I do not believe we will see significant change in US 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 quantities of meds 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 and 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 may 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, and 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. (Perhaps "citizen" could be defined as PFD-eligible persons.) Coverage should be for all medical expenses above an agreed on figure, 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 coverage 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, would likely 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 could bid to manage the Catastrophic Health Care insurance plan, as contractors currently bid to implement existing state health coverage 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, California 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 may be less common than in other parts of the US.
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 do-able if we have the will.
I would like to see our local Democratic and Republican delegations work together and introduce a bipartisan bill for Statewide Catastrophic Coverage for health care in this coming legislative session.
Regardless of what Congress does, 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 Ian Gray is Vice-Chair of the Alaska Democratic Party. A Fairbanks resident, he taught social studies at Lathrop High for 23 years then worked as a financial advisor/stock broker for 11 1/2 years.
BY DON IAN GRAY