Utah stands on the threshold of a new day in health care for all our people. Whether we leap ahead, or settle for the same ol', same ol' may depend on whether we, the people, speak up to tell our legislators and Gov. Jon Huntsman how we feel about the issue, now, before the heat and chaos of the January legislative session.
Does Utah need a new plan? Answer these questions: How's your health care? Do you have insurance? Can you afford it? Do you feel you need insurance? How about your family, your kids and your employees? Do they have access and coverage?
Is the current system meeting your needs? Have you had to test it? Is the insurance industry treating Utahns fairly in their efforts to meet their bottom lines? Most people with whom I speak answer at least a few of these questions in the negative.
During the past spring and summer, a radical health-care reform plan was drafted by the United Way Financial Stability Council, a very diverse group of business and community leaders intent on a remedy for the "free market system" currently failing much of our population and our economy.
The plan is similar in many ways both to the Massachusetts plan, and to the Healthy Americans Act co-sponsored nationally by Sens. Bob Bennett, R-Utah and Ron Wyden, D-Oregon.
The Utah proposal would be a public/private partnership, to include every Utahn, paid for by the total pool of Utahns, subsidized as necessary. Pooled cost would make it affordable to the state.
It is based on the fact that every Utahn will need health care, if not now, then in the future. It would be regulated by an apolitical commission to determine benefits, and an exchange, which would be a clearinghouse for affordable individual insurance.
The fact that this diverse group came to agreement on this plan is amazing, and speaks for the desperation of the 33-member group to solve the problem. The group has held a number of public meetings to get feedback on the proposal, which is available on-line at www.uwfinancialstability.org. Click on "Health Care," then finally click on "proposal" at the bottom.
A bill based on this proposal has been drafted, sponsored by Rep David Clark, House majority leader, and Sen. Sheldon Killpack, Senate assistant majority whip. Gov. Huntsman has also released "a confidential working draft" of his own proposed health plan for Utah, outlined in The Salt Lake Tribune on Dec. 8.
Neither the bill nor this draft has been made public. I have been told this is so legislators can "be brought up to speed on the proposals" and work among themselves to arrive at a "best" bill for passage.
My fear is that the legislative/governor discussion, in typical Utah fashion, will stay sufficiently underground that whatever bill is introduced and ultimately passed will be presented to the public as a fait accompli, with very limited scrutiny or input from those who would be governed by it.
The school voucher debacle should tell our leaders this is not an acceptable way to promote new legislation.
Based on my experience as a pediatrician advocating for children's issues at the Legislature, a legislator determines his or her vote on an issue based on input from four main sources: 1) his or her personal beliefs, philosophy and, sometimes, religion; 2) input from lobbyists who have a personal, business, or advocacy interest but are not typically constituents of the legislator; 3) legislative leadership, often in Utah a very strong input; and 4) the public, the legislator's constituents.
These four factors weigh in variably, depending on the issue. But without all four inputs, particularly that of an educated constituency, legislators operate in a partial vacuum, not at all in a democracy.
I urge transparency - that the governor and legislative leadership put their current proposals before the public, knowing that both will change, to get educated constituent scrutiny and feedback.
Rep. Clark was quoted as saying, "This is the most complicated and challenging issue by tenfold of any I've dealt with at the Capitol."
I respect very much our Legislature tackling an issue with such important and long-range effects on all their constituents and hope they will use the media and the Internet to give information on the issue as it develops, and to seek ongoing feedback from the public. It is simply too important an issue to be dealt with in any other fashion.
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