Palin's health care bill faces challenges in Legislature

Posted: Sunday, January 27, 2008

House and Senate committees have started hearings on Gov. Sarah Palin's Health Care Transparency Act, with some aspects of the bill looking increasingly contentious.

A task force that spent the summer examining health care in Alaska came forward with recommendations intended to make more health care cost information available to the public.

Palin, however, added another controversial recommendation, a repeal of the state's Certificate of Need law, when she introduced her Health Care Transparency Act. The Certificate of Need law requires businesses to prove a community need exists before setting up an operation that would compete with a hospital.

Friday, in testimony before the Senate Health, Education and Social Services committee, Commissioner Karleen Jackson of the Department of Health and Social Services acknowledged sharp divisions on this topic.

"We've had a lot of contention around this issue," Jackson said.

The conflict started Friday, with a strident opponent of the entire Certificate of Need process clashing with Sen. Kim Elton, D-Juneau, over the merits of the process.

Robert Cimasi, a consultant testifying on Jackson's behalf against the CON process, said his extensive study of it showed it had no merit whatsoever.

"They're ineffective at lowering costs, and in some cases raises costs," he said.

Elton said Cimasi's characterization of the CON process was the most stark he'd heard, and that it contrasted with what many other health care experts say.

Bartlett Regional Hospital in Juneau is one of many Alaska hospitals that oppose repeal of the CON process.

"They come to an exactly opposite conclusion than you do," Elton said.

Supporters of the Certificate of Need say that without it, hospitals will struggle financially because they are forced to offer certain types of services, such as emergency-room care, even if patients can't afford them. If clinics are allowed to offer only the money-making services when there isn't enough business to feed both that operation and the hospital, it could hurt hospitals significantly, because they rely on certain money-making services to stay afloat.

The department also revealed it is planning to amend the bill it just submitted to delay repeal of Certificates of Need for some categories of health care facilities for two years. Those would include nursing homes, residential psychiatric treatment centers and critical access hospitals.

Rod Betit of the Alaska State Hospital and Nursing Home Association said he was disappointed the Palin administration proposed doing away with the Certificate of Need, after a committee convened by Jackson spent some 30 hours over several meetings in the last year studying and debating the merits of the program.

Despite 90 percent support for keeping some version of CON by the members of the committee, the administration decided Alaska would be better off without the Certificate of Need requirement.

Jackson said that none of the changes looked at would have solved the problem of multiple CON-related lawsuits, which drew state dollars away from health care to be spent on litigation.

• Contact reporter Pat Forgey at523-2250 or on the Web at

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