As Utah embarks on a massive overhaul of its health-care delivery system, a new national report paints a grim picture regarding the nation's uninsured. They are 25 percent more likely to die prematurely than adults with private health insurance, according to the report by Families USA.

In Utah, at least three working-age adults die each week because they are uninsured or they have too little coverage. More than 800 Utahns ages 25 to 64 died between 2000 and 2006 due to this problem.

As Utah considers meaningful health-care reform, the medically uninsured must occupy a high place on the agenda. If they are placed in health-care plans that have high deductibles, it is unlikely they will receive primary or preventive care that can eliminate or control small problems before they become health crises.

As it stands, the medically uninsured or underinsured are three times more likely to delay seeking health care, according to the Families USA report. Cost and access are clear impediments. According to the report, the uninsured/underinsured are three times more likely to have difficulty obtaining needed medical care. When they receive hospital services, for instance, they are charged 2 1/2 times what insured patients are billed.

It is somewhat difficult for average Utahns to comprehend the challenges faced by people who are uninsured or underinsured. That's because nearly 80 percent of Utahns are covered by a medical insurance benefit plan offered by their place of work. As such, they do not encounter the full cost of medical procedures and services, nor do they face extraordinary challenges obtaining health care.

But policymakers must be mindful of the estimated 100,000 working adults who work full time — many of them self-employed — and have no medical coverage.

Medical costs are skyrocketing due to many factors. People with insurance are not the most careful stewards of the benefits. A growing number of Americans eat poor diets, are sedentary and overweight, which contributes to many health problems. A surprising number of Americans smoke, despite widespread educational efforts and law changes in recent years intended to curb the habit. In fact, the United States has one of the top 10 highest smoking rates worldwide, according to the World Health Organization.

When people who have no insurance are unable to pay their bills, those costs are passed on to other consumers or absorbed by providers and health-care facilities.

It's a no-win for all. Hopefully, as the architects of Utah's health care reform set about their work, addressing the needs of the underinsured and uninsured should be a key factor in their deliberations.