Since 1974, Hawaii has been the only American state with a comprehensive health-insurance system, the Pre-paid Health Care Act, which, in conjunction with other state and federal programs serving the aged and poor, extends basic health-care insurance to an estimated 98 per cent of the state’s 1.2 million residents. Under the act, employers are required to fund a minimum of 50 per cent of the costs of private health insurance, with employees paying the other half or 1.5 per cent of their total income, whichever is less. The basic insurance covers diagnostic, surgical, ma-
ternity and substance-abuse services, and pays for up to 120 days in hospital each year. Now, some state health officials say that they are concerned that a potential health-care program for all 50 states could replace Hawaii’s program with one that reduces the level of coverage Hawaiians currently enjoy. Said Barbara Hastings, communications director for the state health department: “We want to make sure that we don’t lose what we have.”
To that end, Hawaii’s health department officials have stepped up efforts in Washington to sell the merits of their system. They say that universal health care has improved Hawaiians’ life expectancy—a combined average for men and women of 78.2 years, compared with 73.6 in 1971. As well, the state’s infant mortality rate has dropped to 6.5 per 1,000 births, compared with 19.1 1,000 in 1970. And
comparison of insurance rates showed that monthly premiums for family coverage in Hawaii are $302, well below the $578 paid in California for the same coverage by the same companies.
Health department officials attribute the savings to the large number of residents paying into the plan. As well, they say that Hawaiians, knowing that they are insured, seek medical care before health problems reach a critical, and more costly, stage. Hastings said that the main concern now is to provide coverage for the final two per cent of the population who are without insurance. With many Americans lacking any form of health insurance, Hawaii is a comparative paradise.
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