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How Healthy is Healthcare in Hawaii?

Leading doctors and other experts discuss major trends and problems in Hawaii healthcare

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Ten experts in local healthcare joined in a wide-ranging, two-hour public forum on healthcare costs, quality of care, needed innovations and the future of healthcare. Here is an abbreviated transcript of that discussion. Click here for the full transcript.

Hawaii Business, ThinkTech Hawaii, the Hawaii Venture Capital Association and other organizations sponsored a public discussion on Dec. 6, 2011 by two panels about healthcare in Hawaii.


• Dr. Virginia Pressler, executive VP and chief strategic officer for Hawaii Pacific Health.


  • Beth Giesting, the governor’s healthcare transformation coordinator;
  • Dr. Thomas Tsang, senior advisor to the governor on healthcare;
  • Coral Andrews, executive director for the Health Insurance Exchange; and
  • Bruce Anderson, president and CEO, Hawaii Health Systems Corp.

Pressler: The 34-nation Organization for Economic Cooperation and Development recently released a study of comparative data on the quality and cost of healthcare. By every measure, the U.S. pays more for its medical system, more dollars per person, and higher prices for drugs, doctors, and hospitals and administrative costs.

The U.S. spends two to three times more than the average for other OECD countries. Total healthcare spending in the U.S. costs about $8,000 per person per year. The next-highest spender is Norway, at less than $5,500 per person.

Quality is a mixed bag. The U.S. has the best five-year survival for breast cancer in the world and we are the second in colorectal cancer survival, yet, when we look at other measures of quality, we rank 27th out of 34 in life expectancy. We are 31st out of 34 in premature mortality. We are 25th in cardiovascular mortality. The U.S. has the second-worst rate of adult diabetes, behind Mexico, and we have the highest rate of adult obesity. And on top of that, we have 50 million uninsured individuals in the U.S.

Yet Hawaii has some of the best health statistics. A recent study ranked Hawaii as the fourth healthiest state. The state also has the lowest rate of uninsured residents, 8 percent, and we have the second- or third-lowest healthcare premiums in the U.S.

Giesting: When we look at the healthcare problem, we first need to see how our system differs from other parts of the economy. Imagine any other part of the service sector that continues to grow while essentially ignoring its customers. The healthcare sector is largely created for the convenience and benefit of the providers, insurers and professionals in healthcare.

There is almost no information available to consumers about cost and quality. Even when consumers get information from their insuring provider, they may not understand it or know what to do with it. Certainly it is difficult for consumers to get the care they need or the information they need, so I would say consumer-driven healthcare is absolutely a mandate.

Another issue: Imagine any other major economic sector that does not use information technology to improve its own business, that does not use IT to share essential information with its partners. A recent study showed only about 10 percent of physicians across the country use electronic health records in a meaningful way. Our healthcare system pays extensively for specialty services, lots of procedures and duplication. What it does not pay for is primary care or prevention. It does not pay for managing care so that you can maximize benefits from available services.

Hawaii Business magazine invites you to comment on our articles and the issues they raise. Comments are moderated for offensive language, commercial messages and off-topic posts and may be deleted. Some comments may be chosen for inclusion in the magazine on the Feedback page.

Apr 4, 2012 11:43 am
 Posted by  JEngdahlJ

EHR implementations face both high-tech and low-tech hurdles.

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