Tackling the rising cost of state’s health care


It’s a topic that many try to avoid — death.

But in the Midwestern town of La Crosse, Wisc., 96 percent of people who die have an advanced directive, a document that sets out how an individual wants to pass away.

The result: La Crosse spends less on health care for patients at the end of life than any other place in America.

Barry Taniguchi, CEO of KTA Super Stores, played a recording of the National Public Radio piece at Thursday’s Japanese Chamber of Commerce and Industry of Hawaii Economic Development Committee luncheon at ‘Imiloa Astronomy Center.

The seven minute clip, written by NPR’s Chana Joffe-Walt, explained how the town seemed to unintentionally redefine its health care by starting the conversation of how patients would like to live out their dying days.

Jeff Thompson, CEO of Gundersen Health System in La Crosse, was quoted saying “it turns out that if you allow patients to choose and direct their care, then often they choose a course that is much less expensive.”

Taniguchi told the crowd the discussion of advance directives is one he hopes to start with the community through a new board called Community First.

The board aims to identify ways in which East Hawaii can play an active role in tackling the issue of health care and its burden on state funds in Hawaii.

Taniguchi, chairman of the founding board, serves on the panel with Dr. Richard Lee-Ching, Roberta Chu from the Bank of Hawaii, and Kaiu Kimura, executive director of ‘Imiloa.

Although they’ve had only a few talk-story sessions, Taniguchi said the committee intends to meet formally and start the conversation regarding the effects of Hawaii’s current health care system with other East Hawaii residents.

“We hope Community First can serve as a way for the community to come together and identify our most important health care needs,” he said.

He laid out four points he thinks could help reshape the issue of health care costs — ending medical homelessness, ending high blood pressure, rewarding good health and ending uninformed dying.

Taniguchi was one of three speakers at “The Crisis of Cost in Healthcare” event.

Luis Salaveria, representing the state Department of Budget and Finance, and Mike Sayama with IDEAS Health, also spoke about various issues relating to health care locally, statewide and nationally.

Sayama started his presentation with a warning, saying not addressing government spending on health care is an unwise option.

“It will drive the deficit. It will eat everything up,” he said.

Pointing to a slide about the cost of dying, Sayama noted the cost of provided care 7.4 months before dying causes health care costs to spike.

“The question is what’s the value of spending this money the last few months of life. If it creates a meaningful life and improves the quality of life, then I think we would all say that it is worth it,” he said. “But if it doesn’t, and we wonder why did we do that then wonder if that’s what the person really wanted, then that’s an area that the community has to address. It’s a sensitive area.”

Salaveria said health care is a threat to the state’s fiscal health because of unfunded and unsustainable obligations.

He suggested Hawaii look to build a new paradigm and way of thinking about health care.

“We need to be real about what the future entails for us,” he said. “We can no longer kick the can down the road, which is what we’ve been doing for a very long time. This is actually one of the areas that is very important for the state about going forward…

“The new paradigm is going from the bottom up. Let’s manage our employees’ health versus our employees’ benefits… .”

Email Megan Moseley at mmoseley@hawaiitribune-herald.com