Health system
overhaul urged

Rep. Arakaki offers a plan that
would fund health care for all

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By Pat Omandam
pomandam@starbulletin.com

House Health Committee Chairman Dennis Arakaki is proposing an overhaul of the state's health insurance system so health care coverage would be provided to all Hawaii residents.

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"It is really visionary and very foresightful," Beth Giesting, executive director of the Hawaii Primary Care Association. "We are currently looking at a so-called health care system that is far from being a system and really is increasingly broken."

The plan would tackle Hawaii's 10 percent uninsured rate while addressing concerns from local private businesses that they are paying too much in employee health care premiums.

That means employees would likely pay more for their medical insurance, but they could save money under family insurance plans.

"People are going to have to make sacrifices," Arakaki (D, Kalihi Valley) said yesterday. "The unions may not like the idea of being put into one plan, as we've been told, but those are some of the sacrifices we think that have to be made."

The proposal, modeled somewhat after Canada's universal health care system and operated under a plan similar to the state's Quest program, would change the state health insurance system by creating a state health authority to oversee a universal health care fund.

The three-member authority and a separate advisory board would collect payments from private, Medicaid, public worker benefit programs and the medical portions of auto and workers' compensation insurance and put the money into the fund.

Arakaki said that money would be pooled so the authority could purchase health insurance coverage at a greater benefit to all than the various separate programs now available, like the Hawaii Medical Service Association and Kaiser.

"I think when you put together what it costs to administer all these programs, it will probably be a lot less than those combined administrative costs," he said.

Arakaki said he believes the plan would reduce the gap group that cannot afford private insurance and does not qualify for public insurance like Medicaid.

Also, he said, it would help Hawaii regain its reputation as the health care state, a top ranking it held in the early 1990s. It is now ranked 14th.

Richard Meier, president of the Healthcare Association of Hawaii, which represents all of Hawaii's hospitals and home-care/hospice providers and most of the long-term care beds here, said there are serious problems facing Hawaii's health care industry and that the decline in ranking shows it.

"We have to look at something new. We have to look at perhaps something like this," said Meier. He said various local groups have been working on a universal health care program for several years.

"And this is a mammoth project," he added. "It's a tremendous redirection of all of the health care assets in the state. It's probably not going to happen overnight, but you have to begin somewhere. You have to begin talking, and that's what was done last year."

Senate President Robert Bunda (D, Wahiawa) said he has questions about the measure, including how reimbursements would be made and who would control the funding.

He said he needs to see more specifics.

Arakaki admitted that not all the details have been worked out for his House Bill 1617, but, if anything, the proposal would get all the parties to the table.

"We want this bill to be a real serious discussion and a first step toward providing universal access to quality health care," Arakaki said.