Richard E. “;Rich”; Meiers, leader of Hawaii's health care industry for 20 years, is retiring Monday.

“;He has been the face and the voice of the Healthcare Association of Hawaii for so long,”; said Sen. Rosalyn Baker (D, Honokohau-Makena). “;He's leaving some huge shoes to fill.”;

Filling those shoes will be George W. Greene, most recently director of the American Hospital Association for the region that includes Hawaii.

Meiers, 70, has had a 50-year career, including 30 years in the U.S. Army health care system where he earned the rank of colonel. He was chief of staff at Tripler Army Medical Center for three years before going to the Healthcare Association in July 1990.

Arthur Ushijima, president and chief executive officer of the Queen's Health System, said Meiers turned the association around financially and built a solid organization with a good management team.

He expanded services from acute care facilities to long-term care, home care and hospice providers and raised awareness of the health care industry and related issues, Ushijima said. “;He's fair and sincere, a person really trying to do the right thing not only for the health care industry, but the people of Hawaii.”;

The Legislature has relied on Meiers to provide “;honest, unbiased information regarding hospitals and the impact of public policy on health care,”; Baker said.

Meiers plans to travel and spend more time with wife Lynn, daughter Cindy, son Rich Jr. and his daughter, starting with a family trip to the mainland that will include a visit to Disneyland.

Even as he prepares to leave the job, Meiers looked ahead to state and national health care problems in an interview.

He said the health care industry was in “;relatively good shape”; here in 1990, but problems began to surface with managed care, then the 1997 federal balanced budget act that reduced reimbursements for health providers.

“;We in Hawaii are sort of unique,”; he said, noting the state law requiring employers to provide employee health insurance has kept Hawaii's uninsured rate among the lowest in the nation. But the employee rate for coverage, set by law at 1.5 percent of an employee's salary, has never changed, and employees should pay a larger share with rising health care costs, Meiers said.

Inadequate reimbursements are probably the major issue, he said, pointing out if a Hawaii hospital closes because of financial losses, patients cannot drive to another state. “;It's critical that we don't lose much infrastructure.”;

Meiers said he is anxious to see an Ernst & Young financial report for the health care industry in November because of “;tremendously hard times”; the past year. “;We know charity care has gone up.”; The accounting firm reported last year that hospitals lost more than $143 million in 2007 in bad debt and charity care for the uninsured.

One of his disappointments is that lawmakers here and nationally have not done much for tort reform: “;They talk about reining in costs for health care, yet a major piece of it has almost never been discussed.”;

Health reform is needed, Meiers said. “;The question is, What should it be and how fast should we move? I'm concerned that we're moving too fast and the final product is not going to be well thought out.”;

He favors incremental changes with the focus on a good insurance program for the 40 million who are uninsured. Insurance coverage for pre-existing conditions should be addressed, he said, “;and there should be a huge effort to keep people well.”;

One of the challenges ahead will be a “;new normal,”; with an expanded government role and regulatory restructuring, Meiers predicts. More transparency and disclosure will be required of providers, he said. “;Those who don't get used to it are going to have problems.”;

Meiers serves on myriad community, business and government task forces and boards. He said he is remaining on the Catholic Charities board because of its important mission but is not sure which of the other affiliations he will continue.

“;Rich truly has made a huge difference and touched so many people in so many ways,”; said Thomas Driskill Jr., president and CEO of the Hawaii Health Systems Corp.

Driskill has been an HHA board member since 1992 and chairman from 2004-2006. Meiers also served on the HHSC board for eight years.

Meiers has taken Hawaii's health care issues to Washington, meeting often with national health and hospital organizations and Hawaii's congressional delegation and reporting back to HHA members in a newsletter.

“;I know he will continue to want to help and interact with legislators and health care leaders,”; Driskill said.