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SALT LAKE CITY — Randy Williams retired early not because of a lack of skill, but because his employers had no health insurance coverage — which was a problem when he was undergoing treatment for arthritis in his hip.

Instead of continuing to work in construction, a job he’d had since he was 14, Williams quit to qualify for Medicare.

“He was a person who wanted to remain in the workforce. We’re short on labor these days, but here’s a classic example of how health care — or lack thereof — impacts the economy. We lost a taxpayer; we lost a skilled tradesman,” said Brent Baranko, a physician and board member for Common Sense Health Care for Utah.

Williams isn’t alone in this story. In fact, Baranko said many of his patients have had to file for bankruptcy due to spiking health care costs.

In 2018, 429,000 Utahns were unable to receive health care because they could not afford it, according to a Utah Foundation Study in Aug. 2020. Health insurance deductibles also increased by 74% between 2008 and 2018, the study found.

Along with the spike in health insurance deductibles, Utahns’ out-of-pocket costs average about $2,800 per person, according to an analysis at the University of Utah Matheson Center for Health Care Studies.

“Utah is just a microcosm of what’s happening across this country, to a varying degree,” Baranko said. “We have what the rest of the nation has: We have a population of uninsured,”

U.S. per capita health care spending is over twice the average of other wealthy countries, with health care costs averaging about $12,318 in the U.S. and $5,829 in other countries, according to the Organization for Economic Cooperation and Development’s 2022 report.

Dr. Joseph Jarvis, a founder of Common Sense and chair of the nonprofit’s board of directors, saw that while many Utahns had insurance, they still do not receive the health care they needed, oftentimes avoiding care due to spiking out-of-pocket expenses and deductibles.

“The problem with the health care system is for the most part the citizens are healthy, but they don’t really know what’s going on in health care until they have to access the system. And once they access the system, they realize all the dysfunction that goes on,” Baranko said. “These nurses, nurse practitioners, physician’s assistants, doctors — we all know what’s going on.”

In 2021, Jarvis and several other doctors and physicians created the nonprofit that is now working to put its proposed health care system as a ballot initiative in 2026.

Emily Bingham, executive director of Common Sense, said if it passes, the initiative would create an organization called “Utah Cares” that bypasses insurance companies and functions as a state-overseen nonprofit, providing funds to physicians for their services.

Employers can also participate in the program by using it as a health care benefit instead of a traditional insurance provider, and, Bingham noted, by redirecting the funds to Utah Cares, the employers can avoid spending their wages on insurance companies’ high overhead fees. Instead of submitting claims to insurance companies, employers would submit reimbursement for their services to Utah Cares, Bingham said.

“A typical employer spends about up to 20% of their wage income on health care benefits — it’s 15 to 20%. We think we can replace that with around 10-15%, so this is a win for employers,” said Scott Poppen, chairman of Common Sense’s policy committee.

And, the administration won’t just benefit employers by eliminating the need for dozens of insurance companies and high overhead fees. By having fewer out-of-pocket payments and smaller deductibles, “at the end of the day, the net income of Utahns for anybody who makes less than $500,000 a year will increase,” Poppen said, citing results from a preliminary study conducted by the nonprofit.

David Lesser, a member of the Common Sense board of directors, said the initiative will also provide a better work environment for physicians, who often want to provide health care to their patients but may have insurance barriers preventing it.

“Physician burnout isn’t happening because of seeing too many patients. Physician burnout is happening because of the administrative burden and the nonpatient care efforts that have to be — all the hoops that have to be jumped through in order to take care of patients,” Lesser said. “We really think that this will be a much more satisfying practice environment for physicians.”

Common Sense administrators are still working out the details on the nature of the policy and how Utah Cares could cover all Utahns, Bingham said.

“We have a wonderful policy committee working with our site experts so that we can get this just right, and we’re doing a lot of listening. We’re going and listening to businesses, to consumers — we’re listening to even physicians to hear what would that policy look like?” Bingham said. “It’s going to be complicated, and that’s why we’ve pushed the initiative out to 2026 and not 2024.”

As for the funding, Poppen said the program would “incorporate all the federal dollars that come to Utah for health care already,” avoiding hikes in tax dollars and, instead, focusing on funding coming from Utahns’ employers.

“Rather than (the funding) come from here and there, and go through various insurance companies, it’ll all be funneled through one administrative function,” Poppen said. “So basically, we’re already paying plenty of money for health care. It’s already there, but it would come from employers.”

Baranko noted that despite it feeling impossible to implement affordable care on a federal level, Canada first implemented universal health care in just one province.

“The way universal health care came into being in Canada was through one province in the 1950s, Saskatchewan, becoming successful and rolling out universal health care in their province. And it was so successful, it’s spread across the rest of Canada,” Baranko said.

The nonprofit isn’t just planning to encourage Utah in the affordable health care direction, it wants to encourage the rest of the country to follow the example of the Beehive State.

“We believe we’re going to come out with a healthier population, a better business model and be a beacon for the rest of this country,” Baranko said.

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