Getting and keeping hospitals in Hawaii is becoming a serious issue.

Last year, much of Gov. David Ige’s and legislative leaders’ time was spent piecing together a plan to stop the bleeding in just one part of the neighbor island public hospital system.

The only problem addressed, and it was the easiest one, was allowing the Maui public hospital system to be taken over by a private entity.

Maui’s hospital was doing fairly well and was growing enough that it had enough economic horsepower to attract bidders. Kaiser eventually won and is starting the shift to a private operation.

Now back on Oahu, the problem is Wahiawa General Hospital, which is standing on the edge of bankruptcy.

The hospital had its roots in World War II with the Hawaii Office of Civil Defense setting up an emergency medical facility on the site of Wahiawa Elementary School.

It grew as the military grew and then went off to help with private practice cases as the sugar plantations closed.

Hospital officials say the facility has lost $3 million a year over the past three years. More than 85 percent of the patients are Medicare and Medicaid and the federal government has repeatedly cut those payments.

Today 95 percent of patients in acute care — in other words, they are not long-term care patients — come through the doors of the emergency room.

Dr. William Scruggs, president of the Hawaii College of Emergency Physicians, is a physician at Wahiawa.

“I have numerous personal stories of people I cared for that would quite possibly have not survived if they were transported another 20 minutes before receiving care. I have placed breathing tubes for patients within minutes of their arrival because they were unable to breath and on the verge of dying because of asthma, heart failure, and foreign bodies obstructing their airway,” Scruggs told the Senate Ways and Means Committee last week.

The committee came up with a plan to have the state buy the land under the hospital’s parking lot and then lease it back to the hospital, which would amount to a $5 million cash infusion and stop the hospital’s bleeding.

Rep. Bert Kobayashi, a Kaimuki Democrat and former head of the Hawaii Health Systems Corp., says without help, Wahiawa hospital could become part of the national trend of small rural hospitals closing.

“For several decades there have been hundreds of hospitals closing nationwide,” Kobayashi said in an interview.

Many of those hospitals are doing long-term care work, instead of treating the sick and injured and losing money.

“We are using the term hospitals to hide the difference between acute care and long-term care hospitals taking care of older patients,” Kobayashi said, adding that it is unlikely that the federal government is ever going to balance out payments and costs.

Obviously the Legislature’s proposal is just a band-aid and is not a solution for Wahiawa’s problems.

Down the road more problems could surface with the public hospital system in Hawaii County.

The reality is mostly gloomy.

Those living in a five-mile radius of the state Capitol can be treated by five major, first-class hospitals.

Options in many other places of the state are just not that good.

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