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The Honolulu Advertiser

Posted on: Wednesday, May 21, 2003

New prescription plan should move forward

When Hawai'i's pioneering prepaid health law insurance was being written in the early 1970s (it became law in 1974), there was considerable controversy over whether it would work, whether it was legal and whether it was in the best interests of Islanders.

On balance, the concerns turned out to be unwarranted, and Hawai'i became known as a pioneer in the effort to provide near-universal health insurance for its people.

It is true that over the years the prepaid health law has grown increasingly expensive for employers. There may be room for some revisions or updating now that we have almost three decades of experience.

But overall, the law has worked and has contributed to Hawai'i's well-deserved reputation as a healthy state.

The debate now under way about a new state prescription drug plan, called Hawai'i Rx, in some ways echoes that debate back in the 1970s.

Hawai'i Rx, modeled after a law in Maine, would create a state-backed purchasing pool to buy prescription drugs in bulk for those who do not have prescription-drug coverage. It is estimated that more than 200,000 Hawai'i residents may qualify for reduced-cost drugs under the plan.

Gov. Linda Lingle has been doubtful about the plan. In fact, it became a major issue in the campaign for governor, with Democrat Mazie Hirono pushing the Hawai'i Rx plan and Lingle offering an alternative Prescription Care Hawai'i program in which needy patients would be given state help in applying for free drugs.

Generally, major drug companies prefer Lingle's approach.

Because Lingle argued strongly for the Prescription Care proposal, there are doubts that she will release the $200,000 needed to get Hawai'i Rx up and running.

Previously, she said that the plan was in limbo because of legal challenges that could take years to resolve. Well, the U.S. Supreme Court ruled yesterday that the Maine plan could take effect, clearing the way for the Hawai'i plan to follow.

Yes, there may be further legal challenges ahead. But that should not deter Hawai'i from moving on this innovative and sorely needed plan to get prescription drugs into the hands of those who need them.

Lingle should release the money for Hawai'i Rx and continue on with her own Prescription Care plan. The two ideas are complementary, and — when both are up and running — Hawai'i may be able to brag that it offers its citizens close to universal access to prescription drugs at a price they can afford.