Several speakers favor reforms that put more control of health care — and therefore more responsibility and accountability — in the hands of consumers. One option is a health insurance "exchange" that would help people buy insurance that would follow them if they switch jobs, would be paid for using pretax dollars, and would offer consumers more information and choices about their coverage.

That's what the United Way is touting, with Beattie saying Thursday that "health system reform is very tough stuff" and self-interests need to remain "at the door."

An exchange, he said, relies on the private market, and any suggestion it is socialized medicine is "false" and "deceptive." To think otherwise is "either because of the lack of understanding of narrow-minded individuals or basically just uninformed people," Beattie said. "The bottom line, this is not socialized medicine. It isn't even close to socialized medicine."

Also, people who think the current system is not mandated health care is "terribly uninformed," he said. "The problem is who's paying for it, and primarily small business and businesses are paying for it."

Without naming names, he was critical of people who "want to disguise intelligent conversation with scare tactics."

Atkinson pushed for a debate that focuses on facts rather than emotion, citing questions raised from several studies on health-care matters. Studies show most people are satisfied with their insurance coverage but bristle at the high costs. And he added that Utahns already have the lowest insurance premiums in the country.

Atkinson said much of the rhetoric claims the health-care system cannot be fixed "and so we should throw it all out. In the Utah Health Insurance Association, we take exception to that. We know that the system needs refinement. We know it's a system that's expensive. We know that there's a certain segment of the population that's not served by the system. Those are all facts that we need to address. But simply to say that it's unalterably broke, that it can't be fixed, we don't think is a meaningful exchange and adds to the dialogue that's taking place."

Brad Kunhausen, health policy consultant for the Utah Association of Health Underwriters, said the idea of an insurance exchange has been around for 15 years but no one has "actually put together a plan and lowered cost." His group advocates "consumerism," which would change from a system where doctors are paid by procedure — billing for as many as possible and the most expensive ones allowed — to one where consumers get credits to pay for certain procedures but can pocket the difference into their own health-care accounts.

Dr. Mark Bair, president of the Utah Medical Association, said controlling costs is a key to health-care reform, but if consumers do not save money, "we've only created another program that costs money."