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Providing every Utahn health insurance he or she can afford may not be impossible.
But first, 11 legislators must check their differences at the door and hammer out a plan on which both the Legislature and Gov. Jon Huntsman Jr. are willing to spend political capital. Those lawmakers have just been appointed to a health care task force that convenes this month, and are charged with coming up with a blueprint for affordable care by the end of November.
With about 287,200 Utahns - or 10.6 percent of the population - without health insurance, and the skyrocketing costs of care bearing down on the economy, lawmakers say retooling the health system has never been more urgent.
"This is probably one of the most important public policy debates we're going to have in this decade," said Senate President John Valentine, adding that there is "a sense of history" because of what the task force will be asked to do.
The task force will consider 16 action items, including legislation that would allow health insurers to offer cheaper, portable health plans, and require them to change their ratings practices.
"The only totally sleepless night I had was after the governor signed HB 133" outlining the group's mandate, said bill sponsor, Rep. David Clark, R-Santa Clara. "The ball is in our court and there is an expectation, and rightfully so, for this task force to deliver. And that is a very daunting task."
Few of the legislators - four senators and seven representatives - chosen to tackle the issue have health care backgrounds. Instead they are bankers, lawyers, real estate developers, business consultants and engineers.
More importantly, they'll tell you, they're consumers who have faced the very problems they have been charged to solve.
Valentine insists that's by design. Those with strong associations with such groups as hospitals and health insurance companies weren't considered.
But most legislators on the task force have received campaign money from health care organizations.
A Tribune analysis of 2006 campaign contributions shows that, collectively, money donated by pharmaceutical and health insurance companies, as well as hospitals and medical political action committees amounted to 22.6 percent of the task force appointees' $538,483 in contributions.
Some of the legislators, including Clark and Sen. Sheldon Killpack, R-Syracuse - the chair and co-chair - accepted nearly a quarter of their overall contributions from health care sectors. Task force appointee Rep. Merlynn Newbold, R-South Jordan, who is also co-chair of the Joint Health and Human Services Appropriation Subcommittee, registered the highest at 39 percent.
Valentine and House Speaker Greg Curtis said they didn't consider sources of campaign contributions when making their choices because they consider it largely irrelevant.
Campaign contributions are simply part of the political process, said Curtis. "What motivates various companies [to make contributions], I don't really want to speculate."
Last week, Valentine and Curtis also chose two "special masters" - Sen. Wayne Niederhauser, R-Sandy, and Rep. James Dunnigan, R-Taylorsville - whose jobs "will be to meet with major stakeholders to try to refine some of the debate as it's being brought to the committee," Valentine said. Neither are voting members of the task force.
Dunnigan, an independent insurance broker, received almost 28 percent of his campaign contributions from the health industry, while Niederhauser, a real estate developer, received less than half that amount.
"They are choosing to support someone who at least understands their issue," Dunnigan said about his contributors. "I don't feel I'm beholden to them at all."
Matthew Burbank, an associate professor of political science at the University of Utah, says campaign contributions rarely buy votes. But they may buy access.
''Far and away the most effective way to contact a legislator is to say, 'In the past, we've supported you and now we'd like a few minutes of your time to talk about this particular proposal,' '' he said. ''There are very few legislators who are going to say, 'Nope, too busy, can't do that.' ''
In 1993, when the Clinton administration proposed legislation requiring Americans to become enrolled in qualified health plans, health care industry political contributions surged - and haven't dipped since, Burbank said.
"The reality is they have stayed extremely active. As you know, health care hasn't gone away," he said.
Most groups will choose to support legislators whose ideologies most closely align with their own, said Joe Jarvis, founder of the Utah Health Policy Project and a Republican candidate for House District 24.
"You donate to people who you know, or think you can predict, will vote your way," he said. While the process isn't inherently bad, it can lead to a "self-selected group that basically [has] a status quo point of view."
Measuring how much influence the health industry may exert on the politics of health care reform is "awfully hard to measure," said Bob Huefner, a professor emeritus of political science at the U. and former director of the Gov. Scott M. Matheson Center for Health Care Studies.
But a look at HB 133 may offer some clues, he said.
Language in the bill removes the possibility of a single-payer system and strict regulations of the insurance market, Huefner said.
"The burden is being put on the patients and the enrollees," he said. "And the insurance protection is being given to the industry."
Most legislators said they are going to begin their work on the task force with an open mind. But a free-market approach, they agree, is the right one to pursue.
"I do feel very strongly a single-payer system, i.e. government program, would certainly not be my first avenue of choice," said Sen. Peter Knudson, R-Brigham City. ''I believe there are other ways we should at least explore before we throw in the towel and say, 'Feds, it's your baby, take care of it.' ''
Clark said he's been appreciative of the stakeholders' interest and willingness to engage in the dialogue about health care reform.
"With change, there may be a little bit of pain," he said. "They're making sure it's not centered on any one of them."