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What I told health care policy experts in Anchorage


It all starts with government intervention. Once government starts making policy around health care, it starts down a long road that gets swampier and swampier.

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The result for consumers (those are people who need doctors and nurses and medicine) is that they require health care navigators, something that became popular during the rollout of Obamacare. Remember health care navigators?

Health care navigators are still a thing. They continue to help people get through the increasingly complex medical system that government has fostered. The system itself has become so bad, it’s like the Fire Swamp from The Princess Bride.

In the course of three generations, we have gone from “going to the doctor” to becoming a part of a health care “system” that has in many ways served us well, but at an enormous cost. Policy and regulation has benefits and is also crushing the very healers that want to help people get well.

To the conservative brain, it’s almost as if liberals are trying to break the entire health care provider network so that universal health care will become the law of the land. It will be the only alternative in a world where Americans have come to expect a government solution.

And when that happens, it’s the government making the decisions about how much care you receive. You’ll be entrusting the government with your very life, from your slippery entry into the world until your uncomfortable exit.

These are some of the topics I covered in my portion of a panel at the State of Reform conference in Anchorage on Wednesday. I shared the panel microphone with Matt Buxton of and Nat Herz of Alaska Public Media. We had 45 minutes to explain how the media in Alaska views and covers health care topics.

What we showed the audience is that news writers have no idea how to fix health care costs and availability in Alaska.

At the end of the panel, we did a rapid speed-dating question of the audience to find out what they want from the media coverage on health care.

They want more. They want better. They want more informed coverage.  And, likely, they want someone else to pay for it.

But as with health care, the media landscape in Alaska is shallow, overstretched, and underfunded, and that was abundantly clear to them — they were offered two bloggers and a public broadcasting reporter who covers energy — not health care — for the media panel. The pickings for writers were, perhaps, slim. The one writer who typically covers health care the most will be leaving the Anchorage Daily News soon.  One third of the news staff has been laid off there. There are no writers left in Alaska who have the luxury of being health care specialists.


The health care professionals we spoke to were especially interested in Alaska news writers covering these topics:

Must Read Alaska will endeavor to get to these topics in the coming weeks, so long as we are not forced to navigate the three terrors of the Fire Swamp.

Suzanne Downing
Suzanne Downing
Suzanne Downing had careers in business and journalism before serving as the Director of Faith and Community-based Initiatives for Florida Gov. Jeb Bush and returning to Alaska to serve as speechwriter for Gov. Sean Parnell. Born on the Oregon coast, she moved to Alaska in 1969.


  1. Right now insurance companies make the decisions on anyone not already in a a government funded healthcare plan e.g. Medicare/Medicaid. So no matter who you are, someone else is making the decisions and this is not likely to change.

  2. When my husband died on March 26, the municipal fire dept took me off of our health insurance and told me to go get Medicare. In a total mental haze, I did.
    Could not get Medicare until July, because my previous and continuous insurance was from a retirement plan, not an employee plan. It was the same coverage!
    Went back to muni, and they offered Cobra for $1112/month. Essentially had no coverage for the month of April, but still had to pay.

    Around May, I start thinking I need to cancel Medicare. Medicare sent me a form to fill out and return to them at a CA address. Certified mail says they got it June 6, but I didn’t pay for signature. They never send me a reply, but start taking $200/month out of my social security. Dealing with them is like being in the Fire Swamp scene!

    Meanwhile, Medicare notifies my insurance company that I’m covered, so they won’t pay my bills until after Medicare has been billed. They say they are required to coordinate benefits. Is that a LAW?

    After this months $200 deduction, I will be out $800 of much needed money. It will not be refunded.

    I have so much more to say, but this might not be the place. Most of my problem is with Medicare, because they are so impossible to communicate with, they lie, they are punitive and abusive to elders. My experience with them has severely complicated my grief.

    We need to figure this out and fix it. If this been my experience, how many others have been been caught up in their big sucking swamp?

    Suzanne, I would love to tell you more, if you are interested.

  3. The state of Washington spends $1098 per capita annually on Medicaid.
    The state of Alaska spends $1658 per capita annually on Medicaid.

    Alaska needs to initiate fiscal responsibility in every area of the state budget, health care and insurance included. Out of control health care costs will bankrupt many Alaskans and also will bankrupt the state as it absorbs more of the entitlement costs. The LAST thing we need is another government agency.

    Alaskan health care costs are grossly inflated by the few providers. This price gouging is further enabled by lack of transparency, cumbersome billing and fee arrangements, and draconian medical billing systems used by all of the providers.

    The lack of competition is further fueled by arcane decision making processes of insurance companies and government agencies that make it impossible to get less expensive care even when it is available. If it is less expensive to go Outside for operations, imaging, diagnostics and other care then that should be allowed and encouraged. Instead the government and private plans insist on Alaskans staying in state even though the care is often three times more expensive and the service is substandard. Health care providers claim that they need to charge more to keep services here in-state, but these outlandish costs are just not affordable. Transportation and housing Outside are minimal costs compared to the hundreds of thousands local providers charge for surgeries, diagnostics, and other procedures.

    The referenced report on the 80% rule (linked above in Suzanne’s post) concludes that it is likely responsible for $1Billion annually in additional annual health care costs for Alaskans. Quoting the executive summary

    “Spending for healthcare in Alaska increased from $1.5 billion in 1991, to
    $4.8 billion in 2005 and $8.2 Billion by 2014. . . . . the 80 percentile rule accounted for anywhere from 8 percent to nearly 25 percent of that annual growth”

    The 80% rule needs to be abolished. Self funded plans like GCI’s and others should be encouraged and supported. Regulations making creative insurance systems difficult to implement must be removed so people and businesses have more choices. The one regulation needed – (SB129) demanding transparency and cost estimates in advance – is the one rule that would help but it has not been implemented.

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