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Hawaii's QUEST managed-care demonstration program — which blends Medicaid and the former SHIP gap-group plan to cover the state's poor — faces scrutiny from multiple angles in 1996. Winifred Odo, who administers the program, explains that an ADA lawsuit forced the state to add an asset eligibility test, bumping roughly 40,000 enrollees and prompting creation of the lower-benefit QuestNet safety net. Beth Giesting warns that community health centers face simultaneous cuts from SHIP's elimination, lower Medicaid reimbursement rates, and state budget reductions of up to 40%, leaving a shrinking safety net just as more uninsured patients arrive at their doors. George Bussey explains how five competing plans — each with differing rules — have complicated daily practice for community physicians, a frustration echoed by multiple Maui caller-physicians. Fred Holschuh, calling from the Hilo emergency room, credits Quest with improving primary care access but urges greater focus on patient behavior modification — tobacco, substance abuse, violence — as long-term cost-saving measures. Roth presses whether Quest represents a true health model or still mainly a medical model, with Beth Giesting arguing for a shift toward prevention.
Transcript
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Companion newspaper commentaries
Commentaries by the guests, published in The Honolulu Advertiser around the broadcast.
