Health care in Alaska: poised for progress: efforts are being made to prevent illness and decrease health insurance costs.

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

Alaska has many excellent health care facilities and practitioners, with more spent on health care per capita than any other state. However, Alaska, like the rest of the United States, gets less bang for the buck than other industrialized countries. The state and federal system is broken in that priorities are backward. Currently major funding and many systems are oriented toward fixing people once something goes wrong, versus keeping them healthy in the first place.

The resounding theme, need and opportunity is prevention:

* The Bad News: Prevention is the orphan of the health care system.

* The Good News: There is increasing awareness of the importance of prevention.

Seeds of solutions are beginning to take root. Alaska is at a cusp. With focus, determination and strategically deployed resources, health care in Alaska can be poised for progress. Gov. Sarah Palin created the Alaska Health Strategies Planning Council to create an Alaska health care plan by January 2008. The challenges and opportunities facing the council are outlined below.

Question: Why do we need health care change in Alaska?

Answer: We have real, immediate and big problems:

* Health care costs are rising at unsustainable double-digit rates.

* Alaska spends $5.3 billion per year, or about $8,000 per person, on health care, compared to about $7,000 for the rest of the country. Health care spending represents one-sixth of the Alaska economy.

* Businesses; individuals; and federal, state and local governments; are all groaning under the weight of these increases. Increasingly, employers are cutting back on health care coverage and forcing employees to pick up a greater share of the tab.

* Despite these massive expenditures, many key population health measures are much worse than our industrialized counterparts. Diabetes and obesity are becoming an epidemic.

* 85,000 Alaskans have no health care coverage-if living together, the uninsured would be the second largest city in Alaska. Many more are under-insured.

* Alaska medical and surgical procedures are 18 percent higher than Outside; dental procedures are 38 percent higher.

* Alaska is short 300 doctors today, with more needed to replace an aging work force in the future. Similar shortages exist for nurses and other health practitioners.

* Potential gas pipeline construction will further strain the already challenged Alaska health care system.

* The council will need more meaningful data on precise Alaska health care needs to evaluate cost and quality of Alaska health care. Then it can formulate a coordinated state health care plan utilizing best practices...