Archaic law keeps Maui from good health care
Margaret Mead said, "Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has." This is certainly the case for the people of Maui who have been fighting for a new, privately funded, state-of-the-art hospital, known as Malulani. The only things standing in their way are their own legislators and big government.
In 1975, a process was established that requires prior approval by the state for the construction or modification of health care facilities. This process, known as certificate of need or "CON," applies broadly to most health care entities and services, including clinics, pharmacies and hospitals.
The federal government provided Hawaii and many other states powerful financial incentives for developing CON programs. At the time, Congress thought the enactment of such programs would help control health care costs by giving states the power to regulate the development of health care based on need.
By 1987, Congress realized it had made a mistake; it repealed the law and the financial incentives associated with it. Since that time, CON laws have been widely criticized for acting as an impediment to competition, protecting failing medical facilities and increasing health care costs. Fourteen states have repealed their CON laws and nearly 200 bills have been filed in state legislatures across the country to revise or repeal CON statutes. Hawaii's archaic law, however, is still on the books, and last year that law stood in the way of Maui getting a new hospital.
The CON process protects government hospital monopolies -- such as Maui Memorial. In the private sector this would be deemed anti-trust and ruled illegal.
The time is now to improve access to health care by repealing our outdated, anti-competitive CON law. Various bills to reform or eliminate the process have been introduced in the Senate and were held. Unfortunately, the chairman of the Senate Health Committee has refused to hold a hearing.
Last week, the Senate held a marathon session where more than 300 bills were debated and voted on. In the Senate, legislators debated clotheslines and whether to make the monk seal the state mammal. Yet we did nothing to remove the barrier to building a new privately funded hospital on Maui, the reason probably being to protect the state government's most powerful special interest group -- public labor unions. The system needs reform to benefit all our citizens, including the union members.
The message is clear: Government should get out of the way and let the private sector deliver additional health care, choices and competition to the people on Maui. Residents of Oahu and the neighbor islands should realize this issue affects them, too. After all, it's the taxpayer who continues to shoulder the burden of Maui's government-run hospital that can't keep up with the island's growing health care needs. This year, the Legislature is allocating $50 million in "emergency" funds for the Hawaii Healthcare System Corporation, which operates Maui Memorial. Emergency funding has been provided regularly for all too many years.
The grassroots campaign on Maui will continue until a new hospital is built. The residents of Maui and the state deserve quality affordable health care, not errant politicians protecting a government monopoly health care system. We must all support the people of Maui and their quest for a private hospital to complement Maui Memorial.
Sen. Fred Hemmings, a Republican, represents Kailua to Hawaii Kai.