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Mike Leavitt wants you to go shopping.
For your hip surgery, that is.
With health care costs poised to eclipse 20 percent of the economy within the next decade and entitlement programs such as Medicare going broke, the U.S. is in danger of losing its competitive edge in the world marketplace, the Health and Human Services secretary said in Salt Lake City on Thursday.
That's why Americans need to start making health care choices based on cost and quality, and importantly, the government needs to begin organizing a fair marketplace in which that can happen, Leavitt said.
The backbone of a "value-based" health care system, he said, is collecting and publishing data that help consumers make informed decisions. He said that would create competition among providers, and the result would be higher quality care at a lower price.
"You literally can't solve the problem of the uninsured without dealing with the cost," said Leavitt, Utah's former governor and a foe of universal health care. "It would be an easy solution to explain if we just had the government buy health insurance for everyone, but it wouldn't necessarily solve the cost problem."
Take Medicare, for instance.
Leavitt said he learned this week that in October the government will sell $8 billion in bonds it owns in the Medicare system because the public health insurance program is going broke.
"By 2017 or 2018 the money will be gone," he said. "There will be no money to pay claims for people who are on Medicare."
Congress could raise taxes to save it. Or it it could revamp the tax code, giving states the tools they need to create consumer-driven systems, he said.
"Someone in the future is going to be making decisions about your health care," Leavitt said. "Do you want it to be the government, do you want it to be insurance companies, or do you want it to be you?"
Leavitt was in Salt Lake City to designate the Utah Partnership for Value-Driven Care as a "chartered value exchange." That status will give it access to physician quality data from the Centers for Medicare and Medicaid Services.
That data will be combined with data from the private sector to paint a fuller picture of the quality of health care in the state.
By the end of year, for example, Utahns will be able to log on to the Web and look up what percentage of a particular doctor's diabetic patients had controlled levels of hemoglobin, said Marc Bennett, president and CEO of Health Insight.
The database will later include cost data. Over time, the Value Exchange hopes to create measures of cost and quality, and build incentives for providers, payers and consumers to choose the highest-value care.
"We're a long way from that vision," Bennett said, "but we have to take it step by step to get there."
Health and Human Services Secretary Mike Leavitt saluted The Utah Partnership for Value-Driven Care in Salt Lake City on Thursday. The partnership:
* Is a coalition of providers, public health agencies, hospitals and insurance companies that is working to improve the availability and accuracy of health care data.
* Is one of 14 groups in a dozen states designated to receive federal health care data, part of an effort to build a national system of measuring quality of care.