The physician shortage in Hawaii, although highlighted by the pandemic, has been years in the making.  Its causes include a low Medicare reimbursement rate, General Excise Tax (GET) applying to medical practices, and our sky-high cost of living.  Medicare will only reimburse medical work at “reasonable charges” and will not reimburse the doctors for the GET they have to pay.  Doctors usually wind up absorbing the tax rather than attempting to surcharge their patients for it, meaning they have to account for yet another expense amidst Hawaii’s high cost of everything.  A bill now being considered at the Legislature shines a spotlight on hospitals and caregivers who try to deal with GET and aren't doing a great job of it.

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