Here’s the tab: $97.2 million, $108.2 million, $138.8 million and $139.3 million.

Those were the yearly operational losses for the Hawaii Health Systems Corp. since 2010.

During that same period, your taxes paid down those losses, but did not pay everything.

Basically the state is putting a tourniquet on the bleeding, but no one is taking the state’s 12-member hospital system to the doctor to fix the problem.

This year the Legislature came close, but at the last minute, closed the door on the patient.

Star-Advertiser reporter Kristen Consillio wrote on Wednesday that the state agency that runs the public hospitals, including most of the neighbor island facilities, is trying to partner with or be bought by an investor or nonprofit.

If that does not happen, officials say, the roof is about to cave in.

"The whole deal was either they’ve got to give us lots of money or we’ve got to get the ability to partner with somebody, but we got neither. It’s pretty bad. We’re hoping we don’t affect patient care, but the cuts are going to be so much," said Wesley Lo, regional CEO for Maui Memorial Medical Center.

What is needed either from Gov. Neil Abercrombie’s administration or the Legislature is a clear vision of what the hospital system is going to be.

Right now it is not topping anyone’s lists for best American medical facilities.

In testimony this year, Alice Hall, acting president and CEO of the health system, said that to keep services at its existing level, "HHSC will need an estimated $1 billion in capital improvement funds over the next 10 years."

The system is what’s left from the old county hospital system and the hospitals run by the plantations before statehood. The county hospitals started with state subsidies in 1965 and were taken over in 1967. Many are in out-of-the-way parts of the neighbor islands and almost all need major work. One is more than 100 years old.

Instead of a workable plan, the HHSC was left with $102 million in subsidies for next year. The plea for more money was $150 million, so again the problem was eased, not solved.

Besides the problem with rebuilding and possibly moving the hospitals, the other problem is that the employees are public workers with public worker union benefits and contracts.

If someone is to buy or adopt the facilities, what happens to the workers?

That was the question from Kalbert Young, the state’s budget director.

He said the administration supports some sort of transition toward becoming part of someone else’s nonprofit, but worries what the state will continue to owe.

What happens to the pensions, the contracts, and who would be responsible? Young asked.

"Does the nonprofit hospital assume responsibility for constructing, upgrading, maintaining and repairing facilities and equipment?" Young also asked.

And just to make things a lot more complicated, many of the hospitals sit on ceded lands, so who pays the revenues to the Office of Hawaiian Affairs?

Leadership is not for everyone, but to give the neighbor islands good, reliable and modern health care, it is going to take the dedication to deliver more than yearly stipends and Band-Aids.

Richard Borreca writes on politics on Sundays, Tuesdays and Fridays. Reach him at rborreca@staradvertiser.com.