Those closest to where health-care services and access to them intersect — employers — will offer their own road map to system reform Tuesday at a news conference at the Capitol.

Bearing the signatures of prominent members of the local business community, a "Business Bill of Rights and Responsibilities" drafted by the Salt Lake Chamber will outline how they plan to engage the health-care reformation under way in Utah. It represents the endorsement of businesses with a total of more than 400,000 employees.

"Consumers have limited choice and control under the current system," said Scott Hymas, chairman of the Chamber's health system reform committee and CEO of RC Willey.

"Basic cost and quality information is simply unavailable and this lack of information eliminates typical market incentives that naturally encourage healthy competition and control costs. Building a fair, competitive system is our number one priority."

A special legislative task force spent the past five months developing proposals that would fundamentally change how medical care in Utah is provided and accessed. It will make recommendations to the Legislature in January.

Businesses are the front line of coverage for about 1.5 million working Utahns who enroll in insurance plans through the workplace. As a result, they have shouldered the day-to-day responsibility of negotiating benefits packages with a health-care system that is widely regarded as wasteful, inefficient and financially unsustainable.

Utah led the nation in 2007 in the number of businesses that stopped offering medical plans because they could no longer afford them.

About 1.7 million Utahns still have insurance coverage through their work. If a plan is discontinued, it has a compounding effect on the system. It adds to the growing number of residents who don't have insurance, now estimated at just under 300,000. It adds to health-care costs because people without insurance don't receive preventive care such as risk screenings and tend not to seek services until they become sick enough they resort to obtaining services at the system's most expensive providers — emergency rooms. Those bills, more often than not, ultimately go unpaid. Simply put, the health-care mode now in place is no longer sustainable, Hymas said.

Among the businesses that don't drop benefits plans, many employees are electing not to enroll in a health insurance plan, which saves them money but adds weight and cost to the system when they obtain services that aren't covered and they can't pay for, he said.

The Chamber's bill of rights address four key areas of reform: accountability of providers, waste, incentives and compassion.

"Fundamental health system reform is critical to the long-term strength of business in Utah," said Chamber CEO Natalie Gochnour. "As Utah's business leader, the Salt Lake Chamber is committed to working with both the broader business community as well as elected officials to bring about real change."

Those close to the reform process have said a large percentage of restaurant and prepared food outlets do not offer health-insurance coverage, in part because businesses have not been willing to pay a portion of the insurance premium. Larger companies have been better able to provide the benefit because they are given discounts for providing larger pools of people than small operations which have never offered employees insurance or who have been dropping coverage they can no longer afford.

The restaurant association signed the Chamber's rights bill and will be part of the reformation effort, Gochnour said.

Whatever approach is finally adopted, it starts first with increased accountability, both in the quality and quantity of services provided and in the lifestyle choices of individuals that increase the risk to staying well, Hymas said.

"There are a lot of unknowns about the health-care system," he said, adding "that wouldn't work under any other business model."

However, the system can make some real improvements, he said. "We can look at both the business and individual consumer level and carefully look at cost and ways to eliminate waste."

Hymas said the public, providers and insurers must keep in mind that health-care reform is a process, not an event.

"It's going to take a lot of people working together to ensure that accountability is built into the entire system," Hymas said, noting that parts of the system are extremely outdated. "We need better information, better consumerism and most of all to realize that the way we did things 20 years ago probably isn't going to be what we need to have now and into the foreseeable future."

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