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By Mike Terry, Deseret News

Editor's note: This is the fifth in a five-part series.

Contrary to popular belief and Utah's conservative political bent, an overwhelming majority of Utahns consider having access to basic health care as much a right of citizenship as access to a basic education.

More than 80 percent of Utahns said in a new Deseret News/KSL-TV survey that basic care is a right — 59 percent said definitely, while 22 percent said probably. Only 16 percent said it definitely or probably isn't a right.

"This kind of survey question is rare — I don't know of another one — and the results come as a bit of a shock," said Art Caplan, a bioethics pioneer who is keeping close tabs on the course of health-care reform nationwide. "To my eye (the results) clearly indicate there is a lot of sentiment for change in health care among Utahns," said Caplan, who is currently the most widely cited ethics expert by health-care reformers who are figuring out not just what to do but what is the right thing to do.

"Whether health care is a right is the root question of this whole debate, but no one's really talking about it," Caplan, director of the Center for Bioethics at the University of Pennsylvania, told the Deseret News.

Putting the question of basic health-care access on the same footing as access to a basic education "puts it in the correct context," he said. "Is having a healthy society as important to us as having an educated one? This is the heart of the reform debate. This is the toughest public policy question our era will face, and it all comes down to this one moral question."

Health care simply isn't a right, never was and never will be, from the framers of the Constitution to today's society that sprang from it, Sen. Orrin Hatch told the Deseret News editorial board recently.

"Framing it as a moral question is simply wrong because health care does not occur naturally and is not self-evident," said Hatch, a member of the Senate Finance Committee who voted Tuesday against advancing a health-care reform bill for floor debate. The committee approved the bill, however.

"It's a choice. It's the freedom of health care and a kind of personal medical liberty," Hatch added.

Making care a right doesn't mean it's a government entitlement, as it is often regarded by conservatives, Caplan said. "No one is saying anything must happen at all. But if we as a society could just agree on just that much in this debate, a lot of the dissonance surrounding reform would dissipate and we could clarify exactly what reform ought to be."

No one disagrees reform has to happen, and regardless of whether basic care is a right or privilege, all sides agree that due to its spiraling costs — Americans spend $2.4 trillion a year on it — the industry will within 15 to 20 years upend the entire economy. The amount small businesses spend on health-care benefits for their employees is due to equal company profits within the next two to three years, according to studies by local and national Chambers of Commerce.

The poll results come as no surprise to Judi Hilman, executive director of the Utah Health Policy Project research and advocacy group.

"Utah is recognizing that there are fundamental changes that have to be implemented, and that Utahns are expecting their congressional delegation to get as involved as possible in shaping whatever changes are coming," she said.

It might be unexpected that overwhelmingly conservative Utahns would support a liberal idea that care is a right, but we all really do believe it is, and people regularly prove it, Dr. Scott Poppen, a Sandy internist and pro-reform physician, told the newspaper.

If someone falls down on the sidewalk, people will ask if he's all right, someone will call 911, the paramedics will come, and he will be treated, regardless of his ability to pay, Poppen said.

"That says people believe health care is a right," Poppen said. "We don't believe health care is a right; we know it is."

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People believe that if there's no reform, they won't lose their insurance, he said. "That's not true, and it's a phantom comfort at best. People are losing their insurance and jobs every day, especially now. And once you lose medical insurance, good luck getting it back. If you're on a couple medications, you won't be able to sign up because whatever you're taking the medication for is a de facto pre-existing condition. I see people in that fix every day."

Physicians are more fed up than any other stakeholder in the system, he said. "It's the most expensive, most inefficient system of care on the planet. And look around, it's awash in money, it's just that so much of it just gets thrown away.

"If we can just decide that there's a basic fairness about health care being a right," Poppen said, "we're still innovative enough to really develop improvements — and in ways we haven't even thought of yet."

e-mail: jthalman@desnews.com