Dan Burke works with more than 20,000 employees as director of corporate benefits for Turner Industries Group in Baton Rouge, La. However, because about of quarter of the industrial contractor's workers are in the Houston area, he also is the current chair of the Houston Business Coalition on Health.

"My focus has been on finding innovative solutions to help manage our self-insured medical plan," he said. "We know that health care is very nuanced and also very local, with unique challenges that have to do with varying factors in each market, not to mention political and cultural factors in each market. In a perfect world, health systems would have to compete on cost and quality, but we are not there. We have never been there, and we are faced with health care costs that are unsupportable. What can we to begin to develop some collective influence to begin to turn the tide?"