Rep. Cissna's PIP

HEALTH CREATION STORIES

Stories about the uninsured, a growing issue in the US, became publicly recognized very recently. In Anchorage, a group of health providers and health activists commissioned a study of the insured in 1999-2000. The Anchorage Access to Health Care Coalition , in their report, found that 13+% (100,000 Alaskans) of the uninsured in our state must self-pay their medical costs. Other findings included:

       · Alaskans pay the highest prices for health care (up to 60% more than Medicaid, Medicare)
       · 56% are between 18 to 34 years old
       · 71% have jobs
       · Are usually small business owners and/or employees, self employed and non-profit employees
       · 57% are men
       · 66% are in households with less than $35,000 annual household income
       · More than 13% of all people in Anchorage are uninsured

Then, as now, those who cannot afford prevention and primary care finally access the health system through emergency services. Uncompensated care through hospital ER services has risen from two to three times what it was five years ago. These uninsured Alaskans are our hardest workers, most independent, and include small business, the self-employed and nonprofits .

Since that survey there has been no formal survey of the uninsured in the State. During the upcoming Health Caucus on May 1st, we will hear a report on the first comprehensive count of the state's uninsured being conducted at this time.

Several additional groups have focused on the state's uninsured and the systems that hamper provision of affordable access to health care. In 2002 the Affordable Health Workgroup formed and for several years met regularly collecting stories from those concerned about the issue, forwarding several health related initiatives and co-sponsoring forums on the subject .

The MISSION POSSIBLE! Forum held on October 19, 2002 held informative presentations and breakout groups and voted for recommendations for Initiatives or Legislation on:

Health insurance pool for small businesses (which eventually passed in the Alaska State Legislature but has yet to be utilized by the private sector.)
Waive medical liability for physicians providing voluntary services (also passed by the Alaskan Legislature)
Single payer plan on the ballot (this proposal has not been attempted.)
Mandatory coverage (No legislation proposed, but mirrors the Maine Plan)

Breakout groups outlined proposed solutions:

Permanent fund Dividend Tax for a Statewide Health Plan program
Quasi governmental/private clearinghouse for payments Organized health care system Health care services trade out
Tax credits for wellness/health promotion
Dealing with gaps in Medicare coverage for seniors in prescription drugs, long-term care, dental and hearing aids.
Also improvement in Medicare problems:
Not enough physicians willing to take Medicare patients
Over half the physicians in Alaska are over age 50
Very few physicians trained in geriatric medicine

MISSION POSSIBLE II! focused on Promising Solutions at the Post Health Summit Conference, December 4, 2003.

Breakout groups focused on solutions found in: Community, Government, Insurance, Provider, Legislative, Consumer, Training,

In discussing solutions gathered by each group, a large panel of experts representing the major health stakeholder led an interactive session reaching consensus of five critical areas needing immediate focus:

Prevention initiatives,
Outpatient 330 community-based clinic expansion,
Technology/Telemedicine expansion,
Informed consumers,
Examination of single payer or similar statewide insurance plans.

July 2005 Commonwealth North completed a comprehensive study, Alaska Primary Health Care: Opportunities & Challenges, which summarized the three major issues:

Access -- (110,000 Alaskans have no health insurance coverage);
Quality -- (2004 National Healthcare Quality Report ranked Alaska as low in cancer, heart disease, maternal and child health, respiratory diseases, nursing and home health care, 2002/2003 Health Risks in Alaska Among Adults, DHSS, State of Alaska, reported large numbers of Alaskans in high-risk health categories); and
Cost -- (Alaskan health care costs have been estimated to be 40% higher than Seattle health costs. All sectors in health care have dramatic cost increases. )

Recommendations incorporated four areas: Lifestyle and prevention by raising public awareness and personal responsibility for wellness; Access improvement by making more services and insurance available; Quality improvement in health care delivery; Cost reduction in service delivery and insurance to make services available. Commonwealth North proposed an Alaska Health Care Roundtable with major employers, providers, foundations and other participants as invited by the Roundtable, and a list of initiatives to meet the recommended goals. Contact: www.commonwealthnorth.org

The first scholarly discussion of Alaskan health care in recent years was published by University of Alaska Anchorage's Institute of Social and Economic Research in March 2006. It outlined the costs in a report of Alaska's $5 Billion Health Care Bill – Who's Paying? By Mark Foster and Scott Goldsmith.

The detailed report gives a summary of who pays for what, comparing 1991 to 2005 and the impacts of these expenditures, and the shortfalls. The report warns that solutions are not simple. Reports are available at: www.alaskaeconomy.uaa.alaska.edu.

UPCOMING
HEALTH
CAUCUS
FORUM

Introductions/Opening Remarks-
Co-Chairs: Representative Sharon Cissna and Senator Donny Olson

Throughout the following program, individual callers from throughout the state will be called on to speak for three minutes about their own personal or community story.

“Week of the Uninsured” and Primary Care-
Christopher Hall, Alaska Primary Care Association

Update on the Survey of the Uninsured-
Alice Rarig, Alaska Division of Insurance

Alternatives for the Uninsured: Prevention and Strategies-
Dr. Tom Hunt, Anchorage Neighborhood Health Center video
Representative Sharon Cissna, video

Mark your calendar
Alaskan Cover The Uninsured Week Events from May 1 to 7^th

Alaska Health Fair, Inc. provides free health screenings and low cost blood tests to Alaska residents. Please contact us at 907-278-0234 for more information.

May 1, 2006, 11 am – 11:30 am: Kick-off Press Conference at Midtown Wal-Mart – join Mayor Begich, local dignitaries, prominent Anchorage business owners and other concerned citizens as we kick-off Cover the Uninsured Week.

May 1, 2006, 12 pm – 1 pm: Fourth Statewide Teleconference, from Juneau’s State Capitol. Stories will be given by individuals around the state about their own experience and also policy officials will discuss the expanding crisis of the uninsured. Included will be stakeholders from every region of our vast state, voicing many diverse perspectives, costs and promising solutions.

May 1, 2006, 2:00 pm – 4:30 pm: Statewide Forum on the Uninsured, at the Frontier Building 8^th Floor Conference Room 3601 (free parking available,) Anchorage, AK. Session One (Afternoon): Finding a Path to Affordable Health Benefits for All * Who are the uninsured? * What keeps workers and employers from getting health insurance? * What are the geographic, cultural, and economic factors that govern decision-making about offering, choosing or buying insurance? * What do people want for access to care, and access to benefits?

May 1, 2006, 6 pm – 8:30 pm: Anchorage Area Community Forum on the Uninsured at the Fairview Recreation Center, 1121 East 10^th Street

Anchorage, AK, Evening Session: Finding a Path to Affordable Health Benefits for All Opening presentation on the state project on health insurance needs and on options for providing affordable health insurance, followed by a “Town Meeting” style discussion of stories, needs and opinions about who is uninsured. What keeps workers and employers from getting health insurance? What do people want for access to health insurance and to health care? Tell the project staff your thoughts and stories – the report will help document the needs in Alaska for affordable health insurance and health care.

Anchorage AK. Dental-a-thon sponsored by Alaska Primary Care Association and held at the Midtown Wal-Mart-Local dentists and dental caregivers will be on hand to provide free dental screenings and distribute toothpaste and toothbrushes to all who attend.

May 5, 2006, 5:30 pm – 7 pm: Visitor Industry Charity Walk – Get Ready! Get Set! Graze! At the west end of the Park Strip, Anchorage, AK. Join the Cover the Uninsured Team as we walk in this great event and raise awareness and money. Money raised will go to support the Healthy Alaskans Fund. Register to be a part of the team!

May 6, 2006, 9 am – 1 pm: Alaska Health Fair, Inc. at Wasilla Sports Complex, Wasilla, AK, provides free health screenings and low cost blood tests to Alaska residents. Please contact us at 907-278-0234 for more information.

May 13, 2996, 8 am – 12 pm: Health Fair, Inc. Diamond Center, Anchorage, AK, provides free health screenings and low cost blood tests to Alaska residents. Please contact us at 907-278-0234 for more information.

May 20, 2006, 9– 12 pm: Alaska Health Fair, Inc. at Sand Lake Elementary School, Anchorage, AK, provides free health screenings and low cost blood tests to Alaska residents. Please contact us at 907-278-0234 for more information.