Keep health reform local

Utah is in the third year of a 10-year health care reform plan. That's a process that always has been too slow. But given the reprieve Republican filibusters now could offer in Washington, it may yet work.

State lawmakers this year are poised to pass three bills: HB25, HB52 and HB294. Taken together, they would make it easier for insurance plans and health providers to share information and open up a competitive insurance exchange market to businesses that employ more than 50 people. The general idea is to give more Utahns the opportunity to shop among several plans for the one that suits them best. Businesses in financial straits would be better able to pare down the coverage they offer, rather than just dropping insurance altogether.

Critics have lambasted the state's insurance exchange because they say it hasn't worked well. But the system hasn't yet really gotten going. That should change in coming years. About 70 percent of all Utahns are insured through their employers, which offer them one or two options for coverage. The idea is for the state to greatly increase those options and for competition among insurers to drive down costs. Also, it would allow Utahns to keep their coverage if they should lose or change jobs.

If it works, the Utah plan would serve as evidence to Washington that states are better able to enact health reforms than the federal government. Already, the political process here has shown how much easier it is to enact reforms away from the hyper-politicized atmosphere in the nation's capital.

President Barack Obama has invited Republicans to join in bipartisan talks on federal reform efforts. It seems, however, that many Republicans would rather not have Washington involved at all. The 50 states each have unique demographics and health care needs. A top-down approach seems destined to be too cumbersome, clumsy, ineffective and expensive.

Many Americans may be wondering how the current system came to be. The truth is that the health care system evolved over the last 70 years or so, prodded along by government action and inaction. When President Franklin Roosevelt decided to give up on a national health care plan during the Depression, private insurers rose up to fill the growing void. During World War II, Washington made pay raises illegal, and companies began competing for employees by offering them benefits such as health insurance. Then Washington solidified this move by granting tax exemptions for employer contributions to insurance costs.

As it turns out, that isn't the best model. It eventually gave rise to a system with out-of-control cost increases and charges that are hidden from the customer.

The best way to blast through the logjam and change 70 years of evolution is at the state level. In Utah's case, the sooner the better.