This editorial first appeared in the Fairbanks Daily News-Miner:
As employers, insurance companies and consumers grapple with sky-high health care costs in Alaska, we’re hearing more people talk about what some might consider the nuclear option for institutions in Alaska — subsidizing travel costs to send more patients Outside for cheaper treatment.
The state is investigating this idea as one way to help slow the rise in health care costs. Double-digit increases are a ticket to an unsustainable future.
There’s no mystery about the problem — buying tickets to subsidize the travel costs to send a patient to the Lower 48 could save tens of thousands of dollars on major operations.
A hip replacement surgery that costs about $40,000 in the Seattle area could cost more than twice that amount in Fairbanks, according to an estimate presented by a University of Alaska consultant in 2010.
Looking at those numbers, it’s clear that employers might save a bundle on medical costs by spending a few thousand on air fare, car rental, food and lodging to ship patients Outside.
The downside of this concept, however, is as old as the history of Alaska.
The more that we create incentives to send people Outside for treatment, the greater the potential damage to the institutions in Alaska that have higher costs to begin with.
There is a value to having good medical care here at home. There is value in being able to see a specialist without having to deal with the hassles of travel.
There are many cases when travel Outside is impractical or inappropriate for patients, for a host of reasons. When people need emergency assistance and lives are in the balance, surgery in Seattle may not be an option.
Unless the local institutions are on a sound financial footing, we can hardly expect critical services to be there when they are most needed.
Medical facilities and the people who work in health care are part of the fabric of our society.
The ever-rising insurance costs faced by governments and private companies are a serious issue, but so is the financial health of medical facilities in Alaska.
This discussion is an important one for every community in Alaska.
There must be a balance between seeking cheaper care and preserving options for medical care within our state, so that when people need help they can get it at home.
Comments (9)
Add commentSorry 'look local'.....
First - why should it cost more than twice as much for the same operation in Fairbanks should be part of the questioning: Where are costs being inflated, and are they being raised disproportunate to actual costs?
Second - the incredibly annoying "Look Local First" jingle notwithstanding, I still have a right to expect good service for my purchases - if I have a needle biopsy on my breast at Bartlett, I was told that person does only 6 per year. If I go to Swedish Breast Care Clinic, that person does several PER DAY. I think we all have every right to expect excellence when our lives hang in the balance, and to go wherever the heck we need to go to get that excellence.
Lastly, on the "Look Local First" front - I have to say that in the last month, not ONE local business whom I've left a message with has called me back. NOT ONE. A specialty store, a plumbing company, a furniture company, a landscaping company, and a soil delivery company. I had specific requests with all of these firms to spend money with them, as in, "I'd like to buy xyz, please call me to arrange delivery", or from a salesman "give me your number, I'll call you and let you know when that piece of furniture is in" - - ZERO Response. ZERO. Two of them I've called twice. If local companies want my business, the least they can do is RETURN MY CALL WHEN I'M TRYING TO GIVE THEM MONEY!!!!!!
Part of the problem?
Maybe part of the reason only 6 needle biopsys are done a year here in Juneau is because many opt to leave?
Maybe the reason procedures are more expensive in Alaska is because those who do them need to be paid a living wage regardless of how many procedures they do?
What about those who cannot afford to go out of town for testing? Why must they suffer for your selfishness? Not all insurance companies pay for airfare let alone lodging to have tests done out of town. Not everyone can afford the time off to have testing done out of town. Take a single parent, if they have leave at work much of that is used up by childcare issues, sniffles, conferences and a host of other commitments we make to our kids. Kids cannot act as escort so their ticket is not paid for, nor is paying for a sitter while you are gone. So having a simple needle biopsy here in town is vastly less expensive than jetting off to Seattle for a long weekend.
Not even touching those without insurance or public assistance. But rather than blaming the doctors and hospitals, how about realisticly looking at the problem instead of jumping at the first monster in the closet.
lvmykyk - some valid points....
..I am certainly fortunate that I can use miles, which I carefully garner from EVERYWHERE I can all year, to tack a day on to an annual trip to see my family so that I can address my breast care at Swedish. I am fortunate to have health insurance. I am not sure what I would do if I didn't have those things - given my family history I would do everything I could to get the best care available.
Certainly a place with a larger population has people with more experience in specialized care - though I doubt the local needle biopsy person is paid a full time wage just for that.
I'm willing to do a lot of 'unselfish' things to make things better for our town and people who are less fortunate - recycle, pay taxes for things I don't use (i.e. docks/harbors, all kid-related stuff), support planned parenthood and local charities, but the one thing I'm not willing to do to be 'unselfish' according to your personal sensibilities, is die.
cost of living index
Seattle, WA cost of living is 149.10
Fairbanks, AK cost of living is 127.50
http://www.bestplaces.net/cost_of_living
The difference in procedure costs between Fairbanks and Seattle is not to provide a living wage to the employees.
Selfish statement
was less about my personal feelings but a reflection of some of your arguments regarding medical care reform. Not worded well on my part to be sure.
I understand about family history and testing. My brca came back positive. But I also know that those "wiser" docs in Seattle tried to pass off a large mass as the result of an actively breast feeding mom. Almost cost me a sister.
I am sure that the person doing the biopsy here does do other tasks. But I am also sure that lack of volume plays a role in costs. Not only for that one test but many others. There is also the costs of sending material out of town for testing. Not really something you can slap a stamp on and mail out. Sure it must be air freighted as hazerdous material, courier paid to deliver and pick up.
There is no conspiracy to gouge you. The staff here does not deserve the implication that they are sub standard or less than desirable. If the goal is medical coverage and care for all, shouldn't that care be equal? Maybe you will donate your miles to someone without insurance so they can go south for testing and treatment.
Too much government
Too much government involvement in anything = higher costs.
I'm going to go out on a limb and guess that the percentage of Alaskan residents with private health insurance is very, very low in comparison to federal and state covered care. There's the VA, medicaid, medicare, state employees, natives, CHIP, and probably many more government programs.
Also, are most of the hospitals in the state non profits or somehow connected to government?
What percentage of the doctors in the state are operating as a small business as opposed to being paid by a taxpayer funded hospital or community clinic, etc.? Not many, I bet.
Soooo, it becomes a giant circling mess of dollars. This price goes up, that price goes up and pretty soon it's unsustainable. This is what happens when choice is taken out of the equation.
However, with lack of population and such huge geographical obstacles, what's the answer to bring costs down? Don't know. Better just keep drilling and mining full speed ahead to keep the coffers full!
State employees insurance
I would not lump state employees in with medicaid, medicare or NHS. Regardless of their employer, they are working for their insurance and it is part of their employer's benefit package, just like mine. The VA, those vets worked for those benefits and many paid a higher price than anyone should be asked to. I find it disrespectful to lump them together in that manner.
For the record I support medical reform, and think following a SEARHC model rather than medicaid one is the way to go. Worked for GroupHealth.
@lvmykyk - this is hitting a
@lvmykyk - this is hitting a nerve with you...
I would never disrespect our military. You missed my point entirely.
I was merely saying that there are not many PRIVATE insurance patients in Alaska.
Don't equate state employees with private health insurance policy holders either. I know state employees pay a portion into their health insurance benefit package but it's a woefully small percentage. The taxpayer is left to pick up the remainder.
Why do you think the governor is trying to come up with a solution to the high costs of services? Because it's costing the state a ton of money to pay the bills.
lvmykyk - again, valid points.
You are probably correct that labs here, more volume, would affect pricing.
I don't necessarily think hospitals here are trying to gouge me. You've had your experiences and I've had mine. My experience is that care for me is far superior and more consistent in Seattle than here.
I used to donate all upgrades (which they bundled together for tickets back in the day) for cancer patients. Now I donate to the American Cancer Society and participate in the breast cancer walk every year.
Calypso - I'd add that there are also private forces working to increase the costs of services, like profit-driven insurance and pharma companies seeking higher dividends for their boards/shareholders, and malpractice insurance rates.