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Number of
medically uninsured
growing in isles

Seven percent of islanders
have trouble getting and
keeping health coverage

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By Helen Altonn
Star-Bulletin

Apio Alani, 35, a Hawaiian woodwork artist who has asthma, says he cannot afford to be uninsured with basic medical costs totaling $2,400 annually.

Yet, he says he has trouble getting and keeping coverage.

He has one month left on a Kaiser Permanente plan through the Pacific Handcrafters Guild that Kaiser has dropped. He is part of a hui operating Native Books and Beautiful Things that also could not get coverage, he said.

"I'm trying to figure what to do," he said, estimating he must pay at least $200 a month for an individual or sole proprieter's plan with Kaiser, where he has been treated most of his life.

"I don't have a choice," he said. "Can I afford it? Sometimes."

Alani was one of the "faces of the uninsured" discussing their plight at a conference focusing on problems of the growing medically uninsured population yesterday at the Hawaiian Regent Hotel.

About 200 community leaders attended the meeting, convened by the Hawaii Medical Service Association Foundation to kick off "The Hawaii Uninsured Project," a three-year undertaking.

The foundation said the number of uninsured islanders has grown to 7 percent or higher, and is still climbing. "These 100,000 or so people, many of whom are children, face enormous difficulties."

Sen. Suzanne Chun Oakland, chairwoman of the Health and Human Services Committee, said she is drafting a bill to introduce in the next session to cover medically uninsured groups through a pooled purchasing strategy.

Artists, taxi drivers, college students, part-time workers, home care providers, real estate agents, independent contractors, emergency hires, insurance agents and many others fall into the gaps, she said.

"We need to create some kind of program to allow these people to hui somehow," she said, adding that the state is in the best position to negotiate a pooled purchasing program.

Vickie S. Gates, vice president of the Academy for Health Services Research and Health Policy and deputy director of the Robert Wood Johnson Foundation's State Coverage Initiatives Program, described innovative approaches by other states to deal with the uninsured problem.

She said she is impressed with Massachusetts, which is creating 50-50 partnerships with small employers with low-wage workers.

Some states are expanding benefits under the State Children's Health Insurance Program by moving away from regulations, Gates said.

Susan Forbes, with the Hawaii Health Information Corp., said younger working-age residents are most likely to be uninsured. The neighbor islands stand out and Maui is the worst, she said.

The issue of access must be addressed on the neighbor islands, conferees said, noting that many have Medicaid or state QUEST coverage but cannot find doctors.

A Big Island representative said children there are being flown to Oahu for dental care.