More hospitals unlikely in isles, official predicts

A Hawaii health-care association president blames shortages of staff and funding

The president of a Hawaii hospital association says a proposal to build a new hospital on Maui will not likely inspire similar projects on other islands because chronic staffing shortages and a lack of health-care funding would deter other new hospital planners.

"I'm not sure the staff is there to support them," said Richard Meiers, president of the Healthcare Association of Hawaii, in an interview. "The health-care dollars aren't there to support them, either."

A segment of the Maui community has rallied behind a plan to build a new hospital in Kihei called Malulani Health and Medical Center. The hospital would join, and perhaps compete directly with, the only other existing acute-care facility on the island, Maui Memorial Medical Center.

Dr. Ron Kwon, a Maui doctor who has worked for six years to establish Malulani, is applying to the State Health Planning and Development Agency for the right to start the hospital and begin treating patients on Maui. Kwon has enlisted Dallas-based Triad Hospital Corp. as a partner.

A panel of the state agency has started hearings on Malulani's application that will continue today.

Meiers, who said he was sharing his personal observations from 16 years as the head of the health-care association, said Malulani's effort is unlikely to be replicated elsewhere.

"My biggest worry about the addition of new hospitals is I'm not sure we're going to have the people to staff them," Meiers said, noting a serious nurse shortage in the state.

The association has sought to grow the local nurse population by lobbying the state Legislature to spend money on the expansion of the University of Hawaii's nursing school. Funds have been allocated, but years will likely pass before the effort starts generating results.

Hospitals also suffer from a lack of other medical professionals and, in some areas, a shortage of doctors.

"We have a maldistribution of physicians. Right now there seem to be plenty of them on Oahu but not so much on the neighbor islands," Meiers said. "There are a lot of other specialists that go along with running other hospitals. I'm just not sure we have the people to really staff any new facilities."

Equally as important, Meiers said the state's hospitals were suffering from severe financial difficulties as federal and state government have cut back on what they reimburse health-care providers for their services. Meiers was pessimistic this trend would change given talk of additional Medicare spending cuts.

"Our hospitals, nursing homes, home care and hospice providers, our doctors are not being paid for the care we provide," Meiers said.

A rising number of uninsured patients unable to pay their medical bills have further inflated hospital losses. The uninsured population in Hawaii has climbed to nearly 10 percent now from about 2 percent to 5 percent in 1990, he said.

"Obviously, we're not going to put people out when they come to the emergency room to be seen. You still see them," Meiers said. "But we've got to take that out of our hide."

Hawaii's hospitals lost more than $101 million last year providing medical care to those who could not pay for it -- about double the amount of five years ago, the health-care association says.

The Healthcare Association of Hawaii has not taken a position on whether to support Malulani's application to set up a hospital on Maui.