Here is how Richard A. Fineberg describes himself on the home page of his site: The material presented here was researched and compiled by Richard A. Fineberg, founder and principal investigator of Research Associates of Ester, Alaska. Fineberg has observed Alaska petroleum development for three decades as a prize-winning reporter, as an advisor to the Governor of Alaska on oil and gas policy and as an independent consultant to investors, government agencies and non-profit organizations. In recent years his horizons have expanded to include two oil provinces in the Former Soviet Union, the Caspian Basin and Sakhalin Island. Often controversial, Fineberg's petroleum research has earned a reputation for dedication to factual accuracy and carefully reasoned analysis.

I urge you to visit finebergresearch.com yourself and take a look at this extraordinary resource. See in particular a couple of his latest papers, The Arctic Refuge Numbers Game: Update, and, Oil Industry Performs Poorly On International Pipeline Projects. The policy implications are enormous, and, as is typically the case with Fineberg's work, the research is very well documented.

Alaskans for Medical Choice and Competition (AMC2) has launched a lawsuit and a campaign to get rid of Alaska's Certificate of Need program. The problem is that this effort is misdirected. Termination of the Certificate of Need program would likely be a blow to progressive public policy in Alaska. Here is a brief explanation of the CON program found on the Department of Health and Social Services Certificate of Need website:

Certificate of Need (CON) program is a review process used by the State of Alaska to promote responsive health facility and service development, rational planning, and cost containment.... The review process involves evaluation of plan narratives, relevant data, and architectural designs to remodel, expand or build health care facilities and add new services. An important part of the review is the public process. During each review, a time period is assigned to receive written public comments and if it is requested, a public meeting is scheduled to receive comments in person. Public comment activities give local consumers a chance to present their perspectives on how the project should be implemented.

The uncontrolled proliferation of medical facilities can be very profitable for investors, but for the rest of us it can increase medical costs, threaten quality of health care, and decrease access by destabilizing major health care providers. Because of the potential the CON process has for public control of these critical issues, some states, for example Maryland and Maine, have instituted comprehensive studies of their Certificate of Need programs in order to improve them and make them more effective. Alaska should do the same. For more detailed comments on this subject, see the ACPP blog.

ACPP recently received a copy of AARP Alaska Legislative Priorities, dated February 21, 2005. In that document, the organization correctly characterizes the key issues in the latest attempt at "tort reform" in Alaska:

SB 67, authored by Senator Ralph Seekins, will reduce the amount of "pain and suffering" awards from the current maximum of $400,000 to $250,000. The author argues that medical costs are high because of medical malpractice lawsuits. AARP opposes this bill because awards are relatively rare and generally imposed in only the most egregious cases and are not a significant factor in malpractice premium problems. We are encouraging the author to avoid the "lawyer/doctor" debate and instead focus on how we can reduce medical errors. The Institute of Medicine has several recommendations for reducing medical errors that harm people. AARP feels that avoiding errors is much more important than focusing on legal negligence. The IOM has prepared several background pieces on medical error reduction which should be the basis for this bill. We oppose SB 67 unless it can be amended to focus on medical error reduction.

The critical issue is quality of medical care, not changes in tort laws meant to protect consumers. The most comprehensive study of medical malpractice to date is the Harvard Medical Practice Study. The Harvard Study revealed a medical negligence rate of 10 in every 1,000 hospitalizations. The injuries included in the study were serious enough to result in a longer hospital stay, disability upon discharge, or death. Additional studies of malpractice in Utah and Colorado resulted in findings very similar to those of the Harvard study. A central finding of the Harvard study was that only one of every fifty victims of medical negligence ever sued the hospitals, the physicians, or any other party who may have been medically negligent. To quote conclusions drawn by the researchers, "...the civil justice system only infrequently compensates injured patients and rarely identifies and holds health care providers accountable for substandard medical care..."

For more information on the subject of tort reform and the quality of medical care in Alaska, see ACPP blog entries for February 25, and February 28.

email: ldweiss@acpp.info

phone: 907.240.4141

website: http://www.acpp.info