One of the most crucial problems, locally and nationally, is that most of the uninsured earn low wages and often work in small firms. Thus, Utah has created an exchange focused on improving insurance options for them and leaves alone those who have good insurance today. And the exchange facilitates consumer choice based on price transparency, not government regulation and control.

One reform, for example, creates portable coverage — insurance policies that workers can take with them when they leave or change jobs and that can be paid for with pre-tax dollars. Utah consumers also can pick the insurance program that best suits them, taking into consideration cost and level of benefits needed. To assist, the state launched a Web site where consumers can compare policies, pricing and financing, and sign up electronically — all in one place.

Not surprisingly, Utah’s plan resulted from months of research, consensus-building and meetings among legislators, health-care providers, insurers, businesses and community members. It hasn’t happened quickly, in other words — nor is the process over. A few problems have been resolved using the best free-market principles, while others will be tackled down the road.