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Members of a health-care access task force agree that "there should be no unreasonable financial or cultural barrier separating Utahns in need of basic health care from access to appropriate and available care."

That is the first "guiding principle" adopted by the task force during a meeting Tuesday.Now members must decide what constitutes "basic" care - and how it should be made available.

The 1991 Legislature formed the task force in an effort to deal with rising health-care costs and questions of availability. By the time the panel dismisses, it hopes to draft legislation that will assure such access.

Recommendations will focus on cost, quality of care and access.

Among the 10 principles adopted is a provision that individuals who have access to insurance coverage have a duty to use it for themselves and their dependents.

The panel also believes that the patient-provider relationship must be protected, "but not to the exclusion of cost management and employment of managed-care principles."

Defining basic care is the next task.

"Every kind of medical care is essential if you can afford it," Dr. Kate Deiss, a pediatrics resident, said. "As a society we need to face facts. We can't afford that."

Deiss said the question will center around rationing health care, and pointed out that 30 million to 37 million Americans have no health insurance. An unknown number are underinsured.

The task force is considering what other states and countries, including Canada, England and Oregon, have implemented to deal with a crisis in the health-care system.

Besides looking at barriers to accessibility, task force members will attempt to determine what types of medical care have proven cost-effective. According to Deiss, that includes prenatal care, pediatric well-care, preventive care like mammography and immunization, outpatient acute care, acute care for chronic illness, inpatient care, prescription medications (which many poor people skip because they cannot afford it), home health care and mental health care.

Deiss called the last two "humane and likely cost-effective, but politically and fiscally more problematic."

The panel includes officials from Human Services and Health departments, lawmakers, doctors, the insurance industry and others and meets every few weeks.