View Point

By Lyna O. Burian

Friday, October 25, 1996

New law offers hope to those
with brain injuries

State must move to set up advisory board
and qualify for federal grants

Brian, an electronics expert, was shopping at his local supermarket when he slid on a wet surface and fell on the back of his head. He was treated at the emergency room and released but has been having difficulty working on electronic devices since.

Vicky, a college student, was juggling school work and a part-time job, and did not take care of a very bad cold and a high fever that turned into encephalitis. She has short-term memory problems and has to deal with seizures.

Both have brain injury and are trying to get their lives back together again.

Of course, these are not the common causes of brain/head injuries. But they are common occurences. They could happen to any one of us. We need not be riding a motorcycle or a bicycle without a helmet, or driving recklessly at 100 miles per hour. The chances of injury are a threat to all.

Vehicular accidents are the largest single cause, accounting for 70 percent of all brain injuries in the United States. Other causes are: jumps and falls; assaults; gunshot wounds; and sports and recreational injuries.

On July 29, President Bill Clinton signed the Traumatic Brain Injury (TBI) Act into law, after it had been passed unanimously by Congress. This historic piece of legislation will provide states with federal grants to start up model service programs for people with brain injury.

The act also will give the Centers for Disease Control money to create prevention initiatives. Most importantly, by passing this legislation, the federal government has recognized people with brain injury and the problems associated with brain injury.

More than two million Americans sustain brain injuries each year. Of these, about 373,000 are severe enough to require hospitalization. With one brain injury occurring every 15 seconds, this public health concern ranks as the leading cause of death and disability among children and young adults.

For those who survive, brain injury is life-altering. Serious physical impairments are frequently a result, as well as a variety of cognitive, behavioral and emotional complications. In addition, health-care costs are staggering - survivors typically face five to 10 years of intensive rehabilitation, with cumulative costs exceeding $48 billion annually.

Brain injury is known as the Silent Epidemic. Many survivors display no physical signs of disability. They may look like everybody else, but they may have some cognitive, emotional, behavioral, psychosocial or other forms of physical impairments. They may have difficulties with judgment, concentration, communication, planning or spatial perceptions. They also might have problems with impulsivity or disinhibition. Or they may have lost their sense of smell, taste or hearing, or have reduced endurance.

Despite their frequency, there is still much ignorance and lack of understanding about brain/head injuries. The need for education and awareness of the etiology and the management of the disabilities resulting from such injuries is critical.

Hopefully, with the emergence of the TBI Act, the many aspects of traumatic brain injury will become better known. The act had broad support of the Brain Injury Association, a national support group for TBI survivors based in Washington, D.C., which for five years faithfully contacted representatives and senators providing them with valuable information about this condition.

Now it is time for Hawaii to get into the act. The TBI Act authorizes the federal government to spend some $24.5 million during the next three years. Part of this appropriation will be allotted to the states in the form of grants for developing model treatment programs to improve access to health and other services regarding traumatic brain injury.

However, in order for any state to be able to apply for these grants, an advisory board needs to be established, with representatives from the corresponding state agencies, public and private health-related organizations, members of a TBI organization, injury control programs, and a substantial number of TBI survivors and family members.

This board will make recommendations to the state on ways to improve services coordination regarding traumatic brain injury. Now is the time for our state officials, especially those in the departments of Health and Human Services, to put this board in place, so that Hawaii can take advantage of this valuable opportunity.

To improve awareness about brain injury, Hawaii's Pacific Head Injury Association (PHIA) and the Rehabilitation Hospital of the Pacific are sponsoring "Brain Injury - The Long Journey Home," a conference for survivors, their families and medical professionals and caregivers, which began today and continues tomorrow at the Ala Moana Hotel.

In addition, both Gov. Ben Cayetano and Honolulu Mayor Jeremy Harris have designated October as Brain Injury Awareness Month. Hopefully, these and other PHIA projects will enable the brain injury community to get the recognition and services it deserves.

Lyna O. Burian is the vice president of the Pacific Head Injury Association and the parent of a brain injury survivor.

View Point

By Terry Bosgra

Saturday, October 19, 1996

must get out of the way

Kapiolani Boulevard was supposed to be the Wilshire Boulevard of Honolulu and about all it has become is Death Valley for Japanese investors," said marketing analyst Marty Plotnick recently in Pacific Business News.

Then in the same issue Len Richardson, a 19-year business owner, joined thousands of others who are closing their doors and moving to the mainland. Hawaii Reps. Patsy Mink and Neil Abercrombie promise more federal money to help Hawaii's business economy. Abercrombie can get his hands on a billion dollars for construction. Perhaps if we ask Patsy Mink she will send an additional billion. Why not? It's free money.

Then we could still go to our senators and maybe Washington will save Hawaii after all.

Meanwhile, island bankruptcies to date are 2,054 (Star-Bulletin, Sept. 18), which is already 32 more than 1995, with three months to go. In 1995 there were 2,022 and in 1994 there were 1,587 bankruptcies . That is 5,663 shattered dreams in less than three years.

According to the U.S. Census of 1993, we hold the dubious distinction in Hawaii of ranking No. 1 in the U.S. with 441.98 state government employees for every 10,000 residents, and we rank number 48 in personal income, according to the U.S. Commerce Department in 1994.

Now you might add to that a University of North Carolina study (1994) revealing a national cost of $34,772 for every mile of highway. Here in Hawaii (where unions control the state), the cost is $283,000 for every mile of highway. With data such as that we may all be listed in that bankruptcy column within the next few years, or join the mass exodus of good local business brains.

Hawaii laws and regulations stifle business at every turn. But examples of how government can stimulate economic growth abound on the mainland and foreign countries.

In the Makapuu surfing contest here in September, all surfers used "Da Fin." This is a revolutionary new invention by Scott Dillen, along with a local resident. However, they produce their product in Australia because the government there subsidizes them 40 percent for the first two years to stimulate economic growth and to encourage new inventions.

The state of Michigan, which was in economic ruin in the '80s, turned the governorship over in 1990 to John Engler, a Republican businessman who served for 20 years in the legislature. In just six years, Engler eliminated the $1.8 billion deficit, balanced the budget for the last five years and eliminated most regulatory red tape. Michigan has led the nation for the last three years in wage increases, held unemployment for the last two years below the national average and lowered welfare recipients by work requirements.

Engler axed the capital gains tax, downsized the regulatory bureaucracy by eliminating 2,000 obsolete and burdensome, often contradictory, rules. He said one out of every five new manufacturing jobs in America was being created in Michigan last year due to the fact that he has cut taxes 21 times since 1990. When the cost of doing business comes down, manufacturers create more jobs by investing new capital in their businesses resulting in increased productivity and higher wages.

The governor fought for school choice and rewards for excellence. This fosters competition resulting in greater academic skills that should give young people a better opportunity in the market place.

The best way to stimulate economic growth in Hawaii is to remove two government shackles: high taxes and oppressive regulation of private business. We must offer tax incentives to attract venture capital, especially in the emerging high-tech industry.

On Nov. 5, we must move from a unilateral political party that is unresponsive to its constituents to a two-party system. It could be our experiment as we move into the next country, and you know what? It might even work.

Terry Bosgra is a longtime insurance agent who lives in Hawaii Kai.

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