In reports Wednesday and Thursday in The Maui News, Gov. Abercrombie says he understands that Hawaii Health Systems Corp.’s financial stability needs to be addressed. Hurrah. It remains to be seen whether the Oahu-centric Legislature understands this yet.
It was obvious from the start that HHSC was the wrong way to deal with the fact that small, rural hospitals can never cover expenses. And when rural people start demanding urban services (like emergency rooms), the shortfall just gets more impossible.
Hawaii is an island state. Inevitably, some places are going to be distant in time and space from urban services. When that service is health care, it is reasonable to expect government to level the situation somewhat by subsidizing rural care. The question is, how?
The answer, in 1996, was to loot the operating profit of Maui Memorial Medical Center, the only one of 12 outside-Honolulu facilities to run in the black, to fund the other 11. This ensured that the 11 would be on starvation rations, while MMMC would be constrained in its development. It was a stupid idea, but appealing to the Oahu legislators because by not making demands on the funds th4y wanted for their local schemes.
The governor said he is open to public-private partnerships as part of the restructuring of the outlying hospital systems. No doubt the Oahu legislators will go for any version of this that does not touch the funds they want for their pet projects. Neighbor Islanders must be on guard against this poison pill.
Because if almost everything in health care delivery is debatable, one is not: No private medical center will cover mental health. Not one.
That’s what Mauians were asked to give up when Ron Kwon and Jan Shields attempted to do in MMHC in favor of a private Kihei hospital. They promised better, cheaper service, but what they meant was NO MENTAL HEALTH CARE.