Remember that McKelvey helped protect Honolua Bay

I was not on board with the Save Honolua Coalition’s plan for the county to purchase the property, because I knew it would make it harder to get things done due to government red tape. It was not until I saw a drawing of seven house lots on the point where the surfers’ access road is now.

By then we realized that the county was not going to do it. Bill Nguyen was going to buy it (he had invented text messaging and purchased a home by Mokuleia, but his wife saw a ghost and talked Bill into moving back to the Mainland).

I saw Angus McKelvey sign waving by the side of the road and stopped to explain our problem. He asked me to set up a lunch with me, Ryan Churchill (president of the company that owned the property) and himself.

Our lunches soon expanded to include a bunch of concerned individuals, and Angus came up with the idea of special purpose bonds to raise the money we needed (an idea that was later used to purchase the development rights around Turtle Bay on the North Shore of Oahu).

As I had expected, it did make it harder to get things done — like fixing the surfers’ access road — but at least it is now protected.

I will not forget Angus this fall. His opponent represents the rich Mainland people buying up all the houses and raising rents on all of us.

LES POTTS, Napili

Protect citizens’ right to vote

Have you noticed? States are scrambling across the country to assure folks about the integrity of the upcoming elections. This is a baby-step in response to a gigantic effort to install a system of autocratic government where the people trust whatever the leader says, no matter what.

The world has seen populist dictatorship before. It happened in England about the time of the great Puritan migration to America. The group of Puritans that left England brought their senses with them to America, but the group that stayed behind lost their wits to a highly Christian dictator by the name of Oliver Cromwell.

Cromwell took away the vote from the poorest and the richest segments of English society, claiming they were too corrupt to participate. He used secret police as poll watchers in order to assure that the very righteous middle-class Christians supporting him would win the most seats in Parliament.

It is not clear yet if the world will see yet another example of this kind of outrage in 2022 and 2024. This time, the rich are on the side of the dictator, so watch out.

KIMBALL SHINKOSKEY, Woods Cross, Utah

Putting a human face on Hawaii’s doctor shortage

The greatest takeaway from three forums last week about Hawaii’s doctor shortage was the realization that we are dealing with an undeniable human tragedy.

Sponsored by the Grassroot Institute of Hawaii, the forums on Maui, Oahu and Hawaii Island made it clear that the state’s acute shortage of physicians — estimated at more than 1,000 — is not just about doctors, but also our families, friends and neighbors throughout the islands who are desperate for affordable and easily accessible healthcare.

How bad is it? At the Oahu event, James Winkler, a physician associate who is president and CEO of the Kauai Community Health Alliance, described the situation in rural Kauai: “We have no endocrinologist, we have no outpatient neurologist, we have no oncologist. We don’t have a psychiatrist on our island. We have no geriatrics. We have no palliative care medicine. Our ophthalmologist won’t see Quest patients. I just had a patient with senile macular degeneration and diabetes. I tried to get them into an ophthalmologist, and they told me, ‘Send this person to Costco.'”

Winkler said recruiting and retaining doctors is extremely difficult, and those who are practicing here are “exhausted” from working long hours and “broke,” trying to cope with “our high cost of living [and] our high cost of housing.”

He continued: “I haven’t taken a salary in four months just to keep the [KCHA] facility going. … In a way, our facility is a canary in the coal mine, but we’re one of many canaries. There are canaries dropping out every day. We’ve lost 25 percent of our private practices in Hawaii in the last two years. I mean, just think about that for a second: 25 percent of private practices have disappeared in the last two years.”

As for Hawaii’s residents who need healthcare, “It’s heartbreaking to not be able to take care of the patients we take care of,” Winkler said. “So the human face of this is profound. These are patients who are depressed, suicidal, have breast cancer, ovarian cancer, diabetes, hypertension. These are our aunties and uncles. These are our children.”

Winkler’s story has garnered nearly 640,000 views on TikTok, and comments from other healthcare professionals express similar struggles: There is no quick, miracle fix for Hawaii’s doctor shortage, but one obvious first step would be to relieve private and group practice physicians from having to pay the state’s 4.7 percent general excise tax — especially since they are not allowed to pass that expense onto their Medicare, Medicaid and TRICARE patients.

In another viral video from the Oahu event, Dr. Scott Grosskreutz, a diagnostic radiology specialist from the Big Island and founder of the Hawaii Physician Shortage Crisis Task Force, says that more than half of patients in Hawaii are covered by these three government-funded insurance programs.

And because of their exceptionally low reimbursement rates, Hawaii doctors are “basically breaking even, losing money. And then they’re being taxed on top of that, driving them into the red,” he said.

Grosskreutz mentioned one more bad omen for the future of healthcare in Hawaii: “We … have the second oldest cohort of healthcare workers in the country. … We have 37 percent of our providers over age 60. Statewide, 25 percent of us, including myself, are over age 65, and [on] the Big Island, a third of us are over age 65. A lot of these providers are working 60-70 hours a week. And at some point, we’re going to be gone, and we desperately need to bring in new and younger providers to replace us.”

Fortunately, some Hawaii policymakers are waking up to the need for change. In an effort to heighten awareness of this problem, the Grassroot Institute launched a petition this week urging the Legislature to create a GET exemption for medical services. If enacted, it would be a small, but vital, step toward making our state more attractive to doctors — and making healthcare more available to all who are in need.

Together we can make Hawaii a better place to practice medicine. Send a message to our lawmakers by signing and sharing our petition to exempt medical services from the GET.

DR. KELI’I AKINA, President/CEO, Grassroot Institute of Hawaii