Transforming the hospital system here in Hawaii
By AVERY B. CHUMBLEY
Like many other government agencies, the Hawaii Health Systems Corporation (HHSC), which oversees Hawaii’s community hospitals, is facing severe financial challenges in this time of economic struggles.
Increasing demand for medical services in underserved communities, insufficient reimbursements by government health care programs such as Medicare and Medicaid, and cost increases in all facets of health care have put the system in a precarious position.
However, unlike many other public agencies, HHSC cannot simply cut cost by reducing services or by a reduction in force. HHSC provides a 24-hour-a-day, seven-day-a-week medical safety net for Hawaii’s most vulnerable individuals, regardless of ability to pay.
We are at the forefront of expanding access to health care for those who can least afford it, most of whom are located in rural areas and on the Neighbor Islands. We simply cannot choose not to serve them. If we were to close our doors, these individuals and their families would be left with only basic medical care at best, and would be forced to travel to urban Honolulu for most everything else.
Outside of Honolulu, we are the ones who provide our local communities with quality health care services. From emergency care, medical and surgical services to long-term care, our employees save lives. Through our 12 hospitals and affiliates across the state, we have been there for our communities in good and bad times.
Right now times are tough for everybody. HHSC hospitals are adept at working with tight budgets. We rely on Hawaii taxpayers for about 13 percent of our total operating expenses, compared to more than 30percent for other public hospital systems in the country. We think we return good value on that investment.
While these are challenging times, they can also be transformative. Technology and medical advances have put new demands on everyone in the health care services industry, and technology can also help us find new ways to meet those demands.
It’s a much more complicated world out there, but we may also find unexpected help in public-private partnerships and cooperative ventures that leverage our strengths and minimize our vulnerabilities. We must explore them and be willing to try new things.
No simplistic or quick fix will address all of these issues. Our response must be thoughtful, comprehensive and equally as transformative. Nothing short of overhauling our entire HHSC health care system will suffice.
Some have proposed establishing a nonprofit status as a cure for our financial difficulties. However, a solution cannot be just a change in legal status — it must be accompanied by a change in mindset that takes place system wide and by those outside the system who support us as well.
We must tap those who know the system best, as well as those who are served by the system. The process must be inclusive, comprehensive, transparent and honest. Such a transformation cannot happen overnight, as much as we might wish it. The cost could be intimidating.
However, the cost of doing nothing or being timid in our approach could be staggering, not only in dollars, but in terms of human suffering and lives. And that is unacceptable.
Through the Hawaii Health Systems, I truly believe we display the compassion, the caring and concern for others that have always been an integral part of these islands. It is who we are as a people and a community. It is what defines and differentiates us from others.
As we work through this transformation, we will be calling on our friends and neighbors in our island communities to participate, support and commit to this endeavor. We all have a vested interest in providing quality health care to everyone and not just to those who can afford it.
Since 1996, we have been the state’s safety net health care system. With your support and understanding, we will continue to provide quality, hometown health care for all.
Avery B. Chumbley is chairman of the Board of Directors of Hawaii Health Systems Corporation.
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