Who is Politicizing Alaska’s Health Care Crisis?
(2021©donnliston.com)
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| David Morgan’s career includes over 40 years professional senior level operational management and administration, focused on community health center operations, healthcare financial operations, budgets preparation, strategic planning and networking. His technical qualifications include a background in analytical program planning for hospitals, tribal health organizations and primary care clinics with community engagement. |
As a former employee at Providence Alaska Medical Center, and chair of former Mayor Dan Sullivan’s Health Care Commission, David Morgan asks the hard questions and has demonstrated with his own actions how principles of economics can provide better care at cheaper rates, while assuring health care providers make enough money to stay in business. That’s the real reason why the Anchorage Assembly challenged his recent appointment by Mayor David Bronson to head the Municipality of Anchorage (MOA) Health Department.
The Assembly majority isn’t qualified to shine Morgan’s shoes
and doesn’t want Mayor Bronson to be successful in bringing Anchorage out of
the mess created by these misfits. When Morgan realized the caliber of people
he was being judged by in the confirmation process, he withdrew his name from
consideration.
The problems I ran into had to do with my past political affiliations, said Morgan in our recent interview. Republican Party conservatives want to reduce healthcare costs at the state and local levels. This is in contrast with the Alaska Hospital Association and the Alaska Medical Association—the industrial state of healthcare. They are not happy with me because anywhere I have worked costs go down, service goes up, and I produce more revenue, without increasing costs or restricting competition, but by providing better services through efficiencies of scale.
[1]Morgan has an impish smile and talks Kentuckian, as does
my wife Waneta. They determined it is possible they are cousins.
How could the majority of elected officials on the Municipal
Assembly understand this approach as they strive for politically-charged government
dependency over individual Alaskan autonomy?
The point is the entire system of health care for the state
of Alaska is designed NOT to have competition, Morgan continued. Opponents to my appointment
were upset because I pointed out the military option. Their biggest argument
for making us wear masks and require lockdowns was a shortage of ICU beds. They
don’t want anybody to know the JBER 673rd Medical Brigade can
staff 55 ICU beds anytime and hasn’t. If all the local hospital beds are really
full, in five days new ICU units could be set up in the parking lot of Providence
Medical Center or Alaska Native Medical Center—we could have 30 or
40 beds with professional staff quickly available. For the mere price of $1
such an intervention would be called a “training exercise.”
These would be high quality care facilities, too.
[2]My goal for the short time I was Health Director wasn’t a
political goal,
continued Morgan. My goal was to meet five-year budget projections by
reducing costs by eight percent and increasing healthcare for Alaskans. While
on the previous Muni health commission under Mayor Sullivan we found that the
health department was doing stuff that had nothing to do with the mission of
that department. It was doing stuff for politics.
Morgan also
served on the State Health Commission for 5 years, representing Primary
Care (CHCs) Programs and Clinics for the State of Alaska. That
Commission was dissolved by the Legislature--as it started to get to the
heart of the healthcare cost and access problems for the State. This was
explained in MUST READ ALASKA story: Lawmakers Took Big Bucks From Hospital
Group, And Vetoed Accordingly.[3]
This practice
continues to today. A
number of bills in the Alaska Legislature to reform healthcare were killed in
the 3rd Special session.
Both political
parties have members who are captive to the Healthcare Lobby, according to
Morgan. Nothing the Alaska Legislature or the Anchorage Assembly majority have
done is about providing a better quality of life for Alaskans or Anchorage
property owners who pay for this circus.
Read Story Here: https://donnliston.blogspot.com/2021/01/destiny-happens.html
The argument they are using is “it’s a panic,” said Morgan. In reality, we only
have a pandemic of the unvaccinated. There is no reason we cannot reduce
cost and provide better health care for Alaskans overall. I have done it. I
have a track record of doing it but they won’t do it because they don’t know
what it would require.
Alaska’s Colony Status
Anybody who has lived in Alaska for any amount of time knows
this state was a marriage of convenience with the United States of America.
University of Alaska History Professor Steven Haycox wrote
an entire book celebrating this reality, Alaska; An American Colony.[4]
The result is that public policy is convoluted and skewed to benefit a few short-sighted
special interests over the long-term good of Alaskans.
In the case of healthcare, that means Alaska has a lot of rich
doctors.
Over more than a year Covid-19 has shed a light on the
problems of our healthcare cartel. It has become a reason to suspend rights
under the US and Alaska Constitutions, with a disproportionate reaction given our
state’s many other serious health care needs.
Morgan explained: We are the only clinic other than the
military hospital that treats people with TB in airtight rooms. Sexually Transmitted Diseases
(STDs) also require special protocols by health professionals for their
protection. Homeless people can get runny sores, polyps, and samples must be
taken to be cultured. Sometimes when that is being done it can spray—from
everywhere on the human body that sexual activity can happen. We don’t judge,
we are simply trying to stop syphilis, gonorrhea, and other life-threatening communicable
diseases. I required all health workers in the Anchorage health Center to
wear N95 masks.
But the myopic political focus of the Assembly is on Covid:
Around twenty percent of Alaska hospital beds are being used
for Covid patients.
A couple of times in the past we have been full, said Morgan. But the argument is
never about increasing supply, it is about requiring everybody to get a
vaccination, everybody to wear a mask, everybody to lockdown, and we aren’t
going to have normal public school, either.
Read story here: https://donnliston.blogspot.com/2021/08/what-would-don-and-roberta-sheldon-have.html
Previously I used my training to reduce costs, expand service
and make money for the provider, continued Morgan. I might reduce the amount we billed,
but money from the state and federal governments through Indian Health
Services plus Medicaid Treaty Rights provisions expanded it overall.
What we got was not based on billing, it was based on how many people we
served. I started applying community health standards to see people who are not
part of the tribal organizations. For people who were not Alaska Native but were
living in Barrow, later in Sand Point, it is a $900 trip to go to the doctor
for a typhoid shot. We got grants for the rest of the people living in those
rural communities because we were seeing them anyway, with agreements with
other providers like Providence Hospital, to provide tertiary care.
More recently, as director to yet be confirmed by the
Assembly, Morgan had begun the process of gaining nurses-in-training for the
MOA. Approved candidates could have their entire tuition paid for by working in
Alaska hospitals designated as high need areas. This was a supply-side effort that
has gone away now in favor of hysteria of overworked nurses driving healthcare
decisions by misfit Assembly Majority members.
The Political Threat of Competence
Morgan came from a family of physicians. His grandfather was
a doctor, his grandmother was a nurse, his father and two brothers are doctors,
and 14 cousins are doctors. He was weaned on the medical profession but chose
to train in healthcare service administration.
From 1983 t0 1986 I worked for a health co-op called Hunter
Health at Bartholomew County Hospital, said Morgan. It had started back in the 1800s in
Lexington, Kentucky. I was assistant manager for budget and cost. We had
28,000 members. That organization had started as an agriculture co-op, but at
the turn of the century they couldn’t get a doctor. The way agriculture co-ops
work is everybody pays a little money to buy a number of tractors, for
instance, so the cost of a tractor for an individual farmer member is half.
They also sold their crops as a collective. They had a small clinic with two
doctors, three nurses and 4 or 5 beds. Back then the doctors actually went on
rounds by horseback.
Read story here: https://donnliston.blogspot.com/2021/02/the-best-thing-about-being-in-anchorage.html
In 1987 Morgan went to Providence Hospital in
Alaska, where he worked as manager of patient accounts until 1991. After
that, until 1996, Morgan was Finance Director and Acting City Manager for the City
of Whittier and Alakanuk. He was next elevated to Deputy
Director for Operations and Finance for Eastern Aleutian Tribes, Inc.
where he managed day-to-day administration and financial operations for
five primary care clinics, supervising 24 employees, until 2001. From 2001 to
2003 Morgan was ANA Project Manager for the Chugach Region’s Chugachmiut
Inc. as ANA Project Director. Next Southcentral Foundation employed
Morgan as Reimbursement Director to direct revenue cycle operations, compliance
and Medicare/Medicaid Medical and Home Health Costs. Since 2015 Morgan has been
a consultant with Affordable Healthcare Consulting Services providing
strategic financial and data analysis, auditing services, planning
recommendations and other technical services.
Most recently Morgan led a group of Alaska Roundtable
community leaders in development of a comprehensive policy paper on healthcare.
He provided a copy of the executive summary of that 28 page book with tables
for this story. I provide it here in complete form:
Mayor Bronson knows we can do better but it may take an
election of new Assembly members to reimagine local government competency.
Resources:
[1] Alaska Health Care Costs
compared to other states
[2] JBER Medical Personnel Deemed
Best
[3] Lawmakers Took Big Bucks From
Hospital Group, And Vetoed Accordingly
[4] Dr. Stephen Haycox, Alaska; An
American Colony, University of Washington Press, 2002.
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