Healthcare seen as a top issue
By Robbie Dingeman
Advertiser Health Writer
Expanding access to healthcare and making prescription drugs affordable rank as the top health issues confronting state lawmakers, government officials say.
The most high-profile issue appears to be crafting improvements to a law designed to reduce the cost of prescription drugs, a concept that has the support of lawmakers and that Gov. Linda Lingle has warmed to after opposing the idea last year.
ARAKAKI
Hawai'i Rx is modeled after a program in Maine. Under a law scheduled to take effect July 1, the state-
financed prescription program aims to reduce costs by creating a state purchasing pool to buy medicine at discount and pass the savings on to consumers.
Lawmakers are looking at how to fine-tune the law. House Health Chairman Dennis Arakaki, D-30th (Moanalua, Kalihi Valley, Alewa), said the program is likely to be restricted to people who earn no more than 3ý times the federal poverty level. In Hawai'i, that would be $74,500 for a family of four and $36,000 for a single person.
Senate Health Chairwoman Roz Baker, D-5th (W. Maui, S. Maui), is looking for creative ways to provide dental services to people who need them. One idea, she said, would be to allow dentists licensed in other states to work in a clinic setting in Hawai'i without having to get licensed here.
"The clinics deal with the most vulnerable," Baker said. "It would be a way of providing additional dental services."
Poor people without dental insurance can get help only in extreme cases, such as when teeth need to be pulled. "It's a last resort," Baker said.
Rebecca Ryan, executive director of Mo'ili'ili Community Center, said she hoped lawmakers would work on making prescription drugs more affordable, along with various financing issues associated with aging baby boomers.
Ryan also would like to see support for prevention programs, since so many health issues stem from individual choices about "eating right and exercising." Even though government budgets are tight, Ryan said, encouraging healthy habits could save money in the long run. "You have to do prevention, rather than wait to just throw money at a problem," she said.
State health director Dr. Chiyome Fukino also expects to see considerable time spent working on the Hawai'i Rx program and mental health issues.
She's working with federal, state and private authorities on a coordinated plan to protect the state from the West Nile virus. Hawai'i is one of only three states, with Alaska and Oregon, without signs of the mosquito-transmitted disease.
Fukino said it can be difficult to raise awareness about a disease that mostly affects horses and birds, and kills few people. "We just haven't had enough public communication," she said.
But if the disease took hold here, it could affect public health and wipe out native bird populations found nowhere else in the world.
In the House, Arakaki is looking at accessibility to healthcare, trying to find ways to reach the 10 percent of the population that lacks healthcare insurance. He acknowledges it's a challenge.
Arakaki is more optimistic that healthcare can be improved for the mentally ill this year, with the support of lawmakers and the governor. Lingle has mentioned her own family's experience with her mother's struggle with mental illness.
Arakaki expects more home- and community-based programs to emerge. "We really have no choice but to expand," he said.
He also expects considerable attention on substance-abuse treatment, and sees the state providing $10 million to $20 million to help fight addiction, especially to crystal methamphetamine.
Reach Robbie Dingeman at rdingeman@honoluluadvertiser.com or 535-2429.
