Law helps health care, but costs still a worry

THE ISSUE A survey puts the state at the top for providing access to health care.

HAWAII'S ranking as the best state for access to health care can be attributed to state law requiring employers to offer health insurance to its full-time workers and to a variety of aid programs for people who otherwise would go without.

With a steady isle economy, businesses and employees have been able to hold their own over ever-increasing costs of insurance and health care. Nonetheless, an economic downturn could change that.

A survey by the Commonwealth Fund, a private foundation focused on improving health care, placed Hawaii at the top in the nation for "access," referring primarily to the financial ability to get health care. Because of the prepaid health care law, residents here have a better chance of avoiding premature death (before age 75) and breast and other cancers, and of getting preventive care, such as immunizations for children, and regular screenings for those prone to diseases, like diabetes.

The analysis found that states where fewer people had insurance also had poorer quality of medical care. The five states ranked highest -- Hawaii, Iowa, Maine, New Hampshire and Vermont -- had nearly 90 percent of working adults insured.

Despite being first in access, however, the survey showed Hawaii had room to improve in post-surgical treatment to prevent infections and help for patients with heart-related conditions.

The survey interestingly found that high spending did not necessarily conform to high-quality care and as long as the cost of health care, in Hawaii and across the nation, remains an intractable issue, a vulnerable segment of Americans will continue to forgo basic medical care.