Saturday, February 27, 2010

The Future of Off-Island Referrals

Talifaitasi W. Satele

When Governor Togiola mentioned earlier in the year that government already operates businesses (his examples were ASPA, ASTCA and ASCC), he forgot to mention LBJ. Had the government hospital been popular with the People, believe me, he would have touted it as a shining example of government at its best.

Yet, it is not. Perhaps the Governor’s near death experience there didn’t help its standing with him either (no offense, just making a point). When that government hospital couldn’t cure him, he was transported via a government airplane to yet another government hospital (Tripler), only later to be transferred to a private hospital (Straub) where they finally saved his life.

There were two lessons that we’ve learned from the above. First was that not even the Governor’s life is safe at the LBJ. The second was that many of our People, like Togiola, rely on the advances of a largely private sector health care market in the US. Our government hospital may provide universal access, but it unfortunately does not provide the critical services needed to render off-island referrals unnecessary.

The ASG, a long time ago, assumed the responsibility of providing healthcare to all of our People. Yet its actions imply that it has no such duty. Its budget is way over in the red, its spending and purchases are extremely questionable, its revenues in the tank after years of watching our economy fall over the cliff.

There are three important considerations that arise from our medical dilemma.

First is that this is not only a local issue (especially in regards to off-island referrals). In addition to getting its financial house in order, the ASG should argue very loudly (along with Faleomavaega) that waiving the Cabotage law in an effort to lower airfares is really a matter of life and death. The ASG and the Congressman should also look into arrangements where our People can buy insurance from other States, especially if there regulatory hurdles that now stand in the way.

The second consideration is on the national level, where Democrats in Congress are looking to control health insurance prices, mandate Americans to purchase health insurance plans, regulate and even outlaw certain health insurance practices, and compete with the private sector by creating a public option. The goal, of course, is to provide universal access.

That sounds a lot like LBJ. Perhaps Faleomavaega should invite Congressional Democrats to take a trip to LBJ to get a picture of what a government takeover of the health care industry would look like before enacting any major overhaul.

The last but most important consideration is what makes the US healthcare market the most advanced provider in the world. It’s because, for the most part, it’s still largely free-market. Prices for drugs, services, doctors’ fees, equipment and surgeries have governmental oversight but are not controlled. The system still relies heavily on personal responsibility and participation in the form of co-payments and the costs of insurance plans themselves.

There are plenty of inefficiencies in the market today, but it’s a march toward a freer market based system that will make it better, not an LBJ-styled government bureaucracy we’re all too familiar with in American Samoa.