American Samoa's Senate President, Lolo Letalu Moliga, says a decision by LBJ hospital to not pay for the expenses of patients needing off island medical treatment is unacceptable.
The hospital says it will not pay for such referrals because it has no money.
LBJ says it intends to use the 2.6 million US dollars approved for off-island referrals in the fiscal year 2008 budget to cover an overrun in the programme from last year.
But Lolo says the funding was approved to defray the costs of patients sent off island to receive medical treatment that's not available at the local hospital.
And he says he cannot understand how the board can expect patients to pay their own costs when the premise of the off island referral programme is to assist those who cannot afford it.
The Senate president says the board's policy demonstrates a lack of understanding of the people and an utter lack of compassion.
He also cautioned against the board using current year budget monies to settle debts from the previous year.