The single, most-important change health-care reformers must make if they are to have any hope of actually improving the way the system works in Utah is fully realizing that a single, most-important change doesn't exist.

Not only that, three nationally known health-care experts told members of the Legislature's health-care reform task force Monday, the system today defies logic, common sense and every attempt so far by states nationwide to craft a remodel strategy that isn't abandoned within six months.

First, there is no No. 1 thing that must be done, there is a whole list, John Graham told the Deseret News after a round-table discussion with lawmakers. And even if there was a single approach or even a top 10, there's no reason to think that one agency or expert has it the way it will work here, Graham said.

"I say that not to endorse the job security of people like me, but to assure people who are saddled with revamping a system that has broken down in so many ways that there's no single or sure way to go about fixing it," said Graham, who was in Salt Lake at the request of the Sutherland Institute to provide some help in addressing one question no one seems to be asking, let alone answering: Who owns health care?

In comments Monday and in several briefing papers for the Pacific Research Institute where he is director of Health Care Studies, he asserts that despite health care being vitally important to each and every individual citizen, citizens have almost no say whatsoever in the access to or operation of health care in the United States.

And the part they could participate in through workplace-based insurance plans or how our health-care dollars are spent, Graham said, has become such a morass of government regulation of a system driven by sickness, not staying healthy, that bewildered is the most common state of mind among care providers, insurers, the patients themselves and the experts on health-system reform panels now assembled in almost every state.

In the past half century, the level of government control over Americans' health care has increased massively and intrusively, Graham said, noting that almost half of the $2 trillion annually spent on health care in the most expensive system in the developed world is determined by government, not the patients nor the providers.

Doing things in the name of the public good has done a lot of damage and in effect ruined the capacity to pursue or even the notion that people ought to pursue their own health care, Graham said.