The problem, in part, is Utah's aging population and the fact that its economy is dominated by small businesses — which are hurt by the current system in which the major illness of one employee in a small insured group can drive up the premiums of everyone else.

"There's a good chance for lasting health reform in the coming legislative session," Hilman predicts. "But to make sure the right reforms carry the day we're going to need to engage small business owners."

The Utah Health Policy Project is working with an MBA class at the University of Utah's Eccles School of Business to figure out how to engage small business owners, she says.

She defines the "right" reforms as "truly universal, affordable for the neediest ... and flexibility to do creative things with Medicaid and CHIP dollars."

It's important also, she says, to "make sure Medicaid beneficiaries and the poor are also getting good access to prevention and wellness. And we're not there yet."

The group's recommendations will be unveiled on Sept. 25

Meanwhile, Bennett is co-sponsoring a Healthy Americans Act with Sen. Ron Wyden, D-Ore., which would provide private, market-driven insurance.

Calling the rising cost of health care the "biggest single problem we face, outside of the war," Bennett said, "Let's break the link between the employer and health coverage."

He said there would be safeguards built in to ensure that all Americans can receive coverage, but Ku expressed concern that, generally, such plans could eliminate large risk pools. Unader the current system, such pools make coverage more affordable.

"Those policies sound good to those who believe in a free market and individual choice, but they just don't work in the insurance system as we know it," he says. "The people who are the sickest and who need health insurance the most may find themselves much more out of the market."

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E-mail: dbulkeley@desnews.com; jarvik@desnews.com