The best next governor: A focus on health care as a priority is a focus on the people of Guam

This discussion initially focused on the Democrats running for governor in 2026, but I would be amiss not to address the other candidates.

When I look at Guam’s last seven-plus years through the only filter that matters to me, health care, the picture becomes painfully clear. Leadership as a governor should be defined by the importance a leader places on health care and by the actions they take to protect the people of Guam, especially the disadvantaged. 

Health care is not a side issue; it is the core measure of whether a leader understands the real conditions families live through. Research in public administration shows that the same skills required to lead a strong health care system of coordination, accountability, crisis management, and protection of vulnerable populations are the same skills that define strong leadership in every other area of government. That is why health care is the most revealing test of leadership at the highest levels. 

When I apply that filter to the administration of Gov. Lou Leon Guerrero and Lt. Gov. Josh Tenorio, who is now running for governor, the failures are impossible to ignore. The administration controlled GMH, Public Health, the medical board, the complaint systems, the budget and every operational lever that could have stopped the deterioration of the hospital. Yet, GMH remained unaccredited, services continued to collapse, and families were left waiting for answers that never came.

The public auditor documented millions in questionable costs and years of uncollected revenue and none of it was ever meaningfully addressed. Instead, the administration focused on planning and studying, workforce collaboratives, long-term medical campus planning and partnerships that brought in visiting specialists but never fixed the underlying failures.

These were surface-level efforts that did not restore services, did not resolve complaints and did not force GMH to meet accreditation standards.

Many people still say the administration handled Covid well, but national data showed that longer lockdowns were strongly associated with deeper learning loss for children and greater financial strain on small businesses.

Guam’s lockdowns lasted far longer than most states, and families here lived through the same consequences. Through my health care filter, you cannot separate the length of the lockdown from the damage it caused to education, small businesses, and the most vulnerable households.

Sen. Joe San Agustin’s record sits in a different lane but leads to the same outcome. His accomplishments were financial and structural on paper. He authored the law authorizing a 40-year lease-back arrangement for a new integrated health care campus and introduced appropriations sending tens of millions to GMH.

But from my perspective, he enabled GMH's continued failure by providing funding without accountability for how those funds were spent or for how patient care improved.

The repeated appropriations did not resolve long-standing operational failures, restore lost services, or move the hospital toward accreditation. His Public Law 36‑56 never gained traction and led to no improvements for the people of Guam today.

He also made promises to introduce medical accountability legislation that never materialized, and it was reported that more than 20 percent of his donations came from the medical community, raising questions about whether he supported accountability at all.

While the administration focused on planning and Sen. San Agustin focused on funding, Sen. Therese Terlaje focused on people.

Through my health care filter, her work stands out because it aimed at restoring real services that families had already lost. She introduced measures to bring back maternal care, child health services, lab work, dental care, X-ray access, and pharmacy services at the Mangilao clinic. She pushed legislation to strengthen community health centers so families could get care without political interference.

Sen. Terlaje introduced a medical accountability bill to address preventable harm and the stagnation of complaints within the system. She introduced a structural reform bill to force GMH to fix operations, billing, collections, management and accountability. She held oversight hearings that dragged failures into the open and forced agencies to answer for the conditions families were living through. From my perspective, she was the only one consistently fighting to restore services and confront failures directly.

Only after reviewing the Democrats did I turn to the health care records of Speaker Frank Blas Jr. and Vice Speaker V. Anthony Ada, and what I found was disappointing. The public record shows no major health care accomplishments tied to either senator.

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Sen. Blas appears only as a co-sponsor on a community health center autonomy bill authored by Sen. Terlaje. He submitted FOIA requests that produced no improvements in medical care.

Sen. Ada authored no health care legislation at all. From my perspective, the question becomes unavoidable: where have they been while families were living through this crisis?

As for the Independent ticket, Jeff Pleadwell and Charlie Hermosa, I have said openly that I trust their intent and believe they carry themselves with integrity and honesty. They are newcomers, so I cannot compare legislative accomplishments, but I believe they would approach the work with transparency and a genuine commitment to serving the people of Guam.

Focusing on health care as a priority means focusing on the people of Guam, addressing the island's needs in all aspects. 

David Lubofsky advocates for improved health care through medical accountability equity. 

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