Medical Woes
September 3, 2007
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 everything.
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 flow picture
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 Soap Box
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
In case you are having trouble relating to all this talk of aloha, please read Affordable Paradise! 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,
Live Aloha!
Mahalo for "listening."
Skip Thomsen & Ohana
Updated 9/3/07