Hawaii's Hospital Crisis!

[1stwahine]

Re: Hawaii's Hospital Crisis!

K-den. I wrote about what happened to me and kaiser in my Blog the other day."Kaiser and Medicaid! http://www.auntiepupule.com/blog/index.php?id=955

The jest of it is Kaiser Permanente is eliminating ALL Medicaid and Health Quest Patients from their care. They are restructuring their whole Plan and want to dedicate themselves in caring for only "their" MEMBERS per Gail Okata, Supervisor 3rd Floor Kaiser Honolulu Clinic.

I've already contacted Rep. Karl Rhoads per Tita Miulang's advice.

Is it right or is it wrong?

I dunno but I couldn't wait to find out. I found myself another PCP yesterday. As for my neurologist ~ I still am able to see her until the last day when they say no more.

Auntie Lynn

[Miulang]

Re: Hawaii's Hospital Crisis!

I think I know why Kaiser decided to cut off Quest patients. A couple of days ago, one of the other health insurers in the State (University Health)announced that they would be giving higher reimbursements beginning April 1 to doctors who had Quest patients who were part of their system on the neighbor islands (particularly the Big Island and Maui) because of the crisis that has now been widely reported.

Unfortunately, I think Kaiser is holding Quest and Medicare patients hostage in order to force the State to also give higher reimbursements to them. I'm pissed that Kaiser is forgetting the reason why the State licensed them to operate in Hawai'i.

I know the new CEO of Kaiser Hawai'i, Janet Liang, and when she gets to Honolulu in March, she's going to get an earful from me. To put patients' health in jeopardy just because Kaiser feels they are being inadequately compensated for their low income patients is cruel and could be life threatening.

Miulang

P.S. This legislative session, there are at least 7 bills that deal with the issue of health care reimbursements and the scarcity of doctors.

[Miulang]

Re: Hawaii's Hospital Crisis!

Boy, your state Legislators sure have been busy this session! There's another bill that is of special interest to the residents of Maui, and that's a bill aimed at a thorough review and probable revision or elimination of the State's certificate of need (CON) process.

The Governor is also on the side of reform (though not as extensive as what is being proposed) because she was lobbying for the building of a privately funded hospital (Malulani) in Kihei. The State Health Planning and Development Committee was the only group to reject Malulani's proposal, and the reason they did it is not because another hospital isn't needed on Maui, but because it is widely recognized that Maui Memorial Hospital, which is part of the state hospital system, is the "cash cow" of the entire system and is supporting all the other hospitals within the state system. So for Maui Memorial to lose business to a competitor means that there would be less cushion for the state to support the other hospitals it owns.

The governor’s CON legislation (outlined in House Bill 1350) would empower counties with decision-making authority by giving greater weight to the recommendations of a county-level review panel on applications for new
health care facilities. The measure passed unanimously as amended Friday.

The certificate of need process, which is administrated by the State Health Planning and Development Agency, has been widely criticized on Maui, where efforts to build a private hospital were blocked.

Following the state agency’s rejection of the proposed $212 million Malulani Medical and Health Center in Kihei, a grass-roots group called People United to Support a Second Hospital was formed under the leadership of newly elected state Rep. Joe Bertram III. The group, which counts its membership at about 100, has held rallies and petition drives and lobbied legislators for changes to the CON process.

Both Malulani representatives and PUSSH members argued that two of SHPDA’s reviewing panels, which recommended disapproval of Malulani’s proposal, failed to consider “overwhelming” public support on Maui for the private hospital.

The only group to recommend approval of the proposed private facility was the Tri-Isle Subarea Health Planning Council, whose 5-2 vote came after two-and-a-half days of testimony presented at hearings on Maui in July.

Maui is the only main island that only has one hospital located within a reasonable travelling distance (there is a small hospital in Hana). The population growth on Maui has been greater than for any other island, and there is definitely a need for at least one more hospital either in Kihei or Lahaina.

Miulang

[alohabear]

Re: Hawaii's Hospital Crisis!

Maui is the only main island that only has one hospital located within a reasonable travelling distance (there is a small hospital in Hana). The population growth on Maui has been greater than for any other island, and there is definitely a need for at least one more hospital either in Kihei or Lahaina.

Miulang

I think East Hawaii Island also needs a second hospital. Hilo hospital is far away for those in Puna . With two hospitals maybe the ER wait would be less. The average ER vist now takes about 5 hours.

[Ecntrc]

Re: Hawaii's Hospital Crisis!

They take the most critical care first...they say. I have seen with my own eyes that is not true. Onnada story.

Auntie Lynn

And your correct, Ive had to sit in there for 2 hours also with my son almost having an asthma attack and having to use a machine with a mask with him screaming his head off. Luckily that was only once, all other times Ive had to wait only 5 minutes..

[craigwatanabe]

Re: Hawaii's Hospital Crisis!

lets see on the East side of the Big Island we have two hospitals, one of which requires membership (Kaiser) and more urgent care clinics because of the two that exist here. Talk about a crisis, I've been here almost three years and still haven't found a doctor yet. And I've got HMSA! When you call, they ask what insurance you have. If you tell them Quest, forget it they won't pick you up. Doctors here tell me that Quest patients demand the best since they don't have to pay for it.

But even with HMSA I can't get a doctor here. There's simply not enough of them on this island.

[WindwardOahuRN]

Re: Hawaii's Hospital Crisis!

And your correct, Ive had to sit in there for 2 hours also with my son almost having an asthma attack and having to use a machine with a mask with him screaming his head off. Luckily that was only once, all other times Ive had to wait only 5 minutes..

With all due respect, you may not like this.

We have a saying---"If you can scream, you can breathe."

Triage is truly an art.

[1stwahine]

Re: Hawaii's Hospital Crisis!

If you tell them Quest, forget it they won't pick you up. Doctors here tell me that Quest patients demand the best since they don't have to pay for it.

There are Patients who have worked All their lives. Because of an illness, accident, etc. they lost everything. Some even their homes. It is only then they have no alternative but to apply for Quest or Medicaid.

It's not as if they don't 'pay.' They did at one time. Some still do through taxes.

Yes, there are those who take advantage of the system.

Auntie Lynn

[craigwatanabe]

Re: Hawaii's Hospital Crisis!

It's those rotten apples that destroy a good system. Heck when I first moved up here I qualified for Quest because I was between jobs. I did apply and get it and boy I felt like a second class citizen whenever I flashed that really nice plastic Quest card. Even at Safeway Pharmacy the line stops across in the adjacent aisle so those behind you can't see your quest card.

My kid's doctors treated us poorly. I ended up getting Kaiser and paying some big bucks for the family plan until I started working for Home Depot and got HMSA. Suddenly that same doctor was treating me like "normal" person again. But here on the Big Island you don't have much choice for pediatricians so you take what's offered.

It's really bad for medical out here on the Big Island. Having Quest doesn't make it any easier either. I feel sorry for those who have to rely on it.

[Miulang]

Re: Hawaii's Hospital Crisis!

With all due respect, you may not like this.

We have a saying---"If you can scream, you can breathe."

Triage is truly an art.

Well, it happens everywhere, and is definitely not confined to Hawai'i hospitals! One time, I tripped and fell down a flight of stairs in my apartment in Boston. I lived in the South End (Boston City Hospital---the famous "St. Elsewhere" was literally right down the street). After my fall (this was about 7:30 in the morning and occurred because I was rushing out the door to catch a plane for a job interview in Atlanta), my landlord and I went to the ER at Boston City Hospital. Now at 7:30 in the morning, the ER is generally not very busy. So I didn't have all that long to wait--at least I don't think I had to wait very long; I think I was in a state of shock from the fall.

When the doctor came in, the first thing he noticed was the "rug" burns I sustained on the side of my face. So he gave me some topical ointment to put on it to help the skin heal. Then he glanced down at my right wrist. I told him I had tried to stop my fall by instinctively putting my hands in front of me when I fell forward and that I thought I had fallen on my wrist. He looked at it, noticed the "slight" swelling and proceeded to wrap it with an ace bandage. Then he told me to keep the ace bandage on for a couple of days and the swelling would go down.

The next day, the swelling hadn't gone down and the wrist was actually getting very painful. So I went to my own doc who, when he saw my wrist, immediately sent me to x-ray. He discovered that I had a very bad Colley fracture and could see bone fragments all around my wrist x-ray. He put me in a cast which I had to wear for about 6 weeks. I had a stick shift car back then, so it was quite an interesting exercise trying to drive that car with a broken right wrist in a cast that went up to my elbow. Because of that cast, though, I am now extremely proficient at cracking eggs with one hand.

The experience I had in the ER should have been the worst part of that ordeal. But about a month later, I got a nice little bill from the hospital for ER services. I told my own doc about it and he said I should have sued the hospital for malpractice because the ER doc didn't even get an x-ray of my wrist when he first saw me! So I scribbled a little note on that bill, something like, "if you insist that I pay this bill for services which did nothing to help my condition, then I insist that I have to sue you." Never heard another peep out of that billing department again! But I still have the bone chips around my wrist and my doc back then told me eventually I'd end up with arthritis which, knock wood, still hasn't happened yet.

Miulang

[Miulang]

Kupuna sent to Ohio for care

This is freakin' incredulous! I know the State sends prisoners to facilities on CONUS because of overcrowding in the prisons, but now, apparently, some healthcare facilities like Queens are also shipping the elderly off to care facilities in Ohio because of the lack of nursing home beds.

The same shortage of nursing home beds condition is occurring on Maui, where there is only one hospital serving the majority of the island. That's the reason why there's a shortage of hospital beds for acutely ill patients: the elderly don't have places to return to once they are healthy enough to be discharged.

The options given to the families of patients at Queens were shipping the kupuna off to a nursing home in Ohio or taking care of them at home. There are times when it is impossible for a family to care for their elderly relative who might have special medical requirements, so for Queens Medical Center patients anyway, the only option is to look for nursing care on CONUS if no nursing home beds are available locally. Psychologically, it is devastating both for the elderly person and his family to be separated by this distance.

Again, because of the aging of the Baby Boomers and the higher longevity of the elderly in Hawai'i, this problem will only continue to grow. More facilities (both critical care and nursing home) need to be built all across the State. This is not just a hypothesis; this is a fact and a very pressing need. Heh. There apparently is this growing malady in our society called, "if we can't deal with the problem, we'll just ship it somewhere else. And if we can't see it, then the problem doesn't exist." Or, what does an ostrich sound like when its head is buried underground and someone comes along and pulls on its tailfeathers?

Miulang

[Miulang]

More changes coming for state healthcare

In an interesting turn of events, the current Director of the State Health Planning and Development Agency, David Sakamoto, has announced that he will not request to continue in this role after his current term expires on June 30.

This could possibly open the door to all sorts of exciting possibilities for the residents of Hawai'i, if Gov. Lingle appoints someone who is willing to be innovative and work in a collegial manner with the administrators of healthcare facilities across the entire state and to work towards more local governance of each of the publicly supported hospitals.

There is now an acknowledgement by the Legislature that there is a severe crisis in the healthcare sector in Hawai'i that threatens all residents and tourists who might need medical care.

Miulang

[Miulang]

Re: Hawaii's Hospital Crisis!

In light of the reports that Queens Medical Center will sometimes transfer elderly patients to CONUS for care when beds are scarce, the administrator for Maui Memorial Hospital promises that the elderly on Maui will not suffer the same fate.

Maui Memorial has had up to 40 patients a day in need of some form of long-term care service and not hospital treatment, but that number has been inching higher.

“Lately, 50 patients has been the norm. Before 50, it was like wow, we have a lot, but now the numbers are approaching 50,” Lo said.

Hospital officials cannot discharge the patients because they have nowhere to go, and under Lo’s administration, no one will be let go unless they have somewhere to go.

...Krieg said Hale Makua can take two to three patients a week off Maui Memorial’s long-term care list, but because of the lack of space and staff, the nursing home with facilities in Wailuku and Kahului cannot take them all.

Like Krieg, Lo said he believes Maui’s long-term care patients – most of them senior citizens – deserve a chance to stay on the island.

And it's because there is a shortage of long-term care beds on Maui that there's an acute shortage of hospital beds on Maui. And the problem will only continue to grow.

Miulang

[1stwahine]

Re: Hawaii's Hospital Crisis!

In todays Advertiser:http://www.honoluluadvertiser.com/ap...03190330/1001/
Hawai'i nursing shortage critical

By Greg Wiles

"Hale Makua, a Maui-based care home, couldn't make use of all its 254 beds in Kahului last week because it couldn't find enough workers in the midst of a nursing and nurse aide shortage gripping the Islands."

Similar stories can be found around the state.

"We're definitely going to have a nursing shortage that's going to worsen over time," said Barbara Matthews, director of the Hawai'i State Center for Nursing.

A disturbing scenario can be painted if nothing is done, including a decline in access to high-quality healthcare and clinic closings, Matthews said."

K-den....I was in a Real Drama yesterday.

Heart pains and waiting for a room at HMC-East for several hours. I went AMA ~ Against Medical Advice. They apologized to me. Something is definitely wrong with the Facility and also lack of Nurses/Bed? I didn't want to find out. Plus, I need to be at the State Capitol this morning for a Major Resolution. Afta, I go Queens.

Promise.

Have a great and beautiful Day everybody!

I love you!!!

Auntie Lynn Vasquez aka Auntie Pupule

[1stwahine]

Re: Hawaii's Hospital Crisis!

K-den. I wrote about what happened to me and kaiser in my Blog the other day."Kaiser and Medicaid! http://www.auntiepupule.com/blog/index.php?id=955

The jest of it is Kaiser Permanente is eliminating ALL Medicaid and Health Quest Patients from their care. They are restructuring their whole Plan and want to dedicate themselves in caring for only "their" MEMBERS per Gail Okata, Supervisor 3rd Floor Kaiser Honolulu Clinic.

I've already contacted Rep. Karl Rhoads per Tita Miulang's advice.

Is it right or is it wrong?

I dunno but I couldn't wait to find out. I found myself another PCP yesterday. As for my neurologist ~ I still am able to see her until the last day when they say no more.

Auntie Lynn

Update: Rep. Karl Rhoads contacted me today. Director of Regional Executive Office, Lyn Kenton wrote a letter saying I can continue to go to Kaiser. In the first place, I should have not been asked to leave.