If only the medical prices in AK were "just" 1.6 X (= 8/5, your numbers) higher than the lower 48.  They are not, instead they are often many times higher here (read some of the posts here). 

In addition, specialists make mint up here and it is totally ridiculous.  Yes, they should make a comfortable living, but they should NOT be making anywhere near $3 million/year as some do (see earlier piece by Wohlforth).  My spouse is a family doc who can't stand most of the specialists here because they absolutely ream every patient sent to them.  My spouse makes under $200k/year while the specialists make multiples of that - I call BS to that.  (And no, my spouse doesn't need to make more money, we just want to see the specialists make less.)  She has nearly the same training they have and all the medical liability insurance they have.