Is Hawaii ready for universal health care?

February, 2008


I do not believe that universal health care is good for Hawaii’s people. Although other states, including California, Maine and Vermont, are considering forms of universal or near universal health care systems, we really need to consider the impacts of a universal system and how it will affect our state. The goals of health care are most commonly affordability, accessibility and quality. It is extremely difficult to attain all three.

A universal health care system is essentially health insurance for all. There is a misconception that this would mean “free” health insurance coverage. However, in life, nothing is free. Most of the burden will be shouldered by those who currently are employed or have insurance. Stories and data show that countries with universal health care tend to be highly taxed. Ironically, big-government decision making often creates the same problems it was supposed to cure. Goals for attaining accessible, affordable and quality health care tend to fall by the wayside.

Several countries, such as Britain, Canada, Australia and Sweden provide universal health care. In these countries, studies show that individuals are unable to find family doctors, have a hard time receiving routine health care, and are placed on waiting lists for medical care. Some Canadians wait up to two months to get a Magnetic Resonance Imaging (MRI), Computed Tomography (CT), or angiogram. Thirty percent of Australians buy supplemental health insurance. Americans are a litigious society needing reform. In my opinion, unrestricted lawsuits will never mix well with a universal health care system.

The further we move away from personal responsibility for your health costs, the farther we get from containing health care costs. Hawaii’s pre-paid health care system is not perfect, but I believe a universal health care system is too extreme. Focusing on wellness care and early intervention for the insured and those depending on the government’s safety net, and encouraging more competition in the health insurance industry would yield better results.


In the last session of the Hawaii state Legislature, House Bill 1008 was introduced and passed to provide universal health care for children, ages newborn to 19. HB1008 (now Act 236) was a landmark for keiki care, as Hawaii became the second state in the nation to provide all of its children with health care insurance.

Numerous reports have shown that Hawaii’s health care access is the best in the nation, thanks to the Pre-Paid Healthcare Act of 1974, which mandates businesses to pay for health coverage for employees working more than 19 hours a week.

If Hawaii has access to the best health care in the country, why is the Legislature even considering universal health care for all residents? The answer is simple: Cost savings. By providing health care to Hawaii residents through a single-payer system, employers, hospitals and the state will save money. Medical services will be accessible to everyone. Late-stage emergency care will be reduced for those who cannot afford medical care.

Universal health care will better address the shortage of physicians and nurses. It will help focus on the recruitment and retention of doctors and nurses in Hawaii. And it will lead to better pay and a managed health care system to address medical malpractice and frivolous claims. This viable single-payer system will fortify health care in Hawaii.

Right now, business owners pay a substantial amount to provide mandated health care coverage for their employees. However, a single-payer system will reduce costs because it will be managed and regulated by a single entity. The power of bulk purchasing of medical supplies, services and prescription drugs will give us the leverage to seek and obtain large savings.

Hawaii was the first state to enact such a bold law when it passed the Pre-Paid Health Care Act of 1974. Today, we stand on the cusp of passing HB56, which will establish the Hawaii Health Commission to develop a plan for health care coverage for everyone in our state. This bill sits in the Senate Ways and Means committee. If passed in the next few months by the Senate, it will most likely move to conference. If passed in conference, it will go to the governor and, barring a veto, will become law. Hawaii is ready for universal health care, because health care should be a right, not a privilege.


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