When there's someone at the door with a hand out for help, it's important to consider whether they're standing at the head of a line of others seeking the same thing.

That's one of the drawbacks to the current legislation that would offer a tax break to Hawaii Medical Center, the for-profit operator of the two former St. Francis Medical Center hospitals.

House Bill 2759 would seek a six-year exemption from state excise taxes for a for-profit hospital with 60 percent or more of its patients under Medicare, Medicaid and Quest payments. It's a condition that means Hawaii Medical Center LLC would pay no excise tax on its Medicare, Medicaid and Quest revenue.

HMC bought the hospitals a little more than a year ago from St. Francis Health Care System, along with all the debt that St. Francis had incurred through serving such a high proportion of nonpaying, needy patients.

The difficulty is twofold: Although HMC has taken steps to cut costs, the company has not yet shown enough progress in its plans for reversing the downward trend. Until it does, there's a good chance the company will need more help in coming years.

Secondly, as the Tax Foundation of Hawaii points out, issuing an exemption — or, as HB 2758 proposes, a tax deferral — sets a precedent that the state surely will regret later. Other for-profit social service corporations that have contracts with the state could seek similar relief, said the foundation's Lowell Kalapa, and he's right.

The state certainly doesn't want to see HMC's financial failure, which would harm, most of all, the needier populations it has committed to serve.

Unfortunate as that outcome may be, passing these bills would not be sound fiscal policy for the state, which faces its own challenges in ensuring healthcare access throughout the Islands. An annual loss of $6 million in revenue would be very difficult to absorb.

A more reasonable means of nudging HMC back toward firmer financial footing is presented in HB 2757. This bill would authorize the issuance of up to $40 million in special purpose revenue bonds to help HMC make improvements enabling the hospital to offer more profitable services. Among the permitted purposes would be new construction and equipment, physical upgrades and refinancing debt.

This measure would help kickstart a move back to profitability for HMC, which is a goal the entire community should support.