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Editorials
Monday, February 5, 2001Hospitals need help
to survive financiallyThe issue: Hawaii hospitals and nursing facilities are facing big deficits and possible bankruptcy.
THE merger agreement of three Hawaii hospital systems -- Kapiolani Health, Straub Clinic & Hospital and Kauai's Wilcox Health Systems -- is a response to the financial pressures felt by hospitals here and on the mainland, an attempt to improve efficiency and achieve savings in order to maintain financial viability.
Government -- both state and federal -- is part of the problem and must become part of the solution.
How serious those financial pressures have become is shown by a study warning that Hawaii hospitals and nursing facilities can expect an operating loss of $1.9 billion from 1998 to 2002 if no changes are made in state and federal payments. The study was made by the accounting firm of Ernest & Young for the Health-care Association of Hawaii.
Richard Meier, the association's chief executive officer, warns "there is no way the industry can absorb close to a $2 billion loss over five years and still function as it used to." Dr. Philip Hellreich, president of the Hawaii Medical Association, says some hospitals are on the verge of bankruptcy.
As Star-Bulletin writer Helen Altonn reports, the key reasons for the hospitals' plight are uncompensated costs for community health programs and medical education, charity care and bad debts plus Medicare and Medicaid payments that don't cover costs.
The study found that the 1997 federal Balanced Budget Act has cost Hawaii hospital and nursing facilities more than $142 million and a relief measure will give them only $8 million.
In 1999 the facilities lost more than $70 million -- up from $52 million in 1998 -- in charity care and bad debts. In 1998 and 1999 the hospitals incurred a $370 deficit per discharge because of low Medicare reimbursements, for a total annual deficit of about $30 million.
The medical association is lobbying in the state Legislature for a Medicaid omnibus bill that would set payments at a level that would cover the actual cost of care for the poor, aged and disabled. The association is also working with other state associations and the American Hospital Association to increase federal reimbursements.
These efforts deserve the community's support and legislators' attention. Nothing could be more short-sighted than to let these essential institutions starve financially.
Florida will replace
punchcard ballots
FLORIDA'S election officials endured humiliating national exposure when the 2000 presidential election came down to a question of recounting the state's defective punchcard ballots. Although many states still use the antiquated punchcard system, the publicity given to Florida's problems forced the state to resolve to do something about those danged chads.
Now a Florida election reform task force has voted unanimously to recommend that punchcard ballots be barred from elections by next year.
The task force said it will tell Gov. Jeb Bush and the legislature to adopt a system that is supposed to virtually eliminate voter mistakes. The group recommended a system in which voters use a pencil to fill in bubbles next to their candidates' names. If there is a mistake, the system would reject the ballot on the spot and voters could immediately correct their errors.
The panel recommended that the state lease the system for next year's election at a cost of about $20 million, with the state and the counties splitting the expense. It would cost $40 million to buy the system, but the panel said leasing is a better option because advances in computer technology could make it obsolete in a few years.
Twenty-six counties already use the system and election officials report one-fifth the number of discarded ballots compared to the punchcards. In the 26 counties, one electronic system ballot out of every 120 was botched -- almost all of them absentees -- while in punchcard counties the ratio was one out of 24.
The governor appointed the 21-member task force in December, two days after the U.S. Supreme Court stopped a presidential ballot recount requested mostly because of problems with the punchcard system.
The system recommended for statewide adoption in Florida appears to be similar if not identical to the optical scanner system Hawaii adopted in the 1998 elections to replace punchcards.
The system came under heavy criticism in those elections because several of the voting machines malfunctioned -- apparently because the precinct operators hadn't been adequately trained. The protests resulted in a statewide recount that turned up no further errors.
In last year's elections, the same system was used here with hardly any counting problems.
The main criticism concerned the confusing ballot used in the primary elections -- not the voting machines.
In fact, people got frustrated because the machines kept rejecting their ballots. Some gave up and left without casting valid ballots. That was unfortunate, but it verified that the machines were working properly.
The optical scanner system got off to a bad start in Hawaii two years ago but evidently didn't deserve all the abuse it received. It obviously has some advantages, because the same system or something like it is being recommended to solve Florida's dreadful problems with punchcards and spoiled ballots.
Published by Liberty Newspapers Limited PartnershipRupert E. Phillips, CEO
Frank Bridgewater, Acting Managing Editor
Diane Yukihiro Chang, Senior Editor & Editorial Page Editor
Frank Bridgewater & Michael Rovner, Assistant Managing Editors
A.A. Smyser, Contributing Editor
