The cost of underwriting health care as it is puts an albatross on everyone's back, he said, noting that the most common source of medical insurance coverage — a workplace benefit — is also waning under financial strain. Employees pay a lot, but their employers pay three times that to provide medical plans. And those who don't have coverage basically don't have it.

"We basically say today that we want insurance providers to make money by excluding the sick," he said. "We need to make sure they profit by making us healthier."

Bottom line, everyone needs to be able to buy into coverage regardless of health condition or chronic illness that keeps them shut out now, Nichols said. The system has been treated as if providing health care is the same as selling ice cream.

"What we have lost in the name of the free market is a sense to exercise stewardship," Nichols said. "For us to make this work, whether as a nation or in Utah, we've got to take care of everybody, we've got to pay attention to the poor and the sick. LDS Church founder Joseph Smith said the community should take care of those in the community, whether they are believers or not."

The new community approach needs to be what Nichols calls enlightened self-interest — looking out for No. 1 in a way that serves the common interests.

"We look down the road and see we're headed for a really big pothole. We'll get around it and perhaps get to the promised land if we do everything we can to improve things, and all we can to make sure everyone's in on it."

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E-mail: jthalman@desnews.com