MACKINAC ISLAND — A former Secretary of Health and Human Services, Utah governor and Environmental Protection Agency administrator told the Detroit Regional Chamber’s Mackinac Policy Conference that huge changes are ahead for the American health care system, whether or not the Affordable Care Act is overturned by the Supreme Court or repealed by new politicians.

“Health reform is no longer health reform,” Michael Leavitt said. “It has become economic reform.”

And it’s also a collision of two other trends — compassion and dispassion.

“Over the past 50 years the American health care system has been built on compassion, and we must not lose that trait,” Leavitt said. “It is part of the American ethos.”

But, he said, that compassion is colliding with global economic dispassion. He compared America’s condition today to the painful past of Argentina, when politicians began realizing they could win votes by promising fat pensions that later led to crippling inflation.

Leavitt likened the American health care system to a transportation system of taxis. If a city council mandated free taxis, more tax revenue would be needed. And if that revenue wasn’t available, a creative city manager might invent a bus system, to take you close to your destination, if not at its doorstep. And some people will have the money to continue to pay for taxis — while others will be able to afford limos.

“We’re going through a period of dramatic change,” Leavitt said. “It is not being driven only by the Affordable Care Act, or the next election, or what the Supreme Court does. It is being driven by global economic forces… a very strong, glacier-like force.”

He predicted that health care risk will be spread more from insurance companies to providers and patients — obese patients being charged more, for instance.

And he said he believes heath care markets will become more consumer oriented, with more employers giving employees a “defined contribution” that employees can choose to spend how they wish in health insurance exchanges and co-ops.

He also said Americans need to redefine health care quality as airlines do, a safe ride from Point A to Point B, not “the most opulent hospital with the biggest billboards.”

Long term, Leavitt said, he’s optimistic that Americans will work out their health care problems, quoting Winston Churchill: “I love Americans. They will always do the right thing — after they have tried everything else.”