Arbitration debate more clear after compromise
As Intermountain Health Care compromised with the state legislation making mandatory medical arbitration policy voluntary Friday, Utah State University students, professors and local physicians attempt to reason the policy.
Last year, the Legislature passed a bill that was allowing health care providers such as IHC the right to refuse treatment to patients who do not sign an agreement to undergo binding arbitration instead of using the court system to settle litigations. State legislators were working on repealing the law.
According to a Saturday Salt Lake Tribune article, IHC has backed down and made the arbitration optional to patients instead of mandatory.
Advocacy group Patients Against Mandatory Medical Arbitration (PAMMA) believes that the, “policy forfeits their legal rights in order to receive needed medical care.” according to www.pamma.org. IHC’s Web site, www.ihc.com, shows that arbitration offers a number of benefits to patients and doctors such as ensuring physicians as future resources and an affordability in settlement proceedings.
USU pre-med student Katherine Ward said settlements using arbitration can adequately represent the patient and doctor.
“Each side [doctor and patient] allocates an impartial representative, and the representatives agree on an impartial mediator,” Ward said.
According to IHC, arbitration is supported by the Supreme Court and has been supposedly used since the 15th century. However, PAMMA believes the policy is lopsided and the organization is trying to pressure IHC into abandoning it.
Dr. Robert Strebel who practices for both Logan Regional Hospital and Cache Valley Specialty Hospital said, “Patients ought to be worried about finding a physician in the future.”
Many experienced doctors have not been able to afford their practice, forcing them out of jobs because of the high costs of malpractice premiums. Logan has had a loss of obstetricians, who have the highest premiums of all practices, in the past year.
“We are only down to five [obstetricians] from 11 before,” Strebel said.
Ward, who is also the vice president of USU’s Women in Medicine Club (WIM), said there are benefits to arbitration such as the ability to speed up the process of settlements by avoiding courtroom litigation, helping lower liability insurance coverage, and helping to keep capable physicians in practice.
“Anything we can do to save money would be good for everyone,”Strebel said.
Strebel said he has never personally used arbitration but said he thinks arbitration is a “good thing” and a “win-win situation” for both patients and doctors because it shortens the amount of time to settle a case by months as opposed to years in court.
Dr. Jim Davis, director of USU’s Student Health Services, said long court procedures can be a drain on both doctors and patients and believes that MMA also benefits both sides.
“It speeds up the process of a patient receiving money for mistakes and malpractices, it can potentially bring in more money in a short amount of time for a patient because a percentage of the costs don’t go to an attorney,” said Davis, who is not under IHC.
Bioethics professor Andy Anderson said he doesn’t agree with Intermountain Health Care’s Mandatory Medical Arbitration policy.
“The better argument is putting on universalized health care so the patients can get the basic health care they need, another argument is to have the cap for claims of pain and suffering,” he said.
A basic federally supported and universalized health care plan would be more beneficial to Americans as is done in other nations like Canada. In this type of plan, society would decide through the voting process to provide more taxes for the greater good.
“We wouldn’t have this problem of litigation, and so much emphasis on lawyers in this process if people could just get basic health care they need,” Anderson said.
As a professor and adviser to many USU pre-med students, Anderson said, he thinks the MMA issue is being argued the wrong way. He said he firmly believes that students and doctors just want to go to work, help people, improve others’ health, and not have money be a deciding factor.
“From what I have seen with the pre-med students and the doctors in town, none of them want to be in an argument with a patient over money,” Anderson said.
“Unfortunately, this issue is making it seem like doctors want to hang on to their money in the public mind, perhaps to continue business as usual and not allow the public to sue,” he said. “You have physicians on one side, [the] vast majority want to help people, and patients on the other side who want to be helped and in between we got the lawyers who are making the mess out if this.”
Anderson said part of it has to do with the lawyers making a profit, the more pain and suffering the patients have the more profit the lawyers make. The lawyers actually have an incentive to cause trouble, he said.
Strebel said he thinks mandatory medical arbitration is controversial especially in the media because many patients don’t understand the process of arbitration.
Even with the ongoing debates surrounding arbitration, Ward said, she still plans to pursue a career in medicine.
“Unfortunately, like all policies there is the possibility for abuse, but I feel that an impartial representation [using arbitration] would minimize this occurrence,” she said.
Despite all the controversy, Strebel said, he hasn’t had many problems with his patients with signing waivers.
“I haven’t had any problems with patients refusing to sign the waivers, only two to three patients have been reluctant,” he said.
Before the IHC compromise, Strebel said, if he had patients refuse to sign the waiver, he would refer them to another doctor for care.
Anderson described his feelings about MMA: “As a patient my initial reaction would be, I came in because I am sick and suffering, and you [IHC] are treating me like a potential enemy as if I wanted to sue, and before you will agree to do anything with me. In a way, I’ll have to give up a legal right.”
-doantn@cc.usu.edu