Millions of Americans are uninsured or underinsured. There's tension between quality of life and ability to save life. The cost of both care and insurance coverage is climbing faster than inflation, population and economic growth. America is aging, and demand for care is increasing as a consequence.

And Medicare is a financial "train wreck" waiting to happen, according to a member of a health-care working group charged with lighting the way to "health care that works for all Americans."

That panel, the Citizens' Health Care Working Group, will be in Salt Lake City Friday to hear expert testimony on challenges facing the American health-care system. Utah's hearing — one of only five nationwide — focuses on health-care technology and issues surrounding health-care quality, as well as worker and employer issues, including what unions are doing.

The working group was created in 2003 in the Medicare modernization act co-sponsored by Sen. Orrin Hatch, R-Utah, and Sen. Ron Wyden, D-Ore. The 15-member bipartisan panel is charged with formulating recommendations to help shape not only upcoming national debate about health care in America but also policies to address the health-care system's shortcomings.

Within the next year, committee members will hear from experts, draft recommendations, hold a series of town meetings and finalize a report to send to the president and Congress, said Jessica Federer, a working group staff member.

"The Report to the American People" will have the challenge of being just what its title says, chairman Randall L. Johnson, director of Human Resources Strategic Initiatives, Motorola, told the Deseret Morning News.

The group must write a draft document by October that's clear and concise enough to engage the public in the upcoming national discussion on health care. Interactive technology, including a Web site, will be used to collect input on health-care services and how to pay for it. And a series of town meetings will be held nationwide, where citizens can voice their opinions and concerns.

Although no one knows what the group will recommend — including its members — Johnson thinks some will require legislation.

The Salt Lake hearing at the Capitol Friday morning is the third of the five information-gathering sessions, and there are some heavy hitters slated to testify, including the comptroller general of the United States, David M. Walker, who heads the Government Accountability Office. He plans to discuss some of his concerns about how health care fits into the broader issues facing the nation.

Utah has several close ties to the working group. Besides Hatch's sponsorship of the bill that created it, Dr. Brent James, a vice president of Intermountain Health Care and professor at the University of Utah Medical School, serves on the panel. And the 15th member of the working group is Secretary of Health and Human Services Mike Leavitt, Utah's former governor. Other members represent a broad cross-section of America. None of them are elected officials or registered lobbyists, Federer says. Instead, they come from health care, industry, academia and the general public.