Jeff Fortenberry wants to change the debate on health care.

This debate should begin with a focus on improving care and driving down costs, he says.

"We need a thoughtful policy discussion on how to improve health care opportunity, how to improve outcomes and reduce costs, and how to protect vulnerable people," Fortenberry says.

"Now, the debate is how to finance differently what we're doing."

Fortenberry wants the spotlight turned on wellness, nutrition, preventive care.

Weight loss. Smoking cessation.

New risk pools that could drive down insurance costs.

Expanded public health care options that increase access for vulnerable people.

And he's open to better public subsidies to help high-risk patients and their families with insurance premiums.

But moving toward a broad public insurance option that would shift huge costs to the government would only add to what already is an unsustainable level of federal debt, Fortenberry says during an interview at his Lincoln office.

Under his "patient-centered" proposals, he says, "everybody wins."

Fortenberry plans to shine a light on his argument for an emphasis on nutrition, wellness and prevention next month. He says he'll host a House subcommittee field hearing in Lincoln.

The 1st District Republican is ranking minority member of the nutrition subcommittee of the House Agriculture Committee.

Fortenberry says policymakers also need to "rethink the model for care of people with severe chronic conditions."

That means both avoiding expensive emergency room care, when possible, and keeping people at home as long as possible.

Those changes could lead to better care and lower costs, Fortenberry says.

Ask the congressman if he sees any prospect for bipartisan cooperation in reforming the nation's health care system and there's a long silence before he responds.

"I would hope so," he says. "But there's no evidence of that."

The one opening, he says, could be a proposal offered earlier by North Dakota Sen. Kent Conrad to avoid a government insurance option by allowing individuals and small businesses to band together into coops that would compete with private insurers.

"I'll take a close look at that. If there's anything that might become bipartisan, that's it."

Conrad has since appeared to begin to back away from his proposal.

His own words

For those who keep asking whether Fortenberry wants to continue to serve in the House or jump to the Senate or perhaps be tempted to return to the private sector:

"I love this job. I never saw the job as a stepping stone, although I'll keep an open mind about the future.

"I love what I do and I'd like to continue to do it.

"I'm running in 2010."

Fight for funds

Fresh evidence that the University of Nebraska faces a daunting future in its struggle for adequate state appropriations popped up last week.

If you need any confirmation about the uphill fight that lies ahead for the university, check the 11th paragraph of an op-ed written by Jess Wolf, president of the Nebraska State Education Association.

First, a little context: Gov. David Heineman and the Legislature poured $234 million in one-time federal stimulus funds into the 2009-2011 appropriation for state aid to schools.

OK, here's Wolf:

"The federal dollars used for the state aid increase replaced what were to be state funds and, yes, the hope and the goal is that the state's economy will improve enough over the next two years that the stimulus funds will be replaced with state funds."

And if the governor and the Legislature do that, what will be left for the university?

The fact of life at the Capitol is that the university and K-12 schools compete with each other for state funds.

And the schools always win.

That infusion of federal stimulus funding in the 2009-2011 state budget made what already has been an unfair fight even more unfair in the near future.

The university's ongoing battle for adequate state funding has become far more difficult.

Reach Don Walton at 473-7248 or dwalton@journalstar.com.