Cost for doctors just go up and up
Helen Altonn's excellent article on "Falling pay and rising liability drive key doctors from Hawaii" (Star-Bulletin, May 16
) highlights a problem fully realized by most doctors but not recognized by the public in general. For instance, my office rent has doubled in the past 10 years. All other costs of maintaining a medical practice in Hawaii, such as insurance and salaries and benefits for employees, also have risen greatly in recent years. Despite the rising costs, physician's payments from Medicare and the Hawaii Medical Service Association have been reduced to a 1980 level.
The increase in costs of maintaining optimum medical care in this country is caused by the upward spiraling costs of pharmaceuticals, technology and malpractice insurance rates not by physician's fees. For example, our patients now pay four times as much for their eye drops as they did 10 years ago. Hopefully, newspaper articles like this will alert the public to the impending crisis for medical care in Hawaii.
Malcolm R. Ing, M.D.
HMSA, lawmakers chase doctors away
I note that Tuesday's article on falling pay and rising liability driving key doctors from Hawaii
was followed the next day by an article on the Hawaii Medical Service Association's 11.4 percent increase in profit
. Is it disingenuous to ask if there is a link between these two events?
It appears that Hawaii lawmakers are oblivious to the disintegration of the state's health care system referred to in Tuesday's article.
There is a similarity here to what happened in Kauai with the dams. Until the problem hit a critical point, the status quo was OK. When loss of life occurred, there was a huge amount of finger-pointing and responsibility-ducking. Unfortunately, our lawmakers are reactive, not proactive.
If you or your loved ones can't get neurosurgical or orthopedic care after major trauma, just call HMSA and ask them where the doctors have gone. Better yet, call your favorite lawmaker.
HMSA repayments dismal for doctors
In an article about the massive exodus of physician specialists from Hawaii ("Doctors leaving Hawaii fed up with red tape" Star-Bulletin, May 16
), Cliff Cisco, senior vice president of the Hawaii Medical Service Association, states that HMSA's reimbursement rates are better than Medicare.
This is not true. For non-surgical care, such as a standard doctor's office visit or specialty clinic visit, reimbursement rates are actually as much as 13 percent lower than Medicare for certain evaluation and management services.
In addition, HMSA does not reward physicians for higher-complexity evaluation and management services. Reimbursement rates are the same for healthy patients who visit their doctors for a cold or an elderly patient who needs help to manage diabetes with multiple complications, including hypertension and heart disease.
Medicare and Medicaid reimbursements are poor indeed, but HMSA is dismal in comparison for non-surgical specialists, especially when one compares these rates to Blue Cross affiliates in other states.
HMSA is the main reason doctors simply can't make it here, and the main reason we sadly consider leaving Hawaii and the patients we care for.
Linda Anegawa, M.D.
Tourism sets aside local population
Cynthia Oi's column ("'Waimanalo Blues' heard all over Oahu," Under the Sun, May 10
) should be mandatory reading for all of our elected representatives and all of those in the city and state planning and permitting offices.
Her summary of the Hawaii Tourism Authority survey showing that a "definite majority of residents think that the islands are being run for tourists at the expense of local people" fits to a "T" the current development embroglio here on the North Shore.
My wife and I recently met with some New Zealand friends who have many years in the hospitality business there, staying in Waikiki on their second trip in about 10 years, and listened to their valid complaint that there did not seem to be any bar or restaurant that catered to residents. It seems as though most businesses in Waikiki are devoted to wringing the last dollar from tourists. It seems as though with 7 million-plus visitors each year, it doesn't matter if they don't return.
Now that Waikiki has succumbed to the lure of the dollar, with Kapolei well on the way as a "destination resort" to the same fate, it is imperative that the brakes immediately be placed on all hotel and resort development proposed for the North Shore. The cry to "keep the country country" must be heeded.
Spying on citizens should be no surprise
Why should it come as a surprise that the U.S. government has been spying on its own citizens?
The National Security Agency, the CIA, the FBI and all the rest of our testosterone- fueled federal agencies -- complete with thousands of employees, satellites and millions of dollars of electronic equipment -- didn't come close to detecting the 9/11 attack, Osama bin Laden or al-Qaida. And they had quite a time of it with Zacarias Moussaoui, whom they all blamed for 9/11 and who wasn't smart enough to get out of the way.
It's great to see our tax dollars at work.
The Bush administration had to report success spying on somebody.
Hawaii owes much to Outdoor Circle
Three cheers for the Outdoor Circle and its latest victory in protecting the beauty of Hawaii -- stopping the billboard trucks
that do absolutely nothing but travel our roadways advertising products for their clients. Many residents don't know how lucky they are to have an organization like the Outdoor Circle, which year after year steps up to the plate and takes on powerful entities trying to destroy Hawaii's scenic beauty for financial gain.
Stop and think for a moment how the islands would look without the group and its 80 years of volunteerism to keep the state clean, green and beautiful.