Hawaii considering single payer
State of Hawaii
House of Representatives
Twenty-Second Legislature, 2003
House Bill No. 1617
Establishes the State Health Authority to provide health care for all Hawaii citizens.
SECTION 1. (excerpt)
While Hawaii was once known for having a low uninsured population, between two and five per cent in 1994, health agencies are now concerned with the growing number of uninsured individuals. The Healthcare Association of Hawaii estimates that the current rate of uninsured individuals is ten per cent. While the Prepaid Health Care Act requires employers to provide health insurance for employees working twenty hours per week or more, there is no such requirement to provide coverage for employees working less than twenty hours per week.
The legislature believes that while the Prepaid Health Care Act served its purpose during the time it was created and many years thereafter, it is now time to consider other options. Increasing health care costs, insurance premiums, employer costs, prescription drug costs, long-term care costs, together with the growing number of uninsured individuals, and inadequate Medicaid reimbursements are creating a need for new and innovative legislation that will provide affordable health care for all of Hawaii's citizens.
A single payer system, where one entity covers all the health care for a specific population either directly or through contracts with insurers, is a viable option for the State to provide health care coverage for all citizens at an affordable cost.
http://www.capitol.hawaii.gov/sessioncurrent/bills/hb1617_.htm
Comment: Currently, the leading proposals for universal health care coverage include some variation of an employer mandate. Hawaii has provided the testing grounds for this model of reform. The experiment failed. Health care costs have not been controlled, and, worse, 10% of the population remains uninsured.
Other nations effectively control their costs through various mechanisms of global budgeting. If we were to maintain our current, generous level of health care spending, global budgeting would still allow adequate funding of comprehensive services for everyone. And, if we were to establish a single program for everyone, the problem of the uninsured would disappear.
Hawaii has a second opportunity to get it right. Let's hope that they do.