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Health care for Alaska

Posted: November 13, 2013 - 1:00am

Rachael Petro, president and CEO of the Alaska Chamber of Commerce, thinks Alaska should expand Medicaid coverage under the provisions of the Affordable Care Act. If we don’t, she recently wrote, “Alaska businesses and all insured Alaskans will bear even higher insurance premiums and health care costs to cover those uninsured Alaskans.”

But for Gov. Sean Parnell, it may be that the system is too complicated for him to decide, which is why our health care insurance problem will never be solved by turning to the traditional marketplace.

Last year the governor commissioned a study by a Virginia-based health care consulting firm to determine the impact of Medicaid expansion in Alaska. The Lewin Group report was submitted to the Department of Health and Social Services eight months ago. But it has yet to be made public despite requests from lawmakers on the both sides of the partisan aisle.

It’s easy to speculate that Parnell is keeping the report secret because The Lewin Group findings don’t align well enough with his widely-known opposition to the Affordable Care Act. The decision he made earlier not to expand Medicaid coverage to an estimated 66,000 low-income Alaskans echoes his long held distrust for the federal government’s tax and spend solutions to our nation’s problems. If The Lewin Group gave him clear evidence that it would be too costly for Alaska, one would expect him to wave the report around saying “I told you so.” But that hasn’t been the case.

Alaska Department of Health and Social Services Commissioner Bill Streur claims his department hasn’t sufficiently vetted the numbers. After months of analyzing the data, they’ve found significant “disparity from other reports.” Streur believes those figures in the Lewin Group report don’t provide a balanced perspective. But criticizing them because they lean to the opposite side of the spectrum only serves to affirm that the administration is operating under its own biased opinions.

The fact is there are thousands of studies about America’s health care insurance system. We can all easily find plenty that contain arguments supporting our individual viewpoints. That is, if we could fully understand what they say.

Kevin Dayaratna prepared one such analysis for The Heritage Foundation this past August. His 6,400 word examination references more than a hundred other studies and health insurance articles. He doesn’t directly address the impacts of Medicaid expansion under Obamacare, but he does fall into Parnell’s camp by quoting from reports that claim value-based payment systems like Medicaid are “far less likely to work” when “designed by government bureaucrats,” as opposed to allowing industry “to operate more like a traditional market.”

But just like The Lewin Group findings that are largely based on actuarial analyses, Dayaratna refers to concepts such as “multinomial logistic regression models.” These kind of reports aren’t recreational reading. They’re fit only for astute data analysts — the types hired by the insurance companies to effectively analyze risks as a precursor to developing health insurance plans for consumers.

The problem here is that the insurance industry’s primary objective is to maximize profit. The first line of risks they’re worried about aren’t health related. They’re about payouts and the bottom line. From that perspective, it’s in their interest to keep health care costs and insurance too complicated for the average person. And that’s why it doesn’t belong in the traditional marketplace.

Insurance policies aren’t the kind of products that people can examine with their senses like food, clothing and other essentials. They’re not like home electronics, airfares or automobiles, which we purchase with the intent to use immediately. Instead, when shopping, all we get are summaries explaining what kind of coverage they’ll provide for every type of medical exam, treatment and procedure imaginable (and usually hidden behind those are reams of fine print that we hope we never have to read).

Both our government and the industry failed us long before the Healthcare.gov enrollment website crashed on liftoff. What we need is sound policy that makes medical care reasonably affordable and accessible to everyone. And we won’t get that until we simplify the equation with a single payer system like Medicaid that treats every American equally regardless of how much money we earn.

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