The 37-minute airplane ride isn\u2019t the problem. It\u2019s the shortage of flight opportunities coupled with frequent flight delays that all too often lead residents to miss their Honolulu medical appointments \u2014 sometimes repeatedly.\u00a0And when travel costs to access an off-island procedure aren\u2019t covered by health insurers, a trip to the doctor can feel out of reach.<\/p>\n
\u201cIt\u2019s the cost that we pay to live on this island that\u2019s home, where we\u2019re from,\u201d Ka\u02bbai, 45, said. \u201cThe people here, we feel the struggle, we grumble about it, but at the same time we just accept it.\u201d<\/p>\n
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Big city medical help has grown increasingly difficult to access for residents of Moloka\u02bbi and L\u0101na\u02bbi since the number of airlines that serve the islands dropped from three to one in 2021. (Cory Lum\/Civil Beat\/2022)<\/p>\n
One new solution now covers airfare costs for Moloka\u02bbi and L\u0101na\u02bbi patients struggling to access medical care. The taxpayer-funded flights are part of a growing effort to increase access to comprehensive and timely medical care for residents of isolated parts of the state.<\/p>\n
In April, Ka\u02bbai said everyone in his family was about six months overdue for dental cleanings but a trip to the dentist would have cost the family of four about $1,100 in roundtrip airfare, plus Uber rides and on-the-go meals. He was inclined to push off the appointments further \u2014 but then he learned about the Essential Rural Medical Air Transport pilot program<\/a>, or ERMAT, which covered the costs.<\/p>\n Since ERMAT launched in January, nearly 70 Moloka\u2018i residents and about 40 L\u0101na\u02bbi residents have used it to reach off-island medical services, including sleep apnea treatments, dermatology appointments and heart exams. The $2 million initiative is funded by the state through June 2027.<\/p>\n For patients, all that is needed is a doctor\u2019s referral. A project coordinator books the patient a seat on a commuter flight operated by Mokulele Airlines, the only commercial air carrier that serves Moloka\u2018i and L\u0101na\u02bbi.<\/p>\n For project organizers, it\u2019s a bit more complicated. It\u2019s sometimes difficult to find an open seat on a flight that will get a patient to Daniel K. Inouye International Airport in time for an appointment.\u00a0<\/p>\n Morning flights to Honolulu\u2019s main airport are in high demand among Moloka\u2018i residents who must travel by airplane to earn an income or see a doctor. It\u2019s not uncommon for seats on early flights to sell out days or weeks in advance.\u00a0<\/p>\n ERMAT project coordinators sometimes work directly with airline executives to open up seats for patients with urgent medical needs, said Lani Ozaki, executive director of Pulama Ka Heke, a Moloka\u02bbi health care nonprofit hui that\u2019s running the project with L\u0101na\u02bbi Kinaole, a home health care agency.<\/p>\n \u201cIt gets a little crazy but we find ways to get patients out,\u201d Ozaki said. \u201cWhat\u2019s important is people no longer have to delay care.\u201d<\/p>\n Although the project can\u2019t prevent flight delays, it stops people from having to shell out money they can\u2019t afford for flights.<\/p>\n Moloka\u02bbi resident Lesley Sambajon, 71, said she recently put an $853 roundtrip flight for an oncology appointment on her credit card without knowing how she would pay it off. She had to resort to flying first from Moloka\u02bbi to Maui and then Maui to O\u02bbahu.<\/p>\n \u201cI have been traumatized,\u201d the retired district court clerk said. \u201cMany times I had anxiety like, \u2018How am I going to deal with my health when I\u2019m so overwhelmed with the amount I have to pay to get over there to see the doctor?\u2019 That\u2019s why it\u2019s such a blessing to have this program. It feels like there\u2019s a light at the end of the road. Like, \u2018OK, I can do this.\u2019\u201d<\/p>\n The program is now working to boost capacity.<\/p>\n In mid-May, Pacific Air Charters will build on the effort by providing medical charter flights dedicated to the program, President Marshall Ashley said. The flight schedule is to be based on patient needs. Ozaki, of Pulama Ka Heke, said she\u2019s also in talks with representatives from L\u0101na\u02bbi Air, a luxury airline owned by tech billionaire Larry Ellison, that plans to expand to Moloka\u2018i<\/a>. <\/p>\n When things go smoothly, an off-island medical trip can easily stretch into a 12-hour endeavor, one that forces kids to skip a day of school and parents to miss a work day.\u00a0When there\u2019s a hitch, that missed day of school or work could have been for nothing. Missed medical appointments, even pressing ones, can take months to reschedule \u2014 a bane for patients and physicians in the state\u2019s stressed-thin medical system.<\/p>\n![\"Passengers](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2026\/05\/molokai-mokulele-airlines-1024x768.jpg\")
Passengers board a Mokulele Airlines flight in Honolulu. The airline recently announced it was increasing interisland fares due to rising fuel costs. (Nathan Eagle\/Civil Beat\/2022)<\/p>\n
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