The LBJ Medical Center in American Samoa is looking at two hospitals in Manila to provide medical care not available in the territory.
LBJ chief executive Mike Gerstenberger says the off-island medical referral programme has not been fully funded since December 2008 and LBJ had looked using treatment in New Zealand and Australia, as both are cheaper than Honolulu.
But he says most of the funding for the LBJ is from the federal government which does not normally pay for health care services outside of the U.S, however the two hospitals in Manila have US certification and so they could be used.
Mr Gerstenberger has pointed out that the hospital charges in Manila are just a fraction of what they are in Honolulu.
