As it happens, the hospital Rush Limbaugh gushed over in Hawaii is one of the most progressive and union-friendly hospitals in America. One reporter framed the irony:
At the news conference held at The Queen’s Medical Center in Honolulu, Limbaugh added he got the best health care anywhere right here in the United States. What Limbaugh, a powerful and outspoken opponent of the Obama Health Care Plan, failed to mention is the medical system in Hawaii is as close to socialized medicine as there is in the United States, and, much of the Democrats reform bill is based in the Hawaii system.
And why would you want to base many of your reforms on the Hawaii system? Because, as this NY Times article makes clear, it just works:
[T]he most intriguing lesson from Hawaii has to do with costs. This is a state where regular milk sells for $8 a gallon, gasoline costs $3.60 a gallon and the median price of a home in 2008 was $624,000 — the second-highest in the nation. Despite this, Hawaii’s health insurance premiums are nearly tied with North Dakota for the lowest in the country, and Medicare costs per beneficiary are the nation’s lowest.
Hawaii residents live longer than people in the rest of the country, recent surveys have shown, and the state’s health care system may be one reason. In one example, Hawaii has the nation’s highest incidence of breast cancer but the lowest death rate from the disease.
How does Hawaii keep costs so low and get such fantastic results? The NY Times asked around:
In dozens of interviews, doctors and hospital and insurance executives in Hawaii offered many theories, including an active population that is culturally disinclined to hospitals, a significant military presence and a health care market dominated by a few not-for-profit organizations.
But there was another answer: With nearly 90 percent of the populace given relatively generous benefits, patients stay healthy and health providers have the money and motivation to innovate.
If true, it’s a crucial lesson.
Makes sense to me. For over 35 years Hawaii has required that employers pay generous medical benefits to their employees who work at least 20 hours per week. Now virtually the entire population has easy, and inexpensive, access to preventative medicine and routine exams or check-ups. As a result, they stay healthy — much more healthy than those of us on the mainland. And since they continue to pay premiums into a the medical insurance system while generating few costs, premium prices go down and there is more money for innovating care (for example, Hawaii is far out in front of the rest of the nation in digitizing health records). Easy access to affordable care reduces the problem of indigent care and their use of emergency rooms for primary care — one of the biggest culprits for the rise in the cost of medical care and insurance. In fact, in 2007, Hawaii “had 264 outpatient visits to emergency rooms per 1,000 people — 34 percent lower than the national average of 401.” And this is a place with 40 foot waves and active volcanoes!
The truth of the matter is that Rush was right: there is nothing wrong with Hawaii’s heath care system. What’s wrong is that the rest of us don’t have it.