Lawsuits Close in on Hawaii’s Largest Carbon Credit Scheme
Hawaii v Trump: House Judiciary Committee Moves to Ban Nationwide Injunctions
Obamacare: Hawaii loses 51 full-time doctors as physician shortage continues
SA: …patients wait weeks — sometimes months — to see doctors, particularly specialists.
Hawaii lost 51 full-time doctors from 2017 to 2018, the first loss since 2014 when 92 left the workforce, according to the latest physician workforce survey by the University of Hawaii. The state gained 75 doctors last year, 97 in 2016 and four in 2015, the survey showed.
Factors contributing to the shortage include better pay on the mainland, frustrations over lower health insurance payments and increasingly onerous regulations to practice medicine, said UH professor Kelley Withy, who conducts the annual survey.
“This just makes it more challenging for patients to get the care they need when they need it, which could end in significant health impairments and patient suffering,” she said.
The survey is based on the national average for utilization of services, and the number of physicians in comparable populations on the mainland.
By county, Hawaii island has the worst shortage at 41.2 percent, followed by Maui County at 33.8 percent, Kauai at 32.9 percent and Oahu at 16.5 percent. Oahu is short 384 doctors, up from 381 last year, while the Big Island needs 213, up from 196; Maui County needs 141, up from 139; and Kauai needs 59, up from 53. While nearly 10,000 physicians are licensed in the state, only about 3,400 are practicing, according to the survey.
One Big Island neurologist is scheduling appointments a month out for existing patients and three months out for new patients, while a Maui oncologist is scheduling appointments for November. On Oahu, ear, nose and throat specialists are scheduling patients for February, and on Kauai the same type of doctors are taking patients in October, the Honolulu Star-Advertiser found.
Shana Laririt, 42, a clinical social worker on Maui, said the shortage affects mental health as well.
“We’ve gone through periods of time, particularly for geriatrics, when there is no geriatric psychiatrists. It has been as high as a two-month wait to get a psychiatry appointment. It’s pretty detrimental because then you’re looking at someone utilizing crisis resources — the emergency room. And it’s detrimental to the person, too. They’re suffering. They’re sometimes suicidal or homicidal. It’s definitely a danger for their safety. It’s a community safety issue, too.”…
Dr. Edward Gutteling, an orthopedic surgeon in Hilo, said people with significant injuries end up in the ER, unable to see a specialist for weeks.
“The ER will put them in a splint and send them home, then they will call up (a doctor) and get the runaround,” he said. “The staff is so busy. They’re sent home from the ER with a problem that needs to be addressed within days, and when they call up (are) told they can’t be seen for months. The patient is left there twisting in the wind, unable to get the care they need. That’s a horrible thing if the patient’s just left in the cracks like that.”…
Big Q: Have you had to wait more than two months to see a doctor you felt you needed to see (other than for a routine physical)?
MN: Is there a doctor in the house on Maui?
SA Editorial: Doctor shortage becoming acute
read … About the difference between coverage and care
Trading Padded Cells for Concrete Cells—The Price We All Pay for Closing the Lunatic Asylums
CB: …About 60 percent of everyone arrested by the Honolulu Police Department last year suffered from serious mental illness or substance abuse, according to a recent report.
A psychiatrist told Brittany that jails and the legal system have become “kind of the front door of the mental health system,” with many frequently revolving in and out of that door.
More broadly, nearly two-thirds of Hawaii residents with mental disorders didn’t receive any treatment, according to a 2017 national survey….
read … Why Civil Beat Is Taking A Deep Dive Into Hawaii’s Mental Health System
Brace for constitutional amendment campaigns
SA: …With the general election seven weeks away, fresh batches of TV ads as well as mailbox flyers and fact sheets are in the works. It’s a sure bet that much of the material will target a ballot question on whether to amend the Hawaii Constitution to allow the state to tax investment property to help fund public education. Currently, only counties can tax property.
Supporters say (HSTA claims) the levy is needed to support underfunded schools and teachers’ salaries. Opponents say (point out) it could (obviously will) result in raising Hawaii’s already pricey cost of living. If passed, Legislature decides the particulars. Campaign cash is pouring into political action committees formed by both sides….
read … Brace for constitutional amendment campaigns
By Purposefully Deferring Maintenance, UH Admin Builds $1.6B Capital Improvement ‘Ask’
CB: …The University of Hawaii’s maintenance backlog has swelled to $848 million, almost double what it was in 2014.
Decades of deferred maintenance have caught up with many of the university’s aging buildings, and now, UH leadership is proposing an ambitious six-year, $1.6 billion modernization plan — partially to address the backlog and partially to move beyond it.
(Of course, they could have just maintained their building, thus allowing faculty and students to use proper facilities. But instead they sentence their own campus to permanent decrepitude in a permanent and futile quest for magic money from the legislature.)
The system’s Board of Regents updated its six-year plan last month and finalized a $614.5 million capital improvements request that is expected to be sent to the Legislature next year….
While the $1.6 billion renewal plan would relieve — even demolish — some of the deferred maintenance backlog, it can’t eliminate it completely in six years, UH officials said.
In fact, they estimate UH will still have a maintenance backlog of about $742 million in 2025.
The university would have to spend about $962 million over the next decade just to keep the backlog from growing, according to a report by Sightlines, a company contracted to study facility maintenance….
May 2, 2018: UH Exploits Deferred Maintenance to Score Fresh Juicy Capital Improvements –ON FOUR YEAR OLD BUILDING
read … Better Idea: Do the Maintenance and Avoid this situation in the first place
Gene Ward On ‘Broken Promises’ For Hawaiians
CB: …The GOP state representative advocates for more funding and better management of the Department of Hawaiian Home Lands….
read … Gene Ward On ‘Broken Promises’ For Hawaiians
Caldwell Attempts to Impose IAL Designation on Landowners
SA: …some landowners strongly object to keeping their property designated agriculture in perpetuity.
“They don’t want to be designated because they want to have the ability to at some point to come in and change zoning in communities where they think they could build housing, and they’ve asked me to slow it down or to exclude their properties,” Caldwell said. “Some of it is really some of the best farmlands on Oahu, and we have not done that. So I’m sure they’ll be before the Council.”
David Arakawa, executive director of the landowner-backed Land Use Research Foundation and a member of the city’s technical advisory committee, said the situation is more nuanced than what Caldwell described, adding that he and others on the task force were surprised to learn through the Honolulu Star-Advertiser the Caldwell administration had finalized a plan, made it public and submitted it to the Council. Several LURF members have been in discussion with the mayor and city officials about which of their lands should be designated IAL, and they believed those talks were ongoing, he said….
SA Editorial: Good steps taken to save ag lands
read … Impose
Roadblocks to relicensing push some drivers to illegal behavior
HTH: …A bureaucratic barrier, a lack of adequate state statutes and the sluggish pace at which county Departments of Motor Vehicles process road tests have created a glitch in the driver’s relicensing process that’s incentivizing thousands of Hawaii residents to break the law every year….
Major Robert Wagner, Hawaii Police Department spokesperson, said people can lose their licenses for the following reasons: DUI by way of alcohol or drugs, driving with a license that’s already suspended or revoked, reckless driving or inattention to driving.
The irony of the legal system offenders subsequently navigate is that it allows them mechanisms to operate a vehicle while their licenses are under revocation without breaking the law. Yet, once they’ve paid their debts to society and their revocations are lifted, bureaucratic barriers to license recertification put up additional roadblocks that often threaten their livelihoods. People spend months unable to drive legally after their punishments have lapsed, despite having adhered to all requirements levied by the justice system.
That’s because there exists no legal mechanism to bridge the gap between the end of the mandatory revocation period for the aforementioned driving offenses and the availability of DMV-offered road tests, which typically aren’t available for months.
The discrepancy gets at the heart of crime and punishment — commit a crime, serve the punishment. But in these cases, people are allowed to drive legally while they’re being punished for their crimes, as long as they’re willing and able to pay with both time and money for the privilege.
Once their punishments end, though, they’re not allowed to drive legally by any state or county permit/license until they pass a road test. Thus, after they’ve paid all their penalties, their untraversable quagmire begins….
SA Editorial: DMV has ability to upgrade service
read … Roadblocks to relicensing push some drivers to illegal behavior
Banning Fossil Fuels is Complicated
IM: …NCBI asserts that “plastics and pharmaceuticals are primarily derived from petrochemicals, and there are relatively few substitutes for petroleum inputs into these products. Health care's reliance on petroleum for plastics and pharmaceuticals is a longstanding concern, first discussed widely after the 1973 oil embargo.”
Doctors and nurses wash their hands using petroleum-based detergents and sanitizers.
Medical facilities could raise their prices by using cotton or glass and reusing them after washing them in animal fat-based soaps or petroleum-based detergents. Instead, they use sterile and cheap petrochemical-based disposable syringes, bags, masks, and gloves.
Petrochemical-based drugs include synthesized aspirin, penicillin and some cancer-fighting drugs.
Chemicals embedded in plastic react with specific compounds, typically producing a color change that is useful for urine test strips and pregnancy tests.
Petrochemical polymers are used to make time-released capsules, sterile child-resistant packaging, fiberglass for casts, synthetic fibers for stitches, angioplasty balloons for heart patients, modern moldable plastic hearing aids, and prosthetic limbs.
Agricultural-based petrochemicals include plastic sheeting, mulch, pesticides, fertilizers, twine, silage, and tubing.
Household-based petrochemicals include carpeting, crayons, detergents, milk jugs, pantyhose, perfume, safety glass, shampoo, soft contact lenses, and wax….
IM: Banning Fossil Fuels is Complicated: The Issue of Coal
read … Banning Fossil Fuels is Complicated
FDA Should Declare Anti-GMO Labeling Illegal
SA: …The Food and Drug Administration (FDA) has asked the public to comment on what it’s calling a nutrition innovation strategy — and one main focus is how to encourage innovation in the food industry for healthy eating. It’s high time for the FDA to protect food innovation. The greatest tool for breakthroughs in food — genetic engineering — is being vilified in ways that break the law in order to get rid of the technology….
It’s impossible to go to the grocery store today without seeing products saying “all natural,” and “GMO-free.” FDA has realized that words like “healthy” give little guidance to consumers but fails to understand that allowing products to advertise that they do not have GMOs is a backhanded way of making the technology seem dangerous. It’s not different than a competitor badmouthing someone else making the same product — and it’s against the law.
The worst offender is the “Non-GMO Project Verified” label, an advertising symbol founded on the intention of making it seem like products without the stamp could be dangerous or unhealthy. It shocked me to read that the Non-GMO Project wants “to shrink the market for existing GMO ingredients and prevent new commercial biotech crops.”
The label tells customers to go to its website where food is classified according to how much “risk” there is of it having GMO “contamination” — both very scary, loaded words.
This is part of a marketing strategy by the non-GM folks to rely on people’s shortcut thinking. The FDA says it understands this. At a July public meeting to discuss this strategy, the Center for Food Safety and Applied Nutrition’s director, Susan Mayne said, “We know that claims are quick signals that provide consumers with important information about the nutritional benefits of the foods and beverages they choose.”
Negative claims, like the Non-GMO Project label, are sending the wrong message. Because of this bad campaign, even the makers of products that would never use GMO technology, like basil or garden seeds, think they have to use the label so that sales are not hurt.
This is exactly the type of misleading advertising that the Federal Trade Commission says is illegal….
read … FDA must help food innovation in isles
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