Tuesday, July 07, 2020
Hawai'i Free Press

Current Articles | Archives

Monday, May 30, 2011
Abercrombie’s Tough Deal: Penny-pinching Governor demands Control over decision to “Extend Life”
By Andrew Walden @ 12:36 AM :: 5866 Views :: Energy, Environment

by Andrew Walden

Franklin Delano Roosevelt gave America the New Deal; Harry Truman the Fair Deal.  But with Neil Abercrombie it is the “Tough Deal.”  

In a May 10 speech to medical providers discussing how to handle $150M in Medicaid shortfalls, Gov. Neil Abercrombie made it clear that he is taking full advantage of the artificially-created Medicaid crisis in order to implement his vision of how medical care should be allocated to everyone in Hawaii—not just Medicaid recipients.

Abercrombie argues that Hawaii’s best-in-the nation Prepaid Health Care Act is neither relevant nor applicable—this in spite of the fact that Hawaii has the nation’s highest percentage of insured population and medical insurance rates in Hawaii are among the lowest in the nation.  Abercrombie has been denouncing the Prepaid Health Care Act since last October—a fact which has been widely ignored by Hawaii’s so-called media. 

Arrogantly, Abercrombie states that “we” –ie the State—have to “deal with” the question: “Are we extending life or are we prolonging death?” 

This is a question for the patient, doctor and immediate family.  Who is Neil Abercrombie to take control of such an intimate issue?  Will an impenetrable and obtuse State of Hawaii bureaucrat be making life and death decisions about members of your family?

The State’s motivation for grabbing control over your life and death decisions is financial.  And they are in alliance with the big insurers.  If there is any doubt, a May 27 Star-Advertiser commentary by the CEO of the University Health Alliance makes no bones about who they are gunning for:

“We must make the inevitability of death a part of our decision-making so that the last days of life become more loving and comfortable and less brutal and costly.”

Now you know why assisted suicide keeps coming up in the Legislature.

Abercrombie has decided that the Prepaid Health Care Act is no longer relevant or applicable.  He says: “I’ve just come from a meeting with the financial side of construction and dealing with the question of healthcare, dealing with the question of whether we can continue to have a dichotomy between employers and employees.” 

In other words, the cost of employees’ health care is interfering with Capital Improvement Projects like Rail.  Maybe we should kill Rail, not grandma. 

Of course, the possibility of reforming workers comp—as California has already done in a way which improves medical care for injured workers and reduces cost by putting medicine first and litigation last—does not come up.  A 2004 workers comp effort by the Lingle administration was killed by the lawyer-infested Legislature.

TV is nightly full of ads from lawyers fishing for malpractice litigants.  But Tort Reform—putting the axe to the profits of his trial-lawyer contributors and Hawaii’s trial-lawyer Legislators—is not part of Abercrombie’s Tough Deal.

Abercrombie also admits that his goal is to make health care an integral function of the State so that all medical treatments can be dispensed with the same smiling efficiency as all State services.  He compares his proposed “investment” in a “Healthcare Coordinator” with his hiring of Marc Alexander as Homeless Coordinator—and we all know what a stupendous success the Abercrombie administration homelessness policy has been.

The deficiencies of information technology suffered by State departments is well known.  Many computer systems are 20-year old DOS-based programs.  Some offices are a nest of paper files.  But the State Information Technology system is to be integrated with efforts to force electronic medical records—and the controls they enable—on doctors statewide.  Abercrombie makes this clear:

I intend to bring on board very, very shortly a Chief Information Officer whose going to work intra-departmentally, interdepartmentally, work with you in the private sector, in the public sector, with providers, with non-profits, to see to it how we can maximize our capacity to communicate with one another. To be able not to have to duplicate files and services. To be able to give us a sense of control, rather than being totally inundated by information, inundated by data, inundated by responsibility to feel like we can’t have a coordinated sense of control over.

“We” does not include you, the patient.  “We” means the State, insurers, and the physicians, hospitals, and clinics the Corporatist State controls via electronic medical records and budget-driven rationing.  Under Abercrombie’s system, your health care will be just another line item and when the budget runs short, it will be cut.  This is already happening with Medicaid.

Abercrombie digs in deeper: 

Those are the kinds of things that I think the Chief Information Officer is going to be able to help us with. And I intend to move forward dealing with the hardware and software that is going to be associated with the improved communication of effort in a manner that treats it as a capital improvement project rather than operational situation on the operating budget side.

If we do that then I think I can follow up on what’s going to be taking place today. We have to overhaul eligibility and the data systems. We have to take a long look at that and figure out how to do it.

Yes, your health care will now depend on Abercrombie being able to peddle this Statewide software upgrade as a Capital Improvement Project—to be funded with bonds—rather than an operating expense.  Are there any State departments which would not have access to your health records?  Will your medical privacy be violated if you annoy a bureaucrat somewhere in the system?  This is Hawaii.  The question answers itself. 

And why is all of this happening?  Your health care is being turned inside out because Abercrombie is trying to kiss up to Obama.  He explains:  

We have to do this because key provisions of the Affordable Care Act is coming into place and we have to be ready ahead of time. I’d like to see the State of Hawaii actually become an example of not only forward-looking attitude, but an example of people who are ready to implement not only Affordable Care Act and the President’s direction in improving healthcare, but seeing to it that we’re start providing for him and for the country an example of what can and should be done. 

Here’s the entire speech….

 

Full Text of Gov. Abercrombie’s remarks:

Thanks everybody, that is known as ‘scattered applause’.  I appreciate that.

This is gonna be a tough deal.  Everybody knows that.  But I’m optimistic about it.  I’m optimistic because I see this gathering here today….

What I see this challenge as, is an opportunity for transformation.  For years now, we’ve been dealing with the question of medical payments, the question of medical protocols, the question of healthcare, the question of prevention, the question of long-term care, in ways that put us on the defensive.  That made us come at it from the idea of a negative start.  And I think we need to change that whole mentality.  That’s the way I’m thinking about it.  I’m thinking about it in terms of moving forward not in looking backward.

Its easy for me to say.  In some respects my job here today is to act as a kind of cheerleader for what’s coming up.  Which are tough decisions.  That’s why you folks are here.  Everybody here is interested. Everybody here is focused on this.  Everybody is here today because they have something to contribute.  Because you’ve got a foundation of knowledge, a foundation of perspective that many others don’t have.  What is happening in terms of the community at large is that they are dependent upon the judgment that is going to be made by you.  And by extension us.  Because we are an extension of your will, of your knowledge, of your perspective, of your sense of direction, and your commitment.  And that’s what we want to reflect. 

There are no necessarily right answers here particularly as we go through this transformation, but that’s what I want to concentrate on. 

Yes, there’s a cost factor.  I’ve just come from a meeting with the financial side of construction and dealing with the question of healthcare, dealing with the question of whether we can continue to have a dichotomy between employers and employees.  That, what was a progressive system of dealing with healthcare for many years—the Prepaid Employer Healthcare Plans that we had going back into the 1970s, are even relevant let alone applicable in today’s situation.  And the same thing has to do with whether its Medquest, whether its Medicaid, whether its Medicare, whether its Medicare Part B payments coming out of your Social Security Payment.  We have to deal with the realities of a population post 65 that is growing in numbers—in absolute numbers in terms of the population demographics and in terms of life expectancy as well.  What kind of consequences does that have?  What does it mean in terms of long term care?  Are we extending life or are we prolonging death?  Who is going to be eligible and under what circumstances—for Medicaid?  And how are we to conduct the business of providing services.  These are real questions that I know we are going to have to come to grips with. 

So we’ve got to go in a new direction.  We’ve got to transform the way we’ve been thinking.  We have to have better care for high-cost patients.  Even when I used that phrase, it bothered me when I looked at it.  When a high cost patient –what’s a high-cost patient?  How do you define that and which one of us is not going to be put into that category at one point or another.

Better coordination of effort.  Its easy for me to say, it is another thing to do. 

I intend to bring on board very, very shortly a Chief Information Officer whose going to work intra-departmentally, interdepartmentally, work with you in the private sector, in the public sector, with providers, with non-profits, to see to it how we can maximize our capacity to communicate with one another.  To be able not to have to duplicate files and services. To be able to give us a sense of control, rather than being totally inundated by information, inundated by data, inundated by responsibility to feel like we can’t have a coordinated sense of control over

Those are the kinds of things that I think the Chief Information Officer is going to be able to help us with.  And I intend to move forward dealing with the hardware and software that is going to be associated with the improved communication of effort in a manner that treats it as a capital improvement project rather than operational situation on the operating budget side.

If we do that then I think I can follow up on what’s going to be taking place today.  We have to overhaul eligibility and the data systems.  We have to take a long look at that and figure out how to do it. 

We have to do this because key provisions of the Affordable Care Act is coming into place and we have to be ready ahead of time.  I’d like to see the State of Hawaii actually become an example of not only forward-looking attitude, but an example of people who are ready to implement not only Affordable Care Act and the President’s direction in improving healthcare, but seeing to it that we’re start providing for him and for the country an example of what can and should be done. 

We have to have new investments, that’ll include a healthcare coordinator that will be able to succeed.  As you know we have a homelessness coordinator right now.  The Honolulu Star-Advertiser is very, very disappointed that we haven’t been able to solve the homeless challenge in two weeks.  So I figure where the Medicaid, Medquest situation is concerned, we should be able to solve it in 3 1/2 days.  Anything to appease editorial writers who as you know don’t have to do anything except comment on what they think you should be doing. 

I’m not going to take that attitude.  I’m going to take the attitude that everyone in here is dedicated to the proposition that whatever talents we have, whatever experience we have, whatever judgment we have been able to bring to bear as a result of that experience is going to be brought together in a coordinated way, among and with each other.  That there is a community of people out there, not just in this room, but across this state who are going to make their best efforts to work together in a sense of community across this state to address this situation. 

And here’s what you can expect from me; you can expect from our administration.  We’re going to empower you as community partners.  I’m reaching out to you today to ask you to partner.  Let me partner with you.  Let me take advantage of what I’m able to do as governor, institutionally as governor—not me personally, but me as governor, as the chief executive officer of the State.  Let me know what I can do to partner with you to make all of this come about.

That’s what the panel will be addressing today.  That’s what we’re dedicated to doing in the administration. 

We’re going to listen to you, were going to be open to ideas.  We’re going to continue to be open to ideas.  We’re gonna listen and were gonna integrate those ideas. 

We’re gonna change the culture of State government to make it mission oriented.  We’re gonna make it patient centered, not disease centered.  We’re going to make it operationally centered in terms of the human beings that have to do it in real time.  In real life.  And we’re going to do it in a way that does not abstract either you or the people of this state out of the equation

I am looking forward to the opportunity to work with you.  I’m optimistic about it.  I’m enthusiastic about it. 

I think of crises and challenges as the opportunity to recreate, to reconfigure, to refocus.  To utilize the talents and the determination that exists in this room and across the state in a way that we can all be proud of and I’m proud to be here working with you.

Thank you very much.  Aloha.    

---30---

Hawaii Department of Human Services: Video of Community Presentation on Proposed Medicaid Changes from May 10, 2011 (Be sure to listen to the Q&A. A lot of MDs rip this scam wide open.)

Power Point on Medicaid Cuts: http://hawaii.gov/dhs/quicklinks/Proposed-Medicaid-Eligibility-and-Benefits-Changes/

RELATED:

Links

TEXT "follow HawaiiFreePress" to 40404

Register to Vote

2aHawaii

808 Silent Majority

808 State Update AM940

ABCDEFG Blog

ACA Signups Hawaii

ACCE

ALEC

Alliance Defending Freedom

Aloha Life Advocates

Aloha Pregnancy Care Center

American Council of Trustees and Alumni

American Mothers of Hawaii

AMVETS-Hawaii

AntiPlanner

Antonio Gramsci Reading List

A Place for Women in Waipio

Astronomy Hawaii

Audit The Rail

Ballotpedia Hawaii

Better Hawaii 

Blaisdell Memorial Project

Broken Trust 

Build More Hawaiian Homes Working Group

CAFR Hawaii

Castaway Conservative

Children's Alliance Hawaii

Children's Rights Institute

ChinaTownWatch.com

Christian Homeschoolers of Hawaii

Citizens for Recall

Cliff Slater's Second Opinion

Coffee Break

CSIS Pacific Forum

DAR Hawaii

DeedySupport.com

DVids Hawaii

E Hana Kakou Kelii Akina

E Māua Ola i Moku o Keawe

Farmers For Choice Hawaii

FIRE

Fix Oahu!

Follow the Money Hawaii

Frank in Hawaii

Front Page Magazine

Frontline: The Fixers

Genetic Literacy Project

Get Off Your Butts!

God, Freedom, America

Grassroot Institute

Habele.org

Hawaii Aganst Assisted Suicide

Hawaii Aquarium Fish Report

Hawaii Aviation Preservation Society

Hawaii Catholic TV

Hawaii Christian Coalition

Hawaii Cigar Association

Hawaii Coalition Against Legalized Gambling

Hawaii ConCon Info

Hawaii Credit Union Watch

Hawaii Crime Victims' Rights

Hawaii Crop Improvement Association

Hawaii Debt Clock

Hawaii Defending Marriage

Hawaii Defense Foundation

Hawaii Family Advocates

Hawaii Family Forum

Hawaii Farmers and Ranchers United

Hawaii Farmer's Daughter

Hawaii Federalist Society

Hawaii Federation of Republican Women

Hawaii Firearm Community

Hawaii Fishermen's Alliance

Hawaii Future Project

Hawaii Gathering of Eagles

Hawaii History Blog

Hawaii Homeschool Association

Hawaii Jihadi Trial

Hawaii March for Life

Hawaii Meth Project

Hawaii's Partnership for Appropriate & Compassionate Care

Hawaii Public Charter School Network

Hawaii Rifle Association

Hawaii Right to Life -- Big Island

Hawaii Right to Life -- Oahu

Hawaii Shield Law Coalition

Hawaii Shippers Council

Hawaii Smokers Alliance

Hawaii State Data Lab

Hawaii Together

Heritage Foundation

HI Coalition Against Legalized Gambling

HIEC.Coop 

HiFiCo

Hiram Fong Papers

Homeschool Legal Defense Hawaii

Honolulu Homeless Crisis

Honolulu Navy League

Honolulu Traffic

Horns of Jericho Blog

House Minority Blog

House Republican Caucus YouTube

HPACC

Hump Day Report

I Vote Hawaii

If Hawaii News

Imua TMT

Inouye-Kwock, NYT 1992

Inside the Nature Conservancy

Inverse Condemnation

Investigative Project on Terrorism

Iowa Meets Maui

Jackson v Abercrombie

Jihad Watch

July 4 in Hawaii

Kahle v New Hope

Kakaako Cares

Kau TEA Party

Kauai Co GOP

Keep Hawaii's Heroes

KeyWiki

Land and Power in Hawaii

Legislative Committee Analysis Tool

Lessons in Firearm Education

Lingle Years

Malulani Foundation

Managed Care Matters -- Hawaii

Malama Pregnancy Center of Maui

Mauna Kea Recreational Users Group

MentalIllnessPolicy.org

Middle East Forum--The Legal Project

Mililani Conservatives for Change

Military Home Educators' Network Oahu

Missile Defense Advocacy

MIS Veterans Hawaii

Muslim Brotherhood in America

NAMI Hawaii

NARTH

Natatorium.org

National Christian Foundation Hawaii

National Parents Org Hawaii

National Wind Watch

New Hawaiian

New Zeal

NFIB Hawaii News

No GMO Means No Aloha

Northwest Economic Policy Seminar

Not Dead Yet, Hawaii

Now What I Really Think

NRA-ILA Hawaii

Oahu Alternative Transport

ObamaCare Abortion Hawaii

Obookiah

OHA Lies

Opt Out Today

OurFutureHawaii.com

Pacific Aviation Museum

Patients Rights Council Hawaii

PEACE Hawaii

People vs Machine

Pritchett Cartoons 

Pro-GMO Hawaii

P.U.E.O.

RailRipoff.com

Rental by Owner Awareness Assn

Republican Party -- Hawaii State

Research Institute for Hawaii USA

Rick Hamada Show

RJ Rummel

Robotics Organizing Committee

Save Dillingham Airfield

School Choice in Hawaii

SenatorFong.com

SIFE Remington

SIFE W. Oahu 

Sink the Jones Act

Smart About Marijuana--Hawaii

St Marianne Cope

State Budget Solutions Hawaii

State Policy Network

Statehood for Guam

Tax Foundation of Hawaii

The Harriet Tubman Agenda

The Long War Journal

The Real Hanabusa

Time Out Honolulu

Trustee Akina KWO Columns

Truth About Trade & Technology - Hawaii

UCC Truths

Union Members Know Your Rights

US Tax Foundation Hawaii Info

Valor in the Pacific

VAREP Honolulu

Waagey.org

West Maui Taxpayers Association

What Natalie Thinks

Whole Life Hawaii

Yes2TMT