Where are the cranes?

A friend recently noted that he hadn't seen cranes on the Anchorage skyline this summer. It's because they are all south in Seattle, Portland, Denver, San Francisco and Vancouver. Despite $70-per-barrel oil, increased production, the prospect of development in the Arctic National Wildlife Refuge and maybe even a new gas line, our economy remains flat, with no exciting indicators of impending improvement.

What's it going to take to get business to want to come back to Alaska? It's going to take a favorable business environment, and that has to include getting our extremely high health care costs under control. It made me sad to read about the teacher leaving our state because of low, non-competitive wages.

Unfortunately, Alaskan teacher benefit packages have become so expensive that the overall per-teacher cost is too prohibitive to allow for any competitive "raises" in salary. Instead, that money increasingly goes toward maintaining health care benefit packages. Wouldn't we, as parents, rather our teachers spend their limited spare time discussing how to improve Alaska education rather than fighting to maintain their health benefit packages? Public safety officers, ferry workers and public employees are also caught spending way too much time defending their health benefit packages — which, in turn, have compromised their salaries across the Alaskan economy.

A robust Alaskan economy is going to require more than simply reforming our health care system by making it more affordable, but we can't have one without the other. Alaska should take a balanced approach toward growth. It should be business friendly, with competitive health care costs and tax incentives. The state should continue to encourage aggressive development of oil, gas and other natural resources, promote tourism and also develop alternative energy sources. The state should encourage innovation to create new businesses, taking advantage of our geography and climate to develop businesses that would be less expensive to operate here than down south (e.g. cool temperatures for data storage). We need to accept that climate change is real and be prepared for the changes that come with it.

[Diversifying Alaska's use of space will help diversify economy after oil]

Alaska should be at the forefront of the Arctic. But none of that will come with any gusto unless we make health care more affordable here.

There are a number of proposals to reform our nation's health care payment system but the one that makes the most immediate sense to me, for Alaska, is one that would allow groups (eg. teachers associations and small businesses) or individuals, the option to buy into a Medicaid-like, state-administered program (call it AKHEALTH, if you like). There would be no copays, no out-of-pocket costs, few hassles and still very, very good care. There would be better coordination of care. And providers could, and would still be reimbursed at competitive rates. This could be phased in, eventually covering more groups, over five or more years.

Alaska Medicaid currently costs approximately $12,000 per person per year. Wouldn't you like to be able to buy that instead of what you have? The infrastructure is essentially already in place, it would not overly disrupt our existing system, and it would make health care affordable for people considering
moving to Alaska. Change is sometimes slow and incremental, but I think this would be a great move for our state. I urge our federal delegation to allow states to come up with innovative health plans like this that address local problems such as ours.

Alaska has terrific medical providers and hospitals. My personal experience of our health care system is that it is first rate. But the payment structure has truly become a nightmare and needs to be fixed. It is choking our economy. There are now companies that specialize in exporting health care from Alaska because of the high costs here. Good Alaska jobs are indirectly driving south along with them. Wouldn't it be better for our patients and our communities if people were able to stay home for their care? We would all be better off if our care could stay local. And, we just might see a few more cranes on the skyline again.

Alan Gross is a lifelong Alaskan, an orthopedic surgeon and commercial fisherman. He splits time between Petersburg and Anchorage.