Archive for April 2017

Should doctors write job prescriptions?

April 25, 2017

Last month, news of Hawaii’s homeless challenge gained national attention on HBO’s Vice News (Hawaii News Now, 3/30/17). The 5-minute segment spotlights that “Hawaii legislators are debating whether to classify homelessness as an illness and housing as a treatment. (via HBO).” This Vice News report is not the kind of attention that Hawaii wants, but maybe it’s the attention that Hawaii needs.

Correspondent Caroline Modarressy-Tehrani interviewed four people to get their perspectives on the proposal to redefine homelessness as a medical condition. Gary Grinker, who is chronically homeless and has a heart condition; he visited the emergency room 241 times in 2016, costing taxpayers $1.2 million in healthcare. Senator Josh Green, who introduced a bill to redefine chronic homelessness as a disease and allow doctors to write prescriptions for housing. Representative Bob McDermott, who believes that Hawaii has “turned the safety net into a hammock.” And Dr. Daniel Cheng, an emergency room doctor at Queen’s Medical Center, which handles two-thirds of all homeless encounters in Hawaii.

I had three successive reactions to the news report.

First, doctors’ first responsibility is to take care of patients’ physical and mental health. A “prescription” for housing would probably involve time filling out forms and coordinating with social workers – time that doctors need to help patients.

Second, having a home may not make people more responsible for their health or reduce emergency room visits. It may even exacerbate health conditions, if people have health emergencies in their home and are unable or unwilling to seek help.

Third, if a solution to rising healthcare costs and chronic disease were housing, we would have more people living in shelters and healthier people at home. But in Hawaii, an alarming 82% of adults have at least one chronic disease or condition and 53% have two or more chronic diseases (heart disease, heart attack, stroke, diabetes, asthma, disability, cancer, chronic obstructive pulmonary disease, high blood pressure, high blood cholesterol, or obesity), according to the Department of Health’s “Chronic Disease Disparities Report 2011: Social Determinants.”

Instead of a “prescription” for housing, maybe doctors should write a “prescription” for a job.  Research shows that employment increases health status and healthy people are more likely to work, according to a Lead Center Policy Brief, “The Impact of Employment on the Health Status and Health Care Costs of Working-age People with Disabilities” (2015).

“Work is at the very core of contemporary life for most people, providing financial security, personal identity, and an opportunity to make a meaningful contribution to community life,” according to the National Alliance for the Mentally Ill (NAMI) factsheet, “Facts about mental illness and work” (1999).

A job gives people dignity as well as a paycheck. Doctors can assess a person’s physical and mental ability to work, and offer a referral to an employer – who could assess their skills, experience, and trustworthiness.

Do you think that we can reduce healthcare costs by prescribing housing? Could having a job help people be healthier?

Celebrate Earth Day 2017

April 18, 2017

Celebrate Earth Day on April 22 and year-round with events, beach clean-ups, recycling, and more. This year, Earth Day spotlights Environmental and Climate Literacy. Let’s all educate ourselves, take action, and make small changes to be better stewards of Hawaii.

Enjoy an Earth Day event in Honolulu

  • On Wednesday, April 19, attend the Earth Day Festival at University of Hawaiʻi Mānoa Campus Center, 10 am to 3 pm. On Friday, April 21, stop by Earth Fest ’17 at Kaiser High School, 1:30 pm to 8 pm. On Saturday, April 22, participate in the free Mauka to Makai Environmental Expo at the Waikīkī Aquarium, 9 am to 2 pm. On Sunday, April 23, go to the Earth Day Weekend Service and Green Fair, 9:30 am to 1 pm, at Honpa Hongwanji Hawaii Betsuin.

Clean our community by getting dirty around Oahu

There are so many opportunities help clean our beaches, improve our schools, and help with planting. Remember to bring a reusable water bottle, use sun protection, wear closed toe shoes, and choose clothes you don’t mind getting dirty.

  • On Saturday, April 22: Volunteer for the Pūpūkea Paumalū Community Work Day, 9 am to 11 am at Sunset Beach Elementary School, helping to restore the trail from Sunset Beach Elementary School to the pillbox. Meet in the SBES lower parking lot. Contact tim@northshoreland.org for details. Join the Sustainable Coastlines Hawaiʻi Earth Day Event, 9 am to 2 pm at Waimānalo Bay Beach Park. Buses begin departing at 9:30 to different locations nearby. Help out at the Garden of Eden Community Workday, 9 am to 1 pm, Blanche Pope Elementary School, Waimānalo, to help spread mulch and plant trees.
  • On Sunday, April 23: Show your love of nature at the Waimea Valley Workday, 9 am to 3 pm in Waimea Valley. Volunteers are needed to help with native planting, invasive species control, and a new sediment control project on Kalaheʻe Ridge. Email Laurent to RSVP.

Learn about litter, illegal dumping, and environmental enforcement

  • On Tuesday, April, 25, attend the Hawai‘i Environmental Court Workshop, 1 pm to 5:30 pm, at the UH Mānoa Richardson School of Law. The workshop is free and open to the public and will focus on “O‘ahu Litter, Illegal Dumping and Community Environment Enforcement.” Register online.

Clean up your clutter

  • Drop off recyclables, gently used items, and more at the Going Green event on Saturday, April 22, 9 am to 1 pm, at Kapolei High School; and at the Aloha ʻĀina Recycling Drive on Saturday, April 29, 9 am to noon at Moanalua Elementary & Middle School.

Mālama the Honolulu Zoo

  • On Saturday, April 29, attend the Honolulu Zoo Children’s Discovery Forest Ribbon Cutting Ceremony and help pull weeds and plant seeds at the Children’s Discovery Forest Work Day, 9 am to 11 am at the Honolulu Zoo. Meet at the Honolulu Zoo’s Gate #6 across the Waikiki Shell parking lot at 8:30 am. Then spend the afternoon at the Zoo.

Bring your own bag (BYOB) to Foodland

  • When you shop at Foodland and bring your own bags, Foodland is offering customers a $.05 bag credit or 3 Hawaiian Miles for every bag used. During April 2017, you can choose to donate your $.05 bag credit to the Kōkua Hawaiʻi Foundation.

Plan your own Earth Day event

  • Host an Earth Day barbeque or picnic at the beach – any day of the year. The Earth Day Network offers a free downloadable Earth Day Action Toolkit to help you organize and coordinate Earth Day events in your community.

How will you celebrate Earth Day?

We’re growing the wrong tax tree

April 11, 2017

I published this post in 2010 and again in 2013. For those of you who are new to Better Hawaii, and for all of us who could use a reminder, I think it’s worth repeating.

Let’s ignore, for the moment, the fact that the IRS tax code is over 44,000 pages, is so complicated that even tax experts don’t understand it, and desperately needs simplification. Let’s ignore the benefits of a national sales tax or a flat income tax.

Think about this: like a tree struggling to shade us from harm, our tax system needs more sunshine, more pruning, and a lot less graft.

In fact, we are growing the wrong tax tree entirely.

Our current tax system is an overgrown banyan tree, with roots extending down and spreading over the whole economy. The federal government has higher income tax rates, ranging from 0% to 35%. The states have lower income tax rates, ranging from 0% to 11% – with Hawaii at the top – but are dependent on federal funds and must comply with unfunded mandates.

It makes more sense to have a tax system like a strong pine tree, simple and orderly. The federal government, which has national responsibilities and a larger tax base, should have lower tax rates. The states, which directly care for citizens but have smaller tax bases, should have higher tax rates and not rely on the federal government for funding.

The only rational explanation for this upside-down, overgrown tax code is that the federal government wants the power to redistribute taxes among the states. They want to create welfare states and ensure that states are dependent on the federal government.

Does this make non-sense? Do you have another explanation – or better yet, solution? Does anyone have ideas about how states can reclaim their power and independence from the federal government?

Lessons from the carnival

April 4, 2017

Looking back at the carnivals I went to as a kid, my strongest memories are of jail, the swing ride, and cows. I remember the bamboo jail where people got “locked up” and had to wait for a friend or family member to “bail” them out of jail. I remember the swing ride because I was afraid of it, until my best friend finally convinced me to ride it, and I really enjoyed it. And I remember cows because at the State Farm Fair, the cows were large, bored, and pungent.

We had good times at the carnival recently. At the keiki carnival, my 10-year old son disappeared with his friends and popped up later to ask for more scrips. At the neighborhood carnival, we walked around with friends, tagging along as he played games and enjoyed different rides.

Here are a few lessons we learned (and re-learned) at the carnival:

It’s okay to spend money… within reason. Usually, my son has a hard time spending his own money. He hoards it like… gold. But at the carnival, he didn’t hesitate to use his own money. He was having a good time, and he knew how much he was willing to spend. The neighborhood carnival made it a little too easy to spend money. Instead of counting scrips, we reloaded a FunPass, and the credits flew by.

Competitive games can still be friendly. We should all cheer each other’s successes. My son congratulated his friends if they won and was enthusiastic, but not boastful, if he won. He even gave a prize to a friend because she wanted it, and he had one already.

Try something new. I may have been afraid to ride the swing as a kid, but my son didn’t hesitate to try it for the first time. Then he jumped off and ran to the Magic Maze. I had a harder time convincing him to take a bite of funnel cake for the first time.

Look out for others. My son is an only child, but he looked out for the younger kids in the group. He even rode the carousel (not the most exciting ride for a 10-year old) and encouraged a younger boy to hold on tight and not be afraid.

Carnivals are always better with family and friends. When was the last time you went to the carnival? What is your favorite part of the carnival?

“Georgia O’Keeffe’s Hawaii” by Patricia Jennings and Maria Ausherman

April 1, 2017

In 1939, Hawaiian Pineapple Co. (later the Dole Company) asked artist Georgia O’Keeffe to paint two pictures. According to a February 12, 1940 TIME Magazine article, “She agreed, on condition that she could paint whatever she pleased.” And in fact, stymied in her attempt to visit a plantation and dismayed by a cut-up pineapple, she refused to paint a pineapple.

“Georgia O’Keeffe’s Hawaii” (2011) offers a personal glimpse into O’Keeffe’s 1939 visit to Hawaii. Her visit is seen through the eyes of 12-year old Patricia Jennings, who served as O’Keeffe’s personal guide while the artist was on Maui, written with author and teacher Maria Ausherman. O’Keeffe spent 9 weeks in Hawaii, visiting Oahu, Kauai, Maui, and Hawaii Island. She painted 18 paintings in Hawaii, and two after she returned to New York.

The book is divided into roughly three sections: an introduction by Jennifer Saville, adapted from her book “Georgia O’Keeffe: Paintings of Hawaii” (1990), which offers a factual account of O’Keeffe’s visit; a personal narrative written by Patricia Jennings, who was 12 years old when O’Keeffe visited Maui and stayed at her home in Hāna; and an afterword by James Meeker, which highlights Hawaii’s lasting impression on O’Keeffe.

Through Jennings, we see a side of O’Keeffe who was daring enough to travel across the country alone to a new land, thoughtful and caring about a young girl, intensely private as she painted, temperamental about getting her way, and successful and confident enough to choose art instead of commercialism.

Of Jennings, she wrote in a letter to her husband Alfred Stieglitz: “The child too is so lovely – a flower in full bloom with the sun on it –“ In turn, O’Keeffe made a lasting impact on Jennings – she wrote, “But the deepest gift she offered me was the experience, in some way for the first time in my life, of really being listened to and appreciated for who I was.”

There are beautiful color prints of O’Keeffe’s paintings, as well as those of artist Robert Lee Eskridge, excerpts from letters, photographs, and transcripts of letters written in O’Keeffe’s curling, flowing handwriting. Interestingly, O’Keeffe used wavy lines to separate her thoughts and sentences, instead of standardized punctuation.

As I read “Georgia O’Keeffe’s Hawaii,” I asked my then 9-year old son to read “Georgia in Hawaii: When Georgia O’Keeffe Painted What She Pleased” (2012) by Amy Novesky. We talked a little about O’Keeffe’s decision not to paint pineapples: she was true to her artistic vision, but she also didn’t fulfill her implicit obligation to Dole Company. My son’s perspective: pineapples aren’t fun to paint, but O’Keeffe should have kept her word.