Saturday, October 18, 2008
Crisis in Hawaii Healthcare
There is trouble in paradise. The big Island, Hawaii, is experiencing a massive doctor shortage and there is no relief in sight. Here are some facts that might be as surprising to you as they were to me.
There are 140,000 residents on Hawaii, the biggest of all the Hawaiian islands at over 4,000 square miles. There are three hospitals on Hawaii, 2 are state hospitals and one is private and they are all financially desperate.
For the 140,000 residents and thousands more tourists who visit, there is only one orthopedic surgeon who operates. Two ortho docs left this year because they just couldn't make it financially. There are no neurosurgeons and only two OB/GYN doctors after three retired this year.
There is one health insurance carrier who enjoys a monopoly (Blue Cross Blue Shield-HMSA) and, according the the physicians I spoke with, they have terrible reimbursement rates that make it impossible for physicians to practice here. Couple that with the " lower than cost" rates paid by Medicare and you have a system that just doesn't work
Hawaii had enacted "universal coverage" for children through HMSA and that program was cancelled after just 11 months and coverage for 2000 kids. Budget shortfalls caused the program to be abandoned.
The final nail in the coffin for doctors in Hawaii is the high cost of malpractice insurance. That one orthopedic surgeon on the Big Island pays at least $47,000 a year. Tort reform and caps on pain and suffering payments would go a long way toward stabilizing the physician workforce and allowing more doctors to practice in paradise.
There is one take home message here. Who we elect has a critical impact on our health care. Health care policy is the most important aspect of the health of a population. No doctors means no care. It doesn't matter if you have insurance if there is no one to take care of you.
Posted by Toni Brayer, MD at 8:19 PM