Hawaii’s health care providers have a deep history of working together to provide the care that our residents and visitors need.

Collaboration is essential for an island state — most residents simply don’t have the luxury of going somewhere else for treatment, so we rely on all health care providers and hospitals to cooperate and make decisions that focus on the best interest of the patient. In this spirit, Kaiser Permanente does treat nonmembers in our hospital and sometimes our members are seen by other community providers and at other hospitals.

Kaiser Permanente has always valued its relationship with the hospitals of The Queen’s Health Systems. Queen’s plays an important role in the community as a legacy health care provider and we are fortunate to have it as a resource for our members — not just for trauma emergencies, but for some specialty services that we and other Hawaii hospitals may not offer.

It’s this spirit of community and doing what’s right for our people that makes Hawaii a health care model for the nation. That’s why it is especially distressing that we have been unable to reach an agreement with The Queen’s Health Systems that is fair and reasonable to Queen’s, Kaiser Permanente, and the nearly 1 in 5 Hawaii residents who are members of Kaiser Permanente.

Since late 2017, Kaiser Permanente has been negotiating in good faith with The Queen’s Health Systems to establish a new contract for medical services that are provided to our members at its four hospitals: The Queen’s Medical Center, The Queen’s Medical Center-West Oahu, North Hawaii Community Hospital and Molokai General Hospital.

Unfortunately, without a contract, Queen’s has taken an unreasonable position of substantially increasing its charges to Kaiser Permanente for the care it provides to our members, including emergency and trauma services. This is especially unfair, because patients experiencing a medical emergency often don’t have the ability to choose what facility they are brought to.

Additionally, Queen’s has informed us that it will attempt to collect the balance of charges, above what Kaiser Permanente pays as usual, customary and reasonable, from commercial members who receive medical care from any of the Queen’s hospitals.

The practice of “balance billing” puts patients, who may already be dealing with serious and stressful health issues, in the middle of a contract dispute. As of this writing, Queen’s has not agreed to our repeated requests to refrain from balance billing patients.

Kaiser Permanente believes our insured members who receive care at a Queen’s hospital should not be subjected to balance billing, especially after we have already paid the hospital a reasonable amount for services provided. We have filed a lawsuit against Queen’s to protect our patients from these unfair billing practices.

Congress is currently considering legislation that would limit hospitals’ ability to send these kinds of bills to patients. The American Hospital Association, which represents hospitals nationally, has stated that “patients should not be ‘balance billed,’ meaning they should not receive a bill from the provider beyond their cost-sharing obligations. Patients should not have to bear the burden of serving as an intermediary between health plans and providers.”

We are committed to ensuring that our Kaiser Permanente members receive the care that they need, whether from our own providers or from another provider such as The Queen’s Health Systems.

We look forward to future discussions with Queen’s to reach an equitable agreement, but most importantly, one that protects the well-being of our members and the broader community.

Dave Underriner is president of Kaiser Foundation Health Plan and Hospitals, Hawaii.