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- Title
The "Compact Impact" in Hawai'i: Focus on Health Care.
- Authors
Riklon, Sheldon; Alik, Wilfred; Hixon, Allen; Palafox, Neal A.
- Abstract
The political, economic, and military relationship between the former Pacific Trust Territories of the United States is defined by the Compact of Free Association (COFA) treaty. The respective COFA treaties allow the United States military and strategic oversight for these countries, while COFA citizens can work, reside, and travel with unlimited lengths of stay in the United States. The unforeseen consequences of the diaspora of the people of the COFA nations to the United States and its territories is called the "Compact Impact." In 2007 the social, health, and welfare system costs attributed to the estimated 13,000 COFA migrants in Hawai'i was $90 million dollars. The US federal government does not take full responsibility for the adverse economic consequences to Hawai'i due to COFA implementation. The lack of health and education infrastructure in the COFA nations, as well as the unique language, culture, political, and economic development of the region have contributed to the adverse elements of the Compact Impact. The Department of Human Services of Hawai'i, once supportive of the COFA peoples, now looks to withdraw state sponsored health care support. This paper reviews the historical, political, and economic development, which surrounds the Compact Impact and describes Hawai'i's government and community response. This paper attempts to understand, describe, and search for solutions that will mitigate the Compact Impact.
- Subjects
HAWAII; PACIFIC Islands (Trust Territory); UNITED States; TREATIES; MEDICAL care; POLITICAL development; ECONOMIC development; HAWAII state politics &; government, 1959-
- Publication
Hawaii Medical Journal, 2010, Vol 69, Issue 6, p7
- ISSN
0017-8594
- Publication type
Article