Sources of Coverage, 2006-2007
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Seven Months after launching Keiki Care, Hawaii ended the universal healthcare program for children. The state stopped funding
the program effective Nov. 1, 2008. Its private partner, Hawaii Medical Service Assn. (HMSA), paid to cover the 2,000 children
enrolled in the program through the end of 2008. Gov. Linda Lingle (R), who signed the program into law in 2007, said a state
budget shortfall prompted the funding cut. Hawaii faces a projected $900 million general fund deficit by 2011.
The state contributed about $50,000 monthly, or $25.50 per child, to the program, which was available at no cost for participants,
except for a $7 copayment for physician office visits. All uninsured children up to age 18 were eligible for the program.
According to the Department of Human Services, about 85% of children in Keiki Care previously were covered by HMSA's Children's
Plan but stopped paying for it so they could take advantage of the Keiki program.
The Commonwealth Fund ranks Hawaii the best overall state, especially in terms of access to care.
Physicians who serve high numbers of Medicare patients in Hawaii and two other states say they are defaulting on rent, laying
off staff and asking drug suppliers to send drugs without payment because of a backlog of Medicare reimbursements. Problems
stem from reconciling national provider identifiers assigned by the Centers for Medicare and Medicaid Services (CMS) last
May. HAWAIIANS USE 'VIRTUAL VISITS'
HMSA will make online healthcare services available to all Hawaii residents in early 2009 through a strategic collaboration
with Microsoft Corp. and American Well Inc. The 24-hour service enables consumers to talk to a local physician, specialist,
or other healthcare provider from HMSA's participating provider network live on-demand via the Web or by e-mail or telephone.
As a part of this arrangement, all Hawaii residents will have access to Microsoft's HealthVault platform, which allows consumers
to collect, store and manage personal health information and share it with physicians, family members, and other trusted third
parties.
In a recent study by TNS Global, 45% of Hawaii physicians said they are extremely or very likely to deliver care using the
system, and viewed convenience and improved patient care and satisfaction as key motivators to using the service. Ten-minute
"virtual visits" will cost between $20 and $50, according to USA Today.
HIGHER CANCER RATES
Native Hawaiians, Maoris and Polynesians have higher rates of breast, stomach, cervical and lung cancer than whites, according
to a study in the May issue of The Lancet Oncology. Breast, stomach and lung cancer deaths occurred in Native Hawaiian men at a rate of 145 per 100,000 deaths, compared with
117 per 100,000 deaths in white men, the study found. Among Native Hawaiian women, 123 per 100,000 deaths were from breast,
stomach, cervical or lung cancer, compared with 82 per 100,000 deaths for white women.
DIABETES IN HAWAII
About 8.6% of Hawaii's population, or 110,000 people, are thought to have diabetes. Of those, roughly 39,000 have not yet
been diagnosed, according to a report by the state health department. Among the various ethnic groups in the state, Native
Hawaiians are at the greatest risk. About 12% of Native Hawaiians have been diagnosed with diabetes. At 47 deaths per 100,000
people, Native Hawaiians also have by far the highest mortality rate associated with the disease. That's more than double
the rate for Filipinos, the next highest group, and nearly seven times the rate for whites. Experts attribute the disparity
to differences in diet, physical activity and behavioral choices. Obesity is another contributor: nearly 75% of Native Hawaiians
are overweight or obese.
DRUG IMPORTATION APPROVED
Effective July 1, 2009, Hawaii residents will have access to I-SaveRx, a drug program that allows residents to purchase lower-cost
prescription drugs from other countries. Hawaii is the sixth state to enroll in the program, which began in Illinois in 2004
and can provide savings of up to an estimated 55%.
MHE Sources: Centers for Medicare & Medicaid Services; Urban Institute; Kaiser Family Foundation; U.S. Census Bureau; The
Commonwealth Fund.
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