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Medical help for Manu'a and insurance for all — topics at Lafaele confirmation

The “Coverage for All American Samoa” insurance project and economic support for the Manu’a islands were some of the issues raised by senators during the confirmation hearing last Wednesday for Keniseli Lafaele, who is now fully confirmed by the Fono as the new Commerce Department director. INSURANCELafaele headed the group that conducted a health insurance study for the territory a couple of years ago, and issued its finding thereafter. However, lawmakers have complained that no actions were ever taken by the past administration to adopt the federally funded project, which looked at group health insurance as a means to adequately finance medical service for all residents. Responding to questions from senators during the confirmation hearing, Lafaele says a bill is pending in the House that includes findings of the study. He explained that provisions of this bill would have anyone contribute a certain amount of money into a pool to cover medical expenses. Sen. Soliai Tuipine Fuimaono recommended that Lafele provide for the governor full details of the study so that the new administration can conduct a full review and come up with ways to assist with the costs of medical service. Soliai also pointed out that the government lacks funds to send patients off-island for medical treatment and this report should provide some data and a source of funding. He said transmission of this report to the Governor’s Office should be one of Lafaele’s priorities. During his address to the Fono early last month the governor did mention this report, saying that in view of the fact that federal funding of the Affordable Care Act will cease in 2019, “we will seriously look into the federally funded ‘Coverage for All in American Samoa’ research project report which was completed by the governor’s office in 2007 and yet nothing was done with it to this day.”“This administration is considering the viable financing options included in this report; which includes the combination of self-insurance and user fees, and sales tax on goods known to cause non-communicable diseases to which 80% of health care costs are attributed according to several studies,” said Lolo in his official address. Over the last six years, lawmakers have questioned Lafaele several times in both the Senate and House about this same report, which Lafaele says was presented to the Togiola Administration, who had to make the decision on adopting several recommendations.MANU’A ISLANDSManu’a Sen. Nua Saoluaga asked how Lafaele would address the high cost of living faced by Manu’a residents, compared to residents of Tutuila.Lafaele acknowledged that this difference in cost of living continues to exists, adding that this is among the reasons why residents of the island group have moved to Tutuila.However, he said there is no quick fix or solution to this indifference but noted that the government needs to look at this issue thoroughly, and the starting point is the Commerce Department — to work on long term solutions. Lafaele said one of the complaints that he has heard in past is the cost involved with Manu’a residents to see a physician at the LBJ Medical Center. He said the cost is higher, for the fact that Manu’a residents have to catch a plane to Tutuila and then pay the hospital fee.If these and other costs are added together, its Manu’a residents who pay more to see a doctor at the only medical center in the territory, he said and noted that there is also the long wait to see a physician, before heading back to Manu’a. He suggested that one way to address this difference in the cost is to build an adequate medical facility in Manu’a that would cater to residents there. Nua noted that Lafaele, had served at one time as a member of the LBJ board of directors. Additionally, Lafaele has both educational and work background in economic development.“So why weren’t you selected to this [DOC directorship] post by the previous administration?” Nua asked, to which Lafaele simply said that he hadn't applied for the job until now.