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Health insurance plan for territory unlikely says LBJ CEO

LBJ Medical Center chief executive officer Mike Gerstenberger believes a health insurance plan for American Samoa would not work due to the health problems of local residents and a lack of customer base.

Such a plan was raised two weeks ago by members of the Chamber of Commerce during a meeting with Gerstenberger, who spoke on a number of issues, including the hospital’s proposed fee hikes, which have been deferred to allow a public hearing. The hearing is set for this Friday.

He was asked if the hospital has looked into an insurance plan to which Gerstenberger said, “we have certainly explored that” and pointed to a study — Health Coverage for All — in 2000 and a bill introduced in the House last year that would eliminate free medical care and propose an insurance plan for all workers.

He said the House bill “sounds great” but he has some concerns with the proposal, which remains pending in the House. He says health insurance works on the basis of an insurance company collecting more in premiums than it pays in claims.

According to the CEO, such a plan would not work in the territory because “this is such an unhealthy population” with a high rate of diabetes. He explained that insurance premiums are different in various areas of the country; for example, the ones in Los Angeles are different than another city.

He said the average HMO premium in the states is around $400 a person and “because of our less healthy population, our premiums could be $500 or $600. How many of your neighbors can afford $600 in health insurance?”

He also said for an insurance plan to work, American Samoa would need to have a larger population, a larger pool. He said with a population of around 55,000 “we probably don’t have enough people.” He recalled he has worked for a health insurance company, and insurance companies are very interested in “knowing where they can make a profit”.

“If they thought they could make a profit in American Samoa, they would have been here a long time ago,” the LBJ CEO said.

Responding to a question by a Chamber member, Gerstenberger says that the Chamber can probably pool their member resources together for an insurance plan and this could also be done as a community initiative through churches and villages.

Another Chamber member asked about the CEO’s long term plan to stabilize the hospital financially, since health insurance is not a viable option, Gerstenberger said, “quite honestly, we don’t have a long term plan because right now we are so dependent upon the [federal] government” which provides some 80% of the hospital annual funding through Medicaid, and other federal funding.

He did point out that if territory’s priority is health care, then that needs to be communicated to the government. He also noted that the local population needs to think more about taking care of themselves and their families.