Census shows up to 6,500 Kauaians have no health insurance

U.S. Census estimates indicate that over 11 percent of the island’s population, or between 6,500 and 6,600 people, is without health insurance.

But that figure could be even higher, according to the head of the nonprofit group running the island’s only community health center geared toward the neediest Kauaians.

The Census estimate might not include recent immigrants, and may have missed a significant portion of the poorest Kauaians who do not have telephones, as much data is collected in phone surveys, said David Peters, chief executive officer of Ho’ola Lahui Hawaii.

Ho’ola Lahui Hawaii is the holder of a federal grant to provide medical services to uninsured and underinsured Kauaians at a community health center in Waimea.

Peters and group are also involved in a statewide initiative seeking to make health care and health-care insurance available to every resident of Hawai’i.

While it is important to try to reach with medical care and information those uninsured residents and their families, there also exists on this island a “significant number” of underinsured people who are also at risk, he said.

Many groups, including the state Department of Health; Hawaii Medical Service Association (HMSA), the largest medical insurance company in the state; and the Hawaii Primary Care Association, HMSA Foundation, Hawaii Community Foundation, and many other care-giving, government, private and advocacy groups, have joined forces to try to address the problem of uninsured and underinsured state residents, break down barriers between those needing and those giving health care, and essentially break the chain that ends up being generation after generation of uninsured residents.

There was a time when it was thought Hawai’i had the lowest percentage of uninsured residents in the country, around 5 percent. But according to Census figures, the number of uninsured Hawai’i residents has been steadily on the rise for the last five years, from around 8 percent in 1996 to over 11 percent last year.

Oftentimes, the most needy Kaua’i families don’t see the doctor until it becomes necessary to get immunizations required to attend public school, said Noe Foster, marketing and public relations coordinator with AlohaCare.

AlohaCare is second only to HMSA in numbers of members signed up for QUEST, the state’s health-care insurance program for low-income families.

And it is offering free of charge to its members free doctors’ visits for those 21 years of age and younger through the national Early Periodic Screening Diagnosis Testing program (EPSDT), Foster explained.

Children may qualify for overall QUEST coverage through AlohaCare even if their parents don’t, said Foster. And, many families qualify for zero-copay visits. Most Kaua’i clinics accept QUEST patients, she added.

Those without insurance find chronic conditions left untreated have devastating impacts on overall health, Peters noted.

Untreated or undiagnosed, those problems can become killers, Peters warned. “We have a lot of people without health insurance who are not well.”

Addressing the needs of the island’s uninsured population, that is, getting them health-care insurance coverage, is only one part of the solution, Peters feels.

It is important to get insurance for the uninsured, so they’ll get help for minor health problems before they become major ones, he continued.

Getting those people with coverage to use it is another issue, as sometimes the underinsured Kauaian will go without necessary medications, even for conditions as serious as diabetes, simply because there is no money for prescription drugs, or health-insurance policies don’t include drug coverage, he continued.

Waimea was chosen as the location for the island’s first community health clinic for lower-income residents, as the area is eighth on a statewide list of communities at high risk for poor health, according to the Hawaii Primary Care Needs Assessment conducted by the DOH Family Health Services Division.

“I think we’re reaching them,” Peters said of the efforts of Ho’ola Lahui Hawaii and other collaborators.

Reaching out to the island’s other communities is difficult when there is a low likelihood of reimbursement for services rendered, he said.

And if every person on the island without health insurance suddenly turned up at the Waimea clinic’s doors, the doctors there couldn’t see them all.

Still, he feels the statewide effort deserves support, and encourages other community groups and individuals to get involved, to help it along.

The Waimea clinic has dentists on staff because oral health, or a lack of oral health, is a huge issue on Kaua’i as well, he added.

“We’ve got a severe dental problem on the island,” and health problems sometimes first reveal themselves in the mouth, said Peters.

Peters feels he is in the right profession now because he can see the results of his efforts. “I love what I do because we’re helping people. Seeing people get better is an amazing thing.”

Staff Writer Paul C. Curtis can be reached at mailto:pcurtis@pulitzer.net or 245-3681 (ext. 224).

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