Mark the date: Efforts to reform Utah's health-care system began today at 8 a.m., Jan. 30, 2008.

The complete overhaul of the state's health-care service system would be a meridian in history as necessary to the well-being of the next generations of Utahns as learning how to irrigate a desert was to the first pioneers.

"They did it and did it well, and we're literally still here because they saw what had to be done and did it," Sen. David Clark, R-Santa Clara and author of a bill outlining the initial stages of the multi-year reform plan.

"This isn't an adjustment to how insurance claims get done," Clark said. "It's a top-to-bottom 21st century retooling" of medical policy and procedures.

Ask any lawmaker to describe what's wrong with the way the system runs right now, and you'll get a list of problems longer than a month of grocery store receipts. The price of services is No. 1, declining accessibility and covered treatment and the overall quality of care is going down.

Whatever the fixes, they'll take at least three years to design, six years to implement and probably 10 years to become fully realized, he said.

"This is the first step toward finding a path that might lead us there," said Clark, who has probably spent more time than any Utahn the past two years examining health care.

He said he has become the reluctant expert on the subject. Several of his colleagues call Clark a hero for putting together legislation — HB133 — as a starting point.

"Anyone who has looked into this issue at all appreciates his work and the label is accurate and an indicator of what a difficult task were facing," said Merlynn Newbold, R-South Jordan and co-chair of the Joint Health and Human Services Appropriations Subcommittee.

During a Tuesday caucus at which Clark highlighted proposals in the bill, House Democrats were appreciative but also concerned that the bill might be too flawed and too watered down.

Democrats along with business leaders, labor and low-income advocates invited to speak at the caucus said they consider the proposal too vague. They said the insurance industry is overly represented.

Advocates for low-income Utahns said not having any consumers officially at the table indicates a lack of sincerity in finding out what Utahns are dealing with day to day, including low-income residents who would be affected most and most immediately by changes in the system.

The one size fits all approach combined with lack of consumers knowing — or caring — what services cost is not working, Clark said, noting that more options other than catastrophic care and high deductibles must be developed in order for the uninsured to be willing to get insured.