The Utah AFL-CIO is threatening a boycott of Intermountain Health Care doctors by its 90,000 members and retirees if IHC continues to require patients to sign mandatory arbitration agreements.
The AFL-CIO also plans to lobby legislators to change a state law allowing those agreements, Utah AFL-CIO vice president Steve Booth said at a press conference Monday.
The labor organization already has come out against IHC's arbitration plan after Utah's largest health-care system began sending out letters to patients requiring them to agree to binding arbitration rather than pursuing medical malpractice lawsuits. Monday's press conference ratcheted up the AFL-CIO's opposition another notch.
Booth described IHC as "the 800-pound gorilla" and the mandatory arbitration policy as an "oppressive scheme." AFL-CIO president Ed Mayne, who is also a state senator from West Valley City, said he is getting 30 to 40 e-mails a day from people worried about mandatory arbitration in malpractice cases. He said "there's outrage" among legislators "on both sides of the aisle" that the medical arbitration law passed earlier this year is now being used by IHC in a way that, according to the AFL-CIO, "threatens the principle of equal access to the justice system."
IHC is the first health-care system in Utah to mandate arbitration agreements (for patients in non-emergency situations), although some doctors outside IHC's system already have adopted a similar policy. It is not arbitration that labor opposes, Booth said — most labor organizations use arbitration — it's the mandatory nature of IHC's plan that is hard to swallow.
The labor organization also objects that IHC's arbitration plan will hurt medium- and low-income patients because of "up-front costs" of hiring arbitrators. And, argued Booth, the plan requires patients to go through two complicated processes, one to determine liability, the other to determine damages. Booth, who is president of the Amalgamated Transit Workers, and Mayne said they conveyed these objections last week when they met with IHC Physicians Group CEO Dr. Linda Leckman.
Leckman, contacted later, said IHC won't budge on the mandatory nature of the agreement because IHC physicians worry that those most likely to refuse to sign such an agreement are the most litigious. She also argued that arbitration will allow more people to seek and receive remedies because the cases are settled more quickly and require fewer legal expenses.
Meanwhile, malpractice attorney James McConkie issued what Mayne described as a "smoking gun" — a short report about medical arbitration written by the Division of Medical Ethics of the University of Utah School of Medicine and IHC-owned LDS Hospital. According to McConkie, the report, printed in a monthly newsletter, "is inconsistent with what IHC is saying publicly" about the benefits of arbitration.
McConkie points to the medical ethics division's acknowledgement that arbitration expenses "might represent new costs" to patients, that patients might feel "abandoned by the physician in this process" and that "a patient with no other reasonable options for care may not be entering such an agreement as freely as we might like." The report also noted that insurance company investments might be a factor in rising malpractice insurance premiums and that "perhaps they should be addressed simultaneously with tort reform."
IHC's Leckman countered that the ethics committee's conclusion is that arbitration agreements "can be another tool in the efforts to control health-care costs, serving the interests of all parties more efficiently and economically."
"It sounds like Mr. McConkie is trying to make the pieces fit his argument," said Jess Gomez, LDS Hospital spokesperson.
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