Editorial: Invest in Hawaii as ‘Health State’

Health care in Hawaii looms as one of the state’s most persistent challenges — and potentially an economic opportunity its leaders should seize.

Gov. Josh Green, who keeps the “M.D.” after his government title in official statements, has already signaled the importance he places on the health-care field. His announcement last week that he aims to make Hawaii the “Health State” merely made that official.

Green was unveiling the broad outlines of his first executive budget to submit to the state Legislature before it convenes Jan. 18. He has the good fortune of inheriting a $1.9 billion surplus due largely to federal pandemic relief funds and the rapid recovery of the tourism industry and other economic sectors.

In the $9.8 billion in general funds requested for fiscal year 2024 and $9.6 billion for 2025, there were some important sections left blank. The governor said his team was still working on a full housing plan to be presented later.

But he’s clearly given a lot of thought to the finer points of a health plan, and not only because his years as a doctor in the emergency room had supplied him with much of the background.

There is a real need driving this initiative. This is undeniable, particularly with a growing sector of aging seniors requiring care. Lawmakers need to see that these are addressed in the coming session.

Green pointed to the tragic Dec. 15 deaths of emergency transport crew dispatched from Maui to pick up a patient on Hawaii island. The reason transport is so often necessary, he added, is the lack of health services in many rural communities.

Overall, there is a deficit of 600 doctors, and during the pandemic, Hawaii was 700 nurses short. It cost $70 million to fly more in.

This is a serious workforce issue, one that’s been plaguing Hawaii for years. There is an urgent call for capacity-building at the John A. Burns School of Medicine and the University of Hawaii School of Nursing. Both institutions could be training up more providers but must turn away qualified applicants because staffers essential to the training of more students are in short supply themselves.

The budget will include $4.4 million for 60 positions in nursing and medical programs across the University of Hawaii campus system.

And the continued funding of the Hawaii State Loan Repayment Program, which started under former Gov. David Ige, will continue. This program pays off educational loans for primary care and behavioral health providers, two categories in which there are gaps to fill. It’s easier for Hawaii to retain doctors if some of the cost disincentives can be addressed.

The shortages also are felt at the institutional level. Tucked into the spending plan is $50 million for expanding the intensive care and medical surgical units at Hilo Medical Center.

Additionally, seeing that the new Hawaii State Hospital begins to meet its potential should be job one. Green says mental health services are a priority, and the public wants to see him deliver.

Health care presents a whole boatload of challenges to the state, but it also offers potential. There are jobs for the next generation to fill, if the governor hits his marks on adding to the state’s health-care professional opportunities.

He is not the first to envision Hawaii becoming a hub for health care in the Pacific, a training and treatment destination for the region. This is a development that could become a supplemental economic engine.

The old saying about never letting a good crisis go to waste seemingly applies here. Hawaii has a health crisis, but fixing it could bring opportunity well worth the effort to pursue.