It is an economic must: Health reform will boost economy, address Alaska priorities

Posted: Tuesday, June 16, 2009

This is the summer of health reform and great opportunity. If Congress gets it right, Americans happy with their current health insurance and medical care will keep what they have, while everyone will have access to affordable, quality care.

We can do this while addressing important priorities for Alaska.

The goal is ambitious. We need to cover about 46 million Americans who don't have health insurance, including 115,000 in Alaska. When they aren't covered, all of us pay more. The average American family with health insurance last year paid a hidden "health tax" of $1,000 -- when uninsured people can't pay, the cost of uncompensated care shifts to those with coverage.

Providing health care to everyone is not just the right thing to do, it's an economic must. Health spending in America now accounts for 18 percent of all economic output and if unchecked will keep rising by an estimated 6.5 percent annually. If we fail to act, the cost to our economy will be staggering and millions more families won't be able to afford basic health care. Even for those still getting insurance through work, employers will provide less compensation in the form of take-home pay, while an increasing percentage goes to health insurance.

The president's economic advisors say slowing growth in health spending by just 1.5 percent per year will create as many as 500,000 new jobs annually and boost income for a family of four by $2,600 over the next decade.

Reform should not wait any longer. I am working in the Senate to make sure Alaska's interests are understood and addressed. In a letter to Sen. Max Baucus, D-Mont., and chairman of the Finance Committee, I outlined five health reform priorities for Alaska.

First, we must protect and strengthen small business because new jobs from small private-sector employers have long been the engine of economic growth and will drive recovery now. To keep the costs of health reform from falling disproportionately onto the smallest employers we must provide tax credits or subsidies for those covering their workers.

I also am concerned about self-employed Alaskans like commercial fishermen, charter boat operators, craftspeople, hunting guides, store owners and many others. As individuals they deserve the same access to health care; as business owners they should get the same tax benefits as larger companies.

Second, we must address the work-force shortage. When we are successful in covering all Americans, who is going to provide this care? We need more doctors, but there also must be an expanded role for providers such as physician assistants, advanced nurse practitioners, nurse anesthetists, dental health aides and other professionals. In Alaska we should increase the number of state-subsidized medical school seats and residency positions and create a strong loan repayment program.

Next, health reform must include a well-funded commitment to prevention and wellness. Significant cost savings and increased worker productivity will come from disease prevention and health promotion efforts.

Obesity-related treatment costs $195 million a year in Alaska. In one worst-case example, Alaska Medicaid recently paid $379,000 for one patient with end-stage renal disease caused by diabetes. Personal decisions about diet, exercise and tobacco will make the biggest difference, but health reform must promote healthy decision-making through policy leadership and funding for community-based change.

Fourth, we need to strengthen the Indian Health Service and reduce health disparities. The president's fiscal year 2010 budget makes a good start with a proposed increase of $454 million for IHS. This funding will support tribes as they work to administer programs at the local level and, when needed, pay for needed care outside the IHS system.

Finally, we need to work to improve veterans' access to care. An increasing number of veterans have serious service-connected injuries. I believe they should be able to go to any nearby health provider without preauthorization and be covered by the Veterans Administration. This is particularly important to veterans who live in rural areas and often are quite far from VA hospitals or clinics.

To help, I have co-sponsored bills to provide training and compensation to veterans' care-giving family members, and to reimburse health-related airfare for veterans whose incomes are above the pension limit.

Health reform is just one of the issues that will make my first summer in the Senate a busy one. I look forward to this historic opportunity to make quality, affordable health care accessible to all Alaskans and all Americans.

Mark Begich, a Democrat, is the U.S. senator for Alaska. He lives in Anchorage.

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