Monday, January 28, 2008

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.

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