Report highlights urgency of health-care reform

Number of Utahns unable to afford insurance rising

The chief authors of Utah's strategy for reforming its health-care system say the most important set of figures to keep in mind as the project goes along is 1-3-6-10.

The numbers represent the four phases of the decadelong renovation of a system that many believe is a much more serious threat to the basic economy and overall well-being of Utah and the nation than the Wall Street crisis.

One year is needed just to figure out how a wildly disparate, extremely expensive system works and doesn't work. In three years, a legislative blueprint for the overhaul will be developed. By year six — 2014 — changes approved by state lawmakers will be in place, and in 10 years the new and improved system is to be fully implemented.

The schedule reflects both the scale of the task and the time the industry and policymakers have left before health care reaches critical mass — the per household amount spent on it will equal the average household income.

It sounds a long way off, "but if we stay on task and serious about getting done what we need to, we'll just make it under the wire," said Rep. David Clark, R-Santa Clara, co-chairman of a special legislative health system reform task force.

Clark's sense of urgency is warranted, according to a report by the Utah Foundation released Tuesday that is the most detailed account of what works, what doesn't and key issues to resolve.

"It is clear from this report that health-care reform is no simple matter," said Stephen Kroes, Utah Foundation president. "But the legislative task force has assembled a strong group of stakeholders who are taking the matter seriously and working hard to answer the right questions. If reform is possible anywhere, it should be possible here."

Health care is caught in a vicious negative feedback loop: High costs of services and insurance make it unaffordable to increasing numbers of the Utahns. More people forgo insurance coverage, which means they forgo primary care medical services and only see a doctor when they're too sick not to. Because they don't have insurance, they will seek help through public programs such as Medicaid or insurance premium assistance, which increases health-care costs to the state, or they will be treated for free at emergency rooms, which aren't compensated.

That in turn increases health-care costs, which increase the cost of premiums and the size of medical bills to the point that people — even those with insurance coverage — are driven into bankruptcy.

Those aren't dire predictions, but a fact of life of the past decade of rising bankruptcies due to unpaid medical bills and the steadily increasing percentage of people utilizing government-based insurance. At the same time, the percentage of people who have private insurance coverage has declined, according to the report.

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