Clark and Killpack, along with the governor's office, have already outlined a framework for consideration in the 2008 session. It takes a fiscally conservative approach to health-system reform, relies on the private market, encourages personal responsibility and provides consumer information and choice. It's a promising start to a lengthy and tough challenge.

Pignanelli: Last year, my family spent countless hours analyzing quality data, comparing prices and reading consumer reviews. After considerable agonizing mental gymnastics, and several budget adjustments, we finally made the important decision ... on the best flatscreen TV. We spent zero minutes conducting similar price and quality research on the family's health care. Indeed, few Americans expend the critical thinking on health care they utilize in dozens of purchases every day.

A former state governor, prominent on the national political scene for his good looks, intelligence and adherence to the LDS faith, offers the most practical solution to this dilemma. No, it is not presidential aspirant Mitt Romney. The pragmatic prophet is Mike Leavitt, secretary of HHS. Leavitt is currently preaching the value-driven health-care philosophy, based on the four cornerstones of interoperable health information technology, access to quality data, transparency of medical services prices and efficiency through competition.

As an attorney who has lived in the health insurance world for 15 years (former general counsel and current attorney/lobbyist to Regence BlueCross BlueShield of Utah), I have experience and strong opinions. Government has a role to assist the poor, the elderly and the young in accessing health care. But no government agency can promote the efficiency the system commands. As Leavitt articulates well, the only institution that provides this fundamental activity is the marketplace.

Huntsman, the Salt Lake Chamber and the United Way (especially Scott Anderson and Lane Beattie) deserve credit for launching a serious discussion of reform in the state. The Chamber/United Way proposal is a good effort but does not go far enough and is in the wrong direction. True reform will occur only when all the shareholders (insurance companies, providers, consumers etc.) dramatically alter their view how health care is purchased and delivered. Instilling market dynamics will cause major societal readjustment and can only occur when our state leaders take the huge political risk of dragging the special interests out of their comfort zone. Tough decisions and demands, bordering on ruthlessness, will be required.