A bill that is the form and foundation of a multi-year renovation of the state's health care system was approved Wednesday afternoon by unanimous vote and now moves on to the full Senate for consideration.

Committee review of HB133, which was approved unanimously by the House last week, was a pretty much a formality on the way to becoming law. The omnibus bill outlines a general approach to trying to keep the cost of health care form eating the state economy in the next few years.

Quick fixes and good intentions of the state's previous reform efforts won't work with what has become the number one concern of governors nationwide, and at least two presidential candidates.

Now is the last, best chance to really make some practical, meaningful and lasting changes, Clark told committee members, noting that the health care fix-it plans that precede HB133 were well-intentioned and crafted but lacked something this one doesn't: Pain.

Across the board, from families to businesses to government, financial pain has gotten bad enough that it's gotten everyone's attention. Utah led the nation in the percentage of businesses that stopped offering medical benefits last year. Each cited cost as the reason. State and industry experts say the total wages paid in Utah become completely consumed by health care by about 2012.

"It will take at least 10 years to have things developed and implemented," Clark said, noting as he has said in every previous presentation describing the bill, "this is not going to be easy or short-term, but it could be the most important work we ever do here if we do it right."

Only one serious criticism of the bill has surfaced so far --moving some children from a joint state federal children's health insurance plan to a state-funded plan. That portion of the bill has been amended.

Committee co-chairman, Sen.Allen Christensen, R-Ogden and a pediatric surgical dentist, said he endorses the bill heartily and will do his best to help sustain the momentum the issue has now.

"But I'm not sure Utah is hurting badly enough to change the paradigm of health care in this state," Christensen said, noting that even though he is a member of the profession everyone's paycheck would be going to in a few years, "preventive measures have to be taken now."

Sen. Pete Knudson, R-Brigham City, said the state has been "nibbling at this problem" for a long time.

Doug Bronson, an insurance salesman from Ogden, told Clark and the committee that he hopes whatever strategy is finally developed, that it not mimic Massachussettes' mandatory insurance plan. He said when the fiscal year ends June 30, that state will be spending $250 million in state funds on their health care system overhaul. Next year, it is expected to reaise by another $400 million. By 2011, that could be $1.3 billion being spent that governmet officials believe would cost $125 million by then.

According to the Baltimore Sun newspaper, Massachussets is trying to offset the costs by increasing the penalty for not signing up for insurance to $900. The state is also asking doctors fees to Medicaid reimbursement rates. In Utah, physicians are reimbursed by Medicaid at about 40 percent of their normal fees and charges.

E-mail: jthalman@desnews.com