- This time we're
going to focus on something very different from past Updates.
This time it's all about what you will be facing here in the
medical arena. It all comes down to this: There are no doctors!
- What?! How can
that be, you ask? Well, it seems that for a variety of reasons,
doctors are leaving Hawaii in droves. From what I can get from
the media, it has to do with the insurance companies who do business
here not reimbursing the doctors at a fair rate, or at a rate
that compares with what they would get on the Mainland.
- It also has
to do with the enormous malpractice judgements that the State
is unwilling to deal with. It seems Hawai'i is up there with
the few states that have the highest limits on these senseless
awards, so the malpractice insurance premiums our doctors are
required to pay make working in here unprofitable.
- I recently spoke
to a young doc who works at the Hilo Medical Center. He said
that the whole parasitic malpractice environment in which the
medical community has to work is so hostile that he is considering
going into another line of work. Every time a physician makes
a diagnosis on a patient, s/he is vulnerable. Now the doc has
to require batteries of probably unecessary tests just so there
will be documentation that every conceivable possibility has
been explored. And then the patient will sue because of the "unecessary
tests." It's clearly a no-win, highly unfriendly proposition
for the doctor.
- It's interesting
how so many of this country's biggest problems seem to be rooted
in the insatiable greed of lawyers devoid of integrity of conscience.
The consequences of these enormous and insane judgements don't
stop anywhere near what we've just discussed, either. They trickle
down into everyone's pockets eventually. They are at the root
of many of the causes of our country's seriously broken medical
- So the doctors
who are still here are way overworked and unavailable. We've
heard horror stories like somebody with a broken arm waiting
four hours to see an ER doctor. Actually, the young doc I spoke
with said that four hours wait in the ER is normal there now.
- We hear repeatedly
of new arrivals here who have called every physician in the phone
book and none will accept new patients.
- With that in
mind, once you get here and try to secure medical insurance,
one of the requirements is that you "primary care physician."
If you cannot even get an appointment to see a doc, it is unlikely
you'll qualify for insurance.
- An alternative
to all this is Kaiser Permanente, where if they accept you, you
don't have to already have your own doc. Their advertising implies
that you will have your choice of the docs on their staff, but
this is not entirely true here on the Big Island. You will get
whatever doc they assign you, if there is even one available.
They are very short-staffed and what staff they do have rotates
enough that it is unlikely you will have the same doc the next
time you come in. There is one doctor in the Hilo Clinic who
has been there for years, but she is the only one. Also, if the
doc they assign you to determines you need to see a specialist,
the process is that you will have to make an appointment for
the next one they bring over from Oahu. That might mean another
month, or if that doc is already booked solid, two months or
more. BTW, most of what I'm telling you here is from personal
experience, as I am a Kaiser member. If you would like to see
some critical data about Kaiser Permanente before making any
decisions, visit http://www.kaiserpapers.org/. You may just opt
to not have any medical coverage at all.
- There seems
to be no light at the end of this dismal tunnel. There have been
recent media reports of various efforts to encourage our young
people to go into some field of medicine, but that is not a promising
picture for the near future.
- I'll post new
info here as I receive it. Hopefully, some encouraging info will
be forthcoming, but please don't hold your breath!
- The new lava
- Take a look
at http://hvo.wr.usgs.gov/kilauea/update/maps.html for the latest
on the new direction of the lava flow encroaching upon Puna.
Our government officials are currently telling us it's no big
deal, but it would be a good idea to stay tuned if you're planning
on purchasing property in the lava's path! Also, as soon as the
lending institutions get up to speed on this, you can bet they
will bail out on offering mortgages in the district.
- Real Estate
- Not much change
since the last Update. Prices are still dropping for everything
but premium properties. Anything right in Hilo or anything with
a killer ocean view is holding its value, but homes in the Puna
subdivisions continue their slow-but-sure downhill slide. Higher
mortgage rates and way less liberal lending policies are taking
their toll, and of course the huge inventory of new and nearly
new homes there continue to keep prices down. In the subdivisions,
it continues to be a buyer's market. If you have some cash, make
any close-to-reasonable offer on the already low prices and you've
bought yourself a house.
- The Living Aloha
- More people,
more cars, more traffic . . . it all adds up to more even more
of a need to practice conscious living aloha! Give a little here
and there. Practice random acts of kindness. Be thoughtful of
others. Live consciously and feel the needs of others around
you. Be the neighbor you would like your neighbor to be.
Again, my last few updates have gone into this in detail and
it is ever more important as more and more people relocate to
the Islands. If you would like to read my article on Living Aloha
that appeared in the Hawaii Island Journal, please click HERE!
- In case you
are having trouble relating to all this talk of aloha, please
In addition to making it all very clear, there is also a whole
chapter on why Hawaii is clearly not everyone's Paradise. There
are many reasons given to possibly reconsider a move to the Islands,
and even some tests for your feelings on issues that drive some
people nuts here. Relocating to an Island in the middle of the
ocean is a tryuly Big Deal, and Affordable Paradise is one of the few reads
that will tell you the whole story.
- And in the
meanwhile, please, please,
- Mahalo for
- Skip Thomsen