Health care in Alaska: poised for progress: balancing cost-shifting, the feds, technology and opportunities.

• Author: Heyman, Duane
• Position: Special Series: Part Two of Two-Part Series

As discussed last month, the Alaska Health Strategies Planning Council is embarking on the formidable task of creating a comprehensive health care plan for Alaska by January 2008. The Alaska Health Care Roundtable identified certain priorities and the Council will undoubtedly be flooded with other ideas and suggestions. This second article suggests additional considerations to either be dealt with or improved.

CHALLENGES AND NEW INITIATIVES:

* Alaska has information gaps that need to be filled if we are to chart an optimum path to progress. Fundamental research to enable policy-makers to make sound decisions based on facts should continue. It is ironic to compare the amount of money and manpower that Alaska devotes to optimizing fish, game and natural resources, versus what we spend to understand our human health needs. Aren't we more valuable than salmon or moose?

** Quantify and identify the source of Alaska cost differentials versus Outside.

** Understand who is not covered or insufficiently covered.

** Continue to define work force development challenges across the full job spectrum.

** To help coordinate needed information, the University of Alaska Anchorage Institute of Social and Economic Research needs a qualified health care specialist to monitor and analyze Alaska health care economics.

* Electronic health records are the cornerstone of modernizing Alaska health care. No other major industry is as backward in its data processing. The Electronic Health Record Initiative has made substantial progress developing business plans to modernize health records.

* Develop navigation aids and fail-safe systems to help people gain access to and deal with complexities of the system. Many individuals are unable to access needed services on their own. Navigation aids must take into account the human, as well as technological networks, which build healthy lives.

* Continued increases in Medicaid and Medicare costs will necessitate additional matching state funds and overall growth in the state health care budget.

* Monitor and learn from other state's experiments in coverage and cost control.

* Keep track of the changing federal health care environment.

THE FEDERAL ENVIRONMENT

* In inflation-adjusted terms, most federal funding is flat or declining. Federal Medicare and Medicaid payments are not keeping up with the rising cost of providing service.

* Long-standing federal laws require the federal government to provide health care for Native...