Drug-cost issue could return
By Robbie Dingeman
Advertiser Health Writer
The high cost of prescription drugs may again be an issue for lawmakers, despite two measures passed during the last legislative session.
Gov.-elect Linda Lingle, who places healthcare among her top priorities, has expressed disappointment with the Legislature's attempts to address the prescription drugs issue.
The Legislature passed two measures, supported by AARP, that are designed to reduce costs for those who are without medical insurance or can't afford needed medication.
State House health committee chairman Dennis Arakaki, a Democrat, said the Hawai'i Rx law, modeled after Maine's, can be effective in creating a purchasing pool that would negotiate discounts on prescription drugs for some 220,000 Hawai'i residents without prescription-drug coverage.
But that program is set to begin in January 2005, and Lingle has said the bill amounts to "feel-good" legislation that doesn't get to the problem of giving relief now to senior citizens on their drug bills.
Arakaki said the Legislature delayed the Rx bill because of pending lawsuits in the Supreme Court by the pharmaceutical industry against Maine, which put any action there on hold. Rather than implement the law here right away, it seemed prudent to await the legal outcome in Maine.
"We don't have to wait until 2005," Arakaki said. "If there is a ruling during session, we can always revise the implementation date."
The second new law provides a prescription drug program for people whose incomes are up to three times the national poverty level, a step that Arakaki and AARP see as helping the poor and the middle class. Under that plan, a family of four could be in the program and make up to $62,000. "That covers a lot of people. It would probably cover a lot of the retirees," Arakaki said.
Lingle favors a tax credit for those who buy long-term care insurance as a way to shift some of the burden.
Arakaki said more probably needs to be done. "We need to make sacrifices especially in the area of long-term care. Things like tax credits are just not going to cut if for the majority of people."
Greg Marchildon, state director of the Hawai'i AARP, said that prescription drug prices are rising at an average of 18 percent a year.
"We would like to hear any ideas she (Lingle) has to do something about this issue," he said.
Marchildon defends the laws passed last session as a good start. "We didn't want to design a feel-good law," he said. "We knew there was a possibility that the Supreme Court would take this up."
Marchildon noted that Lingle has not said she would work to repeal these two measures.
Outgoing state Health Director Bruce Anderson said prescription-drug prices represent "the most important cause for the increase in the cost of medical care."
He said one drawback to purchasing pools is that it's difficult for a small state such as Hawai'i to be able to draw much power with a population roughly the same as some medium-sized Mainland cities.
As for the new governor's overall health plan, Arakaki said he was encouraged by the emphasis Lingle is placing on the diverse health needs of the the state. "At this point, I'm very hopeful," he said.
Lingle has expressed her support for community mental-health centers and for more home and community-based solutions to long-term care.
Marchildon also said Lingle has reached out to a cross-section of people in the search for a new state health director. She included him and another representative from AARP even though she was critical of the initiatives they have backed.
Without some plan for how to care for the health needs of the aging population, there's trouble ahead, Marchildon said. "If we don't get ahead of the curve on this issue, the system is going to implode under its own weight," he said.
Reach Robbie Dingeman at rdingeman@honoluluadvertiser.com or 535-2429.
