Convinced that the current health care system, driven in large part by employers, is unsustainable, a national group of CEOs and university presidents advocates scrapping the current way of insuring Americans in favor of a plan it says provides broader coverage, more individual choice and better cost controls.

Charles Kolb, president of the Committee for Economic Development, told professionals Tuesday at the Montana Health Care Forum that the current system costs more than any in the world but doesn't offer better health care than any other developed country while leaving too many people without insurance.

Instead, the CED proposes a plan where every American would be offered a menu of health insurance choices, with the government providing a benefit that would allow everyone access to at least the most basic coverage. A system of "regional exchanges" loosely modeled on the independence and structure of the Federal Reserve would set standards for plans across the country.

"We don't think the business sector is going to be able to come together and do what's necessary to save the system," Kolb said. "What we are recommending is the transition to a market-based, incentive-oriented system of universal health insurance through a network of regional exchanges paid for with mixed dollar credits."

A big problem, Kolb said, is that the incentives for keeping costs in line are misplaced in the current system, with the result being health care consuming 16 percent of our gross domestic product compared to 9 or 10 percent in other industrialized countries.

"Business, in 60 years of providing coverage, has never been able to get its arms around the cost," he said.

The problem, he said, is with the way the system is structured: "It encourages cost-unconscious choices by both providers and patients."

One business that claims to be reigning in costs is Wal-Mart, the world's largest retailer. Speaking in the same panel discussion, Kate Sullivan Hare, the firm's director of health care policy, said Wal-Mart's year-old policy of filling prescriptions for scores of generic drugs at $4 apiece has already saved consumers $613 million.

"That's $613 million of cost removed from the U.S. health care system," she said. "Those are now 40 percent of all the prescriptions we are filling."

And 30 percent of those $4 prescriptions are filled by people without health insurance.

The first-year savings in Montana, she said, were $2.1 million, a figure lower than it might be due to state mandates that require certain drugs to cost more than $4.

Wal-Mart is also involved in a new research center, partnering with Blue Cross/Blue Shield and the University of Arkansas, aiming to bring its efficiencies to the health care system.

The idea behind the Center for Innovation in Health Care Logistics, Hare said, is to "leverage Wal-Mart's expertise in supply chain management for the benefit of the health services delivery system."

Kolb said compromise will be necessary in Washington. Democrats, he said, stress coverage for everyone with little emphasis on cost controls, while Republicans focus on controlling costs with less regard for seeing that everyone has insurance.

Borrowing from a magazine column, Kolb said any successful plan must pass four tests: Is it more accessible? Does it restrain cost increases? Does it maximize patient choice? And does it generate more competition among hospitals, doctors, pharmacists, insurers and other professionals?

"The economics of the current system, for employers as well as for most Americans, are simply unsustainable," he said. "As more Americans realize we're buying a quart but walking away with a pint pot, that could be a factor that drives change."

Reporter John Harrington: 447-4080 or john.harrington@helenair.com