Sandy should be writing this. She was a gifted observer of the human condition, who honored every birthday and holiday with original poetry. Her death certificate probably said she died of kidney failure or diabetic coma, but she really died because she had a "pre-existing condition." Due to job changes, Sandy went without health insurance for a number of years and consequently didn't get the consistent medical care needed to control her Type I diabetes. She lost her right leg at age 42 and suffered numerous heart attacks, strokes and life-threatening infections before she finally qualified for Social Security disability and Medicare. Even with Medicare she had to choose between paying for her medications and being able to pay her household expenses. At age 50 she was told she needed dialysis. Sandy requested hospice care instead, and I sat at my lifelong friend's bedside as she slipped away just a few weeks later.

With an estimated 300,000 Utahns without health insurance, medical costs are the leading cause of Utah bankruptcy filings, and Utah businesses are hard-pressed to keep up with employee health benefit premiums with increases of 16 percent a year. With 45 million Americans uninsured, can we set aside the argument about when life begins and instead ask ourselves why life has to prematurely end for some 18,000 uninsured Americans per year? If the United States had an infant mortality rate as good as Cuba's, we would save an additional 2,212 American babies a year. Can any of us with insurance feel certain we will have coverage should we develop a chronic illness or experience a job change?

Gov. Jon Huntsman Jr. set a goal of reducing the number of uninsured Utahns by 50 percent in five years at his Utah Summit on Health Insurance for the Uninsured on May 3. He is sincere and has challenged State Health Department Director David Sundwall to put together a plan. Following state legislative scrutiny, Intermountain Health Care has demonstrated an attitude adjustment regarding its billing policies. The recent announcement of the launch of another free clinic (Maliheh Free Clinic) is commendable. But let's be real; we are rearranging the deck chairs on the Titanic if we don't admit that our market-driven health insurance system is driving up the cost of health care with administrative costs of 25 to 30 percent. Private insurers compete by creating a risk pool that turns away people with chronic illnesses and by refusing to pay claims.