Rep. James Dunnigan, R-Taylorsville, who described the work group's proposal, said the incentive also addresses a major expense of health care — medical treatment for medical problems induced by unhealthy habits such as smoking and obesity.

The bulk of Friday's meeting focused on presentations by insurance industry representatives that drew both mild praise and sharp criticism from task force members. Several said they believe that chronic conditions are a major reason that many of Utah's 300,000-plus uninsured residents don't have coverage. Chronic conditions make them uninsurable under many plans and make buying individual plans unaffordable.

It was less the specifics than the apparent general insurance industry recalcitrance that drew criticism from task force cochairman Rep. David Clark, R-Santa Clara, who accused representatives at the meeting of trying to boycott or outright thwart the reform process.

"Change has become a four-letter word to some who have just provided push back to this effort," Clark said, noting that saying so could well make him part of the "carnage" left behind if the effort falls apart.

"I am deeply concerned, in particular with the (insurance) broker community," Clark said. "It has gone from muscle flexing to putting hands around the neck and choking out what we're trying to do here. I'm deeply concerned, and it's alarming to me, given the effort that has gone into health-care reform."

Clark, who is also House Majority Leader, has repeatedly stated attaining the reform that will enhance and preserve the quality of health care for Utahns is a multi-year, multi-faceted effort.

"We've advanced the ball slightly, but some are out to see that this doesn't move forward," Clark said. "We have about 30 days left to really start to get something under way."

Kelly Atkinson, executive director of the Utah Health Insurance Association, assured Clark and task force members that the comments run counter to any of the reform meetings he has attended.

"What we are concerned with is what happens if changes that increase the risk of insurance providers without addressing the real costs of health care," Atkinson said.

Serious tort reform that the legal community won't discuss but would move providers away from practicing defensive medicine must occur, Atkinson said. "So should discussions of how much technology, which is adding millions to the cost, we can afford. The carrot-and-stick approach with people is part of it. Those are particularly popular, but they're not immediate and at this point we're talking window dressing."

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E-mail: jthalman@desnews.com