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Alaska doctors and dentists tell Gov. Dunleavy his budget will hurt patient care

A crowd of health care professionals pushed back against Gov. Mike Dunleavy’s proposed budget Thursday night, telling him proposed cuts could devastate health care in Alaska and have life-threatening consequences.

Doctors, dentists and others, some wearing scrubs and doctor’s coats, packed the lobby of the Alaska Surgery Center in Anchorage, telling the governor he was making a bad choice by proposing to cut $100 million from Medicaid, which would leave a $300 million federal match on the table.

Chad Winthrop, a dentist who accepts Medicaid patients, said the governor’s proposal to hand out larger Permanent Fund dividend checks, including $3,000 this year, would come at the expense of health care services.

“If you have the courage to help people with what’s really important, you would see fit to take the money that you would hand out to people so they can buy more snowmachines and put it into their health care,” Winthrop said, generating applause.

Dunleavy took the position that his budget cuts are unavoidable. Alaska faces a $1.6 billion budget deficit and will soon run out of money without large cuts, he said. Continuing deficits could cause the collapse of health care and other services statewide, he said.

“It’s a tough situation,” Dunleavy said. “I signed on for the job and we’re going to do it the best way we can to limit the impact on Alaska, but it’s going to have an impact on Alaska. (The deficit is) just too big, too great, for it not to be."

The health care professionals warned that the governor’s plan ignores the long-term consequences that will come with less support from Medicaid, including doctors who can’t afford to keep doors open and patients who can’t afford preventive services, leading to sicker patients and costlier treatment down the road.

Proposed cuts to Medicaid funding, as well as a proposal to de-fund Alaska’s medical school training partnership with the University of Washington, are not popular in the medical community. The state’s hospitals and nursing homes also oppose the cuts, said Becky Hultberg, president of the Alaska State Hospital and Nursing Home Association, in a phone call Friday.

“I’m sure someone somewhere supports it,” Hultberg said. “But the major associations and organizations are opposed.”

Dunleavy said he had an obligation to help that “mother of three” who doesn’t make a lot of money and has begged him to make larger dividend payments based on the traditional formula so she can pay off debts.

That’s a short-sighted approach, Winthrop said. He called Dunleavy’s plan to pay the large PFDs a “legal bribe to voters,” while cuts to Medicaid will eventually cost those people far more than they’ll get in the short-term.

Dunleavy said the state’s spending on Medicaid is not sustainable. He said some worry whether it’s sustainable at the federal level. Everyone wants people to have access to health care, and his administration is working with the federal government to find solutions, he said.

Physician Daniel Mindlin told Dunleavy it appears he’s proposing those large cuts because it’s easy to slash benefits to low-income residents.

“I don’t understand how giving up money that’s three-quarters federal, because you say, ‘It might not be there down the line, so let’s cut it now,' makes any sense other than it’s easier to cut stuff from poor people," Mindlin said.

The governor said that’s not his intent. But Mindlin said that’s the effect. People will show up with advanced cancer or diabetes after skipping preventive care, and won’t be able to afford costly emergency or life-saving treatment, Mindlin said.

“I resent the implication that because that’s not the intention it doesn’t matter,” Mindlin said. “It does matter.”

Benjamin Westley, an infectious disease specialist, stood and asked Dunleavy what he should tell one of his patients who has HIV who might lose access to life-saving care if the Medicaid money that pays for his trips to Anchorage for treatment, from a remote community, goes away, Westley said.

Dunleavy called that question “a tough one."

“Again, we’re trying to get to a situation where we have a sustainable health care approach, so that we have a system that is maintained for some time and doesn’t collapse underneath our feet,” Dunleavy said.

State Health Commissioner Adam Crum suggested the budget’s 5% provider rate cut should not prevent clinics and hospitals from seeing patients.

The audience groaned.

“Oh my gosh, it’s so expensive to run a clinic here," a man shot back.

“That’s it, I’m done,” a woman said.

Westley said he’ll see the patient for less money. “But (he) has to be able to come and get to see me,” Westley said.

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