As a nurse in 1972 when I graduated from nursing school we had preventive health care as the focus of all patient care, the first line of defense by using health education and reliable treatment of chronic diseases to prevent hospitalizations.   We had the medical delivery system in place to achieve this goal. The hospital system in the big city I lived in had "satellite" clinics all over in community neighborhoods, I worked as a student in several of them. My point is that I am for "managed" care which is the new term for this older method of delivering health care to people,  so I support this because it saves not only money but peoples health and lives, and if you don't have your health...... however I have a deep concern about Alaska having worked the medical care delivery system in place and been a patient of for years, do the communities have in place the resources they need to deliver this type of care or will it all be in the larger cities which is a burden to some residents?