Alaska leaders divided on health care reform

Health reform issues that are dividing leaders in Washington, D.C., also are dividing leaders in Alaska.

The divisions in Alaska don't seem as sharp, however, with both Democrats and Republicans saying improvements need to be made in how health care is delivered, and few willing to keep the existing system or make drastic changes.

"Our current health care system is broken," said Dr. Bob Urata of Juneau, who was appointed by former Gov. Sarah Palin to a state health care advisory panel.

While Urata lamented the one-sixth of the nation without health insurance, he said he wasn't ready to support a single-payer system in which the government would use tax money to pay for medical coverage for everyone.

Rising health care costs are continuing to hamper state and local governments, and are affecting private employers as well.

Struggling Hecla Mining Co., which lost money last year, stopped paying medical care for Greens Creek Mine retirees earlier this year. The company, one of Juneau's largest private employers, saved $9 million, according to a Securities and Exchange Commission filing.

In a meeting with the Empire's editorial board in August last month, Gov. Sean Parnell said his administration was monitoring reform efforts, but was focused on making sure that whatever reforms were passed didn't saddle the state with new costs.

"My big concern is that they might mandate a Medicaid expansion based on a poverty level calculation, tell us we need to do it for two years, give us money for it, and then pull the rug out from under us and leave us with an expanded pool of people to serve," he said.

But Jim Duncan, business manager for the Alaska State Employees Association, the state's largest union, said he's in agreement with President Obama that basic reform is necessary.

"We've got increasing costs that are almost uncontrollable," said Duncan, formerly a state representative from Juneau.

Too many Alaskans don't have health insurance and often only seek care when they go to the emergency room. Not only is that care not as good as regular doctor visits, it drives up costs for those with insurance.

"The bottom line is everyone in this country should have access to good health care," he said.

Many in Juneau endorsed a single-payer system at a recent health care forum sponsored by Democratic Sen. Mark Begich.

Since then, health care forums have became heated as angry opponents shouted down members of Congress who were trying to explain current proposals.

In some cases, enraged citizenry told politicians "keep government out of my Medicare."

Medicare is the government health insurance program for those 65 and older.

Department of Health and Social Services Commissioner Bill Hogan said such misunderstandings are one of the difficulties with health care reform.

"I'm not sure everyone entirely understands how involved government already is in health care," Hogan said.

Hogan said Alaska wants to make sure the state isn't hit with unfunded mandates from the federal government, or anyone else.

"We don't think small businesses should be mandated to provide coverage, or frankly that everyone should be mandated to have coverage," he said.

Whatever happens in Washington, Hogan said it will have to be work on a state level as well.

"Forced coverage, in the long run, is not going to work for people," he said. "We've got to take responsibility for our own health care, particularly on lifestyle choices such as drinking and smoking," Hogan said.

On a recent visit to Juneau, Begich spoke with the Empire about what he wanted to see from health care reform.

He said the system currently doesn't work for too many people, ranging from small businesses who can't get affordable coverage for their employees or insurance companies that refuse to cover people with medical issues.

"If you have a pre-existing condition, you should be covered," he said.

It is important to everyone to find a way to provide health coverage for those currently without it, he said.

"If you are someone who now has insurance, you feel pretty good because you are covered; but the reality is you are paying $1,900 for people without insurance and those costs are only going to go up," he said.

Begich said his other priority is to ensure reforms didn't hurt the Veterans Affairs health care system or the Indian Health Service, which funds efforts such as Southeast Alaska Regional Health Consortium.

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