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Mullen: Self-Medicating



When Dr. Christopher Gay walked into the exam room the other day, it felt like I ran into an old friend at the homecoming game. This, in spite of the fact that I was anticipating my annual physical, with one of those ridiculous hospital gowns wrapped around me that gapes open in all the embarrassing places.

Gay and I go back a few years. A family practice doc at the University of Utah’s Madsen Family Health Center, he began treating my family and me 10 years ago when I picked up health-insurance benefits on a new job. I chose him from one of those random lists of practitioners provided by the insurance company. You know how those lists work. You might as well pin the thing on a bulletin board and toss a dart at a “preferred” provider’s name. You know nothing about this person and, you hope, after waiting on the telephone for seven minutes to get a live voice at the appointment desk, that he or she is taking new patients.

Such is the glory of our American health-care system.

Four years ago, after having built a beautiful doctor-patient relationship with Chris Gay, my employer yanked away my coverage by switching to a new insurer. It happened that the new plan didn’t do business with any doctors or clinics in the U of U health-care system. That’s because the medical King Kong in this state—Intermountain Healthcare—and the U system got into what amounted to an administrative bar fight a few years ago. It started with both sides throwing chairs at each other and ended with neither system accepting insurance plans of the other. And that meant—guess: The consumers got screwed.

So I spent a couple of years in the care of an IHC doc. We were just getting used to each other. Then, last April, I changed jobs again. Got new insurance. I was told the IHC doc participated in the new plan when I called to set up that super-fun yearly female exam. Two months after making the appointment (she’s a very popular doctor), I checked in on the appointed day. The receptionist took my new medical card and frowned. “She doesn’t take this one,” she said.

It was a genuine Sicko moment. For those of us fortunate enough to have any kind of health insurance (and there are an estimated 360,000 Utahns who have none), we risk getting caught in some hellish eddy on the insurance waterway: spinning around, going under, bobbing back to the surface. At any second, the current might suck you back down—you’ll lose your longtime doctor, face a huge increase in premiums or lose your coverage altogether.

At least with my new employer, and new U of U-friendly insurance, I got to land safely back in Gay’s care. He even hung on to my old records. Hey, you can go home again.

With stories like this one and far worse come an auspicious group of 130 Utah business leaders, buoyed by advisers of Gov. Jon Huntsman Jr., with a bold plan to cover every single Utahn with health insurance. United Way of Salt Lake is behind the idea. So are the Salt Lake Chamber of Commerce and the Utah Hospital Association.

If I’ve got my arms around this right, pending legislative approval (optimistically, if it happens at all, that could take up to three years), a nonprofit organization would sell a basic benefits package to all Utahns by taking pretax employee dollars and employer premiums as payment.

Businesses would be free of the headache of administering their own insurance plans. Theoretically, competition among insurers would keep ever-skyrocketing prices in line. Coverage would follow an employee from job to job.

The poor would qualify for financial aid in paying their premiums. The emphasis for everyone—middle-class or poor—would be on prevention, early intervention and hopefully, cutting more complex and costly treatments down the road.

The United Way has offered one cost estimate of the plan at a staggering $200 million, but the working group’s members are quick to point out that the expense would be offset by much less charity care and fewer trips to emergency rooms—the primary avenue used by the uninsured for basic medical care.

What’s not to love here? The screaming idealist in all of us ought to be jumping on this thing. Members of the group behind the plan say the uninsured in Utah already cost taxpayers and businesses at least $900 million a year.

Besides, when you finish up with the cost calculations and listening to the lobbyists for the health-insurance interests whine about this sounding like “socialized medicine,” it just shakes out as the right thing to do. Utah, for once, seems to be jumping on board with such wild-eyed liberal states as California and Massachusetts, both of whom grew tired of waiting for a flabby federal government to take charge of this health care mess.

Let Hillary and Barak and Mitt and Fred mix it up for now by nibbling around the edges of this problem, while never really offering a substantial fix. If this little backwater state can do it better, it’s worth a shot. Let’s just do it ourselves.