HEALTH CARE

Increasing access to quality health care, strengthening the State’s ability to prepare for and respond to public health emergencies, and encouraging Hawaii’s residents to practice prevention as a means to improving personal health are among the top priorities of the Lingle-Aiona Administration.

Increasing Access to Quality Health Care

Hawaii's health care system suffers because of a shortage of physicians across the State, especially on the neighbor islands.  Evidence suggests that physicians, including many specialists, are leaving the State or retiring early because of the rising cost of medical malpractice insurance and the fear of being sued.  This problem is not unique to Hawaii and some states have addressed the issue by enacting medical liability reform legislation.  Such legislation places limits or “caps” on the non-economic damages awarded in malpractice suits.  Non-economic damages are awards intended to compensate injuries and losses, such as pain and suffering, which are not easily quantified by a dollar amount.  Caps on these damages have the effect of stabilizing insurance rates and making insurance more affordable for doctors. 

Enacting medical liability reform legislation will help Hawaii retain and recruit a strong physician workforce and expand access to quality health care for all Hawaii residents.  For the third year, because it’s the right thing to do, the Administration will propose medical liability reform legislation that will limit non-economic damages in medical malpractice suits to a maximum award of $250,000; establish limits for attorney’s fees; require economic damages to be allocated based upon proportionate percentage of negligence; and enumerate what constitutes as economic damages.

Under current law, health care providers must be granted permission by the State Health Planning and Development Agency to build a hospital or other type of health care facility, to move the location of a health care facility, or to begin offering most types of health care services.  This process dates back nearly 30 years and has become a barrier to expanding access to quality health care across the State.  Worse yet, the process ties the hands of Hawaii’s residents who work hard to improve the quality of health care facilities and services offered in their communities.

To address this issue, the Administration will again introduce legislation to reduce the number of health care facilities that must be approved by the State Health Planning and Development Agency.  In addition, the legislation will ensure that Hawaii residents have a stronger voice in determining what types of health care facilities and services are offered in their communities.

Many hospitals, clinics, and physicians struggle because of low reimbursement rates for the services they provide when treating us.  Reimbursement rates are set through contracts negotiated by the hospitals or doctors and the insurance companies.  Frequently, the negotiated reimbursements are lower than the actual cost of the service provided.  For this reason, some hospitals and doctors choose not to enter into such contracts.  In these situations, an insurance company generally sends reimbursement for the service to the patient, rather than the doctor.

Doctors and hospitals should be in the business of treating patients, not bill collecting.  To facilitate reimbursement, the Administration is introducing legislation requiring insurance companies to reimburse doctors and hospitals directly, even when no contract between the medical service provider and the insurer exists.

To improve access to quality health care for workers injured while on the job, some private unions and their employers have negotiated stand-alone workers’ compensation agreements.  These collectively-bargained agreements are tailored to meet the specific needs of employers and their employees and have the effect of resolving claims more efficiently and getting workers back on the job.

The Administration is introducing legislation that will give public unions and their employers the same ability that private unions have to negotiate collectively-bargained workers’ compensation agreements.  This is a win-win situation for employers and their employees and ensures that workers are treated in timely manner with quality medical care.

In addition to allowing unions and their employers to negotiate workers’ compensation agreements, the Administration is introducing legislation to increase reimbursements for doctors treating patients with workers’ compensation claims.  By ensuring doctors are reimbursed adequately for the services they provide, patients will have more options and better access to quality health care.  Currently, reimbursement rates for workers’ compensation claims are set at 110% of the federal Medicare reimbursement rate.  This legislation would adjust the workers compensation reimbursement rate over next two years to 135% of Medicare.

(UOH-05)  Nurses are the backbone of our health care system and we must do all we can to retain and recruit more qualified nurses for our State.  To address this need, the Administration is introducing legislation that creates an additional means for gaining a license as a registered nurse.  Under the bill, nursing students, pursuing a master’s degree at an accredited school of nursing recognized by the State Board of Nursing, will be eligible to apply for a license and take the exam to become a registered nurse more quickly.

Strengthening Preparedness

Our ability to lessen the impact from an outbreak of illness or disease depends heavily on early detection and detailed analysis of the source before it spreads.  With the right information, highly-trained scientists, known as epidemiologists, can detect potential threats such as e-coli bacteria found in food, isolate the source, and minimize further damage caused to Hawaii residents.

In some cases, epidemiologists have had difficulty collecting the plant, animal, or food samples necessary to conduct an expedited investigation.  To ensure the health and protection of Hawaii residents, the Administration is introducing legislation that would give epidemiologists needed authority in times of emergency to collect samples and begin an investigation.  

Volunteer medical workers are one of the State’s best resources in responding to public health situations and crises.  These licensed workers can perform important volunteer activities for the State, such as administering flu vaccination for children and the elderly.

Under current law, volunteer workers are protected from liability in officially-declared emergency situations.  In order to encourage increased volunteer participation, the Administration is introducing legislation that will protect volunteers by granting them reasonable immunity from liability in non-emergency situations as well.

Hawaii is like a busy train terminal in the middle of the Pacific shuttling visitors in and out from regions far and wide.  The reality is our environment makes us more susceptible to various disease outbreaks, some of which we have never encountered.  To strengthen our emergency preparedness, the Department of Health is working to implement a cutting-edge electronic surveillance system that will provide early detection and warning of potential public health threats such as influenza pandemic, communicable diseases, and even bioterrorism attacks.

To support this effort, the Administration is introducing legislation that will require hospitals throughout the State to report emergency room data electronically on a real-time basis.  This effort will provide constant surveillance of potential threats and ensure better health and safety protection for Hawaii residents.

Prevention

As the old saying goes, “an ounce of prevention is worth a pound of cure” especially when it applies to health care.  Studies show that the best way to prevent the risk of serious illness such as obesity, high blood pressure, heart disease, diabetes, cancer and arthritis is to maintain a healthy diet and exercise regularly.  Across the country, public and private sector employers are sponsoring worksite wellness programs as a way to improve the health and well-being of their employees.  Such programs can involve lunchtime walking groups, softball leagues, and healthy eating clubs.

This year, the Hawaii State Department will take the lead in developing a worksite wellness program for State and county employees.  The Administration supports this effort and will introduce legislation to ensure that State and county agencies will not be liable for injury and damage that occur through voluntary participation in a worksite wellness program.  To protect employees, the bill authorizes workers’ compensation benefits for employees injured while participating in such programs.

Old habits are hard to break, so why not teach good ones when we’re young?  To improve the health of Hawaii’s students, the Administration is introducing legislation requiring all K-12 public school students to participate in daily physical education classes.  Under the bill, children in kindergarten through fifth grade would receive 45 minutes of daily physical education.  Children in grades 6 through 12 would receive 60 minutes of physical activity per day.  Daily exercise maintains good health and is great habit for the children of Hawaii.