Micronesian Immigrants ‘Straining’ Hawaiian Health Care System, NPR reports

Micronesian immigrants -- "tak[ing] advantage" of a "unique compact" with the United States that allows them to enter and remain in the country without a visa or passport -- are "starting to strain" Hawaii's health system, NPR's "All Things Considered" reports (Smith, "All Things Considered," NPR, 11/29). In 1986, the Republic of Marshall Islands, the Federated States of Micronesia and the Republic of Palau established a "Compact of Free Association" with the United States, categorizing citizens of these nations as "habitual residents" of Hawaii and allowing them to seek medical care in Hawaii or obtain referrals from local doctors to see Hawaii physicians and receive U.S. funds for health care ( Kaiser Daily Health Policy Report, 9/7/2000). An October 2001 General Accounting Office report (GAO-02-40) found that Micronesian immigration has cost Hawaii more than $86 million in health care, as well as education expenses. Loren Yager of the GAO said that Micronesians often arrive "needing health care," because many grew up in poverty and have "high rates" of diabetes and heart disease. Hawaiian hospitals can incur "significant costs" from treating Micronesians because "many of these migrants have very few resources with which to pay the bills," Yager said. Hawaiian officials do not "blam[e] the Micronesians," but are "angry" at the U.S. government and say Congress "never lived up to its promises to pay for all the impacts of Micronesian immigration." Rich Meiers, president of the Health Care Association of Hawaii, said, "The federal government has to own up to the fact that they have a responsibility. They can't just invite these people to come in here and receive their health care and then not pay for that health care. It's wrong." NPR reports that the issue "will come to a head" next month when the U.S. government begins to renegotiate its compact with Micronesian nations ("All Things Considered," NPR, 11/29). The full report is available online. Note: You must have RealAudio to listen to the report.