In April of this year I agreed to serve as the co-chair of the United Way Financial Stability Council Health Care Working Group. The council comprises 130 business, community and legislative leaders working to address the financial challenges facing Utah's middle class - declining wages, soaring debt, negative savings and rising housing and health-care costs.
Our group recognized that Utah has a strong foundation on which to build: a healthy population, lower costs and high-quality care that is a model for the rest of the country and the rest of the world.
However, over the past decade, family health insurance premiums grew by 109 percent, while median household income has grown by just 15 percent.
In 2006, premium increases were twice that of earnings and more than twice that of inflation. If not addressed this trend will result in the cost of health insurance consuming half of household median income in 10 years, and exceeding household income in less than 20 years.
Rising costs are attributable to many factors, most of which are the result of misaligned incentives that promote or allow individual, provider, and stakeholder behaviors that drive up overall costs, often without adding medical value. As costs rise, more people lose coverage - 360,000 of us don't have health insurance at all. This further compounds the problem as people avoid or delay treatment, yet ultimately end up seeking care in the most inefficient and expensive manner.
Much of that cost - hundreds of millions of dollars - is passed on to those who are still struggling to purchase coverage. It is also passed on to taxpayers, who bear the cost of public insurance and safety net-programs for those who might otherwise be insured in the private market.
None of these problems is new. They've been growing worse for many years. Efforts to address the problems typically result in expansion of some program to cover more people or minor modifications to what is truly a very complicated system. But this approach will never work. Covering more people in a broken and unsustainable system is only a Band-Aid. And attempts to fix one part of a misaligned system often have unintended consequences.
These challenges cannot be addressed in isolation, or in partial fashion. Costs cannot be controlled unless incentives are properly aligned. Incentives cannot be properly aligned unless everyone has basic coverage and markets are fair and transparent.
Individuals cannot afford coverage, and overall system costs cannot be sustained, without sharing responsibility on the front end rather than on the more expensive and least effective back end.
The good news is that a new commitment and consensus are emerging to truly solve this problem. Through the United Way Financial Stability Council, the Salt Lake Chamber and the business community have teamed up with Gov. Jon Huntsman, legislative leaders, Utah's hospitals and doctors, and a broad range of community leaders to develop a common sense, business-minded framework for addressing our health-care challenges.
We have a window of opportunity for bold action now, but we must have the courage to take it. Because the current system cannot be sustained, our choices are simple: We can do nothing and wait for a federal government-run system to be imposed on us. We can nibble at the edges and wait for a federal government-run system to be imposed on us. Or we can do something bold and fix the system by taking Utah's health-care future into our own hands.
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* BRUCE REESE is president and CEO of Bonneville International Corp.
