Sustainability is an issue that is being addressed in all of Hawai'i. Since we are geographically so far from anywhere else, it is important to think ahead to build a society that can stand on its own. Healthcare sustainability is particularly important — a strong and healthy workforce promotes a sturdy society. There's no question that if healthcare declines in the future, it will affect Hawai'i as a whole.

As a teenager in Hawai'i, I am concerned about our future healthcare system. Recently we have seen media reports that we are in a healthcare crisis, and that the quality of healthcare will drastically decline if nothing is done.

Healthcare is a complicated matter because there are many components that can affect it. As Dr. Chiyome Fukino, director of the state Department of Health, noted: "There are three factors which determine the state of health you're in: your gene pool, diet and, finally, your physician. Now, people rely too much on the physician factor for their illnesses. Instead, they should look at the whole picture and what led up to their problem. It is important for people to claim responsibility for their own health instead of depending totally on the healthcare professionals."

Indeed, the first step toward healthcare sustainability is to have people of all ages become more proactive in taking care of their own bodies.

Once a physician is in the picture, we need to improve the doctor-patient relationship, which has suffered over the years. The level of respect rendered to doctors has decreased tremendously, while the level of distrust has risen. In the past, people were able to see and stay with the doctor they believed was the best choice for their needs. Today, insurance sometimes limits the doctors that a person is able to see, creating distrust among patients and doctors. Many also are forced to go somewhere simply because they cannot afford healthcare anywhere else.

The growing public skepticism is becoming clearer. For example, the number of Internet sites devoted to finding out the backgrounds of doctors has increased. And the distrust between doctors and patients has often led to malpractice lawsuits, which in turn translates into higher malpractice insurance premiums for doctors. Clearly, it is difficult to keep doctors practicing under these circumstances.

Money, as much as we don't want to admit it, is the governing force of our American society and at the root of our healthcare crisis. Many people walk into the emergency room and are shocked at the outrageous bills they receive afterward. However, in reality, reimbursements are low and doctors receive only a small portion of the payments after the hospitals and malpractice insurance companies get their share.

With Hawai'i's cost of living factored in, many doctors' salaries are substantially lower here than those on the Mainland, especially for specialty doctors. Statistics have shown the average salary of Hawai'i doctors is 10 to 20 percent below Mainland physicians. How can we keep doctors in Hawai'i under these circumstances?

The two most important ideas that would help sustain healthcare in Hawai'i are tort reform and greater government reimbursement to doctors.

Tort reform is an emotional and controversial topic. Of course, people should sue if wrong actions are done, but now our society has become full of miners just looking for loopholes to acquire extra cash. Because of our litigious society, doctors — fearful of high malpractice premiums — are often forced to practice defensive medicine. We need a system that will allow doctors to devote their time and energy to patient care, rather than worry about frivolous lawsuits. There must be a reasonable limit on the non-economic damages that a person can sue for. Sensible tort reform delivers rights to patients while protecting a greater number of specialists from being greatly affected by unnecessary lawsuits.

We must resolve this problem between doctors, patients, and government to conquer the healthcare crisis, or there will be a greater shortage of doctors in Hawai'i. And the problem of finding a specialist who will offer quality healthcare in the future will become insurmountable.

Along with tort reform and better reimbursements, the community can take an active part in solving the healthcare crisis as well. We need to remember to take care of the three factors that are controllable to lessen the dependence on healthcare providers.

Even teenagers can play a large part in solving the healthcare crisis. Never would I have thought that I could make an impact on creating a sustainable healthcare in Hawai'i as I do now. Just being knowledgeable about the solutions to this problem can help us advance to future independence.

I will emphasize to state lawmakers the importance of fixing the tort reform system and offering sensible reimbursements for doctors. And I will do my part to maintain a healthy lifestyle, and encourage my peers to do the same. The health of our future — our sustainability— is on the line.

Kimberly Lee is a sophomore at Punahou School and a member of The Advertiser's Teen Editorial Board. To learn more about the board, including how to apply to join the panel, go to www.honoluluadvertiser.com/opinion. Kimberly Lee's father is a Honolulu physician.