Health care.

It's good that health care is the fastest-growing industry in Alaska. In addition to being a major economic engine, access to quality preventive, primary and specialty care is essential for Alaskans of all ages and socioeconomic groups.

Alaska has traditionally hosted a young population, and therefore has had low rates of diseases associated with older people. However, we must prepare for the care of an aging population; the median age of Alaskans is increasing (29.4 in 1990, 32.4 in 2000) and the number of elders grew by 48 percent last decade.

The habits of healthy nutrition and exercising are difficult for many to maintain, especially in remote areas. Obesity and related chronic diseases such as cardiovascular disease, diabetes, hypertension and cancers are increasing statewide. Mental and oral health are also of concern.

It just plain costs more to get health care in Alaska, 40 percent more than in Seattle, for example. Shrinking resources and rising costs spell bad news for payers, as well as the 19 percent of Alaskans who are uninsured and pay out of pocket. Medicaid, Medicare, private, state and tribal health corporation budgets are under extreme pressure and cost reduction and containment measures will be a continued area of focus.

Despite these challenges, optimism should prevail. Collaborations and innovative approaches to providing health care are at an all-time high. Examples abound of partners--such as those in the private and tribal sectors--working together across systems in ways that were unheard of 15 years ago. There are also numerous examples of how Alaska's cutting-edge approach to the use of technology has opened options for service delivery--such as the use of telepharmacy to provide virtual pharmacists to remote areas.

Marilyn Walsh Kasmar, CEO, Alaska Primary Care Association