Ka Wai Ola - Office of Hawaiian Affairs, Volume 17, Number 3, 1 March 2000 — Federal health measure helps too few Hawaiians [ARTICLE+ILLUSTRATION]

Federal health measure helps too few Hawaiians

ON JAN. 3 the newly reorganized Board of Trustees voted 7-to-l to approve S.1929. the Inouye/Thompson health measure. I was the only trustee voting no. The action amounted to the BOT's rubber stamping the legislation for political reasons. No background or action item had been prepared by staffer Colin Kippen. aka "the Judge." Although the amendments proposed by Pinky Thompson called for OHA to expend millions of dollars. the BOT was provided no fiscal report verifying the cost to the OHA trust. Here's the testimony of several Hawaiian health professionals against provisions of the measure - testimony Senator Dan Inouye ignored: • "At this juncture and until Hawaiian sovereignty issues regarding the Native Hawaiian people's right to self-determina-tion have been settled, the need for a Native Hawaiian health service, a Native Hawaiian health plan or a separate Heahh Care Financing Administration (HCFA) for Native Hawaiians is not warranted. Instead, by memorandum of understandings and through the demonstration project process, we should explore contractual mechanisms. federal subsidies, carve

outs, risk adjustments, target population data collection and the estabhshment of culturally acceptable, communitybased programs. Within this contractual context, such mechanisms will supplement the existing Medicare and Medicaid programs and commereial coverage and provide the oppx)rtunity to leverage the federal govemment's $1 trillion health care expenditures." • "We believe that at the present time, neither POL (Papa Ola Lōkahi)

nor OHA, individually or collectively, is capable of serving as the health care financing agency for Native Hawahans who are entitled to insurance under titles XVB. XIX and XXI of the Social Security Act and other federal health insurance programs. When one considers the total scope of direct and administrative services required to adequately care for patients, the health care expertise of both organizations at this time is limited. The flow of

funding to heahh care providers should not be jeopardized by inexperienee whieh may plaee more Native Hawaiians at risk of losing access to needed heahh care. On the other hand. OHA and POL should aggressively pursue memoranda of understanding, contractual agreements, federal subsidies, risk adjustments, target population data collection, and establishment of culture-based eommunity programs directly and/or through demonstration projects with the

federal government to improve health care access and resource allocation for Native Hawaiians." f en. Inouye's office sent the Hawaiian K health care providers' critical testimo- \ ny to Thompson and Papa Ola Lōkahi lfor comment. In his response dated w Jan. 27, Hardy Spoehr acknowledged, "While we agree that at this time we do not have the technical knowledge, we do

have a vision in mind." The "vision" Thompson, Inouye and Spoehr is in section 6(f)(2) of the bill requiring the OHA trust pay for and provide services that HCFA now pays for and provides. Hawaiians don't need a "vision." They need primary and acute health care services, whieh Papa Ola Lōkahi does not provide. The Native Hawaiian Health Care System receives all the federal funding for Hawaiians, but services only 10 percent of us. The current bill will not expand elinieal service to Hawaiians, but it will require native trust assets be depleted to duplicate federal programs and duties. The health needs of 90 percent of Hawaiians are excluded from the bill. The Inouye/Thompson health measure also calls for federal surplus lands, including ceded lands, to be turned over to Pinky Thompson and Papa Ola Lōkahi. Under the Admission Act, these surplus lands are supposed to go to the 5(f) trust. Despite the dire need for a kupuna health program and supplemental insuranee for medicine, the Inouye/Thompson bill provides nothing specifically for our kūpuna or community clinics such as the one in Hāna. Only those few in the Inouye/Thompson loop will benefit! ■

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