The healthcare crisis in Hawaiʻi demands immediate attention, and the proposed consolidation between Hawaiʻi Pacific Health and HMSA could exacerbate an already dire situation. Governor Josh Green must take action now to prevent further damage.
On the island of Maui, the impact of healthcare shortages is felt acutely. Patients face long waits for essential treatments, with dialysis patients scheduled at odd hours and cancer biopsies delayed for months. Surgeons operate late into the night or on weekends due to a lack of operating rooms, and families are forced to leave the island for care that should be accessible locally. This is not a matter of geographical challenges; it is a result of policy decisions that have restricted supply and limited access.
Maui's healthcare system is designed to restrict supply, with Certificate of Need laws, hospital consolidations, and a two-tier system that leaves residents with limited choices and extended wait times. The consequences are clear: Maui, with a population similar to Little Rock, Arkansas, has only one major hospital system, leading to rationed care and prioritized services based on reimbursement rates.
Consolidation further compounds the problem. Patients on Maui effectively navigate a two-tier system, with Kaiser routing patients to Oʻahu for simple procedures, and a dominant hospital ecosystem offering little competition and incentive for community-based services. The proposed deeper integration between Hawaiʻi Pacific Health and HMSA would intensify this dynamic, concentrating pricing power and reducing transparency for independent providers.
This is not just a theoretical concern; it is a real-world issue with tangible impacts. Research shows that consolidation in healthcare markets consistently leads to higher prices, with little improvement in quality or efficiency for patients. When competition decreases, innovation slows, and service quality declines. The ripple effects are felt across the entire economy, with small businesses and trades suffering from rising healthcare costs and limited access.
The current healthcare system in Hawaiʻi is failing to meet basic community needs. Consolidation has reduced choice, Certificate of Need has restricted supply, and vertical integration has shifted control away from patients, doctors, and small businesses. The lived experiences of Maui residents highlight the urgency of this issue.
Governor Josh Green has expressed a commitment to saving lives and improving healthcare, and now is the time to turn those words into action. The governor has the authority to impose guardrails on healthcare consolidation, open Hawaiʻi's insurance market to competition, enforce network adequacy laws, and pursue measures to make healthcare more affordable and accessible for physicians and patients.
Healthcare consolidation is a powerful driver of rising costs, and the consequences extend beyond healthcare itself. It threatens the survival of Hawaiʻi's families, private practitioners, tradespeople, and small businesses. It represents a deeper issue of sovereignty and control over our daily lives and livelihoods. The demand for healthcare is inescapable, and private equity firms and large corporations are exploiting this to extend their control over various sectors of our economy.
The time to act is now. Governor Green must prioritize healthcare consolidation as a critical issue, not just for the well-being of Hawaiʻi's residents but for the survival of its economy and way of life. The consequences of inaction are too great to ignore.
