Image by An Errant Knight
Republicans love to wail and gnash their teeth at the concept of a single payer for healthcare. And they should — the U.S. government would certainly destroy the quality of our medicine and shorten lives. The miracle of American healthcare today would be long gone with the creation a vertically integrated system run by Uncle Sam. As Ronald Reagan used to joke, the scariest words in the English language are, ‘We’re the government and we’re here to help’.
However, hypocrisy is not something to be lost on any politician. So, it does not come as a surprise that the GOP is overseeing a vast single payer healthcare system in Utah and Idaho that controls approximately 70% of the healthcare lives, with predictable consequences.
Intermountain Healthcare was spun off from the LDS Church in 1974, which donated the fifteen hospitals it owned to a non-profit with the goal of creating a not-for-profit organization formed to provide healthcare to the communities they served.
The entity split into three distinct units in the mid ’90s — the hospitals, the doctors, and an insurance company — Select Health, which since 2006 is alleged to be a completely separate entity.
Soon Intermountain Healthcare will be operating 25 hospitals throughout Utah and Idaho, and is expanding into Wyoming, Nevada, Montana and Alaska.
In 2009, Intermountain Healthcare was identified as a healthcare model by President Barack Obama, “We have long known that some places, like the Intermountain Healthcare in Utah…, offer high-quality care at cost below average,” writes Wikipedia. According to the Kaiser Family Foundation, Utah’s per capita spending on healthcare is 44 percent below the national average.
But all is not well in the Salt Lake valley.
A determined effort to control costs over the decades has resulted in an unhappy, disgruntled workforce. CD Media has learned this was confirmed by a recent survey conducted amongst Intermountain Healthcare employees which delivered a bottom ten percent percentile result as far as employee satisfaction.
Speaking to a medical professional this week, CD Media was told, “Yes it’s true.. I think it was a Gallup pole done by IHC.. so I’m sure not published .. they keep sending out surveys.. I’m sure not improving… whole corporation has gone downhill…”
We spoke with multiple medical professionals (non-physician) employed by Intermountain Healthcare over the last few weeks. We were told of devastating changes to paid time off, talk of walkouts, unionization, and forced cuts in hours to push legions of employees from full to part-time, further damaging benefits to front line workers.
But let’s talk about the doctors, patient choice, and quality of care.
We have also communicated with a large number of physicians involved in healthcare in Utah over the last month. Some are employed by Intermountain Healthcare, others were not. What evolved during these discussions is a picture of monopolistic behavior that has two things in mind – power and money, lots of it. We found this strange for a supposed ‘non-profit’.
Many doctors told us of having to set up practice in south Utah County, in order to be even considered to be ‘paneled’ on Select Health’s insurance plan. This was enforced in order to prevent competition for Intermountain doctors in the Salt Lake City area. If these doctors moved their practice back into the ‘no-competition’ area, they were dis-impaneled from Select Health insurance. In other words, since Select Health controls 70% of the market, the doctors could no longer practice medicine in Utah. This includes highly specialized doctors who were often times one of only a handful in the state in their discipline.
Essentially, Intermountain Healthcare is preventing access to certain doctors for its patients, no matter how much expertise they can provide, and immaterial to the availability of that expertise in the geographic area. They purport that it is a mechanism to control costs, but in fact it gives them ultimate control of the providers and precludes patients from choice for their expert care.
Here are some of the quotes from medical professionals in the Salt Lake City Valley area. Most did not want their names used for fear of retribution from Intermountain Healthcare.
“The doctors sold their souls, when IHC was ‘forming a physician group’ now a medical group, docs were supposed to have control but with spreading the risk of benefits. That didn’t happen. Now they have lost control of their ability to practice medicine the way they want to, for the bottom dollar.”
“The corporation incentivizes physicians to refer to those Intermountain Healthcare has hired…they refer all patients to employees…if a patient wants to see an non-employed doctor, they have to go to another hospital, whether convenient or not.”
“Physicians get bonuses….there is a department bonus portion, for clinics meeting budget….a regional bonus, they have to meet bonus…or they withhold part of their money… and a system wide bonus… doctors have to refer to group, region, system, to keep as much as they can in-house, no matter what is best for the patient.”
“There are a couple other healthcare systems in the valley but IHC consumes everything and the media. They control the legislature, so rules are passed to benefit them only.”
“To decrease costs, they tell doctors what tools they can use on patients, no matter if the physician is experienced on something else. In the push to reduce costs…they are cutting pensions, pushing people to part time.”
“Every single year docs are pressured to do more procedures…RVU…relative value units…female docs pushed to work more and more, no matter their child care situation…the result is patients have less care.”
“Putting money into infrastructure…shiny new buildings…about the patients they could care less.”
Dr. Paul Winterton, an orthopedic surgeon, declared, “They are building massive coffers to build brick and mortar low occupancy buildings in order to capture market share in certain areas of the Valley…building a massive business…the entire state legislature is LDS, where 10% goes to the church, as well as the executives, who are earning millions…they are power hungry with a complete absence of serving the community, circling the wagons, creating market share that is very self-serving.
“When I moved here as a Harvard-trained physician, they said to me directly, “You don’t get the system here do you…we don’t want you in underserved areas; they are doing just fine not knowing your expertise is available…because we’d have to pay you; our business model is to prevent people from getting healthcare”.
“Wouldn’t it be interesting if this was recorded and went to the Salt Lake Tribune?” Winterton said he asked, and that was the end of conversation.
He continued repeating an executives comments, “If you become a member of IHC, we will send you patients, if you don’t — you won’t get any patients….Our business model is to create as many barriers as we can to patients receiving expertise, so we can control costs…”
Winterton continued, “One NICU doctor was forced to leave IHC because kids were improving and there were lower mortality for babies. In other words, babies were not as sick as they wanted, the hospital was losing money with his improvements.
“The CEO of IHC should be aggressively recruiting the best surgeons, but no, because they are beholden to control. The world’s greatest surgeons are not sensing there is any role for them in Utah healthcare.
“These are extremely self-righteous individuals… one day in church spouting morality, then 6 days a week being proponents of this dastardly system.
“There are no community based sub-specialty positions anymore.”
Another doctor said, when he was describing to a patient why she could no longer see him due to actions by Intermountain Healthcare and Select Health, “As she was crying because her healthcare would be negatively affected, she said…they just see patients as an ATM machine.”
Now Intermountain Healthcare is taking this business model into Wyoming and Nevada, as they attempt to expand their monopoly and single-payer system, pushing their benevolent care narrative as a ‘non-profit’.
While highly specialized physicians are being forced out of Utah, Intermountain Healthcare just spent millions sponsoring a stadium for the NFL in Nevada.
The Raiders announced Wednesday that the nonprofit health care conglomerate will retain naming rights for the Henderson, Nevada, performance and training center and is a founding partner of Allegiant Stadium, which sits at the southwest end of the Las Vegas Strip. Intermountain will also provide medical care for the team, reported Deseret.com.
How does a non-profit do that?
Republicans need to focus on creating a capitalistic healthcare system, which will bring the best care for the lowest cost. However, to do that, the GOP needs to make sure competition stays in the mix. Otherwise, you get the result you have in Utah. Bringing down barriers to competition is the answer, not something to be fought to control costs.
CD Media attempted to contact Intermountain Healthcare multiple times via email and phone with no response.