In politics, it often seems, a problem is solved quickly or not at all. But some problems can’t be solved quickly, including Alaska’s health care cost crisis.
The state administration and legislature have changed again. A new group of people will be learning the issues. If they’re exceptionally bright, they’ll be ready to make decisions by the next election, in two years.
Now there is also a group addressing the crisis from outside the annual grind of politics. It has the virtues of patience and realistic goals. Maybe something will be accomplished, although perhaps less — and slower — than many hope.
Almost three years ago, I began writing about how Alaska’s astronomical health care costs erode our economy, government, innovation, competitiveness and basic human decency. All that is still true.
Anchorage teachers just signed a contract that gives an annual raise of about $1,300. The Anchorage School District will also pay an additional $600 a year into each employee’s health care. By those numbers, almost a third of taxpayers’ increased education spending is for doctors and hospitals rather than teachers.
Better teachers make better schools. And economists agree communities with the best education systems gain most in the knowledge economy.
Most Alaska teachers come from outside the state. The newcomers often don’t stay long and research shows their students don’t do as well as students of long-term, Alaska-grown teachers.
One reason for the shortage is that Alaskans go to college at far lower rates than residents of any other state. Becoming a teacher requires four years of college. Teachers’ starting wage in Anchorage, with the raise, is $50,213.
A recent uptick in work in Alaska’s oil fields also produced a shortage of workers. A University of Alaska program is turning out roughnecks to fill those jobs. The two-week training ends with jobs paying $70,000 a year.
Now let’s go back to health care.
Imagine if all the money added to cover fast-rising health care costs for Alaska teachers had instead gone to their pay. By now, teachers might make as much as oil field laborers, and more talented Alaska high school graduates might go to college.
Nothing is more important to Alaska’s future than getting health care cost under control. It affects everything you buy, the quality of employees industry can attract, and the competitiveness of Alaska products. People are leaving Alaska because of the cost of health care.
Meanwhile, we have a new governor and the Alaska Legislature has changed its lineup.
The outgoing Walker administration worked years on a project to create a health care authority, which it never completed. By the end of the last legislative session, leaders had emerged in the House and Senate who understood health care issues. Their roles have changed.
But some of the best-informed legislators remain leaders in the alternative group, the Alaska Healthcare Transformation Project.
I attended the project’s first meeting in October of 2017 and I was skeptical. Those gathered included the organizations with most to lose from reduced health care spending. Much of the talk emphasized low expectations and long timelines. Then subgroups broke off for many months of meetings.
But the instigators of this project were on to something. By including key players from all sides — and inviting everyone — project coordinator Sandra Heffern started a process that could eventually create change, although I wouldn’t use the word transformation for what they intend, as the name suggests.
The group adopted a set of goals, including a specific target for annual increases in health care costs. The goal is 2.25 percent or the Consumer Price Index, whichever is greater. Currently, the rate of increase in Alaska health care is around 7 percent.
In our society of diffuse political control and strong interest groups, it is unrealistic to expect medical providers to reduce costs. But if increases level out to near the rate of inflation, our new investments in teachers and other social goods will begin to reach their intended targets.
Heffern said no one disagreed with the goals, including the hospitals, doctors groups, and insurance companies represented in the project. That alone is a big accomplishment.
Even more important, the group approved a contract with researchers to dig into the issue in a substantive way that hasn’t been done before. Along with looking at potential solutions, respected academics will seek data on the true causes of our high costs.
Who is receiving all this health care money we’re spending? The question is painfully obvious. But Alaska has spent millions studying health care without really asking it.
This group is at least gathering the data.
The state is contributing $500,000 toward an overall project budget of nearly $1 million, with other contributions coming from foundations and the Alaska Mental Health Trust. Heffern would not reveal the cost of the research work. I think that’s wrong, considering most of the money is public.
But that’s a minor complaint compared to the credit Heffern deserves for finding a way to move the issue forward.
Opponents of change are surely part of this project. Either they believe something had to be done, but prefer a slow, incremental approach, or they got involved because the project is large, complex and will take a long time, sapping the community’s momentum for solutions.
The strength of the approach is that many supporters working at a slow, steady pace are hard to stop. Politicians pay attention, too. They love adopting ideas when someone else has already done the work and gathered support.
If health care inflation can be reduced, teacher pay could eventually become competitive. Students could learn more. Alaskans might go to college at higher rates.
Perhaps a generation from now.
It’s sad that our democracy can’t fix such an issue faster and on its own. But that’s the world we live in. This is the best chance for it to work. I’m glad this project has started.
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