While a lack of health care coverage impacts on Guam’s uninsured and underinsured that lack impacts on a variety of other players in the health care field.

Health care providers and non-profit organizations met as two different groups at Ladera Tower on Dec. 6 with Roseann Jones associate professor of economics and her research staff. The team was reviewing health care issues through a federally-funded grant.

A series of meetings will culminate in an island health care summit at the end of January.

The meeting with health care providers kicked off with a discussion on the underlying causes of the growing number of uninsured on Guam heavily attributed to the growing cost. “A high deductible is a disincentive to go to clinics ” was the comment on a factor that encourages higher use of urgent care as well as remarks that higher deductibles meant cheaper insurance costs for companies.

A higher number of walk-ins and a lower number of appointments has begun to create problems for some laboratories and pharmacies. “We cannot anticipate what revenue we are going to generate ” said one clinic representative.

“It’s hard to make sure patients fulfill their annual responsibilities ” and “We plan walk-ins into the schedule because patients wait until the pain is severe and they are very sick ” were comments on the result of the rising cost of insurance.

The limit of a deductible may control care and planning of which treatments.

Island doctors are willing to consider promissory notes and payment schedules for payment towards treatment. Gifts including puga and other means of barter are offered to doctors as payment. Physicians also “dip into profits” by extending the professional courtesy of discount where possible.

The self-pay rate however is higher than for insured parties although one professional group has refused to negotiate with health plan providers on discounts. Discount rates of 10% for care with certain plans were mentioned.

Home health nursing services are provided based on insurability which may determine which patients are cared for at home and which use the hospital for those services and hospice services.

Services for migrants from other islands were discussed — the expectations of migrants for services — “The outer islands see insurance as a benefit of citizenship ” and the positive impact that provision of services by Naval Hospital Guam and Department of Defense educations facilities would have on Guam’s health care and education services. MBJ