The United States is beset with adversities, from a raging war to a wrecked economy, but the defining issue of this generation of Americans is health-care reform.

So said former U.S. Secretary of Health and Human Services and former Utah Gov. Mike Leavitt during a Thursday speech in Salt Lake City on health-care problems and solutions.

Overhauling the exorbitantly priced, quality-indifferent and monolithic medical delivery system "will determine if we're still the home of the brave and the land of the free," he said. "That's how important this debate is."

The era of "don't care, don't have to" health care is over, Leavitt told about 250 Utah business leaders, government officials and medical professionals attending Intermountain Healthcare's Healthy Dialogues lecture series.

Momentum is clearly building to do something about what President Barack Obama said Wednesday is the "ticking time bomb" in the economy. Americans spend $2.4 trillion annually on health care.

Leavitt said ignoring the impact and the current course of health care will not make it go away.

"Quick fixes or adding another government layer for insurance that is emerging in Washington won't do," said Leavitt, whose family owns a private insurance company. He is no longer directly involved in its operation, but his personal knowledge of the industry figured into his efforts to reform health care in Utah while he was governor.

No one disputes the size of the problem nor its implication if the latest iteration of health-care reform ends back on the shelf, he said, noting that "the nitty-gritty of the debate starting, we need to give the collaborative, innovative, uniquely American approach to solving problems a chance to work," he said.

"The trick is not to make it worse by rushing toward a government-only fix that is more Trojan horse than sustainable, effective reform," he told the Deseret News after the speech.

The so-called public option insurance plan, which would give people who can't obtain private insurance an option of going with a new Medicare/Medicaid-like government insurance plan, would crank the health-care spending faucet wide open. And in the process, the private, employer-based insurance coverage that for 50 years has been the main source of coverage for working families would simply dry up, he said.

Obama on Wednesday called such claims specious, pointing out that if private insurers come through with their commitment to offer plans that people can afford and provide coverage they want, a new government option to help provide access for those who might fall through the cracks will be no real threat to private insurers.

"History shows otherwise," said Rep. David Clark, R-Santa Clara, speaker of the Utah House and co-chairman of the special legislative task force reforming health care in Utah, after Leavitt's remarks. Medicaid was introduced in the 1960s as an option for insurance coverage, but people flocked to it because it was cheaper, he said. "The plan is now massive, and it's the single biggest budgetary concern for state human services departments around the country."

Clark, Leavitt and others say a government option should be a loud wake-up call to hospitals and other providers who would lose even more revenue as people with private insurance shift to a government plan that would reimburse providers at 60 percent to 70 percent of what they charge. The difference is made up through shifting the difference to patients with private insurance.

Leavitt said the flight from private to public plans is all but ensured if the so-called employer mandate of offering employees coverage or money to buy it somewhere else is part of the reform package Obama has called for by year's end.

E-mail: jthalman@desnews.com