Gov Sarah Palin has claimed she is a reformer, maverick, independent pit bill, not afraid to take on special interests when it is in the interest of her constituents to do so.
She’s also not afraid to ignore the advice of experts when it runs counter to her ideological position.
Case in point – the Certificate of Need program in Alaska. CoN programs are in place to prevent the building of duplicative/redundant health care facilities. The theory (supported by most research) is that the more facilities there are, the more costs will increase, with no appreciable increase in health care quality. Therefore, limiting the number of MRI machines and ambulatory surgical centers reduces costs.
As I noted earlier this week, Palin has been trying to kill Alaska’s CoN program, claiming it will introduce more competition into the health care market, competition that will drive down costs and increase quality.
But that doesn’t happen. The more facilities there are, the more costs increase – and quality decreases.
When Palin convened an expert panel to review Alaska’s CoN program, they (surprise) advocated keeping it in place. The Governor didn’t like that answer. Palin ignored the advice of the experts and proposed legislation to kill the program.
Palin’s approach to health care is, to be kind, simplistic. According to the Washington Post, “It didn’t matter what you asked her about health care,” said Tony Knowles, the Democratic governor who lost to Palin in 2006. “Getting rid of certificates of need was her only answer.”
Why?
Here’s more from the WaPo piece.
“Palin was part practical politician, accepting more than $34,000 from medical groups that were trying to spur competition, [emphasis added] according to an analysis by the nonpartisan Campaign Money Watch. She also worked closely with Paul Fuhs, an Anchorage lobbyist who was helping imaging firms battle hospitals over control of a lucrative trade. And while supporters and opponents credited her with reaching out to all sides, they also said she was a fierce idealist, taking a philosophical position and not giving ground.”
What’s the net?
Another politician making decisions based on ideology and special interests, not on facts, data, and logic – decisions that will increase costs and reduce health care quality.
Sep
5
Joe,
Take a look at IL’s experience with CON and Health Planning Commission to see how corruption plays into the process. CON is not necessarily the solution to high costs and poor quality. CON’s can also be protectionist for the inefficient hospitals because they don’t allow for competition, particularly in smaller markets.
Rock
Joe, What is Obama’s position on CON’s? Is he in favor of competition, or increasing points of access for healthcare?
Personally, I find Sarah Palin to be a breath of fresh air to this political season and am totally pleased with her record in Alaska, and the positions she is taking to reform Washington. McCain and Palin admittedly will not please everyone on every point, but true reformers never do. McCain and Palin represent something Washington should be afraid of — candidates who mean what they say, and intend to follow through with a tangible plan for change, not just talk.
Hi Joe. Nice coverage on the CoN question and other items in Palin’s record.
For more, may I plug the http://www.pnhp.org/blog/ and my posting there:
“Healthy Thoughts on the Republican Convention”
http://www.pnhp.org/blog/2008/09/05/healthy-thoughts-on-the-republican-convention/
which includes some comments on John McCains’ two sentences on health care last night.
Lowering costs via competition usually means taking it out the providers pockets via more stringent reimbursement contracts and more silent PPO’s etc. It’s a cost shift on our end to the lowest common demoninator with very little concern for “quality”.
Dorrence – thanks for the comment. You can find out Obama’s position on those and other issues on his website. And, yes, he explicitly favors competition.
Paduda
Increased competition tends to yield more cost efficiency, but lower quality, in service industries. In manufacturing it tends to result in more efficiency and higher quality.
A radiological technician in my family reports that when a patient died on her x-ray table, copious feces quickly leaked out onto the equipment. This rad tech’s boss told her to wash the equipment but not to sterilize it. They had to get more patients through.
CON was created in the 1970s to slow/ prevent cost increases…
As the basic premise of your blog implies, that has failed…
CON PROTECTS SPECIAL INTERESTS WITH GOOD LOBBYISTS — since the ‘fox rules the henhouse’ of the decision making boards
Scary, very scary.
Onehealthpro
Perhaps the more salient aspect of the “Palin Factor” is about the Teflon potential of a pretty face, with a pit bull attitude, and the religious right subtext of the message.
Are we prepared for round 2 of the “Teflon Presidency”, where if we like what we hear, then somehow, the “it must be true” seduction prevails over facts? Or will reasoned consideration of cute sound bytes be part of the mainstream health care debate?
I think Orwell said it well….“War is peace. Freedom is slavery. Ignorance is strength.”
Certificate of need (CON) is not perfect, but it is one of the few public voices in the health care development process. Competition in health care currently doesn’t work because the consumer can’t get price information, isn’t allowed to measure quality, and often doesn’t make the decision (physicians and insurance companies more often do that). CON do set standards for access and proper utilization, often with direct quality improvement. Health care is a caring service, not a disposable commodity, and should be monitored.
Although CON may in fact be workable in the Lower 48, I think that perhaps in Alaska it may not work so well. I don’t think any of us would appreciate having to fly from Ketchikan to Anchorage for an MRI just because Ketchikan was prohibited from having one available! Remember the great distances between population centers in Alaska!
She has a lot of company including a number of democrats.
In 1982, the federal government acknowledged the failure of its Certificate of Need law to reduce health care costs and repealed the mandatory health planning law.[11] In the years following federal repeal, 14 states eliminated their medical facility control laws as well.
Connecticut ranks the highest. Its law covers 24 services and expenditures, earning a rank of 28.8. Alaska is next highest – it covers 26 services and expenditures
In July 2004, the Federal Trade Commission and the Department of Justice found that, “the reason that CON has been ineffective in controlling costs is that the programs do not put a stop to ‘supposedly unnecessary expenditures’ but merely ‘redirect any such expenditures into other areas.
http://www.washingtonpolicy.org/Centers/healthcare/policybrief/06_barnes_constudy.html
Seems she is in pretty good company.
I would like to express my view I have been fortunate to have had a great experience with the NHS in Britain and am all in favour of a National Health Care system here in America
My family in England will not use any other although if they wanted could pay for private medicine.