Alaska government struggles with health care

Posted: Saturday, February 16, 2008

Alaska's health care systems need some big improvements, but the state's not alone in its attempts to do that, say state leaders.

Brian Wallace / Juneau Empire
Brian Wallace / Juneau Empire

"It's all over the United States, people are pushing for things to be done," said Bettye Davis, D-Anchorage, chair of the Senate Health, Education and Social Services Committee.

Gov. Sarah Palin has had a committee meeting throughout the legislative interim looking for solutions. Davis, and her counterpart in the House of Representatives, Peggy Wilson, R-Wrangell, have been meeting regularly with Palin's Health Care Strategies Planning Council, developing a legislative agenda for January.

Toward universal care

At the same time, some other legislators have their own proposals, in some cases more sweeping than the governor's efforts.

Sen. Hollis French, D-Anchorage, has sponsored a bill, Senate Bill 160, which would require everyone in the state to have health insurance.

Alaska has a particularly high number of uninsured, and the bill would be aimed at one of the biggest groups there, those working in jobs that don't provide health care or who can't afford to purchase it. It would have a tax of one to two percent on companies that don't offer health care coverage, and provide low-cost subsidized plans to enable everyone to get minimum coverage.

"You have your choice among plans, but you must get coverage," French said.

With current uninsured running up bills getting their care in emergency rooms, French said his plan would help out Alaska hospitals hit hard by providing uncompensated care.

Senate Republican Minority Leader Gene Therriault, R-North Pole, said he'd looked only briefly at French's plan, but doubted there was support for passing it in the upcoming session.

"I'm not sure he got a rousing level of support," Therriault said.

French is a member of the Senate Working Group, the coalition headed by Senate President Lyda Green, R-Wasilla, but public support for French's plan has come from Democratic coalition members such as Sens. Johnny Ellis and Bill Wielechowski, both of Anchorage.

Rep. Beth Kerttula, D-Juneau and House Minority Leader, said she liked the way French's plan enabled those without health care coverage to afford it.

"I think where we should start is something like Hollis' plan," she said. "I know it's not universal, but it is a start."

Wilson cautioned that providing health insurance to everyone wasn't enough anyway. She said that was just one of several things she learned while the planning council was studying how health care is provided in Alaska.

"We found out that just because people have health insurance doesn't mean they are going to be taken care of," she said. Especially in villages, having insurance doesn't guarantee coverage.

"Some people with insurance in the cities, they can't afford the deductible, so they don't go until it is an absolute emergency," she said.

Governor's recommendations

Karleen Jackson, commissioner of the Department of Health and Human Services, will present the recommendations of the governor's planing council to the Legislature in January.

The draft plan notes that the cost of health care in Alaska was too high, making it simply unavailable for some.

"The high cost of health care is a barrier to many Alaskans getting the health care they need, and the present system supports the high and increasing costs of health care, and inefficient utilization of health care dollars," the plan says.

The plan focuses on goals, and some specific recommendations, but doesn't address the cost of implementing them.

Jackson said she wanted to deal with the high cost of health care by lowering the growth rate of health care costs from the current 6 percent per year nationally to 4 percent per year in Alaska, so the state's cost becomes consistently below the national average.

To do that, she recommended increased emphasis on wellness and preventative measures, as well as encouraging citizens to spend their health care dollars wisely.

One recommendation: A state Web site with comparative information, enabling Alaskans to be better health care consumers.

Additional recommendations include better water and sewer systems in rural communities, more Alaska-based training for health care workers, and more personal responsibility.

The plan said there are "significant shortages in the health care work force across the state," and recommended additional training opportunities be made available. That might mean strengthening University of Alaska programs, as well as paying for more education for Alaskans in other states.

"A good start is to 'grow our own' within Alaska, by presenting health care professions more prominently as viable career options, with students continually encouraged to build the skills necessary, and to pursue health care careers," the plan said.

It is likely that this year the Legislature will be only able to accomplish some short-term measures, Davis said. What it would cost and how it would be paid for are also as yet unclear.

"We don't have a dollar tag on it," Davis said.

Finally, the council said its work was not done and urged the Legislature to create an "Alaska Health Care Commission" to continue the council's mission and elevate the discussion of health care to a statewide audience.

"I do believe the Legislature would support it," Davis said. "It's quite important to me and I chair (Health, Education and Social Services Committee) and for sure I will be bringing those recommendations to my committee."

• Contact Pat Forgey at 523-2250 or patrick.forgey@juneauempire.com



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