A Note from the Publisher: Book signing at Gulliver's

The advance copies of Mired in the Health Care Morass are due from the printer today, and the main shipment should be arriving before the end of February. Please contact the publisher if you are interested in obtaining a review copy for your periodical.

Gulliver's Books, Fairbanks, Alaska's local independent bookstore, will be hosting the first book signing on February 28, Thursday evening, 6-8 pm.

More on CON Legislation

A year ago, Governor Sarah Palin, with Administrative Order No. 232 established, in the Office of the Governor the Alaska Health Care Strategies Planning Council. The purpose was to “identify short-term and long-term strategies to effectively address the issues to, and cost and quality of health care for Alaskans,” and to report it its findings “to the governor and the Legislature by January 1, 2008.” In May 2007, the governor appointed 14 voting members to the council which would be managed and operated by Karleen Jackson, Commissioner of Health and Social Services. It would also have as ex-officio non-voting members the chairs of the legislature’s Health, Education and Social Services committees, Senator Bettye Davis and Representative Peggy Wilson. The voting appointees consisted of five doctors, two nurses, one health insurance industry representative, five health association or health facilities administrators, and one town mayor. Notice that no health consumers or health consumer advocates were included in the membership.

One issue taken up by the council was the matter of Alaska’s Certificate of Need (CON) legislation, and the council established within itself a Certificate of Need Negotiated Regulations Committee. This committee issued a report stating that the current CON legislation needed changing, but it reported a very strong consensus among members that the CON process “should not be eliminated” and offered several suggestions for strengthening and clarifying the current regulations.

So what happened then? Commissioner Karleen Jackson ignored these recommendations, and concluded that the CON program does not benefit the citizens of Alaska, “given the litigious environment surrounding it.” Then awarding the council members a second kick in the teeth for their efforts, Governor Palin, as part of her Alaska Health Care Transparency Act presented to the legislature, called for the repeal of Alaska’s certificate of need legislation in entirety.

I bet those people who served on the Health Care Strategies Planning Council will think twice before again agreeing to another committee assignment from the governor. But this sort of thing happens a lot in Alaska state government. A governor has preconceived ideas about something so and appoints a committee in hopes that it will reach a conclusion that will justify the governor’s view and subsequent action.

This time it did not go well, so Governor Palin simply rejected the committee’s conclusion that the CON legislation needed to be both retained and improved upon.What will happen now is anybody’s guess, but let’s hope the legislature follows its conscience and stands up to the governor on this issue. Legislators would do well to listen to what the Alaska Health Care Strategies Planning Council had to say about how to improve the CON legislation and then take steps to do it.

Health care an issue in upcoming Alaska elections

People running for office in Alaska are getting tough questions from their audiences on the campaign trail, apparently. Phil Munger at Progressive Alaska observed this when Ethan Berkowitz addressed the Mat-Su Democrats:

Berkowitz handled an array of questions fairly deftly until the talk turned to reform of our failing medical care structures. He's the least progressive of the three Dems on this, and struggled in his earnest efforts to answer some sweeping questions from the audience, with answers which wouldn't really provide solutions.

Berkowitz is right that medical care reform is a very complex set of problems with no easy answer for one community, let alone for the entire state or for our country. When he talked of waste, inefficiency and greed as being the major systemic flaws, though, his suggestions that we can tweak our way out of this dilemma didn't resonate at all with the audience.

David Sirota writes about alternatives being proposed in Washington state and Wisconsin: publicly controlled not-for-profit health care systems. Proposals like this could be adapted for Alaska, although we'd need to look at what is appropriate here.

Certificate of need law

In her State of the union address on January 16, 2008 Governor Sarah Palin expressed her desire to eliminate Alaska’s certificate of need law. With this statement the governor is demonstrating that she cares more about the needs of profit-seeking business interests than the Alaska public’s need for affordable health care. As I wrote in my Dose of Reality column published in the Ester Republic in September 2007, the elimination of the certificate of need law is guaranteed to drive Alaska health care costs up. Proliferation of unneeded for-profit health care facilities will force nonprofit hospitals to raise their overall rates to compensate for losses incurred when their existing facilities are underutilized. Not only that, health care consumers must also bear the costs of the for-profit facilities, and part of that cost is the profit raked off by the operators of these facilities. Their primary purpose is to make money, and for them the provision of health care is secondary. Counter to what Governor Palin says, it will be a disservice to the Alaska public to repeal our certificate of need law.

Talk at the Interior Democrats' luncheon

Neil Davis on health care finance at the Interior Democrats' Luncheon
Westmark Hotel, 12 noon
813 Noble Street, #1
Fairbanks, Alaska

A Note from the Publisher: About the book

The marketing campaign has begun! The first batch of galleys of Neil Davis' book, Mired in the Health Care Morass, are done and will be mailed tomorrow to prospective reviewers. From the cover:

Mired in the Health Care Morass describes a predicament known to almost 47 million Americans: paying for medical bills without health insurance. Neil Davis navigated this financial black hole and discovered a hidden truth: medical bills don't reflect the costs of medicine. Davis describes the harrowing journey his family took in paying for cancer treatments, and comes to the well-informed conclusion that our health care system is broken, and doesn't have much to do with health.

John P. Geyman, MD, professor emeritus in family medicine at the University of Washington and author of the bestselling book, The Corporate Transformation of Health Care, read the manuscript and provided this explanatory prepublication review of Davis' work:

This is a well written and researched book illuminating the dark interior of health care financing, ranging across billing practices for physician services, drugs, laboratory and hospital services. A penetrating analysis from a consumer's point of view, unique in its detail, which shows how complex, fragmented, unaffordable, and unsustainable our market-based health care "system" has become. Motivated by the tragic illness of a family member, Davis carries his research to a study of our system as it compares with those of other industrialized nations, making a compelling case for a publicly financed system of single-payer national health insurance.