Health care costs are rising and government coffers are shrinking. Who should we protect? Should we protect our poor and indigent and neighbor island residents, or should we protect our government systems like education?

The answer, of course, is both.

The critical state of the public hospitals system is a problem that our Legislature has refused to address for many years, putting public health care employees and the people they care for at risk of losing it all. Our hospital system is broken and broke, and our aging facilities are rundown. How can we as a community continue down this path? We can’t. At the risk of oversimplifying it, all it really requires is bold leadership and courage, which our state has clearly been lacking.

First and foremost, we must accept that the health care environment and technology are changing so rapidly and becoming so expensive, that our state cannot keep up. Government is plodding and slow, quality health care requires innovation and efficiency. The two systems are incompatible as evidenced by the current state of affairs.

Second, as a community, we must agree that providing health care to the poor and indigent and neighbor island communities takes priority. A sustainable hospital system can no longer be held hostage by unions who use scare tactics.

If all stakeholders, including unions, come to the table with an open mind and willingness to salvage this system for our state’s most vulnerable, we can accomplish great things together. This is the nature of collaborative leadership. As governor, I would invite and support all serious collaborative efforts.

Frankly, the state has no business being in the health care business. The administration of the hospital system cannot and should not be left to politicians or elected officials.

We need a long-term solution that doesn’t jeopardize the health of patients and serves our communities. The long-term solution is finding partners who excel at providing excellent care. Those partners may be local, or not. Those partners maybe nonprofits. But the priority must be on finding partners whose business is health care. Whether the solution is privatization or a public-private partnership, I will actively lead and support all options that make the state hospital system sustainable for future generations. There are many advantages to partnering, including better care for patients, better technology, better facilities and better pay for hardworking doctors and nurses.

Further, if our state hospital system was competitive in pay, which the state cannot afford to do, perhaps we could also attract more much-needed doctors to the state as well. Using scare tactics that suggest that local jobs will go away if partnerships are formed is a fallacy. Hospitals will always require workers and many private or nonprofit organizations can take better care of their workers because of system efficiencies.

As a community, we must come together and require leadership of our elected officials and our unions. The path we’re on now is simply disastrous, but I believe the answers are right in front of us; all it requires is the courage to take the next step down the right path.