Sunday, March 16, 2003


Hawaii's entrepreneurs have a particularly tough time getting health insurance coverage, according to Joan White, executive director of the Hawaii Uninsured Project.

Project director sees basic
health care as a right

Joan P. White

>> Title: Executive director, Hawaii Uninsured Project
>> Hired: November 2002
>> Hawaii Uninsured Project: A coalition dedicated to reducing the number of people in Hawaii without health insurance coverage

What attracted you to the Hawaii Uninsured Project?

The need to address the issue. There are those of us who think of basic health care as sort of an essential right, not something you should or should not have depending on what sort of job you have.

What is it's mission?

To ensure health care coverage for all. So we're looking at our target populations and trying to individualize our programs around each of those groups. It's not a one size fits all. We're looking to the private sector for solutions, not the government. But that doesn't mean we're expecting that businesses, especially small businesses, will bear the burden for all of their workers. People will pay for their own coverage if there are plans available that are affordable. We have working groups that are looking at possible solutions now, but we don't have the answers yet.

Your past job was vice president of the Healthcare Association of Hawaii. How did you get into the health care field?

My undergraduate work was in nursing. Then I got an MBA and did a lot in the business side of health care.

According to a recent news story, Hawaii has gone from the state with the fewest uninsured to 11th place, along with four other states, in the last decade. Why is that?

There are probably lot of reasons. In the '90s, Hawaii suffered greatly after the Gulf War and the economies in Asia, particularly Japan, took a tumble. We saw a lot of worry about the future of our economy and the tourism industry. Businesses had to take a hard look at who they hired and whether they were going to bring people on full time. We also have a lot of entrepreneurs in Hawaii. It's not easy for those folks to find insurance at all. If they can get it, it can be very expensive.

How does Hawaii's coverage of children compare with other states?

Hawaii Covering Kids would know more about that and does a lot of good work in that area. But one population we are worried about is families at 200 percent to 300 percent of the federal poverty level. There are about 8,000 children in that category and there is no coverage for them.

What about the business argument that the demands of Hawaii's Pre-paid Health law are simply too onerous?

We're sorting out some of the arguments pro and con on that now. But we do know that in states where there is no such law, costs can be even higher. That doesn't mean there aren't some things about the act we might want to change. We've made no recommendations yet.

What do you think of the Legislature's proposal to tax workers to fund long-term care coverage?

I think its a great idea. This year, the state Department of Human Services had to go in for a $90 million emergency appropriation for Medicaid coverage. If something is not done, that number will grow year after year. Medicaid is the payer of first resort for long-term care, not the last resort. That's not the case for any other part of our health care system. Far too few people have private long-term care insurance. We need desperately to develop a new funding stream to cover long-term care.

What do you think of Gov. Lingle's counter-proposal to give a tax credit to folks who buy their own long-term care insurance?

I think it's fine. And if she wants that, she should be able to get it done. But tax credits don't help the poor, the near poor or even the middle classes. Most people can't afford those premiums out of pocket, they need the money for food and other essentials. But we're in favor of anything that helps people to buy their own long-term care insurance.

Inside Hawaii Inc. is a conversation with a member of the Hawaii business community who has changed jobs, been elected to a board or been recognized for accomplishments. Send questions and comments to

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