Dear Editor,

Your Monday, (12/08/2014) issue of Samoa News published an article entitled, "ASG gets a yes to request for Health Care coverage". I find the article to be great news, as it told of Governor Lolo' s untiring effort to pursue universal healthcare coverage for the people of the territory via the Affordable Care Act (ACA) .

The ASG and the people of the territory, in my opinion, must embrace and support this great vision of the Lolo administration in healthcare.

The most encouraging development so far according to the article is that the deputy administrator of CMS/Director of Medicaid and CHIP has given her support; and, to allow the American Samoa Medicaid State Agency to develop a universal healthcare coverage plan utilizing ASG's Medicaid program is a great step forward. The territory's own Medicaid Director Mrs. Sandra King Young has been very instrumental on behalf of Governor Lolo and ASG.

The Affordable Care Act (ACA) of 2010 has allowed American Samoa and other territories the economic resources to pursue and provide affordable healthcare insurance or universal coverage for their citizens and U.S. Nationals. It is President Barack Obama's vision that all Americans are entitled to affordable and quality healthcare, and that the 40 million plus Americans without healthcare insurance must have coverage. The result of the President's effort was the Affordable Care Act (ACA) as stated; this healthcare law is also known as Obamacare, passed by Congress in March of 2010.

But despite Obama's initiative, American Samoa remained an uninsured population of U.S. Nationals. As a result, its people still lacked access to quality healthcare services mandated through the Affordable Care Act (ACA).

Governor Lolo has aggressively shared and pursued Obama's vision as his own. Therefore it is a moral duty and responsibility of ASG, that the people of American Samoa must have universal healthcare coverage for conventional and specialized care at home and Off-Island, if treatment is not available at the LBJ hospital.

A recent finding by the National Institute of Health(NIH) revealed that chance of death is 30% higher for an uninsured person with chronic systemic conditions than with an insured person with the same systemic ailments — let alone life threatening conditions from an emergency catastrophic situation.

Good to know that the Hawai’i Connector has been contacted for assistance. As we know, the Hawaii Health Connector is the Hawai’i state version of a mandate by the Affordable Healthcare Act (ACA) for all states to establish health insurance exchanges.

For the territories this is not a mandate, but a choice, to op-in or op- out. Former Governor Togiola in 2012 decided that it was not the right time, and decided to op-out due to the same constraints as presented by our current local Medicaid director..

Now Lolo believes that this is the right time to op-in, and therefore took the initiative to pursue it as allowed in the Affordable Care Act (ACA).

The territory, in my opinion, must join the Hawai’i Health Connector if it offers to do so. Should such a merger happen, ASG will have to put in millions of dollars to assist the Connector, but that would still be a lot cheaper course than if ASG is to do it alone.

In pursuing this historical step in healthcare, the task is arduous, and the economic picture could still be blurred: the territory's Medicaid State Plan will have to be re-written; local laws will have to be amended to accommodate the re-appropriation of funds as well as to mandate coverage for legal residents; LBJ Hospital which is empowered by ASG's Medicaid funds might be reluctant to opt-in; local matching funds remain a challenge and healthcare is costly.

Nevertheless, the government must oblige to its moral obligation to avoid a missed opportunity to insure the uninsured, or provide universal coverage for the population of American Samoa. Universal quality healthcare coverage — like a good education is a right and a necessity in the life of every human-being — and not a privilege as it is for the fortunate few.

A significant portion of the territory's population does, however, have some form of national health insurance coverage like the old-aged population under Medicare and Tri-Care for the military retirees. But the majority of American Samoa's population including the ASG employees and their families, the private sector and their families, are still without universal coverage, and would suffer during long term illness as well as in catastrophic emergency situations.

Merry Christmas and a Happy New Year!!!

Tuiasina Dr. Salamo Laumoli

Retired Dental Director, LBJ Hospital

former Director of Health, Department of Health, American Samoa Government