Last week, Republican strategist Kevin Madden chastised President Obama for choosing to vacation in a "foreign place" like Hawaii, concluding "it's much different than being in Texas." Rush Limbaugh, it turns out, couldn't disagree more. The right-wing radio host and avid golfer not only visits the islands every year. After his New Year's Eve scare with chest pains, Limbaugh had nothing but praise for the care he received there. And for good reason: while Hawaii ranks second in state health care performance, the Lone Star State is a dismal 46th.
For his part, Limbaugh predictably touted his emergency hospitalization as proof of an unrivaled American health care system which needs no reform:
"I don't think there's one thing wrong with the American health care system," Limbaugh said. "I got no special treatment other than what anybody else that would have called 911 and had been brought in with the same kinds of symptoms."
No different than virtually all Hawaiians, that is.
As the New York Times detailed in October ("In Hawaii's Health System, Lessons for Lawmakers"), Hawaii consistently outperforms almost every other state for health care access, quality and costs. While only about 10% of non-elderly adults are without health insurance in there, Hawaii's premiums and Medicare costs per beneficiary are the lowest in the nation. The Times explained a major reason why:
Since 1974, Hawaii has required all employers to provide relatively generous health care benefits to any employee who works 20 hours a week or more. If health care legislation passes in Congress, the rest of the country may barely catch up.
That system also paid dividends for Rush Limbaugh:
One result of Hawaii's employer mandate and the relatively high number of people with health insurance is that hospital emergency rooms in the state are islands of relative calm. In 2007, the state had 264 outpatient visits to emergency rooms per 1,000 people -- 34 percent lower than the national average of 401.
(That's a far cry from the GOP's "emergency room solution" to the American health care crisis favored by George W. Bush, Tom Delay and Mitch McConnell.)
The result is that Hawaii can be found atop the Commonwealth Fund's scorecard of state health care performance. After finishing first in its 2007 assessment, the Commonwealth Fund ranked Barack Obama's birthplace #2 across 30-plus indicators of health care access, cost containment, quality, equity and prevention.
Along with other recent studies, the Commonwealth Fund also confirmed what by now is a truism of the politics of American health care: health care is worst precisely where Republicans poll best.
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