Archive for August 2015

A hospital ship for Hawaii

August 25, 2015

Hawaii Hospital Ship

In Hawaii, providing timely and affordable healthcare is made even more challenging by our remote location. We are about 2,400 miles away from California, over 3,800 miles away from Japan, and over 4,700 miles away from Australia. It takes more time and more money to import medicine, medical equipment, and supplies. We have to plan ahead for what we need now and in the future. During emergencies, we have to rely on what we have on hand.

Another challenge: because much of Hawaii’s population is centered on Honolulu County, rural and neighbor islands have an even greater difficulty accessing healthcare. The neighbor islands have higher rates of preventable deaths and preventable hospital readmission rates, according to the Hawaii Healthcare Project’s “State of Hawaii Healthcare Innovation Plan” (2014).

There are many ways we could improve healthcare in Hawaii, and I’d like to pitch one more idea: a Hawaii hospital ship. This floating medical facility could carry medical equipment and supplies, rooms for medical and support staff, operating rooms, patient beds, and boat docks. It addresses the problem of Hawaii’s geographic separation, not just from the rest of the world, but from each other.

A Hawaii hospital ship could operate on a regular schedule, stopping at harbors for 1-3 days as needed, and making a circuit of the islands once a month. Hawaii has ten state-managed harbors on six islands, and I would add one on the North Shore of Oahu – Port Allen (Kauai), Nawiliwili (Kauai), Haleiwa (Oahu), Barber’s Point (Oahu), Honolulu (Oahu) for repairs and supplies, Kaunakakai (Molokai), Kaumalapau (Lanai), Kahului (Maui), Hana (Maui), Kawaihae (Hawaii), Hilo (Hawaii), and back again.

Hawaii Harbors Map

Here are 4 ways Hawaii could benefit from a hospital ship:

* Regular medical services to remote areas. A hospital ship could deliver medicines and medical supplies, and perform lab tests. Ship doctors could provide consulting services or second opinions and assist with operations. Being able to “share” medical equipment could lower costs, and it could save money for patients who could not afford to fly to Honolulu.

* Search and rescue support services. A hospital ship could be diverted to aid the survivors of airplane, cruise ship, and boat survivors.

* Emergency services during natural disasters. The regular medical schedule could be suspended to deal with a natural disaster by offering medical aid, delivering supplies, and transporting aid workers and the injured. It’s an important part of crisis-planning for our state.

* Quarantine facilities. A hospital ship could be converted to a quarantine ship in case of an outbreak of disease or illness.

Realistically, I don’t think a hospital ship is affordable. We just don’t have a large enough population to make it a reasonable option now. But we could take the long view and start planning for the future. We need to be able to help each other, because help from outside Hawaii is so far away.

Would a hospital ship solve a problem in healthcare and emergency response? How could we make it work? Why do you think it wouldn’t work for Hawaii?

Small steps to public speaking

August 18, 2015

Take Small Steps

Earlier this year, my son decided on his own to try out for the speech club at school. He practiced his audition and participated in the Honolulu District speech festival in May. I couldn’t have done all of that when I was his age.

A little while ago, I had an opportunity to be on the radio – nothing definite, just the possibility of being a guest. I was flattered and excited. But I was afraid. So I gently closed the door on the opportunity.

My immediate reaction was relief. I had avoided public speaking. Speaking in public makes me anxious. Giving a speech to more than three people scares me. After a few days, I didn’t feel relief anymore. But I didn’t exactly feel regret, either.

After I read “The Spirit of Kaizen” (2013) by Robert Maurer, I realized that it didn’t have to be all (public speech) or nothing (silence). I could take small, even micro steps, to change something about myself that I wish I could change. I could apply the idea of kaizen to public speaking.

In the book, Maurer relates how he helped a CEO become more comfortable with public speaking. At no time in these steps was the executive asked to do any public speaking! Each step was small and unthreatening. Each step takes as long as needed, until you are comfortable with it and eager to take the next step.

The first small step: the executive asked himself two questions about his company at the start of each workday. The executive wasn’t supposed to answer the questions, just ask them.

The next small step: the executive took 30 seconds each day to imagine himself delivering a quarterly update to financial analysts via video-conferencing. The executive was supposed to feel his straight spine, his hand gestures, his relaxed jaw; and hear his words, steady and genial tone, conviction and enthusiasm. He was supposed to envision the analysts on the screen, responding politely to him.

Another small step: the executive imagined himself speaking in other situations, such as giving talks to civic groups or annual meetings. On his own, he added extra practice time and rehearsed in front of his family.

According to Maurer, “The skill you’re practicing becomes so effortless, easy, and routine that you’ll hardly notice the transition from imagination to real life” (page 116).

I’d like to challenge myself – and you – to take a small step to change something in your life. Whether it’s eating healthier, exercising more, getting rid of a bad habit…

To become more comfortable with public speaking, here’s my first small step: I will take 30 seconds each day to imagine myself speaking in a small group of people. I will imagine myself feeling relaxed and confident. I will hear my assured, positive tone. I will see people listening to me intently.

What small steps can you take to change your life?

“In lieu of money” tax relief

August 11, 2015

In Lieu of Money

Taxpayers owe the State of Hawaii millions in unpaid taxes. How much? Delinquent taxes reached $456.1 million at the end of fiscal year 2014, according to the State of Hawaii Department of Taxation Annual Report, 2013-2014. (I calculated this amount by adding the $429.9 million delinquent tax balance and the $251.7 million in new delinquent referrals, minus the $225.5 million collected last fiscal year.

It bothers me that Hawaii has millions in uncollected taxes (last year saw 3,553 liens filed and $31.3 million in uncollected tax write-offs), and there’s not much we can do about it. We can harass them through letters or threaten them with a lien (and possibly force them out of their home) or subject them to wage garnishment (deduct money directly from their paycheck). None of that makes people want to pay taxes or helps people appreciate all the services that our taxes pay for.

Maybe we need a different way to pay taxes, one that doesn’t involve money. Maybe we need a way to give taxpayers some tax relief and allow them to pay taxes, student loans, and fines “in lieu of money” – that is, through goods and services.

Paying taxes through goods and services would provide tax relief while showing that we value everyone’s contributions, big or small. It could make it easier and less stressful to pay taxes. It could let us share our time, knowledge, and experience with our community. It could give taxpayers more choices in how we interact with government.

How could an “in lieu of money” tax relief program work? Here are a few examples:

* In lieu of income taxes and fines. A hair stylist could pay part of their income taxes in free haircuts to low-income individuals as part of a work-training program. This would give individuals confidence during job interviews and benefits the hair stylist because they may have future customers. A retail clerk could pay part of their income taxes by providing daycare or after-school care at public schools or local parks. This would give working parents access to childcare and help individuals keep more of their wages.

* In lieu of property taxes. A farmer could pay property taxes in fruits and vegetables that could be delivered to public schools or sold at farmers’ markets. This would give students access to fresh, local produce and guarantee a market for some of the farmer’s harvest. A retired senior could pay property taxes by mentoring small businesses and nonprofits. This would give small business owners and local organizations access to experienced business people, while keeping seniors active and connected to the community.

* In lieu of student loan repayments. A teacher could repay Hawaii student loans by participating in after-school mentoring or tutoring for adult education programs. This would provide help for students who want to learn and help new teachers keep more of their wages. A lawyer could repay Hawaii student loans by working on cases for the public defender or prosecutor, teaching classes, or offering free legal advice during community sessions. This would give individuals access to free or low-cost representation or advice.

Who could benefit from this program? Families at the border of low-income and middle-income, where a slight increase in income might mean a reduction in government aid… Recent graduates struggling to repay student loans in a tough job market… Families who are land-rich (for Hawaii) but bank-account poor (anywhere in the country)…

Of course, there would have to be some guidelines in place:

* Limits on “in lieu of money” payments. We would need to set a maximum amount of taxes, student loans, or fines that would qualify for the program. We might cap the program annually at $2,400 in tax payments, student loan repayments, or fines. This would reduce an individual’s monetary tax payment by up to $200 per month; the balance would be paid in cash.

* Caps on assets. People could qualify for this alternative tax payment program by having limited income, a limited amount of cash in the bank, and a single home that they use as their primary residence (no vacation homes or timeshares).

* Simple rate schedules. We would need fair, consistent, and easy to understand rate schedules that convert money owed to the government into goods and services. Ideally, rate schedules would be set by quality, skill, and experience, but there’s no easy way to rank products or capabilities across all professions. Maybe we could set the value of goods at cost plus 5%, and hourly rates based on education level (high school diploma/GED, Associate’s degree, Bachelor’s degree, Masters degree and higher).

* Fair and reasonable negotiators. We would need fair and reasonable negotiators who could approve and suggest accepted “in lieu of money” goods and services. The advocates could be program participants themselves.

The truth is that money is not our society’s most valuable commodity. There are many other ways to contribute to the community, pay it back, and pay it forward. What do you think? Could an “in kind” tax relief program succeed?

Poetry: Mango Season

August 4, 2015

Fiction - Mango Season

Mango Season
By Rachelle Chang
Artwork by BWL (age 8)


When I was young I climbed the mango tree
That grew in our front yard. I played
Bare feet, scraped knees, wild hair, without a care.
I swung my legs. I dreamed. I prayed.
In summer months we used a bamboo pole
To reach high for the fruit. We strained
Arms raised, head back, eyes wide for flash of gold
Up high before the season waned.

When I had climbed beyond the leafy green
Into the sun-bright sky; I dared
Head up, back straight, arms wide, and looked below.
I lost my breath. I paused. I stared.
The mango tree, long rooted in the earth,
No longer stood. Once childhood’s shield
Leaves cut, roots starved, green song silenced
An empty place, a concrete field.

“Written in the Sky” by Matthew Kaopio

August 1, 2015

Written in the Sky by Matthew Kaopio

Ever since his grandmother died, 14-year old ‘Īkauikalani has lived homeless and alone under a bridge at Ala Moana Beach Park in Honolulu. Sometimes feeling invisible, he observes the other homeless people, tourists, even ants, and appreciates the beauty of sunsets and clouds.


Then three things come together that give him the chance to change his life. In a dream, his grandmother tells him to find “Mariah Wong.” At the park, a stranger gives him a flyer about a shaman lecture. And a homeless man named Hawaiian befriends him, leaving ‘Īkau with his journal after he is murdered.


Guided by a Hawaiian owl, his spirit guide, he finds Gladness (Gladys Lu), who offers him work cleaning her yard; shares what he has with other homeless people; finds his grandmother’s estranged aunt; learns the meaning of his name; and gains a sense of family and identity.


“Written in the Sky” (2005) by Matthew Kaopio is a young adult novel about being seen, small kindnesses, sharing what you have, taking care of the land, reaffirming faith in God, and finding a purpose. The writing is poetical, poignant, and ultimately hopeful and full of life. ‘Īkau is resilient, generous-hearted, self-reliant, and mature, and he chooses not be become resentful or bitter. He appreciates small kindnesses and small joys, and he is eager to learn – “He took out Hawaiian’s journal and fed his equally hungry soul with words of nourishment.”


Throughout the book, he is usually referred to as “the boy”; but at the end of this part of his journey, ‘Īkau introduces himself as he starts to write in Hawaiian’s journal. He has found his voice and identity.


There are some adult themes of homelessness and poverty. The plot has bursts of violence (the murder scene is not for young kids) and realistic portrayals of Hawaii’s local culture. It is particularly poignant today with the rising number of homeless families in Hawaii.


How do you react to hardship and loss? Who can you depend on when bad things happen? What are your hopes for the future?