Gay Marriage Decision Requires New Policy Rationale of Legislature?

Dear Editor,        June 27, 2015

The most interesting thing about the Supreme Court's decision on marriage equality is being overlooked.

What is surprising is that Justice Kennedy seems to want those that would defend a legislature's policy rationale to show that the rationale is provably true as well as important or compelling.

The question is: if that is the standard, how often can it be met as a practical matter? And secondarily, are all policy questions susceptible of proof?

I don't object to the results of the Court's ruling, but the process aspect may have some unintended consequences.

Lloyd Lim

Honolulu, Oahu

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Tortured Souls--The New Normal

Dear Editor,     June 27, 2015

Have you heard the news? Being transgender is the “New Normal.” Well, of course you have if you own a TV or noticed the magazines at the check-out counter.

It’s the latest fantasy being sold; and for the record most Americans’ aren’t buying it.

Olympian Bruce Jenner’s cover photo on Vanity Fair titled “Call me Caitlyn” announced it. Bruce feels happier being a woman. So Reality TV and anyone who can capitalize from it is making a fortune.

The photographer Annie Leibovitz, known for capturing the soul, certainly caught it. If “the eyes are the mirror to the soul” then clearly Bruce’s eyes reveal a tortured one. No denying it.

The real “New Normal” is we are living in a world where common sense is being trumped by feelings and greed.

Time we grow some and rethink it.

C. Moore

Kailua-Kona, Hawaii

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Hilo Hospital Cuts are Bandaids

Dear Editor,   June 8, 2015

I learned of the recent plans to "shut down" Hilo Medical Center Home Care. I was shocked and angry. I called and spoke briefly with my former home care staff on the phone and tried to encourage and support them. HMC Home Care was established in 1969 as one of the first home care agencies in the state of Hawaii by former Governor John Burns. Despite the increasing Medicare reimbursement cuts to home care, HMC home care has maintained an efficient and lean budget. Our losses are minimal in the "big picture" of HMC. Home care is exactly what we need more of, not LESS. Home care is the most efficient link of the health care delivery system. It is dramatically less expensive than acute care and long term care. Home care is a more caring, humane and intimate experience by far. Home is where we "heal." Home care keeps patients out of the hospital and prevents them from being readmitted.

Currently, Medicare cuts hospital reimbursement when patients are readmitted earlier than 30 days for the some same specific diagnosis. Home care IS an essential service at HMC. Let's deal with Washington and Honolulu before the HHSC board throws home care under the bus. Let's take a closer look at HMC's "specialty services and clinics" and the real "basic" services that our community REALLY needs. Let's really focus on "reducing costs and maintaining quality" by looking at administration, clinic productivity and the need for employing costly specialists."

We are a community hospital funded by the state and changes to this financial relationship have not yet been addressed by the HHSC or the State legislators. Since 1987, when I first became a staff nurse at HMC Home Care, the fiscal problems have not changed. In 2008, I was interviewed by a Stroudwater Associates consultant regarding home care services. In December 2009, the costly and lengthy "Stroudwater Report" which was commissioned by the Hawaii state legislature and paid by the Hawaii tax payers called on the Legislature to convert the HHSC to a non-profit, back a bond float of $56M and get out of civil service. The report categorized HHSC as in a "financially perilous condition."

Six years later, we continue to ignore the "elephant in the room" because of partisan and political prejudices and non-action. These "cuts" are merely bandaids before the entire system is unsustainable. On behalf of the thousands of home care patients and their families that HMC Home Care over has served over the last 46 years, my staff and the community, I demand that a closer look be taken at HMC's budget and "cost savings. I demand that home care be taken off the chopping block. I demand that our state legislature do what they were elected to do... to serve the people of Hawaii and make our health care system strong and sustainable for all of Hawaii's neighbor islands.

Marie Ruhland

Hilo, Hawaii