The top two Hawaii Democrats running for governor squared off Tuesday morning for an hourlong debate focusing on several key issues affecting the state’s rapidly growing elderly population.
Gov. Neil Abercrombie and state Sen. David Ige revealed how they would improve health care, the economy and quality of life of seniors during the AARP Hawaii-sponsored event at King Kamehameha’s Kona Beach Hotel. They also touted their qualifications, track records and leadership styles.
Several audience-submitted questions centered on whether the candidates would consider taxing pensions. In 2011, Abercrombie had proposed a pension tax to help reduce a projected state budget deficient and the Legislature rejected that unpopular idea.
Ige said, during the hard economic times four years ago, he stood up with the state Senate and “absolutely insisted that we do not tax pensions,” as well as introduced constitutional amendments “to make the law even stronger.” He said, “I will never balance the budget on the backs of the elderly, on the backs of pensioners. It is really unfair.”
Abercrombie countered, saying Ige was the originator of the first bill to tax pensions. Abercrombie also mentioned Ige’s support for House Bill 793 to raise the general excise tax 1 percent, a move he said would have caused a greater impact on everyone. Instead of taxing pensions, an idea Abercrombie claims is “in the past,” he called for the state to continue building its reserves and begin looking into providing tax relief for seniors.
According to a University of Hawaii study, there’s a 34 percent shortfall in the number of physicians needed in Hawaii and the shortage is especially acute on Hawaii Island. The state has tried student loan forgiveness and supporting the Primary Care Training Program at Hilo Medical Center, but this will likely not fill the void, said Gerald Kato, a UH journalism professor and the debate’s moderator.
Ige mentioned his involvement with the John A. Burns School of Medicine to increase physicians in Hawaii, as well as how he helped champion the residency program at Hilo Medical Center because he felt the best way to get physicians to establish their practices here was to have them spend their residency time in the communities that they intend to serve. Ige wants to increase the number of residency programs on the neighbor islands.
“Hilo Medical Center’s residency program was intended to be the first as a model. We need to involve the Kona Community Hospital as a place for additional residencies as we bring doctors and future doctors into the communities we hope to serve,” he said.
Abercrombie said the “practical way” for solving the shortage is having more nurse practitioners and medical personnel. He also thinks long-distance learning should be used to diagnose along with using the expanding nurse practitioner base. He thinks nursing schools should be established across the university system statewide and more scholarships should be offered at the John A. Burns School of Medicine, which he claimed to help establish almost 35 years ago with then dean Terry Rogers.
“Accreditation now means an expansion of nurse practitioners and the ability of the neighbor islands to be able to have people not only who do diagnosis, but administer health care on a much broader basis than just the old physician model,” he said.
Abercrombie expressed regret that the Legislature did not follow his recommendation to increase the budget for Kupuna Care — a state-funded, county-administered program that provides services to frail elderly who can’t live at home without assistance — and make it permanent. While a baseline was put into the budget, he said the program doesn’t have nearly as much funding as it needs, especially considering the number of residents age 60 and older continues to grow and live longer. He also thinks the services should be for Medicaid and Medicare recipients.
A member of the Legislature’s Kupuna Caucus for 20 years, Ige called Kupuna Care a success in helping families take care of their elderly loved ones at home. He promised as governor to make sure the budget for the program next year will start at $9 million. He said legislators are working to expand Medicaid coverage to ensure not only nursing homes costs are covered, but also more of the costs families incurred while caregiving. “Only when we do both of these things can we assure that all citizens get the help they need to take care of the elderly in their home,” he said.
When asked, Ige said he would support a law requiring hospitals to train family members and other caregivers to properly care for discharged loved ones. He mentioned his support for Senate Bill 2264 — the CARE Act — from AARP that would have required such training. However, he said “there were legitimate liability concerns that needed to be addressed,” which was why the Legislature voted for a task force to determine how best to provide the after-care needed.
Abercrombie said he worked with AARP on the bill, which had a statute that “hospitals would not be liable,” but the Legislature wanted to examine the issue more and asked his administration to put together the working group. He assured that 19-member group will be ready with a bill on caregiving next January that will satisfy AARP’s mission and goals.
When it comes to fixing state hospitals, Ige wants to make investments in these facilities while also reviewing the Hawaii Health Systems Corp.’s contracts. He said “the existing contract is very difficult and increases costs significantly.”
Abercrombie called for congressional delegations to fix Medicare and Medicaid problems. He also wants to make significant investments to ensure health centers, particularly those on neighbor islands, have the personnel and equipment to deal with health care needs, as well as partnerships formed with hospitals.
Other issues discussed included education, transportation projects, job creation and the Public Land Development Corp. repeal.