Draw a 5-mile circle around the state Capitol. You will find five major hospitals available to the public: Queens, Straub, Kuakini, Kaiser and Kapiolani.

When St. Francis hospital went belly up, its collapse threw up emergency alerts, but Honolulu residents survived.

Now put yourself in Wailuku or Hilo and ask what happens if Maui Memorial Medical Center or Hilo Medical Center can’t pay employees, buy needles and bandages, and has to close.

Realistically, that is the end of the game for your health care on Maui and Hawaii island.

There are clinics and other medical facilities, but if the Maui and Hilo hospitals close, it might be better to ask the Navy to float a hospital ship into Hilo Harbor than look for alternative medical care.

So this week is critical because the state’s public hospital system is in the emergency room.

Members of the state House are projecting an $800 million deficit over the next decade for Maui’s hospitals.

On the Big Island, Hilo is predicting a $30 million deficit just for this year.

"Catastrophic cuts to services are on the horizon if legislators don’t provide more funding this year," Dan Brickman, director of East Hawaii’s public health care system, which runs Hilo hospital, said in a new report last year.

A legislative conference committee this week put together a bill taking some of the sting out of the Maui deficits, by allowing Gov. David Ige to negotiate a transition on Maui from a public hospital to a private nonprofit.

The Legislature was on the verge of just allowing Maui to make the move by itself until Ige stepped in.

The new proposal expands who can take over the hospital and adds some labor protections for the public workers at the hospital.

Public workers are key because it is their new labor contracts that have added to the deficit. Last year, Brickman projected $18 million in new labor costs.

Maui has been negotiating with Hawaii Pacific Health to take over the Maui facility, but the bill now opens it up to others, including Kaiser Permanente.

The legislation now tabs Ige as lead negotiator for both the Maui hospital and the possible suitors to take over the system.

Here’s the key to this: If Maui has a health care cost dilemma, it remains the low-hanging health care crisis.

The Hawaii island hospital crisis is going to be much more difficult to solve.

In an interview this week, Brickman said Maui, with its relatively well-off population, is a much more desirable property.

"When it comes to the Big Island, we are 75 percent Medicaid or Medicare patients. We have a small tourist base and there are many more economically disadvantaged, so our potential solution is very different," Brickman said.

The problems may be different and the solutions more elusive, but doing nothing, Brickman said, still leaves Hawaii island with erosion in finances, which erodes the services and eventually erodes the health of the community.

"At the end of the day, you are going to hurt people," Brickman said.

For the Legislature and Ige, this week’s action for Maui is a good step — but Hawaii’s health care crisis was not solved.

Richard Borreca writes on politics on Sundays, Tuesdays and Fridays. Reach him at rborreca@staradvertiser.com.