The Samoan clinical health service has welcomed a proposal for shared medical services between the two Samoas.
The American Samoa leadership has suggested the two Samoas should share staff, equipment and medical supplies to reduce costs and maximise health services.
The Samoan director for clinical health services, Dr Stanley Dean, supports the idea.
"It can benefit both sides. It's mainly sharing resources on what they have done and improved on and we can utilise on our side, and also where we have improved on our side that they can utilise. Especially with interrefferal patients overseas, which we both find quite expensive for health services."
Dr Stanley Dean says Samoa has regular visits from foreign specialist surgeons as part of aid deals, but it lacks equipment, while American Samoa has the equipment, but doesn't have enough specialist doctors.
The American Samoan chief medical officer at the LBJ hospital declined to comment.