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LWV-HI Council
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Hawai'i and Health
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Hawai'i and Health

A Campaign for a Public Voice on Health Care Reform

Dr. Peter Sybinsky

The League of Women Voters of Hawaii was the prime sponsor of an educational forum on health care held Saturday, April 9.

The Health Forum is part of an LWVUS Education Fund project-a joint venture with the Henry J. Kaiser Family Foundation. It was one of many town meetings being held across the country to give citizens a much-needed voice in the current health care debate. Leagues throughout the country invite members of Congress, local legislators, and citizens to join together to learn about the proposals now before Congress.

Irene Coogan served as project coordinator working with Dr. Elizabeth Adams, chair of the League of Women Voters of Hawaii Health Care Committee, and committee members Grace Furukawa, Evelyn Bender, Dee Lum, and President Jim Koshi.

The forum was videotaped and will be edited for viewing on VIEWS, cable television's public access channel (Oceanic Cable 24, Chronicle Cable 21). Videography and editing was done by Fourth Wave Productions, Andy Jacobs, producer and director. Copies of the tape will be sent to neighbor island leagues and will be available for loan by community groups.

Anne Lee, past-president of LWVHI, served as moderator. Lee introduced the main speakers and the reactor panel, and selected from the written questions submitted by the audience.

U.S. Senator Daniel Akaka opened the forum with comments; he was succeeded by Congresswoman Patsy T. Mink who presented an overview of the administration's and other proposals being discussed in Congress. Jared Jossem, chairman of the Republican Party, reflected on health care proposals from the Republican viewpoint. Dr. Peter Sybinsky, deputy director of health resources, State Department of Health, described how the varying proposals might affect Hawaii's health care system.

Timer: Evelyn Bender. Reactor panel: Stella Satake, Nancy McGuckin-Smith, Bette Tatum, Alfred J. Fortin, Michael Chaffin, Stephen Wallach.

Reactors included Dr. Stephen Wallach of the Hawaii Medical Association, Dr. Michael Chaffin, president of the Kaiser Permenente Medical Group, Alfred Fortin, Ph.D., of Hawaii Medical Services Association, Nancy McGuckin-Smith, executive director of the Hawaii Nurses Association, Bette Tatum, state director of the National Federation of Independent Business (NFIB), and Stella Satake, Ph.D., state chair for AARP's Health Care Reform Committee. Each spoke for five minutes commenting on the presenter's remarks and offering their perspective on health care in Hawaii and how national proposals are seen.

Anne Lee, moderator, Evelyn Bender, and Suzanne Meisenzahl

Some of the specific points made are the following:

Health care should be seen as an "IRA coverage" concept. Small employers should be permitted to group together to obtain health benefits for their employees. Simpler forms are a must and the number should be reduced. Proposals that control malpractice should be considered as part of the health picture. Reform is a bipartisan effort. The single payer concept can be seen as socialized medicine. There is general agreement that there is need for reform, benefits must be portable (can be transferred from job to job or place to place), the playing field should be leveled (through tax deductions perhaps), there should be adjustments for low income consumers, states should be given flexibility regarding medicare, and tort and libel reform are necessary.

Additional thoughts: there should be access to care but it should not be mandated, choice of physicians is important, and price controls are needed. Yet, caution was expressed that research and development monies should not be cut (as long term benefits and savings can occur with new developments).

It was noted that Hawai'i's employer mandate is done within the market and that the state maximizes private sector input in the health program. A waiver from the strict nationally controlled program is being requested. Good programs (such as Hawai'i's, Washington's, and Oregon's) can show others how good health care can be provided.

Jean Aoki and Pat Shutt staff the information table at the Health Care Reform Forum

Further, people elsewhere do not believe that Hawai'i's system works.

Caps are not good; they will lead to a black market. Caps will distort care provision and lead to limitation of access. Exclusions from HMO programs are being eliminated. Managed care can extend or limit choices, therefore, what style do we want? Hawai'i has a good blend. It will be difficult to control costs if such were mandated since Hawai'i already does well in this area.

There needs to be individual and collective responsibility regarding health care. It is important to watch what we are spending along the way since most dollars are spent on the last years of life. The human aspect is important. Of 6,000 independent businesses in the state, around 75 percent agree with many of the proposals being discussed. Many employers in the state believe in health care to the extent they often pay 100 percent of costs for their employees. It is important to have health care access in rural and underserved areas.

Finally, the 90,000 members of the AARP in Hawai'i are concerned about long term care. They consider care for children and the middle-aged with special health needs as being part of the long term need group.

Copies of Voicing Your Choice: A Guide to Citizen Participation in Health Reform, published by the League of Women Voters Education Fund, are available at the league office.

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