Going too far?

BOISE (AP) - A federal judge said Thursday that a lawsuit between two Idaho hospitals and the Federal Trade Commission comes down to whether St. Luke's Health System really needs to buy more physician practices to bring about promised long-term cost savings and improved care or whether the company has gone too far to curb competition.

U.S. District Judge B. Lynn Winmill posed that question and others to attorneys involved in the case on the last day of a monthlong trial.

The lawsuit stems from St. Luke's buyout of Nampa-based Saltzer Medical Group. The FTC and Saint Alphonsus Regional Medical Center contend the buyout was an illegal market grab and gives St. Luke's an unfair advantage. But St. Luke's contends the acquisition will allow it to improve patient care and launch new medical plans designed to help low-income and uninsured patients.

Winmill called the case one of the most difficult he'd had to preside over because the stakes are high for the businesses and the communities they serve. He said he'll try to have a ruling issued within the next few weeks.

David Ettinger, an attorney representing Saint Alphonsus, sought to pierce a major St. Luke's argument - that it will take years for the positive outcomes of the Saltzer deal to surface. He called that a "Wimpy" defense, a reference to the Popeye character who says, "I would gladly pay you Tuesday for a hamburger today."

Jack Bierig, a lawyer for St. Luke's, countered that after reviewing terabytes of documents and data, none of the plaintiffs found evidence that St. Luke's bought Saltzer so it could control the Canyon County health care market.

Tom Greene, the lawyer representing the Federal Trade Commission, said the buyout will raise prices and won't lead to better health care.

The judge may consider some kind of compromise ruling. St. Luke's proposed one approach in which it would still own Saltzer and employ its doctors, but the companies would still negotiate their traditional payment-for-volume contracts with health insurers as separate entities. But opposing lawyers warned the judge that they believe Saltzer eventually would be involved in all of St. Luke's insurance negotiations, possibly violating a compromise ruling.

Winmill said that kind of remedy could "blunt the effects" on competition while allowing some form of the buyout to happen so that St. Luke's could achieve the integrated health care system it says it's creating.

"No one has proposed anything but a winner-take-all ... (which) means someone is going to be injured," Winmill said. "I have to be mindful of those concerns."