"Health-system reform needs to be done in this state," Huntsman said. "If we do nothing, it would be totally irresponsible on our part, and it would also be economically unsustainable. We now have a very real framework for systemic reform going forward."

By the end of the year, a task force is to have evaluated and made suggestions to change the system. Generally, they include:

• Market-driven health care that transfers choice and purchasing power to consumers. Insurers and providers would be more responsive to consumer needs and preferences.

• A system of consumer-based medical records and publicly accessible information about health-care prices and performance of providers and insurers.

• Risk adjustments that provide insurers and providers greater payment for serving the very sick.

Critics say that making consumer choice and consumer involvement central to medical services glosses over the fact that health-care purchases are not like finding the best deal on a big-screen television.

Doing so implies a paradigm shift in the way people think, not just how they access health-care services.

Regina E. Herzlinger, a business administration professor at the Harvard Business School who literally wrote the book on consumer-driven health care in 1996 and wrote a recent book, "Who Killed Health Care," essentially says health care as we know it is done for.

Taking groups of consumers who haven't given a hoot about what something costs and asking them to make savvy decisions based on a health care delivery system that hasn't given a hoot about what things cost either is going to take a substantial reorientation of thinking, she said.

"There is some time, and there is motivation to working things out," Clark said. "This bill isn't perfect, but this opportunity is, and we'll be asking and answering all those tough questions."

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E-mail: jthalman@desnews.com