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The plan noted that the cost of health care in Alaska was too high, making it unavailable for some.

"The high cost of health care is a barrier to many Alaskans getting the health care they need, and the present system supports the high and increasing costs of health care, and inefficient utilization of health care dollars," the plan says.

Rep. Beth Kerttula, D-Juneau, House minority leader, said it might be difficult to get legislative approval for some of them, but praised the council's decision to look at "how things should be, rather than what we think is possible."

Council member Dr. Michael Carroll said a lack of health-care coverage is a problem for the state.

"They go to the emergency room, and they don't get preventative care," he said.

Jackson said she wanted to deal with the high cost of health care by lowering the growth rate of health care costs from the current 6 percent per year nationally to 4 percent per year in Alaska, so the state's cost becomes consistently below the national average.

To do that, she recommended increased emphasis on wellness and preventative measures, as well as encouraging citizens to spend their health care dollars wisely.

One recommendation: A state Web site with comparative information, enabling Alaskans to be better health care consumers.

Additional recommendations include better water and sewer systems in rural communities, more Alaska-based training for health care workers, and more personal responsibility.

Kerttula said she supported the council's idea to improve wastewater treatment in rural communities.

"It's expensive, but it's more expensive to have the children with the kind of diseases that come from open waste systems," she said.

The plan said there are "significant shortages in the health care work force across the state," and recommended additional training opportunities be made available. That might mean strengthening University of Alaska programs, as well as paying for more education for Alaskans in other states.

"A good start is to 'grow our own' within Alaska, by presenting health care professions more prominently as viable career options, with students continually encouraged to build the skills necessary, and to pursue health care careers," the plan said.

One of those programs helps Alaskans become physicians at the University of Washington, and Kerttula said she'd like to see it expanded further, especially since a doctor from rural Alaska would likely be more willing to remain in rural Alaska after graduating from medical school.

"That's an idea I'd be extremely interested in beefing up, especially in rural Alaska," she said.

Finally, the council said its work was not done and urged the Legislature to create an "Alaska Health Care Commission" to continue the council's mission and elevate the discussion of health care to a statewide audience.

The plan Jackson presented was amended by the council Monday, and was subject of a public hearing in Anchorage in the evening. Written testimony on the plan will continue to be accepted until Dec. 10.

Monday was the last meeting of the council, and the final plan will be adopted by e-mail later this month. It will be presented to the Alaska Legislature next year.

• Contact Pat Forgey at 523-2250 or patrick.forgey@juneauempire.com.