By Paul Drewes
(KHNL) -- Doctor shortages, a scarcity of specialists, and higher costs for hospitals have some worried about the future of medical coverage in the islands.
Healthcare in the islands is a big deal to patients and physicians, but it is also big business.
When it comes to care, someone has to pay to reimburse doctors for their services. But a number of physicians say those costs come up short in Hawaii.
"Physicans in Hawaii are reimbursed at the lowest rate in the nation," said Dr. Larry Peebles, a hospital chief of staff.
Much of the finger pointing is at the state's largest private insurer, the Hawaii Medical Services Association or HMSA. It claims its reimbursements cover the cost of services.
"We pay physicians higher than medicare, 20% higher over medicare," said Cliff Cisco.
HMSA "could" pay doctors even more, which would provide more incentive to stay in this high cost of living state. But the medical insurer insists, many of "you" would end up paying the price.
"Every increase in revenue to providers translates to a higher health care cost at the paycheck level."
Low reimbrusement levels and high malpractice costs clearly drive some doctors away, leaving rural areas and especially neighbor islands struggling to keep specialists and even physicans on staff.
So is Hawaii's healthcare on life support?
"We don't see it as a crisis, we have a lot of issues some unique to our community," Cisco said.
One of those issues is getting more doctors to practice in smaller towns by encouraging education in the state. Because many locals like living in Hawaii's rural communities.
Another is coming up with creative ways to provide care, when doctors aren't available.
"We provide the service of finding an appointment in Honolulu and providing airfare to get them there and vice versa, flying physicians to the Big Island."
But even those measures will not provide enough medical care for all patients.
And many feel, the prescription for high quality Hawaii healthcare, comes at a high cost.
"Money is what makes everything work."