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IHC CONTROLS HEALTH-CARE MARKET

It was my impression that the Readers' Forum was an editorial page rather than an advertising section. However, after reading "IHC still committed to its mission" (Forum April 4), by one of IHC's paid administrators and board members, Dr. Gregory A. Schwit-zer, I'm not sure.

Like most good advertising, the overall feeling of the piece gives one a sense of security about the unique benevolence of our paternalistic health-care provider, IHC. Further, like most advertising, both the contents of the column and the facts do not exactly support the feeling created by this ad. I would like to point out some of the discrepancies:1. It dedicated a significant proportion of space outlining Columbia/HCA and HTI's holdings outside of Utah that will not be materially affected one way or the other by the outcome of a merger in Utah. At the same time, it glossed over IHC's current greater than50 percent market-share holdings in Utah (which also will not be changed regardless of the outcome of the Columbia/HCA and HTI merger) by saying "IHC is well-positioned in Utah."

In reality, what happens outside Utah does not make a material difference to what happens inside Utah. Should the Columbia/HCA and HTI merger proceed without federal government intervention, the combined entity would still only have one-half of IHC's market share.

2. The letter makes a big issue of IHC's nonprofit status. The implication is that somehow this "legal" status makes IHC an asset to the community. In reality the only difference I have been able to discern between a for-profit hospital and a nonprofit hospital (like the IHC system) Is that a for-profit hospital actually returns something to the community in the form of taxes while a nonprofit hospital is exempt from paying taxes.

Columbia/HCA and HTI treat just as many indigent and charity patients per capita (if not more) as IHC. IHC pays its administrators and top level management just as much money as Columbia/HCA and HTI in Utah. In fact, in many cases IHC charges more for comparable services performed at non-IHC hospitals.

Modern Healthcare reported that IHC earns in excess of $50 million per year in profit. It would seem to me that a responsible agency should take a long, hard look at IHC's nonprofit status and see that IHC should be returning something back to the community in the form of taxes.

3. The letter also emphasized IHC's community connection, implying it is unique in what it offers in many areas of health care. It implied that IHC is unique with its voluntary local boards, in its commitment to rural health care and in its "mission." In reality, except for transplantation surgery and level-one trauma, Columbia/HCA and HTI are essentially indistinguishable from IHC in all these areas.

There is no question as to the competence and professionalism of IHC and its hospitals. They are correct when they state that they have provided high quality health care for 20 years to our community. I am proud and grateful to be on the full-time staff of an IHC hospital. However, the facts are that IHC has 52 percent of the Utah health-care market (not to mention a statewide dominance insurance plans); that there is essentially no significant difference between a nonprofit and a for-profit hospital; that if we actually believe, as a society, that competition is good for increasing the quality of health care while minimizing costs, then the merger of Columbia/HCA and HTI should be allowed to proceed as proposed so that IHC actually does have some competition in this market place.

G. Remington Brooks, M.D.

General surgeon

West Jordan