Maui suffers from a shortage of medical specialists. Even family practitioners are specialists.
It takes a decade or more of schooling and internship before a doctor can become a board-certified specialist. For most that adds up to a huge debt that must be paid off when they begin practicing. That's on top of the income drains faced by everyone.
The lack of facilities and the high cost of housing on Maui are often cited as key reasons specialists are reluctant to set up shop on Maui, no matter how attractive the island might be as a place to live. Two critical factors are low and slow reimbursement rates and staggering malpractice insurance premiums.
Hawaii's average medical malpractice insurance premium shot up 90 percent between 2002 and 2006, from $33,000 to $63,000 a year. This is one area where the Legislature could make a significant difference by limiting noneconomic damages, which are more punitive than legitimate compensation and which encourage the filing of unwarranted lawsuits.
When Texas limited non-economic damages to $250,000, the number of medical license applications increased 50 percent, the number of neurosurgeons increased 12 percent and the number of orthopedic surgeons increased 9 percent. At the same time, malpractice insurance rates dropped 25 percent and there was a 50 percent reduction in malpractice lawsuits.
Attorneys often benefit financially by getting sympathetic juries to award exorbitant noneconomic damages. Hawaii's Legislature is filled with attorneys. Legislators should look beyond individual financial gains to the overall effect on the state's health system.
Maui is not alone; the entire state suffers from a lack of specialists. In a time when spending public funds for facilities seems out of the question - private community hospitals would have a greater chance of raising the money - passing malpractice reform is a noneconomic measure that could pay very large dividends.
(A version of this editorial ran last year in The Maui News around the start of the legislative session.)
* Editorials reflect the opinion of the publisher.