Jul
24
This is what high-end realtors tell me: that mainlanders who want to retire to neighbor islands, often change their minds and retire to Oahu, after checking out the quality of health care on other islands. They prefer the slower pace of life on other islands but settle for Oahu because they want to survive their first heart attack.
That comes to mind as two Big Island hospitals cut staff to try to control their ballooning operating deficits.
The little hospital in Kealakakua is on the verge of cutting more than 50 jobs and the hospital in Waimea-Kamuela has already done the same thing, so upsetting the community that I heard reports someone threatened the new head of the hospital, who tried to fix but didn’t create the problem. (He’s resigned.)
Doctors have been telling us for years that medical care on neighbor islands is threatened by soaring malpractice insurance costs, insufficient compensation for treatment of Medicare patients, and limits to state and local financial support for hospital operations. They weren’t making it up.
Malpractice insurance costs are driven by lawsuits, which I assume increase when the quality of medical care suffers. The gap between Medicare compensation and the actual cost of treating Medicare patients has been growing for years, and for years no one did anything about it except to soak others to make up the difference.
Congress did vote this month to bar any cuts to Medicare compensation. Governor Lingle agreed to a plan to increase state compensation, triggering a federal match, but backed out of a plan to make it retroactive to the just-ended fiscal year, citing tighter state finances. This same factor is likely to put limits on what the state can do to resolve the hospital crisis.
Kaiser Permanente has been trying to control costs through smarter procedures in its system. The jury is out on that one. As a 30-year member I can tell you it has never been harder to get in to see someone for a non-emergency matter, though emergency treatment does not seem to have been adversely affected.
This is already a major issue, but it will get even bigger. Hawaii has an aging population, and to some extent represents where the rest of the country will be in a dozen years. Older people need even more health care.
In fact, a local health care executive — he comes from the bean-counting side of the house, not the knee-thumping one — told me people are surviving so many illnesses that used to kill them, now they’re living to a ripe off age and then suffer wholesale health collapse leading to expensive care through their final days and months.
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