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.

At stake is nothing short of "the future of health care, the whole system," James says. "We're starting to hit the wall, around cost, and we know the debate's coming. The trigger will be when Medicare moves into the red," estimated to be about six years away. It's important, he notes, to make some key decisions before the country is in crisis mode.

In advance of the hearing, several members of the working group will visit LDS Hospital Wednesday to see a demonstration of how IHC uses technology to improve quality and efficiency of care, from using computers to ensure best-practice treatment to electronic medical records.

The working group's "agenda is to get people engaged before the crisis occurs," James says. "It's an attempt to shape the debate so it helps."

They've even drafted Newt Gingrich to show them how to build a national community using the Web. He's had considerable success coordinating a grass-roots movement online.

There's clear evidence that "in health care if you improve patient outcomes, you drive cost down," says James, who also works for the Harvard School of Public Health and Tropical Medicine and the University of Sydney.

In his travels teaching quality improvement in the practice of medicine around the world, he says, it's clear that the challenges are the same everywhere, from Canada to Sweden to Taiwan and the United States.

"All have similar failure rates and a big gap in performance." All face rising costs and tough decisions, James says.

Other experts scheduled to testify at the Salt Lake hearing include David Blitzstein, director of the United Food and Commercial Workers International Union; Paul Lee, Pacific Business Group on Health; Don Berwick, Institute for Healthcare Quality Improvement; Jack Wennberg, Dartmouth University, whom James credits with creating a series of video presentations that offer impartial information to help patients make their own treatment choices for specific conditions; and Betsy Gilbertson, Hotel and Restaurant Employees International Union Welfare Fund.

The group has already held hearings in Washington, D.C., and Jackson, Miss. The next stops are Houston and Boston, then working group members will write the first draft of their report.

Friday's hearing begins at 8:30 a.m. in the Capitol's west building, Room 125.

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E-mail: lois@desnews.com