Hawaii pols push for health care funding


Hawaii’s congressional delegation this week pushed for more support of a measure that would provide funds to train health care providers in rural areas.

At least half the delegation — Sen. Brian Schatz and Rep. Tulsi Gabbard — said they would also support increasing Medicare reimbursement rates for Hawaii doctors. The late Alaska Sen. Ted Stevens secured higher reimbursement rates for his state’s doctors, and doctors in Hawaii have long asked for a similar increase here, a recognition of the challenges patients face in seeking care, and the challenges doctors face in providing it in a rural, high cost of living area.

“I have long been a strong advocate for increased Medicare reimbursement rates,” Gabbard said in an email response Tuesday. “By instituting these higher rates, we can expand health care access and retain physicians in our rural communities, and follow the model of success seen in Alaska after making this change. I will work to pass legislation that will help address the unique health care needs and challenges of our rural island communities.”

Gabbard, during her election bid last fall, said an increase would be appropriate, calling the idea a “no-brainer.”

Schatz, in an email Tuesday, said he has voted for legislation to provide funds to reimburse doctors for services.

“Reasonable reimbursement rates under Medicare are a real challenge to access for care,” Schatz said. “People in West Hawaii in particular experience extraordinary challenges in accessing even basic care and services. … In the long run, we have to create a system that is more efficient and recognizes the difficulty of providing high quality health care on our neighbor islands.”

Sen. Mazie Hirono’s office did not respond to a request for comment on increasing Medicare reimbursements, but during her campaign last year, Hirono said she supports increased Medicare and Medicaid reimbursements — not just to Hawaii’s doctors, but across the country.

Hirono and Rep. Colleen Hanabusa were the original co-sponsors of the Rural Preventative Health Care Act, which Schatz and Gabbard introduced Senate and House versions of Tuesday. This legislation would fund preventative health care training for students capable of treating the 110,000 Hawaii residents who live in rural areas, the delegates said. The funding is not specifically for doctors — although the congressional delegation focused instead on the lack of physicians in their remarks supporting the measure.

“Access to quality health care is a basic necessity, and one which oftentimes does not exist for those in our underserved rural communities. This bill takes steps to address this urgent problem,” Gabbard said, adding Lanai, for example, has no pediatrician or dentist. “In rural areas, medical emergencies have to be airlifted to Honolulu. Women may have to travel to and stay on another island before they give birth in order to ensure a safe delivery. This is unacceptable. People from every island deserve access to the highest quality of health care.”

Hirono noted a John A. Burns School of Medicine report that Hawaii has 600 fewer doctors than it needs and faces health care professional shortages in particular on the neighbor islands.

“By encouraging programs that help train health care professionals in our own backyard, we can help tens of thousands of Hawaii residents get better access to preventative care and make our state healthier,” Hirono said.

The act will provide students pursuing careers in preventative care with the chance to receive a stipend to attend a community college or institution that serves rural communities, the delegates’ staff said. The act will also increase staff support, so these preventative health care training programs become self-reliant.