The future of the state and national economy would be pretty much a worst-case scenario if health-care reform doesn't get taken seriously and Congress doesn't get busy, according to an assessment released Wednesday a respected health policy research group.

The Robert Wood Johnson Foundation's state-by-state accounting reads like a lot of gloom-and-doom predictions about the predicament families and employers would find themselves in during the next decade if the cost of the U.S. health-care system continues on its bank-busting pace.

The foundation, which prides itself on providing reasoned and impartial evaluations of issues facing the country, makes clear that if federal reform efforts fail, 10 years from now:

As many as 540,000 Utah residents could be uninsured — up from 389,000 now.

The average Utah resident would see his/her health-care spending rise by as much as 87 percent.

Utah employers would see premiums continue to skyrocket — increasing by up to 128 percent.

Utah government would see Medicaid/CHIP spending rise by as much as 126 percent.

The amount of uncompensated care in Utah would increase by as much as 127 percent.

Foundation researchers examined the effects of three possible alternatives. In the best of economic circumstances — if unemployment goes down and growth displaces economic stagnancy — the health-care system would continue to put "tremendous economic strain on individuals and businesses in all 50 states," the report states.

The report specifically excludes Medicare and other senior-specific spending.

Every state would see its spending for Medicaid, the joint state/federal insurance plan for the poor and disabled, and the Children's Health Insurance Program rise by more than 75 percent by 2019. Half the states would face cost increases of more than 100 percent, according to the report, and the amount of uncompensated care in the health system would more than double in 45 states.

Even in the best case, uncompensated care would increase by more than 50 percent in 48 states. That's care provided to people who don't have health insurance that gets passed on to people who do.

Utah is undertaking its own health-care system overhaul, the centerpiece of which is a series of bills setting up improvements in access, cost-containment and quality improvement.