The dramatic increase in health care costs over the last few years is obvious, but industry analysts don’t expect it to get better any time soon. Health care in the United States is estimated to cost more than $3 trillion by year 2012, more than double the $1.4 trillion cost of 2001, according to the Kaiser Family Foundation.

Considering that health care has become the biggest purchase most people will make in their lives, far surpassing housing or education and measuring a considering chunk of the gross national product, the trend is understandably alarming.

Although interest groups are working on solutions for some of the problems, such as medical staff shortage, the escalation of other factors has seemingly turned the battle for more cost-effective care into a closed circle that is only getting bigger.

In Washington State, the fight is on for tort reform, which insurance companies and doctors say will solve the surge in malpractice insurance, one of the expensive line items on the health-care price tags. The reform, which proposes to cap the amount of non-monetary awards in malpractice suits to $250,000, will not decrease coverage rates, insurance companies say, but it will over time stabilize an out-of-control system.

Gov. Gary Locke presented an alternative proposal in December he said would protect patients as well as control malpractice costs. The proposal, part of his supplementary state budget, would set aside $10 million to increase Medicaid reimbursement to physicians who deliver babies, and another $10 million toward costs of excessive malpractice suits. The plan was praised by the Washington Academy for Family Physicians but called “a band-aid approach” by the Washington State Medical Association (WSMA), which has been lobbying for the lawsuit caps.

“These funds have been tried elsewhere,” said WMSA President Jeff Collins. “They do not lower costs. Physicians and hospitals end up paying two premiums, one to the insurer and another to the fund. Meanwhile, personal injury attorneys and other costs continue to eat up over half of every premium dollar.”

He added, “Failure to enact meaningful reform — including a cap on non-economic damages — will adversely affect access to care and drive up health care costs.”

The WSMA will offer its own tort reform package which seeks to cap non-economic damages for medical malpractice suits and limit the amount of time patients have to file them.

Another aspect, staff shortage, is being successfully addressed in Kitsap County, as well as other areas of the state, by looking for ways to train more qualified staff. “Schools that educate health care workers don’t keep up with demand, and many have cut back on the courses available,” said Cassie Sauer, spokesperson for the Washington State Hospital Association.

A coalition of health care and allied organizations, called the Olympic Health Care Alliance, has focused on the staff shortage in Kitsap, Jefferson and Clallam counties, as part of the Olympic Workforce Development Council. OHCA has set up training programs for registered nurses, is working with Olympic College and Peninsula College to expand their courses, and finding other ways that will ensure area medical establishments have qualified personnel.

“There are plenty of qualified students applying for the programs. The bulge of the python is increasing capacity of the training programs and the opportunities for practice at clinical sites,” said Leif Bentsen, Kitsap County human services planner who coordinates the OHCA.

Currently, the shortage crisis has eased, Leif said, partially because slow economy has forced some nurses out of retirement or to return to the field from other careers. But it’s a short-lived relief.

“The current staff is getting older and folks are getting ready to leave the profession. At the same time, with the retirement of baby boomers and the aging of population, the demand (for their services) will increase,” he said.

Kathy Sanford, vice president of nursing services at Harrison Hospital, echoes that concern. “This is a highly people-intensive industry, and where there is a shortage of people, the expense goes up,” she said. Harrison has a vacancy rate for nurses of 7 percent, which is considered fairly good, compared to 30 percent or more during the shortage crisis at some hospitals. As the shortage eases up, the hospitals rely less on traveling nurses who cost more, and other expensive measures.

But the average age of nurses, Sanford says, is 40, and by the year 2020 the medical system will be short of 25,000 nurses, not to mention other highly specialized staff.

Add to that the increased cost of technology, pharmaceuticals, the cost shifting caused by the growing number of underinsured, nonpaying or Medicaid/Medicare patients, and the math becomes simple.

“The cost of prescriptions rise seven percent per year and will continue to do that in the foreseeable future,” said KPS Health Plans Chief Financial Officer David Peel. Technology and how we save lives has also tremendously changed, he said: “For example, breast cancer treatments have produced improved survival rates, but run into hundreds of thousands of dollars. We have a population that expects more and uses more (health care).”

KPS gives their insurance consumers a choice: Pay less in premiums and deductibles and spend more for visits, or pay more upfront for better coverage. It’s that type of consumer economics that ultimately needs to underlie health care, said Dr. Gerald Yorioke, a physician on the board of directors for the Washington Academy of Family Physicians.

“Everyone trying to get a discount (like insurance companies, government programs) may do good for themselves but it ultimately raises the sticker price for everyone,” he said, adding that Washington is No. 43 in the country for the amount of Medicare reimbursements, which are not the same in every state, and each year the disparity grows. “It’s a major aspect that is not really appreciated by people who are trying to solve these problems….It takes a broader view.”

Ultimately, the solution may be in accepting that better health care simply costs more. “If we want the best health care, we have to be willing to pay for the research and technology,” Sanford said.