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Health care with the Aloha spirit

DCblogger's picture

Pacific John at Alegre's Corner

A public health expert from Hawaii took his turn in utter exasperation: "We've already run the experiment and come up with the solution! All you have to do is see what we did and copy it!" In short, what Hawaii did was cover nearly everyone, funded by a modest hike in the payroll tax. The last I knew, they offered all people of working age three major options: an HMO for little or nothing aside from the payroll tax, a fee for service plan with very modest premiums, and a version of Medicaid for those who would otherwise fall through the crack. Hawaii would put the private plans up for bid every couple of years, with intense competition for price and quality.

Oh yeah, Hawaii covered nearly everyone for substantially less per person than on the mainland where we don't cover 10s of millions. Cheaper insurance, better quality, everyone's covered, and all within the free market. It seems like a Blue Dog dream.

I've heard it argued that for various reasons, Hawaii has a healthier population, but still! Why the media blackout?

Because health insurance parasites own the media.

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jumpjet's picture
Submitted by jumpjet on

I'd never heard anything about Hawaii having a particularly unique health care system.

But it almost sounds like the dream of Obama and every other Democrat who insists that they don't want to abolish the for-profit health insurance industry. Hawaii has one, keeps costs down, and makes sure everyone is covered. Why not copy their model?

Of course I think by this point we all know the answer to that question.

Submitted by cg.eye on

has come up with an Uniquely American Healthcare Solution , and we're only hearing of this now?

He has a ready-made campaign in front of him, and not one peep of this in his speeches? *sigh*

Submitted by hipparchia on

basically all they did was pass a law requiring all employers to provide all employees with [fairly comprehensive] health insurance. they did this back in the mid 1970s, which means that for the past 35 years, they've had a fairly low rate of uninsured people.

from the article jeff links to below:

Hawaii law requires employers to offer standardized health plans with low co-pays, no deductibles and few out-of-pocket costs. Cliff Cisco, a senior vice president at the Hawaii Medical Service Association, said that having a standardized and popular benefit has helped keep administrative costs to just 7 percent of revenue, among the lowest in the nation.

there probably are some other factors too, but hawaii, like canada, underlines the basic fact that if everybody can afford to go to the doctor pretty much whenever they need to [employees' share of premiums can't be higher than 1.5% of their pay in hawaii], the population as a whole stays healthier.

Jeff W's picture
Submitted by Jeff W on

from a few days ago here.

There's this strange take about midway through the article:

Other states tried employer-mandated care only to repeal the efforts after employers threatened to move across state lines. Hawaii’s isolation forestalled such threats, and its paternalistic plantation history made employer-provided care an easy fit.

In interviews, leaders and employers in Hawaii referred with surprising earnestness to an “aloha spirit” and a sense of familial obligation known as ohana to justify providing care to nearly everyone.

So there's the "paternalistic plantation history" or the "aloha spirit" and ohana—take your pick.

Health economists like Princeton's Uwe Reinhardt have said it's a lack of social solidarity in the US that prevents it from having a health care system like the rest of the advanced world (or, maybe just "the advanced world")—so maybe he's in the "aloha spirit" camp.