Monday, June 18, 2007

Hawaii: Trouble In Paradise

The Commonwealth Fund praises Hawaii as a model of how a state can implement "universal health care". However, they are committing the common fallacy of confusing "health insurance" with "health care", according to this story from the 6/17/2007 Honolulu Star Bulletin:
"Doctor Shortage Belies Top Ranking"

Many islanders can't find a doctor, especially on the neighbor islands and in rural Oahu areas, despite the state's top ranking nationally for access to health care, says the Hawaii Medical Association, a local physicians association.

A Commonwealth Fund survey said Hawaii has the best access to health care in the country, primarily because of a high number of residents with health insurance. But the study didn't consider availability of doctors, Hawaii Medical Association members say.

"If we don't have doctors available to see them, what good does insurance do you?" said HMA President Linda Rasmussen, a Kailua orthopedic surgeon. High malpractice premiums and low insurance reimbursements have created a "state of crisis" in Hawaii with physician shortages limiting access to health care, she said.

..."If I have a patient who needs a total joint (replacement) and has an abnormal EKG (electrocardiogram) and needs to see a cardiologist, it's almost three months to get an appointment before he gets cleared," she said.

"If a person calls when they're 50 for a colonoscopy, they're almost 51 before they get in."

..."People are frustrated," said HMA Executive Director Paula Arcena. "They have insurance coverage but they can't find doctors." The neighbor islands and rural Oahu are affected the worst, especially in specialty and trauma care, she said.
David Hogberg of the National Center for Public Policy Research makes a similar point in his recent article, "'Health care,' more or less".

(Via KevinMD.)