Those closest to where health-careservices and access to them intersect — employers — want consumers to have more rights and a lot more responsibility in the coming era of reformed health care.

Invoking in tone and title a previous set of precedent-setting documents, the Salt Lake Chamber unveiled its "Business Bill of Rights and Responsibilities" on Tuesday. The three-page list outlines four key ways the health-care system can be purged of waste, reduced in price and made a lot more accessible to the 300,000 or so uninsured Utahns.

Most of the 1.5 million Utahns who have health coverage obtain it through the workplace. Executives from companies representing 400,000 employees had signed on to the proposal by Tuesday evening.

"Consumers have limited choice and control under the current system," said Scott Hymas, chairman of the chamber's health-system reform committee and chief executive officer 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 No. 1 priority."

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

Businesses shoulder 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.

That has added to the growing number of residents who don't have insurance, which in turn increases health-care costs, Hymas said. 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.

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 addresses 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.

Those close to the reform process have said a large percentage of restaurants 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 that have been dropping coverage they can no longer afford.

Members of the restaurant association in Utah endorsed the chamber's proposal.

Whatever approach is finally adopted, a strategy starts first with increased accountability, both in the quality and quantity of services provided and in the lifestyle choices of individuals, Hymas said.

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

Key to the chamber's model is the core goal to allow every person in Utah to not only have health insurance but to tailor it to their needs and be portable if they change jobs.

Consumers would have more rights but also the added responsibility of becoming actively involved in their own care through a continuing primary-care physician and access to an Internet portal of up-to-the-minute information on the cost and quality of procedures and providers across the state.


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