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In Sandy Springs, Georgia, private companies provide service for everything except police and fire. That includes hospitals, parks, permitting, the water department, traffic management, a city call center and 911, among other services. Oliver Porter, creator of the city of 100,000 people, visited the Hawaii recently to share the benefits of the public-private partnership model.

Mr. Porter explained that elected officials still develop policy, set the budget, and set the responsibilities for the companies, “but the companies are really your worker bees.”

A citizen who notices a pothole can call a 24/7 hotline where a live person will discuss the problem. “They issue a work order while you’re on the line to the proper department to have that fixed,” said Oliver. At the end of each year, all of the companies are evaluated, and can be re-bid if the citizens are unsatisfied.

So far, citizens of the town are happy with the government accountability that has resulted. “To date, our community has been pleased,” said Sharon Kraun, Communications Director. “If the polls are indicators, our founding mayor, who ran on the public private partnership platform, won two terms in office with overwhelming support.”

The annual budget for the city of Sandy Springs is only $106 million, a fraction of what it costs to run the comparatively sized Maui County at $732 million per year. The town has a $45 million surplus, and zero public debt and unfunded liabilities for pensions and health care benefits.

According to Dr. Keli’i Akina, President of the Grassroot Institute of Hawaii, “Public-private partnerships save money and increase efficiency. That’s why Maui’s hospital transition to a public-private partnership may save the healthcare system from collapse, and bring new benefits to Hawaii’s people.”

Oliver Porter said of Maui’s public hospital transition, “A hospital is really like a mini-city. So if you’re talking about contracting for services, it’s no different from what we’ve done…it’s so do-able.”

Of course, in Sandy Springs, the hospitals have always been run by private companies. “We’ve never even heard of a publicly run hospital,” said Oliver.

Transitioning to a public-private partnership model may be difficult in Hawaii, but it could offer a better system, one that is more-efficient and would offer better access to care for patients.

“There is one problem,” said Oliver. “It’s a thing called politics. Finding existing leaders who are willing to stick their necks out and do something different is difficult.”

Dr. Keli’i Akina said, “Studies have shown that the Maui Hospital system could be saved through a public-private partnership. We need leadership to ensure that Hawaii’s citizens can benefit from a stronger healthcare system.”