Health care merger places Hawaiʻi's well-being at risk.
The Queen’s Mission:
To fulfill the intent of Queen Emma and King Kamehameha IV to provide in perpetuity quality health care services to improve the well-being of Native Hawaiians and all of the people of Hawai‘i.
Many introduced diseases decimated the Hawaiian population, but the smallpox epidemic of 1853-54 was the catalyst that led King Kamehameha IV and Queen Emma to establish The Queen’s Hospital in 1859.
At the urging of Queen Emma, the King Kamehameha IV signed an act to establish a hospital “for the relief of sick and destitute Hawaiians,” as well as to “provide for…patients of any description who are fit subjects for hospital treatment.” It was Queen Emma’s idea to collect subscriptions, or pledges, which both the King and Queen personally solicited from private individuals, government representatives, and local businesses to help build the hospital. When the King and his cabinet met, they named the new hospital The Queen’s Hospital in recognition of Queen Emma’s passion and vision in its establishment. The hospital was organized as a corporation, with governance shared between elected trustees and government-appointed members. With this collective support, Queen’s Hospital was able to provide free care to many in its early years.
In the beginning, most of the hospital’s operating income came from tax revenues and legislative grants from the Kingdom of Hawai‘i. Prior to 1900, when the Territory of Hawai‘i was established, government support was substantial: approximately 80% of Queen’s Hospital’s financial income came from the Kingdom of Hawaiʻi and, later, the Republic of Hawai‘i. These funds were government appropriations intended to subsidize care for Native Hawaiians and others admitted to Queen’s Hospital—not from Queen Emma’s personal estate.
While The Queen’s Hospital did provide free treatment to Native Hawaiians in its early years, it did not do so unconditionally. Free care was determined by each patient’s need, the availability of beds, and whether the hospital had the ability to treat specific medical conditions. Queen Emma lived for 25 years after the hospital was established, living until 1885. She bequeathed much of her land to The Queen’s Hospital without restrictions or stipulations on how the lands were to be used.
Today, The Queen’s Hospital is known as The Queen’s Medical Center. It is a member of a family of companies under the umbrella of The Queen’s Health Systems, which is supported by various sources, including substantial reimbursements from government payers such as Medicare and Medicaid as well as payments from insurance companies and patients. The Queen’s Health Systems continues to provide health care services to all the people of Hawai‘i regardless of their ethnicity or their ability to pay—the same as it did since The Queen’s Hospital was established in 1859.
The Queen’s Health Systems helps patients who are uninsured or underinsured to qualify for the level of financial assistance that is based on their ability to pay. As a health system, we are now bound by federal and state laws that prohibit preferential treatment or discrimination in healthcare based on race, age, and disability. Nevertheless, we remain committed to equitable access—especially for those with the greatest need—regardless of ability to pay or ethnicity, including care for Native Hawaiians. Our commitment to offering financial assistance based on financial need is one way we uphold this principle. Aligning with these regulations ensures that we can continue to provide equitable care and access to Native Hawaiians and all the people of Hawaiʻi, as our founders intended. For patients who qualify, financial assistance may be provided as free care or as a discount applied to inpatient and/or outpatient charges (excluding cosmetic or self-pay flat rate procedures). This policy covers hospital/facility charges and professional fees for employed providers. Qualified persons of every race and ethnicity are eligible to receive such free or discounted care through Queen’s long-standing Financial Assistance Policy and Self-Pay Discount Package Pricing Policy.
Queen Emma, circa 1859
King Kamehameha IV, circa 1855 (Daguerreotype by Benajah Jay Antrum)
Queen’s is also dedicated to providing community benefits and resources focused on improving the health and well-being of Hawai‘i’s people, with a particular emphasis on programs that address the health needs of Native Hawaiians. These include consumer health education programs; community health programs; support for community health centers in low-income neighborhoods; and support for Hawai‘i-based medical education and research programs.
You can also explore Queen Emma’s Will through the state archives.
Explore The King and Queen’s entire probate collection here.
The Queen’s Health Systems is committed to providing medical services to patients and objectively considers each patient’s financial ability to pay for the cost of hospital services.
In her will, Queen Emma bequeathed much of her land to Queen’s Hospital. However, she made no specific provision of providing free treatment to Hawaiians. While The Queen’s Medical Center does not have a policy on free care for Native Hawaiians, it does have a Discounted Care Policy, which is based on the patient’s financial ability to pay, for all patients who utilize The Queen’s Medical Center’s services. After verification of a patient’s income and assets, The Queen’s Medical Center may provide discounts for health care services at no charge or at reduced rates for patients who do not have or cannot obtain adequate financial resources or the means to pay for their medical care. Such discounts, if any, will be based solely on the patient’s ability to pay and will not be decided on the basis of race, color, age, gender, religion, national origin, marital status, physical condition, political beliefs, genetic information, veterans’ status or sexual preference.
Furthermore, such discounts, if any, only cover The Queen’s Medical Center associated costs. Physicians, laboratory work, imaging, etc. may incur a separate bill. Please call (808) 691-4210 or visit our Financial Services Office to determine if you qualify for our Discounted Care Policy. Upon approval of the financial assistance application, individuals will receive either a 100% or a 76% discount.
Yes. The Queen’s Medical Center continues to provide care to all residents regardless of their ethnicity or their ability to pay. If a patient is not eligible for Medicaid or Quest, The Queen’s Medical Center may apply a maximum discount of 30% to a patient’s account provided that the patient agrees to a prompt payment schedule acceptable to The Queen’s Medical Center. After verification of a patient’s income and assets, The Queen’s Medical Center may also provide discounts for health care services at no charge or at reduced rates for patients who do not have or cannot obtain adequate financial resources or the means to pay for their medical care. Such discounts, if any, will be based solely on the patient’s ability to pay and will not be decided on the basis of race, color, age, gender, religion, national origin, marital status, physical condition, political beliefs, genetic information, veterans’ status or sexual preference. Furthermore, such discounts, if any, only cover The Queen’s Medical Center associated costs. Physicians, laboratory work, imaging, etc. may incur a separate bill.
Please call (808) 691-4210 or visit our Financial Services Office to determine if you qualify for our Discounted Care Policy. Upon approval of the financial assistance application, individuals will receive either a 100% or a 76% discount.
The Queen’s Medical Center is a health care provider and does not cover or pay for services incurred by patients with other medical service providers
The Queen’s Medical Center is a health care provider and does not cover or pay for expenses incurred by patients to travel to and/or from our facility. Check with your insurance plan first to see what travel assistance is offered by your plan. The Queen’s Medical Center does offer Concierge Services. Staff are available to assist with non-medical needs, including air and ground transportation, hotel accommodations and business services.
Reach Concierge Services by dialing (808) 691-4331 (option 3). If you are an Oncology patient, ask your Queen’s oncology provider about patient navigation.
For The Queen’s Medical Center patients who have insurance coverage, we will work with the patient to file the appropriate documents with the insurance company. Normally, this insurance will cover a large portion of a patient’s charges. If a patient is unable to pay for services rendered, a patient account representative is available to meet with the patient to assist the patient in determining an appropriate resolution.
Please contact The Billing Team at 808-691-5300 to speak to a patient account representative.
The Native Hawaiian Health Program is a program addressing the overall health needs of Native Hawaiians through providing health care professional training, research projects, outreach to the community, and clinical services with The Queen’s Medical Center. The Native Hawaiian Health Program’s vision is to enhance the Ola Pono (well-being) of Native Hawaiians to ensure comparability of their health status with that of other ethnic groups in Hawai‘i. The mission of the Native Hawaiian Health Program states that The Queen’s Health Systems will make a long term commitment to provide, in perpetuity, quality health care services by aligning its strengths with priority health needs of Native Hawaiians. The Native Hawaiian Health Program does not provide direct care services or financial distributions.
Contact our team with any questions or inquiries you have about Queen Emma Cares or the history of Ka Hale Ma‘i O Ka Wahine Ali‘i (The Queen’s Hospital). We are more than happy to help answer your questions.
Email us at emmacares@queens.org
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