Anchorage is the largest city in Alaska. We all know that.
But there's a big community here that often gets overlooked. It encompasses 10,000 more people than the populations of either Fairbanks or Juneau. It has 36,000 more people than Homer. Eighty times the population of Aniak.
And who populates this would-be second-largest community in Alaska? The 41,500 uninsured Alaskans who would benefit from a state expansion of Medicaid.
Contrary to a popular stereotype, these are not people who loaf and live on the dole. For the most part, they are men and women who work hard for not much money -- the "working poor." With minimum wage jobs, maybe more than one, they do their best to support their families.
This is not a community with political connections. They don't hire lobbyists. They can't afford to fly to Juneau to bend the ears of legislators. (No matter. They couldn't take the time off anyway.)
Often these aren't workers whose employers pay livable wages, offer health care, provide something for retirement. They are ones who start out behind and struggle not to lose ground. They are employees who can be replaced tomorrow without a second thought.
If you think the Wal-Marts of America feel ethically or morally compelled to take care of these low-rung employees, employees who help keep their owners in the billionaires club, guess again. Isn't happening. Won't ever happen by choice.
Instead, they are more likely to whine about paying taxes to provide their former and future employees food stamps, low-income housing and federally mandated health care. (Of course it's all Obama's fault. If he weren't president, there'd be pork loins falling from the sky, and senior management positions with Cadillac health insurance for everyone who could fog a mirror -- as long as they have a good attitude and patience. Lots and lots of patience.)
Believing that nonsense is what absolves some people from any sense of responsibility as they watch prosperous companies enrich themselves by transferring their labor costs onto the rest of us. No health care for workers means bigger dividends for stockholders. It's what the Founding Fathers intended!
The uber-right says, let the free market sort it out. Sure, I can see how that would be comfort enough for a single parent with a sick child.
In Alaska there is one person who can literally change the lives of these folks with the stroke of a pen. That would be Sean Parnell, our governor. Sometime soon he will decide whether or not to expand Medicaid to cover those 41,500 Alaskans.
Should he? Let's hope he asks these questions before deciding:
Would it improve the health of Alaskans? Create jobs? Improve our economy?
Several comprehensive studies have considered those questions. The Alaska Native Health Consortium commissioned one, titled "Healthier Alaskans Create A Healthier State Economy." It estimated that within five years of an expansion our overall death rate would decrease by 6.1 percent. That's one death prevented for each 176 newly covered residents. Will preventing the deaths of hundreds of Alaskans seem like a good investment to our "pro-life" governor? I'm not betting on it.
From a moral and ethical perspective, Medicaid expansion is a no-brainer. That's why the Anchorage Faith & Action -- Congregations Together produced a brochure about Medicare expansion. ("When I was sick, you denied me affordable health care" isn't exactly in lockstep with the Bible.)
Over the next four years a Medicaid expansion would create 3,500 new jobs in Alaska and generate annual wages of $180 million. It would create billions of dollars in economic activity here.
The federal government will pay 100 percent of the initial cost of expansion, and 90 percent thereafter.
That's why the Alaska Chamber of Commerce made Medicaid expansion a top priority. Businessmen know a good deal when they see one.
The governor knows all this. And he has the benefit of his own $80,000 study, which he refuses to make it public -- even though that's the law. He won't give it to legislators, much less us lowly citizens.
What doesn't he want us to know? My bet is the new report says the same thing the others have: expanding Medicaid will improve our health and our economy. And yet the governor just can't seem to make up his mind. Is he trying to figure out which choice is better for his political career?
Alaskans are sick of politics as usual. Just like the rest of the country. Let's hope this is one decision in which common sense, smart policy and basic human decency trump politics.
It really is a no-brainer.
Shannyn Moore can be heard weeknights from 6 to 9 p.m. on KOAN 1020 AM and 95.5 FM radio.
By SHANNYN MOORE