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Ketchikan: Ordinance for Healthcare Cost Transparency Urged by Ketchikan Chamber of Commerce - In a recent letter to the Ketchikan City Council, the Ketchikan Chamber of Commerce is urging the Mayor and Council to take action to adopt a healthcare transparency ordinance requiring healthcare practitioners to estimate charges upon request in a reasonable and timely manner.

The letter states that healthcare consumers, especially those with high-deductible plans, are increasingly seeking more information about the cost of health care procedures in the Ketchikan area.

Quoting the letter, "The Chamber believes that timely, transparent disclosure of healthcare costs is essential to protecting the interests of consumers, and allowing markets to function efficiently." According to the letters signed by Chelsea Goucher, President of the Ketchikan Chamber of Commerce, healthcare is currently the only industry in which consumers receive a service without being able to understand the price in advance.

Goucher wrote on behalf of the Chamber that many residents of the Ketchikan community have reported difficulties in obtaining information about the costs of healthcare services in a timely and predictable manner creating consumer frustration, uncertainty, billing disputes, and an increased tendency t6o seek medical services outside of the Ketchikan area -- none of which are in the best interest of local practitioners.

The Chamber's letter expressed support for the Municipality of Anchorage's Ordinance 2017-26 (as Amended) that taken a proactive approach to mitigate these issues by adopting an ordinance which requires healthcare practitioners to estimate charges upon request in a reasonable and timely manner.

The Anchorage Municipal Ordinance AO 2017-26 requires health care practitioners and facilities in Anchorage to provide cost estimates to patients who request such information. Upon request by a patient, and within 10 business days from receiving the request, AO 2017-26 requires health care practitioners and facilities, to provide a written or electronic estimate of reasonably anticipated health care charges to treat the patient’s condition when receiving nonemergency medical services. In addition, the ordinance requires health care practitioners and facilities to post a sign in patient waiting areas with specific language regarding requesting cost estimates. This ordinance does not require providers to publish price lists, or to determine their most commonly ordered services or procedures. However, if a State law is passed that requires this, then practitioners must comply with both State and Municipal laws. The ordinance does not apply to emergency services, and does not prohibit actual charges from differing from the estimate.

"The Chamber appreciates that some practitioners in the Ketchikan area may be willing to voluntarily improve their billing practices, the Chamber believes that is none-the-less in the best interest of the Ketchikan community's residents to adopt an ordinance mirroring Anchorage's. which treats all practitioners equally, and requires all practitioners to follow the same set of predictable, reliable guidelines," states the letter. - More...
Monday PM - December 04, 2017

Fish Factor: Tough Year in the Forecast For Alaska Fishermen By LAINE WELCH - It’s going to be a tough year for many Alaska fishermen. 

Following on the heels of announcements of a massive drop in cod stocks, the industry learned last week that Pacific halibut catches are likely to drop by 20 percent next year, and the declines could continue for several years. 

That could bring the coast wide catch for 2018, meaning from Oregon to British Columbia to the Bering Sea, to about 31 million pounds. 

Scientists at the International Pacific Halibut Commission (IPHC) interim meeting in Seattle revealed that survey results showed halibut numbers were down 23 percent from last summer, and the total biomass (weight) dropped 10 percent. The surveys are done each year from May through September at nearly 1,500 stations from Oregon to the far reaches of the Bering Sea. 

While the Pacific halibut catches have ticked up slightly over the past three years, indications of a fall back have been noted, said IPHC senior scientist Ian Stewart.

The biggest drop stems from a lack of younger fish entering the halibut fishery.  Stewart said the 9 to 18 year old year classes that have been sustaining the recent halibut fishery are not being followed up by younger fish.

“In 2018, and especially projecting out to 2019, we are moving out of a fishery that is dominated by those relatively good recruitments starting in 1999 and extending to 2005. We see an increasing number of relatively poor recruitments stemming from at least 2009 and 2010,” he explained.   

Although they are not factoring them into their halibut catch computations, scientists for the first time are looking closely at environmental and habitat conditions, as well as trends in other fisheries.  

Stewart said warmer waters starting in 2007 appear to correspond to the lower halibut year classes. Most relevant to the drop in halibut recruitment in recent years, as with Pacific cod, are the effects of “the blob”. 

 “Especially through 2015 to 2016 we saw that warmer water extending even to deeper shelf waters in the Gulf of Alaska,” he explained. “We’ve seen a big increase the last several years in pyrosomes, which are these nasty gelatinous zooplankton, well documented sea bird die offs and whale strandings.  So some abnormal things are going on in the Gulf.”

The IPHC does not always follow the recommendations of its scientists. Final decisions will be made at the annual meeting Jan. 22-26 in Portland, Oregon. - More...
Monday PM - December 04, 2017

Analysis: Two little-known ways GOP tax bill would make chasm between rich and poor even wider By DANIEL HEMEL - The tax bill passed by the Senate in the wee hours of Dec. 2 will – if it becomes law – widen the gap between the rich and the poor at a time when income inequality is already approaching historic heights.

Initially, most U.S. households are likely to experience a modest tax cut under the Senate plan. However by 2027, the average family earning less than US$50,000 would pay about $250 more in taxes under the Senate plan, while the average family earning more than $1 million would experience a tax cut topping $8,000 a year, according to estimates from Congress’s own Joint Committee on Taxation.

Yet even those stark statistics understate the full impact of the Senate bill on long-term inequality in the United States.

In my own research, I examine the relationship between the tax system and inequality. In my view, there are two significant reasons why the bill’s impact will be even more dramatic – and even more regressive – than the Joint Committee on Taxation’s estimates suggest.

First, under a 2010 law known as the Statutory Pay-As-You-Go Act, or PAYGO, the revenue losses resulting from the Senate bill would trigger automatic cuts in federal spending.

The program that would be most affected by the automatic cuts is Medicare, whose budget would be slashed by more than $25 billion a year. Other programs that would experience deep cuts include vocational training for individuals with disabilities, block grants for foster care and Meals on Wheels and federal funding for historically black colleges and universities.

Because lower- and middle-income families rely more heavily on these programs than wealthier Americans, these spending cuts would amplify the regressive consequences of the tax-side changes.

In theory, Congress could forestall these cuts by passing legislation that waives the PAYGO law. But such legislation would require 60 votes to overcome a Senate filibuster, and it is far from clear that the votes in favor of waiver are there.

And in any event, a PAYGO waiver would not change the fact that the tax bill increases the federal deficit by more than $1.4 trillion over the next decade. Spending cuts to social safety net programs would likely have to come at some point, and when they do, lower- and middle-income families are likely to bear the brunt.

Broadly similar legislation passed by the House last month would trigger automatic cuts as well. Because the House bill violates Senate procedural rules, the final legislation is likely to resemble the Senate’s package more closely than the House’s version. - More...
Monday PM - December 04, 2017

MONEY MATTERS: HOW TO TAKE THE FEAR AND PAIN OUT OF COLLEGE COSTS By MARY LYNNE DAHL, CFP® - Every fall parents of high school students all over the nation face the dreaded Free Application for Federal Student Aid (FAFSA) application. Currently applications are accepted from October 1 through June 30, 2018. The purpose of this application is to secure the best chance of getting financial aid for college and the early bird usually gets the worm. The FAFSA is a form used to determine how much, if any, a student may get in financial aid for college. It is the starting point for all types of grants, scholarships and financial aid programs throughout the entire US college system. Most high schools offer some basic assistance to parents or guardians who need help filling out the FAFSA form, but even with help, it can be daunting for many people. So much so that every now and then, we get requests from clients to assist them with the form and from this experience over many years, I can attest to the truth that this form is not easy to complete, but it is necessary. By the time you complete the FAFSA, you are definitely able to apply for financial aid in its various packages, and that is a good start to a college funding plan. For more information go to www.fafsa.ed.gov.

With this in mind, let’s review the choices available for college funding. The place to start is shortly after your child, or grandchild, is born.

On average, most students start college at about 18 years of age. Therefore, if you started a college funding plan at birth, you would have 18 years to accumulate enough money to pay for a 4 year degree. For example, a college fund that started with annual contributions of only $2,000 per year at the beginning of each year, for 18 years, with an average annual return of 6%, would be worth $65,520 by the time the student started his/her freshman year of college. Non-profit organizations that track college costs in the US say that the average cost for a public university, in-state resident student, is slightly under $10,000 per year currently. That is for tuition and books only; note that this does not include room, board and personal expenses like a car and clothing. Depending on how frugal the student is or is not, those expenses can double the cost for each year of college. - More...
Monday PM - December 04, 2017