WAILUKU, Maui — Gov. Linda Lingle yesterday came out in support of a privately run acute-care hospital on Maui, saying the state can't be counted on to provide the substantial funding necessary to help Maui Memorial Medical Center meet the healthcare needs of the island's growing population.

Lingle's backing of the 150-bed Malulani Health & Medical Center was a new development in a passionate debate over whether the island can support two hospitals. Maui Memorial is a state-subsidized facility whose leaders have voiced vehement opposition to a competing medical center, saying it would siphon off $55 million in annual revenue and endanger patient care by diluting services.

"The ability of the state to build a new hospital on Maui is limited, despite the good economy and a healthy state budget surplus," said testimony presented by George Kaya, the governor's Maui liaison, during a Tri-Isle Subarea Health Council public hearing on Malulani's application for a certificate of need. "There continues to be significant demands on the state budget for many worthwhile projects on all islands."

A standing-room-only crowd of approximately 200 jammed the Baldwin High School multipurpose room for the daylong hearing, which will reconvene at 9:30 a.m. today to accommodate the long list of testifiers.

State law requires providers of new major medical facilities or services to obtain a certificate of need, or CON, to ensure Hawai'i's healthcare needs are met and that the market can support additional competition while maintaining adequate services. The Tri-Isle Subarea Health Council is one of three panels that will review Malulani's application before a final decision by Dr. David Sakamoto, administrator of the State Health Planning and Development Agency.

The new hospital, proposed for 40 acres off the Lipoa Parkway in Kihei, is being developed by Malulani Health Systems Inc., spearheaded by longtime Maui physician Dr. Ron Kwon, and Triad Hospitals Inc. of Plano, Texas.

The partnership estimates it will cost $212 million to build, equip and finance a state-of-the-art healthcare campus whose major components include a comprehensive imaging center, open-heart surgery capabilities not now available on Maui, a 20-bay emergency department and a heliport.

All patient rooms would be private, with 110 set aside for medical/surgical cases, 25 for critical care, 10 for labor and delivery, and five for neonatal intensive care, also not currently available.

Although the staff and administration of 202-bed Maui Memorial received general praise from most of those testifying, a series of physicians and residents expressed frustration in dealing with a slow-moving government bureaucracy, inadequate equipment and facilities, and a chronic bed shortage. They also spoke of the financial and emotional toll of having to seek treatment on O'ahu or the Mainland.

Dr. Howard Barbarosh, head of the Maui County Medical Society and former chief of cardiology at Maui Memorial, said a majority of the society's members support Malulani. He said the existing hospital has not kept up with the community's medical needs.

"As the years have gone by, I find more and more of my patients wish to go to Honolulu for care and bypass Maui Memorial Medical Center ... ," Barbarosh said. "We need more hospital beds. We need competition."

Thirty-year Kihei resident Patricia Ross, 83, urged the health council to approve Malulani's application, saying "my life depends on it." Ross said she suffers from an aortic aneurism that can't be treated here. She also said a second hospital would improve care to disabled veterans and senior citizens.

Speaking as head of the county Office of Economic Development, Lynn Araki-Regan addressed concerns of a work force shortage to staff two hospitals. Just as the Maui High Performance Computing Center created a high-tech industry on the island and attracted trained professionals, Malulani would draw medical staff from off-island by virtue of its cutting-edge facilities, she said.

Speaking as a mother who spent a month on O'ahu last year when her baby boy was born 2 1/2 months early, Araki-Regan said tearfully: "My dream is for future mothers not to have to experience what I and other mothers had to go through."

Malulani also had the support of Mayor Alan Arakawa, who waited more than 6 1/2 hours to testify that the state realistically cannot be expected to respond in a timely manner or with the needed financial backing to help Maui Memorial catch up with the island's growing population.

Maui Memorial officials asked the health council to put aside the emotions surrounding the issue and analyze Malulani's application based solely on the required CON criteria, saying "the very future of healthcare on Maui" rests on their decision.

"The idea that a second hospital in Kihei will improve health services on Maui is an appealing vision. Unfortunately, the vision is a mirage ... ," according to written testimony provided by the hospital. The reality is "that there are only so many healthcare personnel, so many patients and so many financial resources to go around."

Maui Memorial officials said Malulani flat-out failed to de-monstrate the project's financial feasibility, and that its potential competitor provided "misleading, erroneous and incomplete" information on its projected impact on Maui Memorial and other healthcare providers, while underestimating labor and construction costs and overestimating demand.

Maui Memorial consultant Jim Dannemiller of the SMS research and marketing firm said Malulani's revenue estimates, population data and visitor forecasts were off base and overly optimistic, presenting an inaccurate picture of the project's potential profitability.

Hospital officials pointed to ambitious improvements planned by Maui Memorial, part of the quasi-public Hawai'i Health Systems Corp., as a more effective and less costly way to meet the community's needs. These include a $42 million hospital wing slated to open in September, expansion of the emergency department, and a pending CON application for interventional cardiac catheterization and heart-surgery services.

The hospital acknowledged periodic overcrowding, but said that is largely because many of its acute-care beds are being used by patients needing long-term care, indicating Maui has a greater need for long-term-care beds, not more acute-care beds.

Reach Christie Wilson at cwilson@honoluluadvertiser.com.