Scott Parker, outgoing CEO of Intermountain Health Care, says the greatest challenge for the U.S. health-care system is access, with more than 42 million Americans without health insurance.

"The question is how much of the gross national product can we as a nation spend on (health care) when it gets too much? What can we sacrifice?" he said.He said that all health systems throughout the world, no matter their structure, share three basic "commonalities" - providing access, maintaining high quality and affordability.

Parker said the United States has achieved high quality and a degree of affordability but has not found a balance for access. Parker spoke during the eighth annual Spencer Fox Eccles Convocation at the University of Utah's David Eccles School of Business on Wednesday.

"Until we can fill that third piece of access to all, we can never (although we strive to be) an international model," Parker said. "Is it so impossible that we can't figure this out? I think it is doable, that is what is so frustrating to me."

Parker said the government should pay the insurance premiums of those who cannot afford insurance and combine those into a buying group. That group would be placed in the marketplace where health-care systems could bid services with set fees and time limits.

"We could solve that problem like that," Parker said, snapping his fingers. Parker said he is waiting for a political leader who would advocate such a plan.

"I can tell you that health-care systems around the country would be vitally interested in bidding for that. . . . We don't have to do it nationwide, like the Clinton administration proposal. This lends itself beautifully to trials and pilots. One or two states. Give it a try."

Parker said the American health-care system has its roots in charitable hospitals of religious institutions. He said it continued the Middle Ages tradition of providing "hospices" at cathedrals for weary and sometimes ill travelers. That tradition was continued as religious orders established early hospitals in America.

"They are based in a tradition of compassion," Parker said, contrasting the American health-care system with others in the world. He said that the nonprofit tradition would help support a universal health-care plan.

He said the United States faces unique challenges because health care is provided as a benefit of employment. That's not done in other countries. He said employers help reshape the health-care system by forcing an integrated system that controls costs.

He said that mergers of health organizations will continue and that hospitals may continue to close as the system eliminates excess costs.

Parker was named president of Intermountain Health Care 23 years ago and will retire this year. IHC operates 23 hospitals across Utah and the Intermountain West. On Wednesday, Parker was also inducted into the U.'s business school hall of fame.