newsminer.com

A 21-member committee of Alaska health care professionals met last fall and concluded the state certificate of need program should not be repealed, but revised.

The Palin administration formed the committee to seek solutions to the controversy about the state program that limits competition in some areas of health care to protect community services.

The committee included top executives of Alaska’s major hospitals, one state official and leading private physicians from across the state.

They reached consensus on some key points.

In a report to Karleen Jackson, commissioner of health and social services, about 90 percent of the committee members opposed elimination of the CON program. They said the state should “seek out resources for clarification of issues” related to health care regulation.

But Gov. Sarah Palin ignored the advice of the committee when she announced last month that she wants to do away with the CON program as part of a health care “transparency act.”

She said “market mechanisms, not static governmental restrictions” are the best way to ensure that “proper business decision-making guides the development of health care services.”

In an phone interview this week with the News-Miner editorial board, Palin said she hadn’t changed her position since her campaign on the CON program.

However, the action she took in introducing the transparency act is in conflict with the effort last fall of the health care committee set up by her administration.

In the announcement last September seeking individuals to join that committee, Jackson said the goal was to find solutions and reach consensus on CON reforms. The committee met five times in October and November and released a report Dec. 28 that said the CON process is broken and needs to be fixed.

Members of the committee and legislators said they were surprised at Palin’s decision to dismiss the advice and introduce the bill to repeal the CON.

Speaking in favor of the bill Friday, Jackson said the main point is to look at health care from the consumer’s point of view. She said the current system looks at everything from the provider’s point of view.

The consumer wants good service on a timely basis with as little out-of-pocket expense as possible.

But the financial foundation of the health care provider is essential to the consumer and that takes some understanding of the provider’s point of view.

In the Fairbanks area, the battle over the certificate of need program has been between doctors’ groups that want to compete with the hospital in areas such as imaging and surgery.

The doctors say the free market should be allowed to operate and that more competition won’t hurt Fairbanks Memorial Hospital, which has ample cash reserves. Competition would be good for consumers, they say.

The hospital responds that the doctors want to “cherry pick” the few profitable activities that help subsidize the hospital services that are not lucrative and are not provided by anyone else.

The most persuasive argument is that the hospital takes all patients, regardless of their ability to pay, and operates 24 hours a day with emergency service for everything from broken bones to psychiatric care, every day of the year.

“Market mechanisms” alone won’t provide those services.

In a real sense, the CON program exists to ensure vital community needs are protected.

The state should keep the CON law in place, follow the advice of the experts who served on the health care committee and reform the system.

The word transparency has been worked to death. What we need from the Palin administration is support for more research about the complexities of financing and providing health care in Alaska.