Finally, The Trib 's editorial board seems to understand that the problem in health care reform is cost, not just coverage ("Health costs: Reform must tackle health inflation" Our View, July 21). The board is correct that extending coverage to millions more Americans just pours gasoline on the fire of a dysfunctional, hugely expensive system. Massachusetts is finding that out, after it put universal, mandated coverage ahead of cost containment.

The board is also correct that cost containment is where the real fight begins with the medical-industrial complex. Professionals, institutions and corporations have been feeding at the trough of a market-driven system for years. Taking back our health care system as a public resource and not another commodity for sale will be a huge fight. It has just begun.

Single-payer insurance (or standardized insurance for everyone) is certainly needed. But the problems facing us are much more complex than just getting rid of private insurance (which is a bad business model). It is systematically tackling cost reduction (not just cost increases) with much better management and bargaining power than has ever been used in American health care.

Richard Passoth Co-director, Utah Healthcare Initiative

Salt Lake City