The Complicated World of Health Care: A Letter to the Editor – Anchorage Daily News

Price versus Cost: The Debate on Repealing Alaska’s 80th Percentile Rule

In response to Jim Grazko’s commentary, “Repealing 80th percentile rule is vital to Alaska,” his argument is that the only way to reduce health care costs in Alaska is for health care insurers like Premera to bring them into the network and control how much they will pay. He emphasizes the difference between price and cost, with the insurer focusing on the price they pay and health care providers concerned with the cost of providing care.

However, Sandra Heffern argues that the repeal of the 80th percentile will not be the “easy button” to reducing Alaska’s high health care costs. She points out that health care pricing and costs are complicated, and that providers strive to provide high-quality care for Alaska patients.

Grazko compared Premera Alaska’s health care costs to those in Washington, but did not provide information on what other commercial insurers are currently paying. He also mentioned Medicaid and Medicare, but failed to offer specific comparisons to commercial insurance products. Grazko’s point is that it would be difficult for Premera to compare the amounts paid for health care across multiple payers, as Alaska does not have the structure to collect or analyze this data. He suggests that an all-payer claims database, like those in other states, would help better understand who is paying for what.

In conclusion, while Grazko’s argument may hold some merit in terms of controlling costs through insurance networks, Heffern raises important points about the complexities of health care pricing and provider motivations. Ultimately, any solution to Alaska’s high health care costs must take these factors into account and involve collaboration between stakeholders across different sectors of the industry.

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