These politicians - including Utah GOP Sen. Bob Bennett - met Monday at The New School to debate massive health care proposals that, if enacted, would radically change the relationship between insurers, doctors and patients.

All the proposals try to strip the incentive for insurance companies to reject the truly sick, for doctors to perform unnecessary tests and for patients to go to the emergency room for standard care.

And all of the officials said they can achieve this without spending more money.

"We are spending enough money today on health care," said Oregon Democratic Sen. Ron Wyden. "We are just not spending it in the right places."

Wyden and Bennett are the architects of the Healthy Americans Act, which they herald as the first bipartisan attempt to tackle health care in more than a decade.

Their plan would break the link between employers and insurance companies. Employers would pass along the amount they now spend on health plans to their employees and then the employee would be responsible for signing up for a personal plan.

Health insurance would become mandatory and each state would create a way for its residents to view the options. Those who didn't sign up for a plan would be charged a fee when they received medical care.

This proposal would bring market forces into health care, Bennett said.

"We don't know who does the best job now because those of us who want the services are dependent on those who pay the price to make those decisions for us."

But Sen. Tom Coburn, R-Oklahoma, says the Healthy Americans Act's mandate for insurance "is not freedom."

Coburn has his own plan, which he is sponsoring with North Carolina GOP Sen. Richard Burr, which would change the tax code to give every person the refundable tax credit for health care. They could purchase insurance through their employer or go out and get it on their own. States could create a blanket plan to cover those who don't sign up on their own. Those who fell into this default plan wouldn't be penalized, but they would have a high deductible, making them responsible for a sizable chunk of the final bill.

Both of these proposals would provide financial incentives for people to get preventive health care.

The other option discussed Monday was a universal government-run plan sponsored by Rep. John Conyers, D-Mich. His proposal would expand Medicaid to cover every person. No co-pays. No premiums. It would raise payroll taxes, though.

Bennett rejects a government-run plan because he said the lack of competition would eliminate the drive for efficient and quality care.

He said the differences between the plan he supports and the one that Coburn and Burr are backing are small. The important part is that any proposal needs to get the support of both Republicans and Democrats to get through a fractured Congress.

Wyden organized Monday's debate with New School President Bob Kerrey, a former senator from Nebraska, as the first of what he hopes will be a number of public discussions about health care reform.

mcanham@sltrib.com