[ OUR OPINION ]
ALTHOUGH a strike by nurses at three Hawaii hospitals revolves around predictable disputes about staffing levels, overtime, benefits and pensions, the walkout finds its roots in the far-ranging issues in the health care industry. The strike will probably reach resolution, but health care problems will remain unless the industry, political leaders, insurance companies and the public look for solutions together. Strike is a symptom of
health system’s ailments
THE ISSUE The walkout at three isle hospitals reflects the financial squeeze in the industry.
The immediate concern with the strike is to make sure patients get the care they need. St. Francis hospital has stopped admitting people, terminated outpatient surgery and laid off 100 other workers. The two other hospitals affected by the strike -- Queen's and Makiki medical centers -- say they have not yet experienced major disruptions in service. However, the longer the strike continues, the more likely services will be curtailed, and with Christmas and the New Year holidays just a few weeks away, the number of emergencies is sure to grow.
Of the three hospitals, St. Francis appears to have the most acute financial troubles. With 80 percent of its operations tied to Medicare and Medicaid patients, it has been hurt by reductions in hospital reimbursements from the federal government. Despite trimming its operations, it lost more than $5 million in the year ending June 2001.
Other medical facilities share the same difficulty, according to a report from Healthcare Association, an advocacy group for hospitals in Hawaii. The report says hospitals and nursing homes have assumed more than a half-billion dollars in unfunded costs since 1998 due to reduced reimbursements for Medicare and Medicaid.
A quick end to the walkout is unlikely.
Meanwhile, members of Congress -- their attention diverted by national security, Iraq and midterm elections, and at odds with the Bush administration and one another -- went home last month without action on major health care legislation. Included were proposals to forestall a 4 percent reduction in payments to hospitals, nursing homes, doctors and health care plans, another to ease the way for low-income parents to obtain coverage for their children, larger subsidies for Medicare HMOs, more money to help states pay for Medicaid and lowering costs for prescription drugs.
Congress did manage to pass a piece of legislation that may ease the nursing shortage, a key element of the current strike. It provides scholarships to encourage more people to train for the profession, which in Hawaii has a 21 percent vacancy rate.
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