The latest effort to reform the way medical care works in Utah and around the country is as doomed as the half-dozen attempts since Harry Truman was president, according to Salt Lake physician and longtime health-care critic Dr. Joseph Jarvis.

He believes true reform won't happen short of putting it on the ballot, which he is trying to do through the Web with his Utah Health Care Initiative.

In the fine American tradition that the lobbyists, not the people, hold the most sway, "health-care lobbyists will never be interested in actually fixing our health-care system," Jarvis said last week in explaining the purpose of his new grassroots initiative.

Jarvis believes that no matter how sincere and well-intended reformers might be, those at the top of the incredibly powerful, $2.4 trillion-a-year health-care sector simply will not stand for it.

Jarvis is among the re-emerging and hardier heretics within the system who say it isn't a system at all but a fragmented network of critical treatment and expensive prescription-drug dispensing silos that make and waste money at a rate that would make a former Wall Street investment banker blush.

"People have got to recognize that the inertia of the for-profit health-care industry, if it remains unchecked, will inevitably unplug an economy already on life support," Jarvis said. "This is not crying wolf; this is the simple fact of life for U.S. health care that people have got to understand."

No one knows better or appreciates the advances in understanding and treatment of serious diseases that have come by way of medical-research underwriters, he said.

"But it's rampant waste, both in money and in quality of care, that has become too big to ignore," he said. Other reform efforts have recognized that but withered because the end result has been the shoring up of the status quo in ways that have "made about as much sense as deciding to put out a grease fire in the kitchen by repainting the bedroom," Jarvis said.

As an example, he points to the announcement two weeks ago by big-money hospitals, drug companies and medical equipment suppliers:

"On Mothers' Day, they showed their commitment to mom, apple pie and to reducing the cost of health care by announcing a cost concession of 1.5 percent over the next 10 years," Jarvis said. "A reduction of 1.5 percent over the next 10 years in an economic sector that accounts for nearly 20 percent of the entire economy whose costs are going up annually at more than twice the rate of inflation," he said. "They might as well have walked up and kicked us in the shins."

Jarvis echoes fellow primary-care physicians here and around the country who say that reformers once again are going through the motions of real reform, and the sad fact is that for a country that spends twice as much on health care as any developed nation, it ranks no better than 37th in the general physical health of its citizens.

Both reformers and the general public must understand that the health-insurance business model consists of two massively wasteful and massively motivating concepts: Exclude anyone from coverage who might possibly need to use medical insurance, and creatively and bureaucratically deny payment for benefits as much as possible.

"These two principal activities are expensive and induce the providers to have wasteful billing and other administrative practices," Jarvis said, noting that health-care spending for overhead and administration alone is five times higher than any industrialized country.

E-mail: jthalman@desnews.com