Palin's Efforts to Reform Health Care Are Complicated

Sarah Palin, shown talking to reporters after a lunch with fellow governors on the final day of the GOP convention, waged a battle over competition in health care in Alaska. (By Melina Mara -- The Washington Post)
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In November 2006, during a debate with her Democratic gubernatorial opponent, Palin took a clear stand on the issue, saying she wanted to do away with the certificates-of-need program, as 14 other states had done. Changes, she said, should be made "with the consumer's needs in mind."

As governor, she empaneled a commission of experts to review the issue -- including at least two of her largest campaign contributors -- but the group recommended that the certificate program remain in place.

"She wouldn't go for it," said Fuhs, the lobbyist who had worked on Palin's campaign and who served on the commission. "She said no, she wanted to open it up for everything. She stood on her principles and said, 'No, we're going to get this done.' "

In January, Palin sponsored legislation that would scrap the certificate process.

Critics said that Fuhs's political support gave him undue influence with Palin on the issue, an allegation he denies. "There really wasn't any influence-peddling with her," he said. "I worked hard and long on her campaign and I got nothing special. In fact, I got less because she wouldn't have liked the appearance that she was helping me."

Palin pushed forcefully. In February, she wrote the opinion article and promoted the proposal in her state of the state speech. "We will allow competition," she said. "Alaskans want health care in the hands of doctors, not lobbyists and lawyers."

But by March, the legislature had watered down her proposal so it would apply only to certain types of medical facilities. Despite Palin's push, the legislation died.

Palin's political opponents say the battle was evidence of a simplistic approach to a complex issue. "It didn't matter what you asked her about health care," said Tony Knowles, the Democratic governor who lost to Palin in 2006. "Getting rid of certificates of need was her only answer."

But Morrow, the hospital administrator, approved of the way Palin handled the issue, even though he opposed her. "We were glad we got a seat at the table, that she took an opportunity to listen to us," he said. "I think she was sincere in that endeavor. I think at the end of the day she just saw it differently."