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The rising cost of health care hurts -- not only people who pay their own medical bills and buy their own health insurance, but also businesses that are saddled with steadily rising premiums for employee health coverage.

When companies get squeezed, that kills jobs -- and when jobs are lost, that hurts people. It's a vicious cycle everyone can live without.

While there are no easy answers, new information can shine a light on potential solutions.

A local analysis of Medicare data collected by the Dartmouth Atlas of Health Care shows that the federal program spends more on hospital care per person in the Pittsburgh region -- $5,500 a year -- than anywhere else.

The research, done by Harold D. Miller, president and CEO of the Network for Regional Healthcare Improvement and a monthly columnist in the Post-Gazette's business section, also shows that the region has the second-highest rate (after Nashville, Tenn.) of admissions for preventable hospitalizations. Such hospital stays treat chronic conditions, like asthma or diabetes, that can be addressed without the patient being admitted.

Although the numbers represent Medicare patients, Mr. Miller said they are a reliable indicator of broader medical practices since the region has so many people using the program. His findings, which were covered in an article Sunday by the Post-Gazette's Steve Twedt, have also been conveyed in presentations to organizations in Pittsburgh and around the country.

Mr. Miller, who operates the Downtown-based consulting firm Future Strategies LLC, said his research reveals other things about health care practices in southwestern Pennsylvania. For instance, the region spends less on physician care, which may be responsible for fueling more spending on hospitals. He also said the high rate of spending on hospitalization cannot be attributed to one provider or one insurer but rather to regionwide factors like overall poor health and many solo physician practices (which typically don't have staff, like a nurse, to implement cost-saving measures).

In his view, health care costs can be curbed with new practices in medicine and insurance that reward successful outcomes, like keeping patients healthy. Unfortunately, the status quo rewards doctors and hospitals for making mistakes, for example, when they can charge patients for additional treatment due to a hospital-acquired infection.

Mr. Miller believes that if physicians and care centers offered a warranty, like one that comes with a car, and they had to treat mistakes for free, then the medical community would be more vigilant on care and cost.

The Pittsburgh region is in a formidable position to benefit from new thinking, he said, if only its dominant care provider, UPMC, and its dominant insurer, Highmark, would deal amicably with each other. If UPMC's 3,000 doctors and 20 hospitals had a contract allowing Highmark's 3 million customers in-network access, the insurance company could incentivize modern practices on a broad scale and UPMC could benefit financially from the offer.

Just call it one more way in which UPMC's refusal to negotiate with Highmark harms the region.

Meanwhile, health care spending as a share of the nation's gross domestic product keeps rising, and last year it hit an all-time high of 18.2 percent. How to reduce that burden as a cost to society -- through new practices at the doctor's office, the operating room and the insurance company -- must be a national priority and a regional imperative.

Fresh thinking like that put forward by Harold D. Miller and others can lead the way.

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