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Since 1974, Hawaii has required all employers to provide relatively generous health care benefits to any employee who works 20 hours a week or more.
There have not been any serious efforts in Hawaii to repeal the law.
Perhaps the most intriguing lesson from Hawaii has to do with costs.
This is a state where regular milk sells for $8 a gallon, gasoline costs $3.60 a gallon and the median price of a home in 2008 was $624,000 — the second-highest in the nation.
Despite this, Hawaii’s health insurance premiums are nearly tied with North Dakota for the lowest in the country, and Medicare costs per beneficiary are the nation’s lowest.
Hawaii residents live longer than people in the rest of the country, recent surveys have shown, and the state’s health care system may be one reason.
In one example, Hawaii has the nation’s highest incidence of breast cancer but the lowest death rate from the disease.
With the populace given relatively generous benefits, patients stay healthy and health providers have the money and motivation to innovate.
With more people given access to care, hospital and insurance executives in Hawaii say they have been able to innovate efficiencies.
For instance, the state’s top three medical providers adopted electronic medical records — years ahead of most mainland counterparts.
The Hawaii Medical Service Association, the state’s largest insurer and a Blue Cross Blue Shield member, offers the nation’s only statewide system whereby anyone for a nominal fee can talk by phone or e-mail, day or night, to doctors of their choosing.
Kaiser Permanente Hawaii, which covers about 20 percent of the state’s population, screens 85 percent of its female members ages 42 to 69 for breast cancer, among the highest screening rates in the country.
One result of Hawaii’s employer mandate and the relatively high number of people with health insurance is that hospital emergency rooms in the state are islands of relative calm.
In 2007, the state had 264 outpatient visits to emergency rooms per 1,000 people — 34 percent lower than the national average of 401.
Dr. Ray Sebastian splits his time between the emergency room at Kapi’olani Medical Center at Pali Momi and a hospital in Los Angeles. Nearly all of his poorest patients in Hawaii have routine access to family doctors who can provide follow-up care, while fewer than half of those in Los Angeles do, he estimated. So, he said, the emergency room in Hawaii is not clogged with patients suffering minor problems like medication adjustments and cold symptoms, and patient waiting times are a small fraction of those in Los Angeles:
“It’s like greased lightning here,” he said.
http://www.nytimes.com/2009/10/17/health/policy/17hawaii.html?pagewanted=all
There have not been any serious efforts in Hawaii to repeal the law.
Perhaps the most intriguing lesson from Hawaii has to do with costs.
This is a state where regular milk sells for $8 a gallon, gasoline costs $3.60 a gallon and the median price of a home in 2008 was $624,000 — the second-highest in the nation.
Despite this, Hawaii’s health insurance premiums are nearly tied with North Dakota for the lowest in the country, and Medicare costs per beneficiary are the nation’s lowest.
Hawaii residents live longer than people in the rest of the country, recent surveys have shown, and the state’s health care system may be one reason.
In one example, Hawaii has the nation’s highest incidence of breast cancer but the lowest death rate from the disease.
With the populace given relatively generous benefits, patients stay healthy and health providers have the money and motivation to innovate.
With more people given access to care, hospital and insurance executives in Hawaii say they have been able to innovate efficiencies.
For instance, the state’s top three medical providers adopted electronic medical records — years ahead of most mainland counterparts.
The Hawaii Medical Service Association, the state’s largest insurer and a Blue Cross Blue Shield member, offers the nation’s only statewide system whereby anyone for a nominal fee can talk by phone or e-mail, day or night, to doctors of their choosing.
Kaiser Permanente Hawaii, which covers about 20 percent of the state’s population, screens 85 percent of its female members ages 42 to 69 for breast cancer, among the highest screening rates in the country.
One result of Hawaii’s employer mandate and the relatively high number of people with health insurance is that hospital emergency rooms in the state are islands of relative calm.
In 2007, the state had 264 outpatient visits to emergency rooms per 1,000 people — 34 percent lower than the national average of 401.
Dr. Ray Sebastian splits his time between the emergency room at Kapi’olani Medical Center at Pali Momi and a hospital in Los Angeles. Nearly all of his poorest patients in Hawaii have routine access to family doctors who can provide follow-up care, while fewer than half of those in Los Angeles do, he estimated. So, he said, the emergency room in Hawaii is not clogged with patients suffering minor problems like medication adjustments and cold symptoms, and patient waiting times are a small fraction of those in Los Angeles:
“It’s like greased lightning here,” he said.
http://www.nytimes.com/2009/10/17/health/policy/17hawaii.html?pagewanted=all
