This is an archived article that was published on in 2007, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.

The premiere of Michael Moore's "Sicko" comes at an awkward time for Utah. We're at a critical juncture in addressing our own health-care crisis, but the solutions that Utahns are working toward don't look anything like Moore's single-minded focus on a single-payer system.

Utah's situation is distinct in several respects: Small businesses are the engine of our economy, yet they can no longer function with double-digit increases in health-care premiums; Utah's population is younger and thus healthier than other states; we have a national model for health-care quality in our largest not-for-profit health plan, which gives us a leg up on cost control. Given these advantages, we have to craft solutions that build on our inherent strengths and values.

It appears that a critical mass of political and business leaders in our state - including health insurance executives - are saying they are ready for fundamental reforms in the way we finance and deliver health care in Utah. Will Utah's health reform plan be perfect? Of course not. But the reform efforts currently under way could serve us all better than the status quo.

Against this background it is a relief that Michael Moore has refrained from his usual whistle-blowing and finger-pointing. Hopefully the filmmaker's reputation will not detract from today's serious and good-faith discussions to address the crisis of the uninsured. After witnessing a near-empty theater at the premiere screening Friday, one has to wonder: Will enough Utahns of influence see the film or read the reviews to notice the change in the filmmaker's approach?

This film is designed to wake up a public that has grown numb to the fact there's something terribly wrong with a society that puts up with 45 million uninsured. The cost shifting and care delays that cause medical conditions to become too expensive or advanced to treat conflict with a caring American society.

"Sicko" will have done us all a service if we allow the film to move us to action. The Utah Health Policy Project is committed to directing that action to comprehensive health reform that guarantees health and financial security for all Utahns. As long as our state-based, home-grown approach meets certain principles (affordability, quality, cost control, risk sharing), the current solution-seeking can lead to meaningful and sustainable reforms.

The solution proposed by the Governor's Office of Economic Development - the Utah Health Exchange - wisely builds on the Massachusetts Connector model. However, Utah still has work to do. The Massachusetts Connector has a strong base of public insurance (Medicaid and CHIP) to make premiums affordable for low- and moderate-income working families. As Utah policymakers learn more about the role that Medicaid and CHIP can play in making job-based coverage more affordable, they need to leverage Medicaid/CHIP's generous federal matching dollars to support the Health Exchange. This could be expensive and difficult to defend in a 45-day legislative session, but the success of the Exchange demands it.

Those with a stake in health care reform (especially small-business owners, advocates and providers) need to organize as never before. We must work with legislators to help them understand that Utah can't afford to turn back.


* JUDI HILMAN is executive director of the Utah Health Policy Project at www.healthpolicy