HONOLULU -- Hawaii is facing the same health care problems sweeping the rest of the United States.

Federal dollars for medical care are shrinking when more people are seeking medical services.

Hawaii hospitals and other private care providers face delays in their Medicaid reimbursements this year due to the state's $86 million shortfall.

Hawaii's two front runners in the democratic primary for governor, former U.S. Rep. Neil Abercrombie and former Honolulu Mayor Mufi Hannemann were asked at a forum Wednesday what they would do to stop the state's continuing Medicaid shortfalls.

Hannemann said if elected governor, he would never raid Medicaid funds to fund other budget shortfalls.

Hannemann said his key solution to getting more federal dollars to Hawaii for health care costs would be a management audit of all state functions he said would be his first order of business if elected governor.

Hannemann said his audit would be certain to turn up unexpected sources of money currently not available because of wasteful spending and inefficiencies.

"We need that management review because it is the only way we are going to be able to identify the funds that we are now losing as a result of not being able to have the matching funds when the federal reimbursement funds come our way," said Hannemann.

Abercrombie scoffed at Hannemann's audit idea. He said he doesn't need to do an audit. He already has plans in place to maximize federal dollars.

"I am not sure how long you can wait. If you can wait for an audit or a study as Mr. Hannemann suggests before you pay your bills, it is all well and good." said Abercrombie. "However, my plan and the federal dollars already available in the short term will handle the kind of money you need right now. You don't have to study if you need money. You need it."

Another concern from health professionals attending the forum was the increasing numbers of doctors retiring early or moving away from Hawaii because of the high cost of medical malpractice insurance and what they perceive as an unwillingness in the legislature to cap malpractice awards.

"My greatest concern is the physicians have been unified on this for some time and it has not gotten the traction it needs to make a difference," said Kevin Roberts, the chief operating officer of Castle Medical Center.

Abercrombie said he has a proposal to reduce malpractice insurance costs by using state and federal funding to provide malpractice insurance to doctors who treat Medicare and Medicaid patients. The coverage would be similar to what is already given to community health center doctors.

"That is my idea of real reform that allows you to do your work without anxiety," said Abercrombie.

Hannemann said he was also concerned about malpractice insurance costs . He said the issue is complex and needs more discussion.

"It is going to require all of us looking into how do we share the costs. How do we get everyone who is going to be a part of it involved," said Hannemann.

Hannemann also said his administration would investigate ways to make Hawaii more attractive to doctors to make them more eager to settle and remain here.

The forum held at the Japanese Cultural Center in Moiliili was attended by about 100 health care professionals. The Healthcare Association of Hawaii and the Hawaii Chapter of the American College of Healthcare Executives sponsored the event.