On Tuesday afternoon, Mike Leavitt, the secretary of Health and Human Services, made another of his frequent trips to New Orleans on a mission that speaks volumes about his approach to what is arguably the most important domestic policy job in the federal government.

In an interview hours before his departure, the former Utah governor told me that his purpose was to exchange ideas with local officials about how to make the hurricane-stricken city “a model of a new design for delivering health care in this country.”

The urgency of the task was underlined by a report that the journal Health Affairs issued as he left Washington. Its key finding: Health care, which now consumes 16 percent of the U.S. gross domestic product each year, will eat up 20 percent of it by 2015 – a level that Leavitt said is “unsustainable without serious damage to our economy.”

Steps like the health savings accounts President Bush has recommended can nibble at the problem, Leavitt says, but far more fundamental changes must be made if costs are to be brought under control without sacrifice of quality care.

Leavitt is attacking the problem at two levels. At the top, he has set his department the task of developing, by the end of this year, national standards for four “breakthrough projects” applying 21st century information technology to medical offices and hospitals. One would standardize systems for registering patients and listing their prescriptions and other basic medical data, so those do not have to be entered on separate clipboards with each visit. A second would set standards for equipment allowing remote monitoring of chronic illnesses, such as the blood sugar tests required by diabetes patients.

A third would focus on systems for exchanging medical test results from office to office. And the fourth is a “bio-surveillance system,” designed to alert public health officials to any change in the pattern of illnesses that could forewarn a pandemic.

Once the standards are set, he said, they will be applied in the purchase of systems by Medicare, Medicaid and the departments of Defense and Veterans Affairs, creating a market that the private sector is likely to follow.

Such information systems, along with better measures of health care quality, could empower people to become much smarter consumers of health care, Leavitt says, an essential step to ensuring care at more reasonable costs without burdensome government regulation.

But worthy as these big projects may be, it is clearly the New Orleans challenge that stirs Leavitt’s juices. “Hurricane Katrina wiped out the health care system of New Orleans,” he said, “but it also gives us an opportunity” to build something better.

On previous visits, Leavitt enlisted local officials for such an effort. On this trip, he planned to compare “the principles for such a system we have devised up here with the principles that they have developed for themselves. I have a pretty clear picture in my mind,” he said, “but it has to evolve from them.”

Once the principles are defined, he will await their suggestions on a structure for the new system – and then approve what he calls “a large demonstration project” to test that design.

One feature, he suggested, will be building the system around community-based health care centers, emphasizing screening for disease and prevention, rather than around the old hospital-centered system, with all the costs of caring for bed-ridden patients.

Leavitt is far too experienced – and modest – to imagine that either the new technology initiative or the New Orleans model by itself will solve the health care crisis in this country.

He acknowledges that as long as millions of Americans lack basic health insurance, forcing the costs of their care onto taxpayers, the system will remain out of control.

But given the size of the health care challenge, it is fortunate the country has an executive as creative as Leavitt heading the federal effort in this field.