Articles: Marshallese and Micronesians Rally for Continuation of Dialysis and Cancer Treatments
LEGAL CHALLENGE: Lawyers for Equal Justice are considering legal action to delay implementation Tuesday of a new state health plan key legislators say "could be a death sentence" for some residents. Opponents of the Lingle administration's planned changes in medical coverage for noncitizens rallied yesterday at the state Capitol. Because of the state's revenue shortage, the state Department of Human Services is transferring about 7,500 noncitizens from comprehensive medical assistance to a "Basic Health Hawaii" plan with limited benefits. Pregnant women and children are excluded."It's a good plan for healthy people," said Noda Lojkar, consul general of the government of the Republic of the Marshall Islands. Basic Health Hawaii will become the first program in Hawaii to kill individuals it is meant to help," George Massengale, a cancer society official, said in a letter to state Rep. John Mizuno (D, Kalihi), House Human Services Committee chairman. Mizuno and Senate Human Services Chairwoman Suzanne Chun Oakland (D, Kalihi-Liliha) have asked Gov. Linda Lingle either to grandfather in people on dialysis and chemotherapy or delay the plan for six months.
GOVERNOR: A group of Micronesians and non-U.S. citizens made a last-ditch effort on Friday to save their benefits before Tuesday when the basic health coverage kicks in."It's a form of discrimination. It picks a vulnerable the minority group: the Micronesians. It identifies us as a group of fundings that should be stopped," said Elma Coleman, of Micronesians United. "This is not the right decision. This is going to save the state money, but how much money is equitable or equal to a human life and it's not just one life that's going to be affected theirs many, many men and women who will die if chemotherapy is stopped, if dialysis is stopped," University of Hawaii student Angela Hoppe-Cruz said. The group walked into the governor's office demanding to speak with Linda Lingle. However they were told she was in a closed meeting and not available."She should at least have the decency to step out of her meeting because she will have health care next week," Hoppe-Cruz said.They waited for an hour and a half eventually sitting down but the governor never showed. She addressed the situation later in the afternoon. "This is a federal government responsibility. I recognize that it doesn't help the individual people for me to say that. It is just that fact that we don't have the money anymore," Lingle said. The governor said she is compassionate toward those affected but her hands are tied.
CRISIS: The Hawai'i state Health Department’s decision to remove Marshall Islanders’ eligibility for dialysis and cancer treatments starting next Tuesday will become a “humanitarian crisis” if it happens as planned, Marshall Islands Foreign Minister John Silk told Hawai?i Gov. Linda Lingle in a letter last week. Silk said that 100 Marshall Islanders could die if these services are terminated next week. "The proposed curtailment of services will affect approximately 50 Marshallese citizens undergoing scheduled dialysis treatment, and a similar number receiving regular chemotherapy for cancers," Silk said to Lingle in a letter obtained Wednesday. "While I understand the economic realities of today, I would ask that you view this situation as a humanitarian crisis for many Marshallese whose lives are literally at stake." Silk said he understood that U.S. funding for Compact-Impact costs of islanders living in Hawai?i and elsewhere “is not nearly enough to cover the reported annual cost incurred by the State of Hawaii." Silk commented positively on Abercrombie’s move in the U.S. Congress to make islanders eligible for Medicaid, and asked Lingle to "reconsider the changes to the Hawaii Quest program and continue with the medical coverage for dialysis and chemotherapy treatments for at least the next few months to give the U.S. Congress the opportunity to deliberate and, hopefully, allow for the Medicaid coverage of FAS citizens. Hawai'i has always been the one special place within the United States that has reached out to help its fellow Pacific Islanders, and it is in this spirit that we urgently seek your help and intervention."
DEALTH SENTENCE: State Rep. John Mizuno, D-30th (Kamehameha Heights, Kalihi Valley, Fort Shafter), and state Sen. Suzanne Chun Oakland, D-13th (Kalihi, Nu’uanu), wrote a letter to Gov. Linda Lingle yesterday asking her to delay a new state health plan for compact migrants scheduled to take effect in September.“Basic Health Hawaii” will be a stripped down version of the medical care now available to migrants from Micronesia, the Marshall Islands, and Palau and noncitizens who have lived in the Islands for less than five years. Migrant advocates have complained that the new plan will not provide dialysis or chemotherapy, but the Lingle administration said it has found a way to temporarily continue dialysis and is working on chemotherapy. "We respectfully ask that these patients be either grandfathered in or delay implementation for six months. Many patients have not received their notice that such life saving services would be discontinued and others have been sent this notice which is not in their native language. Moreover, we are concerned that this plan was made public only in late July 2009, which is barely one month’s notice. This is not enough time to prepare community members who will no longer have such life saving dialysis or chemotherapy services available to them or their loved ones. We are working with our Congressional delegation, and they have a measure to reinstate Medicaid benefits for our compact migrants. This means that the federal government will once again contribute by providing more than $15 million dollars to Hawaii each year. If the state chooses to follow through with these cuts, the decision could be a death sentence for many compact and nonresidents in Hawaii."
DIALYSIS: It is a death sentence to not have dialysis if your kidneys have failed," clinic director Jane Gibbons said.House Rep. John Mizuno has pages of signatures from Marshallese and Micronesians who object to the state's new health insurance for non-citizens. Basic Health Hawaii will no longer pay for dialysis and chemotherapy. "There is a solution. I believe if the governor can delay this program from being implemented for six months," Mizuno said. The program starts September 1. Attorney Victor Geminiani said the patients were caught off guard. "Those individuals, very few of them have been notified by the government and told exactly what's going to happen," he said. But the state said it can't afford to subsidize care to COMPAC nations. Basic Health Hawaii would save $15 million a year. The Department of Human Services has to cut $47 million from its budget over the next two years.Mizuno said other money can cover it."We have quite possibly well over $500 million in federal monies, stimulus monies, that we haven't locked in on," he said. If the state sticks to its timetable, Liberty Dialysis will continue to provide dialysis to fifty patients losing their coverage. The clinic will do it free of charge, but that can't go on forever.
PROTEST: A group of about 30 people sat in a public area of the governor's offices, singing Micronesian songs and holding signs. They requested a meeting with the governor, but were told she wasn't available. Elma Coleman, a member of Micronesians United, said she was disappointed no member of the administration came out. "It seems like she doesn't care," Coleman said of Gov. Linda Lingle. The group said it would be back on Monday to again request a meeting with the governor. "We're hopeful it will send a message to her," said Tita Raed, vice president of Micronesians United. The new health care plan goes into effect Tuesday, and is aimed at saving the state about $15 million a year.
RALLY: "Basic Health Hawaii" begins next week. It'll cover about 7,000 migrants but no longer pays for chemotherapy and dialysis treatments. "The service that we were receiving under MedQuest was unlimited. But now we are limited to twelve outpatient visits a year. That means once a month. Now who knows that we're not going to be sick and wanting to go and see the doctor more than twelve times a year," Elma Coleman of Micronesians United said. The new plan will save the state $15 million this fiscal year. The state spends more than $100 million a year on services to Micronesian migrants.
ALARM: State Rep. John Mizuno, House Human Services Committee chairman, said the coverage changes are "morally wrong" and "not acceptable." He also told the more than 75 people who attended the legislative briefing yesterday that he would do his best to "correct this injustice." The state plan "must have coverage for our dialysis and chemotherapy patients," said Mizuno, D-30th, (Kamehameha Heights, Kalihi Valley, Fort Shafter). "To have a health care plan that may cost the lives of more than 100 people, it's wrong."
expensive for state But officials say the economic crisis means the state can no longer afford to cover comprehensive health care coverage for the 7,500 Micronesians, who would otherwise be uninsured. And they said there are other ways the patients can seek care, including through community health centers. They also stressed that children and pregnant women would not see any coverage cuts. The state is in a fiscal crisis and simply cannot afford to fund the federal government's obligation anymore," said Dr. Kenneth Fink, administrator for the Med-QUEST division in the state Department of Human Services. He added that Hawai'i is the only state that provides medical assistance to those who move to the United States under the Compact of Free Association.
TREATMENT: Pius Henry came to Hawaii nine years ago from the Marshall Islands. He is a kidney patient who goes to dialysis three days a week.Starting Sept. 1, Henry and thousands of other low-income non-citizens will be shifted to a basic health insurance plan that will no longer pay for dialysis treatments."Without dialysis, I'm going to die, according to the doctor. They told me that even if you miss one date, you're going to die," Henry said.Some patients said they don't have the money to pay for the treatments."No, I'm here because I don't have money. I don't have nothing," patient Rilang Rilang said.State Department of Health and Human Services officials say the federal government should pay for health coverage for Marshallese and others who are covered by the Compacts of Free Association, because the U.S. government conducted nuclear bomb tests there in the 1940s and 1950s.The federal government provides just $11 million a year to Hawaii. It costs the state $35 million for Micronesians, Marshallese and Palauans.The new health coverage applies only to generic drugs, meaning many name-brand chemotherapy pills for cancer patients will not be covered, and neither will rental wheelchairs or other medical equipment."A lot of these people were in the nuclear-affected areas of the Marshall Islands. These patients have come here because they have no choice," Marshallese advocate William Swain said.