Letter: Health care merger not answer to broken system

Single-payer health insurance is the clear alternative, says Honolulu resident.

Apr. 10, 2026 at 10:05am

Got story updates? Submit your updates here. ›

A minimalist design in the style of Keith Haring, with a glowing neon outline of a stethoscope against a dark background, conceptually representing the core tools and technology of the medical profession.A glowing neon illustration captures the essential tools of the medical field, hinting at the ongoing debate over the future of the U.S. health care system.Honolulu Today

A Honolulu resident argues that the proposed merger between HMSA and Hawaii Pacific Health is not the solution to the unsustainable healthcare system. Instead, the writer advocates for a single-payer, 'Medicare for All' approach, citing the advantages of reduced administrative costs, universal coverage, and better patient outcomes seen in other countries with such systems.

Why it matters

The debate over the HMSA-HPH merger highlights the ongoing challenges in Hawaii's healthcare landscape, with rising costs and concerns over the current market-based model. The letter writer's call for a single-payer system represents an alternative vision for providing affordable, accessible healthcare to all residents.

The details

The letter writer argues that the 'obvious alternative' to the proposed HMSA-HPH merger is a single-payer healthcare system, also known as 'Medicare for All.' They cite the advantages of such a system, including reduced administrative costs, simplicity, universal coverage, and a nationwide pool of payers to subsidize high-cost patients. The writer notes that there are 'multiple examples in other countries where per capita health care costs are lower and patient outcomes better.' They criticize the 'obsession with market-based, for-profit approaches' to healthcare, arguing that it 'does not fit and should not be based on this model.' The letter concludes by stating that the admission by HPH's CEO that the current model is 'unsustainable' is a 'call for a not-so-new way to provide health care, not for a new merger.'

  • The letter was published on April 10, 2026.

The players

Travis Idol

A resident of downtown Honolulu who wrote the letter to the editor.

Ray Vara

The president and CEO of Hawaii Pacific Health, who acknowledged that the current healthcare model is unsustainable.

HMSA

A major health insurance provider in Hawaii that is proposing to merge with Hawaii Pacific Health.

Hawaii Pacific Health (HPH)

A healthcare system in Hawaii that is proposing to merge with HMSA.

Got photos? Submit your photos here. ›

What they’re saying

“The obvious alternative to a merger between HMSA and Hawaii Pacific Health (HPH) that no one seems to want to mention is single-payer health insurance, aka 'Medicare for all.'”

— Travis Idol, Honolulu resident

“The admission by Ray Vara, president and CEO of HPH, that the current model is unsustainable is clearly a call for a not-so-new way to provide health care, not for a new merger.”

— Travis Idol, Honolulu resident

What’s next

The proposed HMSA-HPH merger will likely continue to be debated, with advocates for single-payer healthcare pushing for that alternative to be seriously considered as a solution to the state's healthcare challenges.

The takeaway

This letter highlights the growing calls for a fundamental shift away from the current market-based, for-profit healthcare model in Hawaii towards a single-payer system that could provide more affordable, accessible, and equitable care for all residents. The admission by the healthcare industry's own leadership that the status quo is unsustainable lends credence to the writer's argument for a 'not-so-new' approach to meeting the state's healthcare needs.