Health hot issue for Baker, her challenger

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KIHEI - State Sen. Roz Baker and her Republican challenger, Jan Shields, clashed Monday during a debate sponsored by AARP's South Maui Chapter at the Kalama Heights Retirement Residence in Kihei.

Shields maintained that Baker was to blame for the death of a bill that could have cleared the way for an acute-care hospital in South Maui, an important issue for many seniors in the community.

Baker shot back that Shields was wrong, describing the challenger's remarks as "baloney."

In October 2006, the State Health Planning and Development Agency denied the Malulani Medical and Health Center its request for a certificate of need. The agency sealed its rejection of the proposed Kihei hospital in January 2007.

Seeing the certificate of need process as a roadblock, Malulani supporters appealed to state lawmakers for the elimination of the state permit required of proposed new health care facilities in Hawaii. That measure failed to pass, and Baker has come under fire from Shields and others for its failure.

But on Monday, Baker pointed out that she and Maui Sens. Shan Tsutsui and J. Kalani English introduced the bill requested by Malulani supporters to abolish the certificate of need process. But the Senate's Health Committee chairman chose not to hold a hearing on abolishing the certificate process and a separate measure recommending a waiver for the failed Malulani project, Baker said.

She said she favored having the certificate of need abolishment measure debated in the Senate. "I was outvoted," she said.

Baker was adamant in saying the measure "did not die" on her desk and pointed out that not all proposals have widespread support. "That happens a lot in the Legislature," she said.

The two candidates gave contrasting views about how they would approach health care reform. AARP in Hawaii lobbied successfully in the 2008 legislative session for a Long Term Care Commission to study ways to address problems and challenges in long-term health care.

In Kihei, seniors expressed concerns about access to medical care in general and a desire to have a hospital in their neighborhood.

Shields said she would push for the sale of all government hospitals, including Maui Memorial Medical Center. She said she would keep the emergency room but convert the rest of the facility into a center for services such as drug rehabilitation and mental health care.

If elected, Shields said she would introduce a measure to eliminate the certificate of need process. She would also entertain tort reform measures and possibly model a bill on what's been done in Texas where physician shortages have been addressed by legislation on medical liability insurance and health care reimbursements.

Baker said she believed the issue of improved hospitals had nothing to do with public versus private, but that it was based on how government could support what health care systems already are in place.

For example, she "wholeheartedly" supports the proposed critical access hospital for West Maui and getting government to speed up approvals on state permits and county zoning, she said.

She pointed out that Maui Memorial Medical Center has become a leading site for stroke treatment and will soon provide state-of-the-art cardiac care, including open heart surgery. Baker has supported government funding to support Maui Memorial's operations.

In response to a question from the audience of about 75 people, Baker and Shields agreed that salary increases are needed to draw more people to seek office in the state Legislature.

The state Salary Commission recently approved a 36 percent pay hike, from $35,900 to $48,708 for legislators working in the 2009 legislative session.

Shields, who worked as a nurse on both Oahu and Maui, pointed out that the average nurse on Oahu earns about $90,000 a year. "I don't think it's outrageous," Shields said about the approved salary increases. "We need to attract good people."

Baker said that when she was majority leader in the Senate, she rejected pay increases in 1996. She said she believed that the legislators should pay for raises through the appropriation for legislative business, not from the general fund.

Baker is fielding a challenge from Shields for the 5th Senate District seat, which includes West and South Maui. Voters in the district can choose either candidate on Nov. 4.

State House Rep. Joe Bertram and his Republican challenger George Fontaine also made their pitches to the AARP audience for the South Maui 11th House District seat.

In responding to a question, Fontaine identified health care reform as an important issue, saying he would like to probe possible medical tort reforms and perhaps seek tax cuts, particularly the general excise tax.

Bertram said the economy would be his top priority. He would seek to strengthen a safety net for Hawaii residents facing home foreclosures and job losses. He'd also like to support programs that provide credit counseling for those who need it.

Both candidates said they support greater funding for charter schools. They also support the establishment of local school boards as proposed by Republican Gov. Linda Lingle, but they acknowledge that getting approval from the Legislature would be difficult.

AARP South Maui Chapter President Tony Fisher said Monday's debates drew the largest crowd ever to his group's monthly meeting. He said the AARP does not endorse candidates because it wants to remain nonpartisan.

* Claudine San Nicolas can be reached at claudine@mauinews.com.