Posted on: Thursday, January 30, 2003

EDITORIAL
Universal healthcare is a worthy goal

It seems as though Hawai'i has been paving the way for universal healthcare since the passage of the 1974 Prepaid Health Care Act, which requires employers to pay the lion's share of premiums for their full-time workers.

But it pains us to learn that too many Islanders — 11 percent — are uninsured. Many businesses avoid paying health insurance premiums by hiring part-time employees. Meanwhile, the population is aging and in need of more health services, and the cost of those services and prescription drugs is steadily rising. Our health is at the mercy of the market.

The question is, do we want to place it at the mercy of the government? One alternative being floated by some Democratic lawmakers is universal healthcare coverage in the form of a single state-run insurance fund. According to the proposed legislation, a state authority would collect payments from private plans such as HMSA and Kaiser Permanente, Medicaid and worker's compensation insurance, among other sources.

We support the concept of universal healthcare, if everyone — and we mean everyone — is covered. Sure, taxes would increase, but then we wouldn't be paying those monthly premiums. Besides, it's justifiable to raise taxes to pay for human needs.

Of course, we have a lot of questions about how a state-run system would work, and whether the quality of healthcare would be compromised. We imagine that would depend on how the system is run. England's national healthcare system has managed to garner a poor reputation. On the other hand, France's socialized medicine is widely touted.

Here in the U.S., healthcare coverage has largely been kept away from government bureaucrats, but that doesn't mean the system is working as well as it should. More than 40 million Americans are uninsured. Many go to the emergency room for primary care, which is enormously costly. And private insurance doesn't always guarantee choice.

Many HMOs have notorious reputations as micromanagers when it comes to making medical decisions.

Hawai'i's healthcare system, largely dominated by the fee-for-service HMSA and Kaiser's health management organization, receives generally top ratings both for the quality of care and its relative affordability. We are far ahead of many jurisdictions, and there is a strong argument against fixing what is largely not broken.

But even in the Islands, there is a case to be made for healthcare reform that will bring coverage to a wider range of our citizens.

We're open to suggestions. But while the search goes on for alternatives, it is crucial that the underlying prepaid healthcare law be kept in place. It's far too important for the well-being of our state.