Opening Keynote: Hawaii Gov. Josh Green discusses workforce shortages and infrastructure changes


Alex Nelson, Hannah Saunders


Hawaii Gov. Josh Green said increasing the healthcare workforce and improving healthcare infrastructures through investments are top healthcare reform priorities at the 2024 Hawaii State of Reform Health Policy Conference in January.

“We’ve always been known as the health state for many reasons,” Green said. “So many giants led Hawaii forward over the many years to make Hawaii a special place to ensure almost everyone (has) access to healthcare.” 

Green said Hawaii residents have the longest lifespan in the U.S. due to the fact that healthcare is provided in different ways than it is in other states. 

“We can go much further beyond anything that we’ve ever dreamed of in the past because of the foundation that we have.” 

— Green

As the only physician governor in the country, Green feels a sense of commitment to health issues and said he wants to be held accountable as a leader. Statewide, there is a shortage of 4,000 healthcare professionals and 1.9 beds per 1,000 Hawaiians, he said. 

“Sometimes we have enough beds but we just can’t find enough personnel because it’s so difficult—so difficult—to afford Hawaii.” 

— Green

Green said there are not currently enough investments being made to improve healthcare structures. In order to modernize facilities and entice providers to work in the state, he invested $128 million into rural care and hospitals. 

“We were historically (at) about $250,000 a year to repay loans, and I bumped it to $30 million, which was not insignificant.”  

— Green

The Hawaii Healthcare Education Loan Repayment Program is assisting health professionals with student loan forgiveness, Green noted.

“This four-year period, and perhaps a little longer, we will get healthcare and providers to absolutely everybody in our state. One reason that the community accepts this program very favorably is because—though there is sometimes a misconception that all healthcare providers are wealthy—that’s not the case for any number of people working in social work, psychology, and other disciplines. They’re not going to be very wealthy anyway, and it’s also not the case for many physicians.”

— Green

While loan forgiveness will help ease financial constraints for healthcare professionals, housing affordability remains a barrier to the workforce, Green said.

“Housing is still going to loom large, so we have to—for all of our people, especially those on Medicaid—find a way to get them housing and reduce their cost of living.” 

— Green

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