Facing Hawaii’s Healthcare Crisis
Wednesday - May 10, 2006
“Health is worth more than learning.” - Thomas Jefferson in a letter to his cousin, June 11, 1790
What do you think is the most pressing need in our state? Traffic, gas prices, education, crime, three strikes, tax relief?
Wrong, wrong and wrong again.
And it’s in crisis.
While our state and federal politicians are desperate to give us gas pump relief, our hospitals desperately need financial relief. They need more acute-care patient beds, nursing homes for our disabled elderly, registered nurses, emergency room doctors, and insurance reimbursements that at least cover the high cost of treating Hawaii’s sick and injured.
What we all take for granted - our fine, state-of-the-art medical facilities and top-notch physicians - is being stretched to the breaking point. Because of escalating costs: malpractice insurance, high price of business (union wages, rent, equipment), decreased reimbursements from HMOs, specifically Medicare and HMSA, and doctors leaving our state while hospitals struggle to attract new ones.
“We can no longer take quality healthcare for granted,” warns Ginny Pressler, M.D., vice president, Service Line Development, Hawaii Pacific Health. “There’s a price that comes with the advanced medical technology we have come to expect. Hospitals are simply not getting adequately reimbursed.”
I’ve been associated with the Kapiolani Medical Center for Women and Children “Children’s Miracle Network” since 1983, and have witnessed amazing medical breakthroughs over two decades.
Until the mid-‘90s, Hawaii’s infants needing heart surgery went to hospitals on the Mainland. Today, we have our own neo-natal heart surgery unit. The survival rate of childhood leukemia is up from 50 percent to 85 percent. Newborns with fatal heart defects now have a 70 percent survival rate. Preemies weighing 1 pound are being saved!
The Agency for Healthcare Research and Quality’s 2005 report on Hawaii’s Overall Health Care Quality ranked ours well ahead of California, New York and Texas. But face it: Quality costs money. Saving lives isn’t cheap.
Since 2000, Hawaii’s hospitals have lost more than $200 million, according to Chuck Sted, Hawaii Pacific Health’s president and CEO. “These chronic years of losing money have forced Hawaii’s hospitals into making choices that threaten to compromise quality healthcare for our youngest, our oldest and our most vulnerable.”
Pressler is concerned about the number “wait-listed” patients. These are acute-care (stroke, heart attack, etc.) hospital patients who are no longer critical, but still need full-time nursing care and don’t have a bed to go to. “We can’t make them move out of the hospitals,” she says. With a shortage of beds for incoming hospital patients, the medical dominoes are falling backwards. When will they land on your doorstep?
Hawaii (and Alaska) have the least number of long-term care beds in the country. The national average is 50 beds per 1,000 people over age 65. We have about 15 per 1,000 in rural and 30 per 1,000 in urban Hawaii. This forces hospitals to send patients - some on ventilators, some with mental health problems - to facilities on the Mainland (like our prisoners!).
Hawaii also has a shortage of registered nurses. Today it’s 17 percent - around 1,600 nurses short. By 2010, we’ll be 2,267 short, and by 2020 we’ll be deficient by 4,593 or 35.79 percent. (Source: HRSA National Center of Health Workforce Analysis).
Sted and Pressler, experts on why Hawaii’s hospitals are sick and how they can be healed (Yes, there’s hope!), are educating anyone who will listen on health-care realities. Our Legislature urgently needs to listen. Legislative solutions are: malpractice reform (special interests, i.e. trial lawyers, impede this), a statewide trauma system (not just center) to address disasters, passing SCR 77, which supports essential children’s health programs, and SCR 71, which studies our aging populous (in a decade, baby boomers start hitting 70), and construction of long-term care facilities - now. Call or write your representative today.
As you make your appointment for your mammogram or colonoscopy, take your spouse for chemotherapy treatment, hold your preemie’s tiny hand in a neonatal intensive care unit, head to the emergency room with chest pains, or visit your mother in a nursing home, think of the real cost. What kind of healthcare do you want?
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