I am a recent graduate of the University of Hawaii at Manoa, back in Hilo working my first full-time job.
On a limited budget, I am sensitive to the price of gas, since I have to pay for it myself now. In November, gas prices for the state were 33 percent higher than the national average. When regular gas cost more than $4 a gallon, it was headline news.
But what if gas was $10 a gallon? How would that impact us? It would create an outrage across the state. At the same time, we would feel powerless to do anything about it. The hard truth is that health care costs impact us far more than $10 a gallon gas.
Last year, the average family coverage health plan cost about $20,000 a year in Hawaii, about $1,700 a month. In Hawaii, if we assume that on the high side we drive about 10,000 miles a year at 20 miles per gallon, that’s 500 gallons per year, or $5,000.
We would demand changes in policy and pricing. We would change our behavior: drive less, car pool, buy smaller cars. Yet, we pay four times the price of $10 a gallon gas for health care. We just don’t know it or feel it because the Prepaid Healthcare Act of 1974 caps employee concentration at 1.5 percent of salary. In 1974, that was a much larger percent of our salaries; today, it is an almost immaterial percent of health insurance premiums. Make no mistake, however. That money is coming from funds that could go to higher salaries.
In the few months since I started my job at the East Hawaii Independent Physicians’ Association in Hilo, I’ve learned a lot about the health care system. I realized many of us are unaware of the alarming and unsustainable increases in health care costs that have been occurring during the past decade. Instead of waiting until costs increase further, we should act as if this was more of a crisis than $10-a-gallon gas and do something about it right now.
After attending a presentation Nov. 15, organized by the Hawaii Island Chamber of Commerce and Community First called “Hilo’s Escape Fire,” I realized we, as a community, must come together to respond to this crisis. There were business leaders, hospital executives, physicians, health care providers, health plan executives and county leaders giving their views.
I learned health insurance in Hilo costs 11 percent less than the rest of the nation, and for that, we should be proud. In fact, Hawaii has the lowest spending for insurance across the country, according to a recent New York Times article. If you compare that to the average income of a single household, however, we make 23 percent less in comparison to the average nationwide. So actually, we pay more than most places as a percentage of income for health insurance.
Many of us don’t realize how much we are paying for health care because it comes from our employers or the government. We need to understand that the pool of money is limited, in the private sector and the government. If we can decrease costs, that savings can go to salaries or other public needs such as education or housing.
At the presentation, I also learned we have to change how we think about health care. Health care is not just treating disease and something for which physicians are responsible. Health care is about taking care of health — something for which we all must be responsible. It will take a community to change the idea of health care. It will take effort at all levels, but most importantly, by each of us in our daily lives.
I also learned the health care industry must make fundamental changes in paying — not fees for services, but fees for the quality of care and the health of a population — in how medical information is integrated and shared while protecting privacy, and in how care must be coordinated in our complex system.
Most of all, I realized we cannot transform without the support of the entire community. We need to start talking about health care with our friends and neighbors, give preventive care to our patients, get in contact with patients who haven’t been to the office lately and ask our employees what kind of coverage their family needs.
It’s up to us to change the landscape of health care. After all, it’s our money, and it’s costing us way more than $10 for a gallon of gas.
This column was prepared by Community First, a nonprofit organization headed by KTA’s Barry Taniguchi, and supported by a volunteer board of local community leaders. Community First was recently established to help the community respond to the health-care cost crisis and support initiatives that change health care from just treating disease to caring for health.
