Lt. Gov. Elizabeth Roberts shares her vision for the future of health care in Rhode Island as part of URI’s 2007 Distinguished Lecture Series, yesterday at the Providence campus.

The Providence Journal / Bill Murphy

PROVIDENCE — Lt. Gov. Elizabeth Roberts called for a reinvention of the state’s health-care system yesterday that would demand not just cooperation among such adversaries as doctors and insurance companies, and the governor and the legislature, but carry a mandate that all Rhode Islanders have health insurance.

“Call me optimistic. You can even call me a Pollyanna if you want,” Roberts said, “but I believe, with the right leadership we can take on that challenge, balance the budget in the long term and make affordable health care a reality.”

Roberts’ speech before more than 100 invited guests in the fields of business, health care and politics at the University of Rhode Island’s Feinstein Providence Campus, kicked off the college’s 2007 Distinguished Lecture Series.

Her appearance behind a brightly lit stage lectern and her repeated calls for better leadership in government, also lent to the event the air of a campaign launching, though an aide to Roberts said the speech was strictly a policy initiative.

Roberts’ vision, as she described it, would bring all the parties involved in health care together to devise an insurance system that assures primary-care coverage for everyone and slashes the high cost of the uninsured depending on expensive alternatives such as emergency-room care.

Under her plan — laid out in very general terms — everyone would have some level of insurance based on a sliding scale of what they could afford, small businesses would enjoy the same insurance rate savings as larger employers, and the state would “work with insurance companies to make sure doctors get paid to keep their patients healthy…”

How this would happen — and who would pay for it — would all depend on what framework decision-makers finally choose, said Roberts.

Certainly some of the changes could be partially financed, she said, through savings in those higher-cost services — a reality Massachusetts officials are discovering as they launch their new health-care program, which requires all residents have health insurance.

“There are resources in the system. We can do the same,” said Roberts after her 30-minute speech. However, “there are clearly going to be resources needed. But I would argue that as we transform how we use the system,” those state subsidies will drop.

“We really need to start at the beginning and not just take the system we have now and pay for it. We need a system that serves our needs more directly.”

Roberts said that mandating that everyone has some form of health insurance “would be a very important goal for us so that nobody would be left with a health crisis without insurance … . I think it is important that we are all responsible for our health care and our health-care needs … Let’s talk about the different ways we can do that.”

Roberts said her plan was purposely short on specifics and meant to start the debate.

“This is not a piece of legislation that I spoke about today because what I want [is] people in this room, people who care about this issue, consumers, providers, government [to] start participating and finding the solutions. I may not have every single right answer.”

Roberts said she expected to file some legislation concerning health-care reform in the next session.

Roberts, who chaired legislative health-care committees during her decade in the state Senate, said other states are proposing similar reforms of their health-care systems and that Rhode Island is in a good position of learning from them and avoiding pitfalls.

No matter who is elected the next president, she said, the issue of health care will have to be dealt with on the state level “because I don’t believe there will be a one-size-fits-all [federal] solution.”

Reaching consensus among doctors, insurance companies, hospitals and state government won’t be easy, she said. But “sitting around the table alone isn’t going to solve anything.”

“Let’s have the goal of making sure every Rhode Islander has access to health care at a cost that they can afford, their employers can afford and the state of Rhode Island can afford.”

tmooney@projo.com