Hawaii Ending Universal Child Health Care After 7 Months

Big surprise! Offer something valuable for free and people will rush it!

Hawaii is dropping the only state universal child health care program in the country just seven months after it launched. Gov. Linda Lingle's administration cited budget shortfalls and other available health care options for eliminating funding for the program. A state official said families were dropping private coverage so their children would be eligible for the subsidized plan. "People who were already able to afford health care began to stop paying for it so they could get it for free," said Dr. Kenny Fink, the administrator for Med-QUEST at the Department of Human Services. "I don't believe that was the intent of the program."

State officials said Thursday they will stop giving health coverage to the 2,000 children enrolled by Nov. 1, but private partner Hawaii Medical Service Association will pay to extend their coverage through the end of the year without government support. "We're very disappointed in the state's decision, and it came as a complete surprise to us," said Jennifer Diesman, a spokeswoman for HMSA, the state's largest health care provider. "We believe the program is working, and given Hawaii's economic uncertainty, we don't think now is the time to cut all funding for this kind of program."

Hawaii lawmakers approved the health plan in 2007 as a way to ensure every child can get basic medical help. The Keiki (child) Care program aimed to cover every child from birth to 18 years old who didn't already have health insurance - mostly immigrants and members of lower-income families. It costs the state about $50,000 per month, or $25.50 per child - an amount that was more than matched by HMSA.

State health officials argued that most of the children enrolled in the universal child care program previously had private health insurance, indicating that it was helping those who didn't need it.

The Republican governor signed Keiki Care into law in 2007, but it and many other government services are facing cuts as the state deals with a projected $900 million general fund shortfall by 2011.

While it's difficult to determine how many children lack health coverage in the islands, estimates range from 3,500 to 16,000 in a state of about 1.3 million people. All were eligible for the program. "Children are a lot more vulnerable in terms of needing care," said Democratic Sen. Suzanne Chun Oakland. "It's not very good to try to be a leader and then renege on that commitment."

The universal health care system was free except for copays of $7 per office visit. Families with children currently enrolled in the universal system are being encouraged to seek more comprehensive Medicaid coverage, which may be available to children in a family of four earning up to $73,000 annually. These children also could sign up for the HMSA Children's Plan, which costs about $55 a month.

"Most of them won't be eligible for Medicaid, and that's why they were enrolled in Keiki Care," Diesman said. "It's the gap group that we're trying to ensure has coverage."

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Australia: More deadbeat public hospitals

How disgraceful that it takes big publicity in order to get a hospital to pay its bills

Shoalhaven Hospital, on the South Coast, came close to halting all surgery recently because it had just a day's worth of sterilisation solution left due to unpaid bills, a senior doctor says. The head of surgery, Associate Professor Martin Jones, told the Herald the hospital was also put on "stop supply" 10 days ago for cataract lenses - the second time in two months - by a supplier tired of waiting for bills to be paid. "We just haven't paid our bills," he said. "All the sterilisation in theatre was coming to an end and we didn't have the supply to go for more than 24 hours. "The hospital would have to close . because nothing would be sterilised."

He said the bill was paid urgently and the supply ban lifted after he had wasted considerable time chasing management about the problem. "We who are working on the ground in getting the simple operations done to look after the rural people of the health service just don't need that as a frustration," he said. "We do run very close to the bone in a large number of supply goods."

The Herald understands tens of millions of dollars are owed to medical suppliers by four area health services - Northern Sydney Central Coast, Greater Southern, South Eastern Sydney Illawarra and Greater Western. The NSW Health Department has refused to reveal how much it owes and has gagged its area health services. South Eastern Sydney Illawarra Health did not respond to Professor Jones's claims.

The state Opposition health spokeswoman, Jillian Skinner, said she had been contacted by several businesses over recent months complaining about unpaid bills. One company, Leeton Diagnostic Imaging, confirmed yesterday it was owed $35,752 from May until two weeks ago. Yass air-conditioning mechanic Touie Smith was owed $18,386.50 for accumulated bills from April until the end of August, when they were finally paid.

Roger Christie, who owns Merimbula Taxi Service, said he has been owed $4423.65 since July for transporting patients and blood from Pambula to Bega hospital. As he has the only taxi service in the area he said he felt obliged to continue servicing the health department. "Obviously, I would prefer the money was in my bank and not their's. It's an ongoing thing. I got a call at 1.30 this morning to take blood . because someone had a car accident. It was an emergency so I can't really say no," he said.

The State Government has had to release $11 million urgently in the past few weeks to cover debts to suppliers after many refused to grant credit to NSW hospitals.

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