Community Perspective
Alaska can insure its own
Catastrophic coverage is needed now
Published Sunday, October 18, 2009
Digg
delicious
Facebook
Mixx
Reddit
Stumble It!I do not believe we will see significant change in U.S. health care policy this year despite the intense debate. Perhaps there will be an end to “denial of coverage based on pre-existing conditions” if everyone is forced into coverage, adding generously to the premium-rich number of insurance company clients.
No “single-payer” or “public option” will mean no realistic competition and great future profits for those corporations. Large drug companies have signed on since the administration has agreed not to buy medications from Canada or Europe. Medicare is barred from negotiating with drug companies for cheaper medicines already on grounds of “unfairness.” Health care providers (hospitals and doctors) apparently have been added to the coalition by their professional organizations.
I’m a Democrat, yet I share Bill Moyers’ recent public concern that the Democratic Party inside the Beltway has become like the Republican Party, deeply influenced by corporate money. It’s tragic that narrow interests at the national level have run roughshod over the interests of ordinary Americans. A few changes might be rung up by the end of October, but not much that is really new and actually works. Basic health care will remain a privilege enjoyed by the privileged, not a right for all, as it is in most other industrialized nations.
So what should Alaskans do for Alaskans? I believe the state of Alaska should self-insure all its citizens for catastrophic health care insurance coverage, with those eligible perhaps defined as Permanent Fund Dividend-eligible persons. Coverage should be for all medical expenses above the catastrophic level — $20,000, $30,000, $50,000? — whatever the Legislature can agree on.
There are several positives to look forward to if this plan were created. Personal bankruptcy because of receiving vital medical care should never happen to any Alaskan. Those already covered by employer-sponsored or individual insurance would probably find their premiums lowered, since the private coverage would now have a lower ceiling. This would benefit small businesses and individuals especially. Any medical expenses under the catastrophic level would be handled by Alaskans however they currently handle them. Those with money and no insurance would continue to pay their medical bills, and those without means would depend on charity or go without, as is currently the case.
Using the hospital emergency room services as a “free” medical center, with the bills being transferred out to paying clients, likel would continue, though perhaps the state could spend more money on advertising low- or no-cost medical care available at locations like the Fairbanks Regional Public Health Center to lessen the load.
The state Alaska Care health insurance for retired teachers and public employees is currently a program of self-insurance by the state, with a vendor hired to act as gatekeeper and administer it. The present vendor is Wells Fargo Insurance Services. Such contractors could bid to manage the catastrophic health care insurance plan, as contractors currently bid to implement state programs. Or state employees could manage the plan —whatever the Legislature decides to do.
Careful monitoring, especially in the initial years, would be essential. Our population of under 700,000 is about the same as metropolitan Fresno, Calif., or El Paso, Texas. It is not a large number. We tend toward a younger, healthier population, so very expensive medical procedures that tend to be near the end of one’s life might be less numerous, percentage-wise, than in the U.S. population as a whole.
This is not to say there would be no unintended consequences. Perhaps we’d see an influx of new Alaskans trying to live here long enough to be eligible for the state to pay for part of the cost of their heart bypass. Of course, they would still be responsible for the first $50,000, for example.
Run the numbers. It is doable, if we have the will. I would like to see our local Democratic and Republican delegation, Messrs. Thomas, Coghill, Paskvan, Kelly, Guttenberg, Kawasaki and Ramras work together and introduce a bipartisan bill for statewide catastrophic coverage for health care in this coming legislative session.
Maybe the U.S. Congress will surprise us and provide the greatest transformation of the U.S. health care system since 1965. Maybe not.
In any event, Alaskans can be protected from possible economic devastation because of the cost of heath care and at a reasonable cost to all. Universal health care access will remain a national goal.
Don Gray taught at Lathrop High School for 23 years, was a financial adviser and stock broker for almost a dozen years and is vice-chairman of the Alaska Democratic Party.
Community Discussion
Newsminer.com doesn't necessarily condone the comments here, nor does it review every post. Read our full user's agreement.
Yeah, Don, lets run the numbers:
Alaska already has the most expensive government in the United States on a per capita basis- spending about $18,000 per person, per year.
Alaska has a deficit to the PERS/TERS retirement plan for public employees of about ten billion dollars.
Alaska realistically has only one source of revenue, (oil) and oil throughput in TAPS has been declining for 27 years. In the near future we will be going bankrupt.
Public employees in Alaska will soon be paying significantly higher taxes because they have "Cadillac" health insurance plans. You can thank your Democrat friends in Congress for that.
So... what new taxation scheme do you propose, Don, to pay for your idea? Maybe end the dividend program? Or just impose a statewide income or sales tax?
Alaska funds community health centers that provide a sliding fee scale for people. You do not have to be poor to use them, they will take health insurance. So to complain that people do not have health care in this and other Alaskan communities because they can not afford it, is a total misrepresentation of the facts. The system is already in place in Alaska. the question that needs to be asked, is what exactly are people in Alaska looking for, health care or someone else to foot the bill so they can go to the "uptown " doctors rather than a community health center. Alaska needs to enhance these centers which already provide affordable basic health care.
The majority of the State's population is already covered by government funded health care plans. Over 50 % work for the government of some kind: local, state federal, Native Health covers many more as
does the V.A. system, low income have Medicaid & Denali Health Care
and the seniors have Medicare. Thoes numbers add up to what percent of the State's population? So what is the big deal, we're already under a one payor system of a fashion.
(This comment was removed by the Newsminer.com staff. Please see our User Agreement for further information.)
FreeDarfur, yes it is true that health centers provide on a sliding scale, but you miss Don Gray's point. He is talking about catastrophic health issues. The heart operations, the brain tumors and other cancer related issues. The health centers are great if you get sick, have the flu, or some other easily treatable issue, but not catastrophic health care. What the state of Alaska could do is to insure that no one loses their home, their retirement etc for lack of adequate insurance. A 50k max deductible for those who don't have the greatest health plan to begin with. It will save lives and likely keep the private insurance premiums much lower in the future knowing that the private insurance carriers wouldn't have the burden of paying out huge hospital bills. I would be willing to see my P-fund lowered or even eliminated if by doing so I knew that I would never be faced with homelessness over some health condition that would take away everything I owned.
akbearable said:
"I would be willing to see my P-fund lowered or even eliminated if by doing so I knew that I would never be faced with homelessness over some health condition that would take away everything I owned."
Same here. I suspect you're right, even with the monopolistic control the insurance racket has not only here but nationwide we'd see a lowering of policy rates if something like what Gray proposes could be put into effect.
Because the dems are spineless, they were scared to fight for the only way to effectively control the medical rip here in America and that is a single payer of some sorts like the rest of industrialized world has. But it is what it is and the present dem bill will do nothing but probably cost me & the employer more money until it gets pushes all of us to the financial breaking point and very few except for the fatcats will have coverage of any sort. At the present rate, the group policy I have will cost well over $50,000/year for a family of three (with sizable deductibles and co-pays) in 10 years. How many companies and employees will be able to afford that?
The rep 'no-plan' though is even worse. At least the gutless dems give me some feel good in that I'll be helping others, with the 'no-plan' the rates will rise just as fast and no feel good.
Good post akbearable, you put some twists into Gray's idea I hadn't thought of.
diogenesFBKS, yes the democrats have been spineless, or bought off by the insurance corporation monster. This whole idea that we are now going to force citizens to buy insurance from, guess who, the same insurance companies that are out of control now is in my opinion a step backwards. The CEO's must be laughing their a$$es off. The public option is better but only to a degree. What will happen then is it will just create a new class of people whom the insurance companies now begrudgingly cover, at least till they can dump them. That being the ones who are getting older and have the usual age related health issues, or the ones who have serious medical issues such as cancer etc. Under this plan insurance co's will be able to dump the least profitable who will then be forced to the public plan which will quickly turn into a quagmire. The only way it will work is single payer. Anything else will be just as bad as what we have now or worse. That said I do like the idea of what Gray said. I first thought it would be bringing to AK the sick and uninsured from the states, but because it only would kick in after 50k and the state could screen out pre-existing people who move here to be covered under it. It is likely that few would move here. This plan would however do wonders for what the insurance companies rates would be because they would never have to pay out more then 50k themselves. When I think of how much a good insurance plan actually costs the money saved on the reduced premiums might be more then the dividend.
I think Obama is playing "rope a dope" with Congress.
Remember...that is how Ali beat Foreman in one of his last big fights. Ali covered up and backed into the ropes letting Foreman wear himself out throwing punches. Then when Foreman pooped himself out Ali decked him with a single punch.
Obama is letting Congress thrash around with all these complicated, unworkable plans until legislators finally come to the realization that the only solution for the health care problem is a single payer system administered by the federal government.
We're starting to hear the obvious solution now being talked about even by conservative democrats-- just gradually implement Medicare Part E(veryone).
Funding Medicare expansion is easy... Just allow the Bush tax cuts expire in 2011 and return top rates to the levels they were under Ronald Wilson Reagan. After all, the wealthiest 5% of the population have 90% of the wealth... they use their wealth to buy the government they need to keep their privileged position...tax them enough to prevent the rest of us from going bankrupt due to health care catastrophes.
I don't want to pay more in insurance than I can get out of it. I get flak from my dentist's receptionist because I don't have dental insurance, which could cost around $150 a month * 12 months = $1,800 a year, I only get two checkups and sometimes a filling for around $300 each * twice a year = $600 a year...forcing people to get insurance they don't need sounds GREAT for people who don't do math or need me to support their bills.
I can't afford more, so when I'm forced to spend more I'll have to make due with less...and the justification I keep hearing is that I'm costing the liberals when I get healthcare, only problem with that is, I'm not getting healthcare right now (that excuse only makes me mad) and forcably taking my money based on a lie is only effective when no one cares what I think, do, or say.
Post a comment
Commenting requires registration.