Call and Email to Support Universal Health Care via Funding The Hawai`i Health Authority Aloha, Urgent Action for Universal Health Care! Please take a minute to CALL or EMAIL the Chair and Vice-Chair for the Senate Ways & Means Committee (WAM). They will be deciding to fund (or not fund) the Hawai`i Health Authority (HRS322 HHA), which is the group tasked with developing a Hawai`i state-based healthcare plan and system (aka Universal Health Care). The deadline for 'on-time' testimony or phone calls in support of funding the HHA is 9:30am Tuesday (March 28). However, the hearing is on Wednesday at 9:30 am. Testimony submitted late will still be noted, so long as there is a lot of it. Full info: https://www.facebook.com/events/1958627831027708/ Four Ways to Take Action! CALL Chair Jill Tokuda # 808-587-7215 Vice Chair Dela Cruz # 808-586-6090 Governor Ige # 808-586-0034 Sign the petition: https://www.change.org/p/hawaii-state-legislature-support-universal-single-payer-health-care-introduced-as-a-bill-in-hawaii-in-2017?recruiter=9811641&utm_source=share_petition&utm_medium=copylink “Aloha, my name is First and Last Name , I live on Kauai, or your Island, and am calling to urge you to please support inserting a line item in the budget for HB 100 HD 1, to fund the HRS322 Hawai`i Health Authority. Mahalo for your time.” SUBMIT WRITTEN TESTIMONY Sign In / Create an Account on www.capitol.hawaii.gov Log Into Your Account, then click here: HB 100 HD 1 or search for ‘HB 100’ Next, click on the blue ‘Submit Testimony’ button Follow the directions to select the appropriate options. Select ‘Support’ for your “Testifier Position” Copy/Paste Testimony below into the “Additional Comments” box Personalize your testimony if you have the time RE: HB100 March 29, 2017 9:30 am, WAM Room 211. "Aloha, my name is First and Last Name , I live on Kaua`i and am submitting testimony in strong support of inserting a line item in the budget for HB 100 HD1, to fund the Hawai`i Health Authority. Mahalo for your time.” 7. Submit Testimony (you will receive an automated email with a copy of your testimony 'Like' and 'Follow' Us: Kaua`i Women's Caucus on Facebook 'Like' and 'Follow' Island Wide, specifically for Health Care: https://www.facebook.com/groups/healthcareforallhawaii/ Encourage others to email us and get notified of meetings, actions and events: kauaiwomenscaucus@gmail.com For events on Oahu: singlepayerhawaii@gmail.com Inline image 1 COMMUNITY COALITION FOR HAWAII UNIVERSAL HEALTHCARE THROUGH COMPREHENSIVE PLANNING March 27, 2017 To: The Honorable Jill Tokuda, Chair The Honorable Donovan M. Dela Cruz, Vice Chair, and Members of the Senate Committee on Ways and Means Re: HB 100 – State Budget Position: Request to add $250,000 item to Department of Budget & Finance for Hawaii Health Authority, an attached agency Hearing: Wednesday, March 29, 2017, 9:30 a.m. Conference Room 211 We are an unpaid group of Hawaii residents representing literally thousands of very politically active Hawaii residents, mostly active Democrats. We believe Hawaii is facing a healthcare crisis that urgently needs your immediate attention. We strongly urge you to add to the Governor’s budget a line item for $250,000 for the Hawaii Health Authority (HHA), to help it fulfill its critical mandate to develop a comprehensive State-based plan for a healthcare system for Hawaii. The HHA was established by HRS Chapter 322H. This Legislature wisely administratively attached the HHA to the Department of Budget & Finance precisely to protect it from bureaucratic pressures from the Department of Health. The HHA uniquely serves as a small, independent policy-planning board composed of 9 volunteer members with diverse expertise in medicine and related fields. It is beholden to no specific director or political ally. We urge the Senate Ways and Means Committee to insert this authorization of $250,000 to allow the HHA to hire a full-time Executive Director at up to $80,000, and additional staff persons and other administrative and contractual expenditures with the balance. Under HRS 322H-2(b), the HHA is tasked with the responsibility to develop a comprehensive health plan that includes: (1) Establishment of eligibility for inclusion in a health plan for all individuals; (2) Determination of all reimbursable services to be paid by the authority; (3) Determination of all approved providers of services in a health plan for all individuals; (4) Evaluation of health care and cost effectiveness of all aspects of a health plan for all individuals; and (5) Establishment of a budget for a health plan for all individuals in the State. This is a huge task, and $250,000 would be a bargain amount to get this done. The HHA’s oversight is ESSENTIAL for unbiased and incentive-neutral repair of our unsustainable status quo, even under Obamacare: a “healthcare bubble” of needless expense, waste, and compromised care. HHA’s job is to research and plan comprehensive universal healthcare as an alternative strategy to the current system. As the Trump Administration threatens to make the most volatile and unpredictable changes Hawaii could be facing in healthcare policy and delivery, we can’t afford to abolish the only State agency that is specifically designed to propose innovative solutions to already imminent and likely intractable problems. Just in the past week or two we have seen how close Hawaii’s future healthcare situation has skirted complete disaster – Right now, one out of every four Hawaii residents relies on Medicaid for healthcare. Yet the Republicans in Washington are ready to seriously curtail funding for Medicaid. Then, what will we do? We do not know the answer to that question. That is why we need the Hawaii Health Authority to help figure this critical issue out for us! Currently, Hawaii’s healthcare system is beset with major problems from multiple directions.And these problems originate in the deep past, and have not been fixed by Obamacare. In fact, Obamacare has made some of them worse. These challenges include, but are hardly limited to, the following: Under federal ACA and MACRA laws, doctors are being pressured to restrict and deny necessary care, and from assuming responsibility to care for sicker, more complex, and socially disadvantaged patients; The system is creating equally perverse counter-incentives of “pay-for-performance” and risk-adjustment that burden doctors with excessive documentation and data-management demands; The system is increasing costs for both providers and payers (Medicare, Medicaid, private insurance) where physicians and office staff must: Spend more than 15 hours per week on “quality” measures and reporting; Spend more than $40,000 per MD per year on “quality” measures and reporting; Spend twice as much time paying attention to computers as to patients; Respond to measures, most of which have little to do with actual quality of care; There are pressures to replace fee-for-service systems with “value-based” payment, shifting insurance risk onto doctors and hospitals, so they have a financial incentive to restrict care; The insurers are markedly increasing pharmaceutical formulary restrictions and prior authorizations for drugs and imaging, adding more administrative barriers to care. These problems have resulted in the following in Hawaii, in rapidly increasing effects in just the past couple of years. Your constituents will confirm this to you: Rapid loss of physicians from private practice all over the country, but especially in Hawaii where two thirds of our physicians were in individual and small-group practices prior to the ACA, leading to: Premature retirement; Leaving Hawaii; Taking administrative jobs to get out from under micromanagement of the care of their patients; Taking jobs with hospitals and big health systems, with higher overhead and higher cost for payers; Patients losing access to doctors in out-patient settings, an accelerating problem: October 2016: 31% of Oahu primary care practices closed to all new patients, double the rate of the previous year; 47% closed to new Medicare patients, with even more refusing new Medicaid; More care pushed to ERs and hospitals for those who can’t get care elsewhere; An epidemic of physician burnout – at 55% in December 2015 and rising annually – here in Hawaii!; Rising costs (premiums, deductibles, co-pays), less access, and thus the threat of health system collapse in the very near future, EVEN IF Trump and the Congressional Republicans do not make our present bad situation worse than it already is. For all these reasons, it is essential that Hawaii follow through with the well-planned procedures set out several years ago in HRS Chapter 322H to develop a system that will stop the cost-explosion, and begin us on a road to cost-containment. The HHA is the ONLY AGENCY that can streamline health planning and policy management by ridding the system, through careful planning and analysis, of the barriers and burdens that everyone in it is suffering. Please add $250,000 to the budget of the Department of Budget and Finance for the Hawaii Health Authority, so that it may proceed to plan for a comprehensive universal healthcare system. Thank you for your kind attention to this serious and pressing issue, and for your foresight in considering our request. Stephen Kemble, M.D. Alan B. Burdick Marion F. Poirier, R.N. Daria Fand Dennis Boyd Miller Erynn Fernandez Contact: burdick808@gmail.com singlepayerhawaii@gmail.com