In the short term, you can buy a round trip air ticket to lower 48 locations where procedures are less than half the cost and in many cases better quality.  For the long term, Alaska medical insurance will be more affordable if part of a larger pool, preferably a regional or national pool of patients.  If this works with auto and homeowners insurance in Alaska then it can work with medical insurance.  Finally, thinking that a critical and necessary service like health care should only be operating in a "free market" economy is a fundamental error, this thinking in itself has led to insurance companies and doctors increasing their fees as fast as the market will possibly bear until costs and CEO salaries are absurd.  Who wants to deal with doctors and insurance companies that care more about making money than serving their patients???   A centralized good quality hospital for reasonable cost would provide the best competition against the private monopolies that now pirate Alaskans.