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Show Mandatory Medical Arbitration: The Wrong Answer to the Rising Cost of Health Care in Utah Bryson B. Morgan that a patient voluntarily opted for arbitration; while S.B. 245 called for a panel of three. At first IHC opposed both pieces of legislation, but as a local newspaper reported: IHC had only tested the policy for three months before bowing to pressure from legislators, patients' advocacy groups, and trial lawyers. Now, the 400 IHC-employed physicians in Salt Lake County and Bountiful will no longer demand patients to sign agreements or be refused care.... IHC reversed its hardline support of forced arbitration and agreed to back a bill proposed by Sen. Leonard Blackham, R-Moroni (Hamilton 2004c, A01). Even Elliott J. Williams, a prominent former advocate for S.B. 138, when speaking in a Utah House Minority Caucus meeting stated, "We all agree that compulsory arbitration was not a good idea.... [Arbitration as an option if chosen voluntarily is a good one" (2004). The complete reversal of opinion was almost immediate as IHC struggled to maintain its reputation. The issue soon turned into not whether or not a physician could require arbitration agreements, but whether a one or three member panel should be used when a patient had voluntarily chosen arbitration. Strong opinions were voiced from each side. Senator Parley Hellewell said, "With three arbitrators, it guarantees that IHC wins every single time" (Spangler 2004), while Elliott Williams, the self-proclaimed Utah arbitration expert, said that "Most Utah arbiters are reluctant or refuse to take cases where they are the sole decision maker." The advocates of a single arbiter cited lower costs to consumers, while the advocates of a three member panel cited the "small universe of people qualified to be a sole arbiter" as the basis for their argument (Williams 2004). The issue continued to be debated until the final hours of the legislative session. It was finally resolved in a quick hall huddle in the final few hours of the legislative session. "That was one of the quickest conference committees I've been to.... Fast and furious" remarked Senator Blackham (Bryson 2004b). The result of the conference committee was a widely accepted compromise, and the final bill: 1. Prohibited a health care provider from denying health care to a patient in the sole basis that the patient refused to sign an arbitration agreement. 2. Allowed the patient to rescind a signed arbitration agreement within 10 days of signing it. 3. Established a three member arbitration panel unless both sides agree to a single arbiter. S.B. 245 passed the Utah State Senate on March 3, 2004 by a unanimous vote of 26 to 0 with three absent, and later passed the Utah House of Representatives on the same day by a vote of 64 to 6 with 5 absent. "We hope this will be resolved once and for all," said Senate President Al Mansell (R-Sandy) (Bryson 2004a). Senator Blackham, the sponsor of S.B. 245, commented, "I believe this is a well balanced approach that is fair and reasonable" (Bryson 2004b). However, not all were pleased with the outcome. Cheryll Willey, office manager at Wasatch Internal Medicine, said, "We were getting a five percent discount from UMIA, which is peanuts, but every little bit helps because the malpractice rates are so expensive" (Hamilton 2004, A01). While a five percent discount on medical malpractice premiums may help some struggling doc-tors, the Legislature agreed that mandatory medical arbitration was too high a price to pay. Conclusion The repeal of S.B. 138 was a victory for the citizens of Utah. It shows, to a certain extent, that the opinions of Utahns can have a significant effect on decisions of the Utah State Legislature. Mandatory arbitration was enacted due to a lack of information and foresight. The overwhelming majority of legislators accepted the claims by the UMA and UMIA that health care costs were rising due to large medical malpractice payouts. Few legislators understood the complexity and scope of the problem. Once properly informed, the Legislature acted to right the wrong it had created only one year prior. In this case the Utah State Legislature should be commended for its quick response and urged to give a more thorough and critical analysis of the hundreds of bills proposed each year. Many of us unrealistically expect and assume that our elected officials make decisions only after being properly informed. The passage and later repeal of S.B. 138 shows that there are serious faults in the way that our legislators receive their information. In many instances important decisions are made without the proper time for debate and analysis. As not only the sheer quantity of legislation increases, but more complicated issues come before the Utah State Legislature, more and more legislators turn to lobbyists, colleagues, and other special interests for direction. In this setting of rushed analysis and speculation, it becomes easy for a legislator to accept the facts and figures presented by interest groups as reality. In an intense and compact legislative session, it is ever more unrealistic to expect any issue to receive adequate attention, and the possibility of "legislative errors" is enhanced. References A.M. Best Company. 2001. Aggregates and Averages. American Arbitration Association, American Bar Association, American Medical Association. 1998. Commission on Health Care Dispute Resolution Final Report. Bryson, Joi. 2004a. "Compromise Makes Arbitration Voluntary." Deseret Morning News, 7 February, Al. -. 2004b. "Hall Huddle Settles Arbitration Dispute." Deseret Morning News, 4 March, A9. Collins, Lois M. 2003a. "Arbitration Foes Picket IHC Clinic." Deseret Morning News, 24 December, Bl. -. 2003b. "Doctors Seek to Head Off Lawsuits." Deseret Morning News, 14 October, <http://www.desnews.com/ cgi-bin/cqcgi_state/@state.env.htm> (20 April 2004). 48 |