Health care advocates must unite to fix system
Many people perceive medical liability reform as a battle between physicians and lawyers. However, the root concern of physicians is that access to medical care in Hawaii is plummeting. Our state policy-makers need to demonstrate that they are willing to help fix our broken health care system before it is too late.
While legislators like Rep. Josh Green, a physician, and others who recognize the seriousness of this problem have been strong advocates, meaningful legislation has been blocked year after year. Despite a mountain of facts demonstrating the success of medical liability reform in improving access to medical care in Texas, California and elsewhere, plaintiff attorneys have prevailed in defeating legislation. Attorneys Rep. Sylvia Luke and Rep. Tommy Waters are the House's most recent Judiciary Committee chairpeople and both refused to hear medical liability reform bills. Our Legislature's leadership should be held accountable for committee chairmen and women who put their self-interests before the greater good.
Reimbursement issues fared just as poorly this session. The inadequate rates physicians and hospitals are paid for their services are a serious barrier to patient care. When physicians are not paid enough to cover the cost of providing care, services are simply not there when we need them. Strong lobbying efforts by health insurers, including the Hawaii Medical Service Association, defending their current reimbursement levels mask the real story. The Hawaii Medical Association asked the Legislature to intervene because insurers refuse to fairly pay those who provide medical care.
HMA thanks the Legislature for approving Act 284 in 2007, which increased reimbursement rates for health care services for the patients insured by Medicaid. Act 284 provided long overdue, albeit short-term, increases to physician and hospital reimbursements. Gov. Linda Lingle has been supportive of increasing medical reimbursements and of medical liability reform. However, the state's current budget woes have put Act 284 funds in question. This brings us back to the fact that we need long-term solutions to resolve these problems once and for all.
Legislators claim that incentives for physicians to work in rural underserved areas, such as a loan repayment program, tax credits and stipends, were the victim of budget restrictions. It is ironic that liability reform would cost Hawaii's taxpayers nothing, yet it received the most vehement opposition. The same is true for legislation that would have given out-of-network health care providers the ability to collect payment directly from insurers, giving patients more freedom to choose their physicians. While they would have cost the taxpayers nothing, the bills received no more than a few hearings and headlines.
The only way reform will occur is for all concerned parties -- hospitals, physicians, nurses and patients -- to pursue a consensus agenda of reforms in health care. Combined, these groups can create a force equal to the personal injury lawyers and HMSA, leveling the playing field at the Legislature.
If we as a community do not unite in this effort, the state of health care in Hawaii might continue to deteriorate at an alarming rate. Patients will not have timely access to quality care, physicians will continue to leave Hawaii, those who stay will become more frustrated and our health care system will continue to fail to meet our needs. All of us as patients will be the real losers.
HMA is ready to do its part to reverse Hawaii's health care crisis.
Cynthia Jean Goto M.D. is president of the Hawaii Medical Association.