Rush Limbaugh Endorses Health Reform

Not really.

But he did note, upon his discharge from a hospital in Hawaii where he was evaluated for chest pain, that he got the best health treatment in the world “right here in the United States of America.” 

Actually, Rush Limbaugh got his care in a very unusual state indeed. Hawaii is second in the Commonwealth Fund’s ranking of the 50 states (and the District of Columbia.)

Hawaii is different than the rest of the United States.  It has great weather, is geographically isolated, and has never had much heavy industry.  It also has an unusual health care system - one that has many elements that are similar to those being proposed as part of national health care reform.

 Here are some of the unusual elements of health care in Hawaii.

1) Hawaii was the first state to enact an employer mandate in 1974 - and has one of the lowest rates of uninsured in the country. 

2) Hawaii has expanded Medicaid eligibility substantially. Again, this lowers the rate of the uninsured

3) There are two dominant nonprofit insurers in Hawaii, The Hawaii Medical Service Association (HMSA--a Blue Cross plan) and Kaiser Permanente. The employer mandate explicitly requires coverage at least as generous as those plans offered by HMSA and Kaiser – just as proposed national health care reform would mandate minimum credible coverage.

4) Kaiser Permanente cares for 20 % of the nonelderly population of Hawaii.  This salaried, integrated staff-model health plan has a world class electronic medical record system, which facilitates collaboration among its primary care physicians and specialists.  Regions with large penetration of Kaiser tend to have low costs (compare the costs in San Francisco with those in Los Angeles, for example)

5) Hawaii regulates its health plans strictly, prohibiting excessive or discriminatory rates, and allowing the insurance commissioner to wide latitude to impose financial penalties on health plans that violate its regulations.

6) Hawaii has among the lowest Medicare costs in the country (but very high overall quality).  I'm attaching a graphic from Health Affairs (researchers from Dartmouth and now HSPH) showing this.

So, with an endorsement of the health care system of Hawaii – Rush is in favor of many of the elements of the Senate health care reform bill that he has railed against.

(I couldn't resist posting on Limbaugh's comments.  I'll be posting part 2 of my New Year's observations tomorrow)