Editor,
Guam needs both: a new hospital and a strong private partnership.
Dr. Mike Cruz and I agree on more than many might expect. Like him, I believe a strong public-private partnership is essential to the future of Guam Memorial Hospital and to our island’s healthcare system. Where we differ is not in the value of better governance or stronger partnerships, but in the fundamental reality that no change in governance can save a hospital building that is literally falling down around us.
The U.S. Army Corps of Engineers concluded plainly, “The current infrastructure of the GMH facility is in an overall state of failure due to age, environmental exposure, lack of financial resources to support pre-planned capital infrastructure replacements, and lack of previous facilities design adherence to building codes.” Their report is unequivocal — replacement or equally costly extensive repair is required to protect patients, staff, and visitors, and to meet hospital accreditation standards.
Dr. Mike knows better than most that major battles are often fought on multiple fronts. For Guam, that means BOTH constructing a safe, modern facility where care can be delivered and improving the management and administration of care itself. Our families deserve a hospital safe enough for our nurses and doctors to work in and advanced enough to deliver the quality care our grandchildren will need.
Dr. Mike continues his service with the Leon Guerrero-Tenorio Administration as the adjutant general of the Guam National Guard, and I take seriously the opinions and suggestions of the intelligent people who choose to serve alongside me every day. That is why our administration is advancing both objectives at once. Earlier this year, we entered a memorandum of understanding with USC Keck Hospital, one of the top hospitals in the United States. This partnership will strengthen GMH’s management and operations, modernize the delivery of care, and allow us to implement best practices from leading health systems. GMH has already begun a collaboration with USC Keck Hospital to enhance specialized services, training, and patient outcomes. Later this month, Dr. Joleen Aguon and I will be traveling to meet with key leadership to further solidify this partnership. We intend to expand on that success with a comprehensive Public Private Partnership framework.
As a health care worker and public servant, I admire Dr. Mike’s honesty and join him in acknowledging that Guam’s healthcare system is not where it needs to be. It was failing with pay-less paydays when he was in office from 2007 to 2010. But he joined my administration in 2023, and we’ve made significant progress to the point where we are far better off than we were when he was lieutenant governor and our island had only one functioning ambulance. Dr. Mike knows all too well how difficult it is to repair a failing hospital while running out of epidurals for mothers in labor. He knows the stories of employees who were unable to retire because GMH failed to make the required contributions on their behalf.
Dr. Mike also knows that GMH’s financial burdens are real. He once supported my predecessor’s call to raise the business privilege tax to 6%, dedicating a portion of that increase as a permanent funding source for GMH. Today, we are building on that same recognition: a stable hospital requires a stable source of funding.
The difference now is that we have a plan — not just to repair the old, but to build anew. Our strategy is two-fold: construct a new hospital that meets modern standards of care and simultaneously strengthen the one we operate today through partnerships with nationally recognized institutions.
While every governor has been responsible for GMH, none have had the power to meaningfully aid it in an emergency. This is why I asked the legislature for a change and called for a special session. Unfortunately, the legislature chose to go on recess instead.
In 2022, the Guam Republican Party proposed that the government purchase GRMC as an alternative to building a new hospital. That is not a solution. It would reduce the total number of available hospital beds at a time when we desperately need more, not fewer. It would also invite unnecessary speculation about motives and conflicts.
Guam deserves a clear path forward. Our goal is to invest in a state-of-the-art hospital that will serve our community for generations, while partnering with some of the best minds and institutions in American healthcare to ensure that our care is not only modern but also excellent.
This is not about politics or personalities. It is about the health, safety, and dignity of every person who calls Guam home. And on that, I believe Dr. Mike and I can still find common ground: that our people deserve nothing less than the very best.
Gov. Lourdes A. Leon Guerrero
