Maui Hospital Charges:
Proposed Increase Contested

BY BUCK QUAYLE

Maui Hospital Charges

The State Health Dept.'s facts and figures on a proposed increase in hospital charges were contested in a public hearing on Maui last week.

For the most part, the dozen speakers from the audience of 50 presented their opinions in a "gentlemanly" fashion-though one shouting match and one oratorical presentation on "government of, by, and for the people" managed to slip though the "thin veneer of civilization".

State Health Dept. officials, hospital administrators, and most doctors who addressed the public hearing last Thursday favored an increase in Maui hospital charges.

Most private citizens did not.

The hearing-one of a series being help throughout the islands-revolved around two basic proposals. The first was a general increase in rates. The second was a change from an individual fee system to an all-inclusive daily charge for each patient.

Hearing Chairman Dr. Walter Quisenberry, director of the State Health Dept., explained the rate increase is intended to make island hospitals 90 per cent self-supporting, with the other 10 per cent to be subsidized by the State.

Neighbor island hospitals now are 60 to 70 per cent self-supporting.

Dr. Ralph Berry, deputy director of health, said there has been no increase in Maui hospital charges since 1969. At that time, he said, the average cost to the hospital per patient per day was $66.68. In 1971, he said, the expense had risen another $29.02. Due to this increased expense, the Health Dept. felt a raise was appropriate.

According to State figures, Maui Memorial Hospital now charges $33 a day for a semi-private room. The state wants to increase the charge to $55. This would not include charges for services such as operations and lab work, or other expenses.

However, if the all-inclusive system is adopted, the same room will cost $46 per day, plus a flat fee for all additional services. This additional cost would be $70 the first day in the hospital, $63 the second, $51 the third, $40 the forth, $35 the fifth, and $29 for each day after that.

The sliding scale reflects the more expensive procedures which generally are conducted on the first days, including surgery and lab work. However, there also would be additional Maui hospital charges for anesthesia, blood and take-home drugs.

Berry said the all-inclusive form of billing was first tried at Massachusetts General Hospital, which saved over $300,000 in one year through decreased paperwork.

The benefits of all-inclusive billing were strongly disputed by Charles Street, manager of the Wailuku Sugar Co. Using examples of Wailuku Sugar employees treated at Maui Memorial, Street said the all-inclusive billing system would result in higher charges to patients.

Street also opposed the rate increase in general. Last year, he said, Wailuku Sugar employees racked up $32,500 in hospital bills. The increase would mean a jump of $12,000 to $16,000 annually-an increase he called "unreasonable".

Among doctors speaking in favor of the increase were Mark Sowers and Sakae Uehara. Both said they would like to see hospitals become completely self-supporting. Dr. Milton Howell of Hana, said he would favor some subsidy for hospitals.

George Shimada, who protested the all-inclusive rate structure, said he was concerned about the "marginal people-the poor people". Shimada and Berry engaged in a brief shouting match until the altercation was broken up by Quisenberry.

Speaking for himself, John Middleton expressed gratitude "that the price of air hasn't gone up".

Yoneto Yamaguchi, chairman of the County Council's finance committee, asked that "the proposed hike in rates be deferred until such time that a complete study and justification is provided".

Quisenberry said he would reach a decision by Feb. 17 on the proposed rate changes.