Freedom of choice and the CON
After practicing medicine in Kona since 1981, and experiencing multiple and ultimately futile attempts to fix Kona Community Hospital, I can only conclude that it is unfixable. We again are hearing candidates for public office extolling the virtues of their particular schemes of “public-private” partnerships that have failed in the past and are extremely unlikely to succeed in the future. The public employee unions blame mismanagement by the Hawaii Hospital Systems Corporation, the hospital management entity created by the state Legislature to manage our state-owned, taxpayer-funded hospitals. HHSC, supported by consultants’ studies, blames the excessive cost of hospital operations on the unions. I believe that they are both absolutely correct.
What I have not heard from any of the candidates, is any proposal to allow a private hospital, either not-for-profit or for-profit to be built and operated in our community. Financially, this is a challenge, but not nearly as challenging as obtaining a certificate of need. A certificate of need must be issued by the State Health Planning and Development Agency. This process, when it was first instituted in the 1970s, purported to control hospital costs by preventing “excessive competition.” In that era, hospitals were rapidly expanding and could not fill their beds. To stem losses, they simply charged more.
Today, the situation is radically different. The payers — private insurance, Medicare and Medicaid — are in control. Hospitals cannot compensate for excessive overhead costs by charging and collecting more for their services. If they could, archaic, mismanaged, union-controlled hospitals, such at Kona Community Hospital, would not have to beg the state Legislature every year for additional funding.
Among the criteria for obtaining a certificate of need is a clause that requires the new hospital to essentially not interfere with an existing hospital facility. This requirement was used to prevent a private hospital from being built on Maui, because it could have affected the state-run Maui Memorial Hospital. This is the equivalent of preventing a new restaurant from opening that may impact the sales of existing restaurants.
The only solution I can see is to dump the State Health Planning and Development Agency and the certificate of need process. Allow a private hospital to compete with Kona Community Hospital. Give the people who live here a choice. The residents of Oahu have multiple choices, we have none. Ask your favorite candidates their positions on this issue.
Peter Locatelli, MD
Kealakekua
Put sacred before almighty dollar
All people of faith, whose god is not the dollar, need to stand in solidarity with Native Hawaiian practitioners in prayer and action for the sacred temple — Mauna a Wakea — Mauna Kea.
Kaliko Kanaele of the Royal Order of Kamehameha put the matter sharply in reference to the $1.4 billion, 18-story, Thirty Meter Telescope planned for Mauna Kea when he said: “We can’t keep on desecrating.” Kanaele’s words of wisdom apply not only to Mauna Kea but equally to the continued bombing at Pohakuloa Training Area, the drilling into Pele for geothermal energy, and the overall profit driven pollution of the planet causing a global climate crisis.
It is time for all people of faith to come together and put the sacred before the almighty dollar and demonstrate through our actions. Stopping the TMT (Too Many Telescopes) on Mauna Kea would be a good start.
Jim Albertini
Malu Aina Center
For Non-violent
Education & Action
Kurtistown
Haven’t we done enough already?
I am not for or against science and looking for ways to combat fruit diseases but I am against messing around with Mother Nature. So far, I have yet to see what good has come from introducing the mongoose to combat the rat problem. In all of these instances, not enough thought has gone into actions to fully understand the impact it has on our natural environment.
I have seen that the genetically modified papayas produce more and are resistant to fruit diseases, but what are the effects on our health in the long run? Who knows what it will cause down the line?
I can see why those companies that produce chemicals would want us to start using GMO seeds since it will increase their profits. As usual, greed over the welfare of mankind is the reason for most innovations.
Why can’t we find more natural ways to combat diseases that affect our crops? Why rely on chemicals and poisons? Haven’t we done enough to ruin our environment already?
Colleen Miyose-Wallis
Kona