With America already short $38 trillion needed to pay for Medicare insurance for the elderly over the next 75 years, the nation must focus on controlling health-care costs, according to Dr. Michael Pramenko, president of the Colorado Medical Society.

The U.S. economy can’t afford to see the share of gross domestic product spent on health care spiral from today’s 17 percent to a projected 34 percent in a generation, Pramenko said in a presentation at Colorado Public News.

“Other countries – not socialist – are covering all citizens and doing it for half the cost,” said the family doctor from Grand Junction. The United States spent an average of $7,290 per person on health care in 2009, while nine other major developed countries spent $2,581 to $4,417 per person.

Pramenko, who became president of the Colorado Medical Society in September, also is a spokesman for the health-care system in Grand Junction, which is rated as one of the highest-quality and lowest-cost in the nation. That has given Pramenko a role in working out the details of change being created by the health-care reform act. He’s on the committee overseeing creation of health-care cooperatives.

He sees a major opportunity for cost control by using scientific research to determine the most effective and lowest-cost treatment. As an example, he cited studies that show most back pain can be treated better without expensive spine surgery.

“That’s not rationing. That’s being smart. It’s using good science to determine where your dollars should be spent,” he said.

As costs continue to climb, he warned, the alternative to intelligent choices actually will be rationing health care. He cited the recent decision in Arizona to remove people from organ transplant lists for lack of funds.

“Medical professionals should decide, so legislators aren’t forced into making decisions like that,” he said.

Speaking to a group of health-care and other community leaders, Pramenko called for a wholesale shift in the American health-care system from treating health problems to preventing them.

In Grand Junction, he said, all pregnant women have access to prenatal care regardless of circumstance. In addition to resulting in healthier babies, the practice saves a fortune in expensive intensive care for babies born too small and too early, he noted.

“We’ve got to change the whole system,” he said.

Ann Imse is editor of Colorado Public News, a nonprofit news service based at Colorado Public Television 12, Denver’s independent Public Broadcasting Service station. www.coloradopublic news.org