American Samoa's Senate President has expressed concern over the practise of sending patients to the Philippines and New Zealand for hospital treatment.
Some patients suffering from heart conditions, cancers and diabetics are getting treatment overseas because American Samoa's LBJ Hospital does not have the facilities.
Buying treatment in New Zealand and the Philippines is significantly cheaper than sending patients to Hawaii.
Our correspondent in American Samoa, Monica Miller, says the Senate is concerned because patients have to travel a long distance for treatment and are without the support of family members.
She says patients themselves are also worried about the standard of care they are receiving.
"According to the Senate President there have been so many complaints from patients about why the hospital is sending patients to a far away place like the Philippines. It's just this notion that America has the best solutions for everything and so they have this notion that they're not going to get the type of services they would in a US hospital. I think that's where most of the concerns stem from."
The CEO of LBJ hospital in American Samoa says sending patients to a hospital in the Philippines is cost effective and was made after proper review.