbitration (PAMMA) and the Utah's Citizen's Alliance (UCA), both fighting to repeal S.B. 138, while arbitration supporters included IHC, the Arbitration Alliance, and hundreds of Utah physicians. Each organization had well funded agendas and convincing lobbyists to sway the views of not only the lawmakers, but the public as a whole. As the Deseret Kiorning News reported on December 24, 2003: Members of a group called PAMMA, Patients Against Mandatory Medical Arbitration, picketed outside the Salt Lake Clinic...handing out information packets and waving signs with messages like 'IHC refuses to treat sick babies! Sign or Suffer' (Collins 2003a, B01). On the first day of the 2004 Utah General Legislative Session lawmakers were greeted in the capitol with a rally of more than 30 protesters urging the repeal of S.B. 138. They were joined by legislators such as Representative Mike Thompson (R-Orem), and Senator Parley Hellewell. Two pieces of legislation were proposed to repeal S.B. 138: S.B. 117 sponsored by Senator Parley Hellewell, and S.B. 245 sponsored by Senator Leonard Blackham. At the beginning of the session, the differences in the pieces of legislation were few. They both repealed the right of a physician to refuse care to a patient who declined to sign an arbitration agreement, however S.B. 117 called for a sole arbiter in the case 47 |