Staying healthy costs a lot in the United States. But in Utah, a lot amounts to a lot less.

Residents in the District of Columbia, for example, spend the most per year, per capita — $8,295 — according to a study appearing in today's issue of the journal Health Affairs.

Utahns spend $3,972 — the lowest per-person health-care spending in the country.

The data, gathered by the U.S. Centers for Medicare and Medicaid Services, include totals of all spending in individual health care from all sources: private insurance, personal expenses, Medicare and Medicaid, the joint state/federal insurance program for the poor.

The figures are from 2004, the most recent available.

Being lowest in per-capita spending is a good thing in this case; it's not the same as low spending for education or poverty programs, in which Utah also ranks lowest or low compared to the rest of the country.

"It's another indicator of both our general good health and our generally younger population compared to other states," said Dr. David N. Sundwall, director of the state Department of Health. "It also has a highly effective and financially efficient network of hospitals. That drives the cost of care down as well. It is cited nationally and regularly as being the country's best bang for its health-care buck."

Many other states also serve a much larger sector of poor residents and many states have unionized health-care staff members who are paid much higher wages than workers in the industry in other states.

Another element of the spending rate is essentially ignoring a health-care cost that other states aren't ignoring, what Sundwall called the state's "embarrassing and escalating trend" in the growth of sexually transmitted diseases. "We can't rest on our laurels as a healthy and morally oriented community and must address that fact."

One big element in health-care spending getting bigger in Utah, at least as far as several legislators are concerned, is Medicaid. It is the third-largest health-care insurance provider in the state, covering some 300,000 seniors, disabled and low-income Utahns. A special task force is spending the interim between general legislative sessions finding ways to rein in the program that now represents nearly a fifth of the state's total $8.9 billion state budget.

The state's general fund is growing at a rate of 5.5 percent per year while Medicaid expenditures are increasing at 11 percent per year, according to the Legislature's main policy analysis office. At that rate of growth, the program would account for more than a third of the state's budget by 2022.

Sundwall and other health-care agency officials say moderate savings could be achieved through consolidating programs and combing through options to save on prescriptions. But they note neither the costs of health care in general nor the need for services are declining; they're doing the opposite.

Previous state and national discussions on lower expenditures for health care describe the situation as a "death spiral," although James Cardon, a professor of economics at Brigham Young University, and others believe no one really knows what will happen, other than predictions will continue to be dire.

Studies of this type aren't only provocative, Sundwall said, their value is helping states find out if what works in one place might work in another.

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E-mail: jthalman@desnews.com