Even before the COVID-19 pandemic, we were warned that lack of healthcare capacity in our state was a deepening problem. The last two years have revealed that things are even worse than we thought.
As I discussed in my Wall Street Journal commentary published last weekend — “Hawaii Is No Paradise if You Need Medical Care” — Hawaii’s healthcare crisis includes a growing doctor shortage, lack of specialty care in rural areas, high emergency room wait times and the fact that we have among the fewest hospital beds per capita in the nation.
These are problems that have been highlighted by the pandemic, but they did not pop up overnight. They are the result of decades of regulations and policy decisions, including high taxes, extensive regulations and Hawaii’s notoriously high cost of living.
According to Lisa Rantz, my guest on this week’s episode of “Hawaii Together” on ThinkTech Hawaii, many people are still waking up to the reality of the state’s healthcare shortages.
Rantz is the executive director of the Hilo Medical Center Foundation, which has been conducting a comprehensive study of community health needs. She noted that while the state has done “a great job” at ensuring that people have health insurance, “having health insurance does not equate to having access to healthcare.”
If anything, Rantz said, the numbers understate the depth of the healthcare crisis in Hawaii. While we usually hear that the state is short about 820 doctors, Rantz says that the real shortage, at this point, is over 1,000 physicians. And it’s not just more doctors that we need. The nursing shortage is also growing. Hawaii County has the third-largest nursing shortage in the country, followed by Maui at No. 5 and Kauai at No. 13.
The shortage of specialists has long been a problem on neighbor islands, where people have to fly to Oahu or the mainland for care. But now, even Oahu is starting to notice the effects.
“I think as we’ve seen more neighbor island folks getting care on Oahu, as our shortages increase across the neighbor islands, we’re starting to feel that on Oahu,” said Rantz. “When you call your doctor and they’re like, ‘Oh, you can’t get in for two weeks,’ or ‘We can’t see you for three weeks because we have appointments from neighbor island community members,’ then all of a sudden it hits home. I think as the shortage increases, we’re starting to see more of the impact on Oahu.”
The shortages restrict possible solutions to the problem. Rantz said that when speaking to legislators about the lack of doctors, they’ll suggest using nurse practitioners or physician assistants to provide primary care. But that won’t work when the shortage exists across all medical positions.
Why does this shortage exist?
Rantz says it’s the result of a “perfect storm” of factors, many of which will be familiar to anyone who has followed our “Why We Left Hawaii” series. The state’s high cost of living — including housing costs — is especially discouraging to medical students who are already struggling with heavy debt. Combine this with the high taxes and low reimbursement rates for doctors and it becomes very difficult to recruit young medical professionals to Hawaii.
In other words, the same problems that contribute to our state’s overall population loss are exacerbating our healthcare woes.
Clearly, the first thing that lawmakers ought to do is embrace policies that will reduce the overall cost of living, like lowering taxes and making more land available for residential development. But there are other reforms that could directly address our state’s healthcare capacity issues.
We could start by liberalizing Hawaii’s so-called certificate-of-need laws, which are among the strictest in the country. A study from the Mercatus Center found that states with certificate-of-need programs have 30% fewer hospitals per 100,000 residents and 13% fewer rural ambulatory surgical centers per 100,000 residents.
Rantz also singled out Hawaii’s low Medicare rates as a problem that could benefit from the attention of our congressional delegation. At the state level, she said, the general excise tax is a significant problem for private-practice physicians. Though most people perceive the GET as a small charge, it is imposed at every transaction level and ultimately totals two to three times more than its face value of 4.5%. Combined with the state’s low Medicare reimbursement rate, that leaves private-practice doctors in Hawaii scraping by with very low margins.
Rantz said that between the high cost of living and the GET, it is very difficult for Hawaii doctors to maintain a viable practice.
“We actually just lost three providers here in East Hawaii on Hawaii island that are closing up their doors and moving to the mainland, because they can’t make the numbers work. They just can’t do it,” she said.
If policymakers are serious about improving healthcare access in our state, addressing the GET and low Medicare reimbursements are just the beginning. Other avenues to explore include reexamining licensing laws, exploring the potential of public-private partnerships, improving telehealth and, of course, repealing or reforming the state’s CON laws.
What we cannot afford to do, however, is stick our heads in the sand and hope the problem will go away. If we want to be prepared for future emergencies, we need bold changes to encourage and facilitate the provision of healthcare. ____________
Keli’i Akina is president of the Grassroot Institute of Hawaii.This commentary was his weekly “President’s Corner” column for Dec. 11, 2021. If you would like to have his columns emailed to you on a regular basis, please call 808-864-1776 or email info@grassrootinstitute.org.
If you’re in downtown Honolulu and you’re driving past Restaurant Row, you’re likely to see a sign on the makai side saying, “Foreign Trade Zone No. 9.”
In this country, a foreign trade zone (FTZ) is a geographical area, in (or adjacent to) a United States Port of Entry, where commercial merchandise, both domestic and foreign, receives the same Customs treatment as if it were outside the United States. The zones help American businesses to be competitive in the global economy by reducing tariff burdens on the importation of foreign inputs and on exported finished products. Businesses can set up shop in the zone for loading, unloading, handling, storing, manipulating, manufacturing, and exhibiting goods and for reshipping them by land, water or air. Merchandise of every description may be held in the zone without being subject to tariffs (customs duties) and other taxes based on the value of the goods. This tariff and tax relief is designed to lower the costs of U.S.-based operations engaged in international trade and thereby create and retain the employment and capital investment opportunities that result from those operations.
The FTZ in Honolulu was established in 1966 at Pier 39 in Honolulu Harbor. It has since grown to include 13 sites and 2,600 acres.
So, what’s the current problem with the FTZ? Of course, it has to be a tax problem. It involves Hawaii General Excise Tax, and the question is whether it applies in an FTZ.
State law, HRS section 212-8, already makes clear that merchandise that is admitted into the zone and that is sold for use or consumption out of state is exempt from GET, Use Tax, fuel tax, liquor tax, and tobacco tax. (Tax still applies if the merchandise is sold to someone in the state.) But there has been some confusion over whether other activity performed in the zone is subject to state tax. For example, a factory in the zone that manufactures products for export breaks down, and a technician comes in to fix the broken machinery. Is the technician’s fee subject to GET?
For a while, the Department of Taxation was telling folks that the answer is no. They thought that a FTZ was a “federal enclave,” where the laws of the states just don’t apply. Washington, DC is one example. It was carved out of Maryland and Virginia, and neither state’s law applies there. Other federal enclaves include some federal courthouses, military bases, federal buildings, and national forests and parks.
The Department, however, recently had an epiphany. Eureka! FTZ’s are not federal enclaves!
After realizing its mistake, the Department did what a typical tax agency does: it started telling people it wanted back taxes for all open years. For most businesses that filed returns, the statute of limitations is three years. If a business “substantially omitted” income by failing to declare it even though it was claimed exempt, the Department can go back six years. If a business didn’t file returns, thinking they didn’t have to, the Department can go back to the beginning of time.
The Department, one can easily imagine, was licking its chops at the thought of millions of additional revenues it could bring in. Potentially affected taxpayers, meanwhile, began losing sleep.
Do we think that this is the kind of issue where the Department should let bygones be bygones and just make sure that the rules are clear going forward? Or are we all okay with the Department saying, “Well, we screwed up in the past, but our mistake doesn’t matter because the duly enacted laws say you owe the tax”?
Maybe it’s time for the Legislature to step in and run interference between an obviously hungry Department of Taxation and the taxpaying public.
It’s no secret that adding a red dot optic to a handgun is a red-hot trend.
Over the last few years this has been catching on with polymer guns, such as the Glock MOS system, the Smith & Wesson M&P series and other manufacturers who are now configuring slides on a number models to accept optics.
Of course, adding optics to “old fashioned” handguns such as 1911s or wheel guns is nothing new. Bullseye shooters have been doing this for generations.
The difference is that putting an optic on a 1911 almost always entails outfitting them with a rail type mount. What’s new with this platform is that Caspian Arms, the venerable manufacturer of 1911 kits, now offers a optics-ready slide to accommodate a red dot. Providing a mounting platform, along with the appropriately tapped holes, allows the end-user to easily place a red dot directly on the slide.
My starting point with this project was the Rock Island Armory Pro Match Ultra 6″. Out of the box this is an extremely accurate, well-finished gun. I simply tweaked it, so that it would easily accept a red dot, and turned it into something more applicable to my own needs.
Caspian Arms, one of the most respected manufacturers of 1911 parts and accessories, is a small company and they don’t spend much on marketing. They don’t have to. They have a great reputation for their products, mostly frames and slides which are used almost exclusively for competition guns. I suspect a good number of the winners at Camp Perry use Caspian frames or slides. I own a 1911 built with a Caspian frame and it’s one of my most prized possessions.
The Caspian/C-More combination on the RIA 10mm will work for everything from home defense to pig hunting
When I learned about the new Caspian optic-ready slide option I knew that’s how I wanted to modify my RIA PRO Match Ultra. Essentially you tell the Caspian folks what optic you want mounted on your gun and they’ll machine a Caspian slide to match the footprint. This is not exactly a mass produced product but it’s faster and less expensive than having a gunsmith do a custom job.
I was introduced to this model at the 2016 SHOT Show in Vegas and was smitten. It was accurate, well finished and reasonably priced. RIA guns are manufactured in the Philippines which gives them a competitive edge in pricing. Just because the Phillipines is not traditionally thought of as gun manufacturing mecca don’t let that dissuade you from a purchase. RIA, aka Armscor, makes more 1911s than anyone else in the world and based on this model, I would not hesitate to recommend them.
Street price is about $950 which is a bargain, considering that you are getting a match grade 1911. The stock gun served as the perfect platform for this project.
You’re not going to be shooting Bullseye matches with a 10 mm handgun but it’s ideal for hunting and taking to the silhouette range. The 10 mm chambering, combined with the extra velocity afforded by the 6” barrel, makes it perfect to reach out and touch something at a long distance.
It’s a great little gun but with a red dot it becomes more functional by an order of magnitude. That was my rationale for adding this slide/optic combo.
C-More Systems is a family owned optics company that you may not hear about as much as the larger manufacturers but don’t let that put you off. They specialize in high end gear for race guns and have been doing so for years.
Founded in Manassas, Virginia in 1993, its primary products are red dot sights for M1911 pistols, Glock pistols, and AR-15s. Their sights come recommended by FN Herstal for the M249 SAW (light machine gun) and M240 machine gun. The company also manufactures the M26 Modular Accessory Shotgun System for the United States Armed Forces.
I really liked the lock-down feature which ensures that your windage and elevation adjustments stay put.
Quality is first class because it has to stand up to the pounding it’s inevitably going to get in a competitive or combat scenario. Hence many of C-More’s clientele tends to be Bullseye competitors. That said, it’s reasonably priced—much less than the expensive stuff from Europe or this country for that matter.
The C-MORE RTS2 series reflex sight is C-More’s newest product and is among their smaller reflex sights. It offers the shooter a parallax free design which means you can acquire a target without having to center the dot in the lens. The company uses a “beam-splitter lens” manufactured of hard coated glass to protect the product from scratches.
The housing is manufactured from aviation alloy and the electronics are designed to deal with hot loads from large caliber firearms. In short this system is perfect for an energetic round like the 10 mm. It offers 1 moa click adjustment for both windage and elevation. A 10 position, manually operated push button switch offers plenty of options for intensity adjustment and it will shut off automatically after eight hours of inactivity. A nice touch is that after setting your adjustments you can lock them down securely with a separate tweak using an Allen wrench.
One of the coolest features about the RTS2 is that you can replace the battery (a CR2032 lithium model) without dismounting the sight. That means you don’t have to re-zero it every time you replace it—which shouldn’t be that often. Very clever those Americans. What’s more, the battery compartment has an O-ring seal to keep it waterproof.
It’s a cool little optic that works splendidly for longer shots, which was exactly what I wanted.
Mounting the optic couldn’t have been more straight forward. The Caspian machine shop tapped the holes so all I had to do was to cinch down the RTS2 and apply a little Loctite.
Adding the slide assembly to the frame is pretty standard stuff if you own a 1911. However, the RIA model has a 20 lb recoil spring to contend with. Shall we say it’s a bit challenging to put back on.
I did need the services of a gunsmith to fit the barrel to the slide. The slide fit on the rails of the frame perfectly so nothing had to be done in that department.
I preferred Magpul grips over the stock RIA offering, which I felt were overly aggressive.
Magpul Grips
In addition to the slide assembly I added one more essential item to transform this gun into a much more user-friendly firearm–a set of Magpul MOE grip panels. Why do so? There’s nothing inherently wrong with the stock (VZ) grips on the RIA but like all things in life it’s a matter of preference. I thought they were too aggressive for my sensibilities and started to literally grate on me. I understand that control is an issue with a 10 mm handgun. However I found the Mapguls, which have diamond-shaped cross section to prevent twisting in the hand, offered both control and great ergonomics. They felt better in my hands and at $19.95, didn’t break the bank.
Working up a load
I reload and this resolves a couple of issues right off the bat. First off, store-bought 10 mm ammunition is expensive. Not only can you cut your ammo bill in half by rolling your own, but just as importantly you can manufacture cartridges precisely to your own requirements and often with more potential accuracy than a factory round. The challenge is of course coming up with an alchemical equation that takes into account the weight of your bullet, the length of your barrel, the make of your primer and a half a dozen other factors.
What I found really useful in the 10 mm space was to join the 10mm Firearms forum. As you’d expect, these are hard core enthusiasts who have done a lot of experimentation when it comes to reloading. They were incredibly helpful.
Finally, none other than famed shooter Jerry Miceluk was also a source of info. He likes heavier bullets for longer distance shooting which meant at least 180 gr. I wasn’t about to second guess him.
So what did I discover? First off a disclaimer. This was hardly a scientific endeavor but I did shoot hundreds of experimental rounds for this article. One of the primary lessons that I learned (and this most likely is not going to be an epiphany to hand loaders) is that hollow point bullets are the most accurate. However, at 25 yards and under, I didn’t see that much of a difference between the flat point and the hollow points.
The Montana Gold 10 mm 180 gr HP bullet was accurate at 100 yards.
At 50 yards plus jacketed hollow points (such as Montana Gold) also worked splendidly. Between the jacketed and the plated I would say the former were more accurate than the plated bullets at longer distances. I used both 165 and 180 grain bullets, jacketed and plated. I also opted to experiment with some locally cast 180 gr bullets from a true craftsman here in Hawaii.
That said, the results were pretty nuanced. That means a really competitive shooter will appreciate the difference between the jacketed and plated bullets. The average shooter, just plinking away, is not going to see much of a difference, if any between plated, jacketed and cast bullets.
Picking your powder
My selection of powder was not entirely scientific.
I have a quantity of Accurate Arms (aka AA) powder from Western Powders on hand so I used it for my experimentation. I’ve used this brand for years with 357 and .41 magnum loads with stellar results. The very same powders that excel in the magnum space, AA #7 and AA #9, are excellent for the 10 mm which is essentially a magnum round. (For good measure, I also tried AA#5 which also worked well).
What I liked about AA #7 and AA#5 is that you don’t have to max out on the load to get good efficiency. AA #9 on the other hand usually (but not always as I found out) needs to be loaded on the heavier side. Thus you can get away with less than a full-on load with AA#5 and #7 and get some very impressive results.
Why does this matter?
My bias, perhaps from shooting Bullseye guns for years, is come up with a load that is the most accurate with the least recoil. A full house load has it’s place but too much recoil too much of the time is a drag. Not only is it going to put more stress on you, but on your firearm as well.
My go-to powder for the Caspian/RIA 10mm was AA No. 9 for 180 gn bullets.
With this in mind, I managed to come up with a couple of balanced loads for this gun which worked exceptionally well:
I found that 12.5 gr of Accurate #9 over a 180 gr (plated) bullet from a plated or jacketed bullet such as Montana Gold hollow point was particularly effective. This load also worked well for the Rainier 180 gr FP (a bullet with a flat point that resembles a truncated cone).
For a 165 gr jacketed or plated bullet (either hollow point or FP) 11-11.5 gr of Accurate #7 worked great. 8 gr of AA#5 also worked wonders for the 165 gr plated bullet.
If you’re shooting a cast 180 gr bullet, a light but very accurate load was 8 gr of AA #7.
The recipes for all of the AA powders on this round usually fills at least half of the volume of the cartridge. That’s a good thing because if you accidentally double-charge, the powder will spill thus tipping you off.
Picking the right load for a plated bullet
There is one important issue to consider when loading for the 10 mm or similar magnum style round. Donny Shride, former owner of Rainer Ballistics, suggests that you use the recipes for jacketed bullets of the same weight and style. Thus if the recipe calls for 165 gr hollow point, jacketed bullet, that same recipe can be used for a plated 165 grain hollow point.
However there is an important caveat.
Shride stresses that you should only load plated bullets to a “mid range” level. Thus, if the reloading guide says use 10 to 13 grains of powder for the particular load, you shouldn’t go higher than 11.5 grains. The base of plated bullets (unlike jacketed) tend to deform more easily under high pressure loads so it’s not a good idea to push them too much.
Western Powders publishes a very useful reloading guide and there’s no shortage of “pet loads” on forums. Of course you have to be a bit careful about using data off the internet. Naturally the standard reloading guides from Speer, Lyman and others also have data.
A tack driver at 25 yards. Montana Gold 165 gr bullet.
Shooting the gun
The RIA/Caspian hybrid was wickedly accurate. At 25 yards it wasn’t much of a chore to get a decent group. At 50 yards, it’s going to take a bit more work, as you’d expect. Within a few minutes of getting the sight zeroed in, I got some pretty good groupings that I’m sure would be even better with a few more outings.
I was also able to accomplish a personal goal with this setup–to whack an 8″ diameter gong at just over 100 yards.
For those not familiar with the 10 mm, it’s not a handgun for the fainthearted. You’re going to get a good dose of recoil commensurate with magnum-like character of the round. Of course recoil can be tweaked with your loads. If you don’t like the heavier loads, 8 gr of AA#5 was a sweet load for a 165 gr plated bullet.
Other Tweaks
The only other modification I made was lightening up the trigger perhaps by half a pound. The stock trigger is excellent but I wanted it modified to my own specs. At the time of publication I’m also experimenting a bit with the recoil spring. The stock spring is 20 lbs. With the heavier Caspian slide to move I put in a lighter spring and so far that seems to help the gun to cycle. Of course, it still needs to be broken in so we’ll see how this plays out. Ordinarily I don’t think it’s a good idea to second guess the factory settings but in this case I did–at least for the time being.
Conclusion
Let’s begin with the optics. The C-More worked splendidly.
The use of a red dot, particularly for longer shots, was exactly what I wanted. The red dot is a crisp little orb and 6 MOA functioned perfectly for my needs. The C-More RTS2 retails for $418.49 on Amazon.
There are several advantages going with a custom slide/optic combination. First off there’s no rail to contend with. All you do is mount the optic on the slide by screwing it on. It sits lower and is aesthetically more pleasing and cleaner than a rail. There’s nothing between the optic and the slide.
To fit the barrel, material had to be removed from the slide in several areas including the edge of the dust cover.
The disadvantage is that you can’t change your brand of reflex sight unless it has the exact same footprint as the original optic. It’s also going to be a bit more expensive adding the whole assembly rather than a rail.
Price for the Caspian Long Slide (which I needed for the RIA gun) is $302 with an additional $61 to machine the rear sight cut. The serrated round top option for the slide is $38. Caspian will be able to machine a cut for any slide. However, in some cases Caspian may want you to send your optic to them to make certain they have the correct dimensions in order to do the work. Your best bet is peruse their catalog and determine what part you want.
One more caveat. Note as alluded to earlier, you may have to spend a few more bucks to get your Caspian slide fitted with the barrel. This necessitated some removal of metal from the slide in several areas with a dremel. It wasn’t major surgery but you want to leave this to the pros. In my case it was the deft hand of my gunsmith, “Bobot” Duquez, a superb Hawaii gunsmith.
The entire upgrade endeavor will set you back about $1000, including gunsmithing. However, considering the price of a decent accurized 1911 without optics will run at least $2000, this is a bargain.
If you’re a 1911 owner and you want to add a red dot, the Caspian “Optics-ready Option”, in combination with a quality sight such as the C-More RTS2, is an upgrade worthy of consideration.
The South Pacific Island nation closed its borders to international tourists in March 2020, and remained closed for nearly two years, reopening on 1 December 2021. During this period, all of us have had the opportunity to do some introspection. With a biblical plague at our doorstep we’ve had a chance to assess what’s really important in our lives. That’s’ where “Experience a Different Fiji”, the Savusavu Tourism Association’s new campaign, fits in.
Both Delia Rothnie Jones, who serves as Chairperson of the association, and her colleague Monica Laurence, a former Hollywood entertainment and Silicon Valley executive, reckon that it’s time to get back to basics. As Savusavu resort owners, Delia and Monica are in an ideal position to introduce visitors to the area’s natural wonders and connect them with local people.
I think they are on the right track and I believe you’ll enjoy hearing what they have to say.
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Rob: Now that tourism is opening, what protocols must be followed to get to Fiji and then, Savusavu?
Monica: Visitors over 18 must be vaccinated and test negative 3 days before flying. On arrival they must spend the first 3 days in a CFC (Care Fiji Commitment) accommodation, and have a Rapid Antigen test within 48 hours of arrival. Whilst in Fiji they are asked to download the Care Fiji app for contact tracing, and are further asked to avoid any areas that have low rates of vaccination – there are very few of these but some villages have resisted the vaccination. But generally visitors will be free to move around and enjoy the hospitality of a nation that has over 90% of the over 18 population vaccinated.
Getting to know Fiji: Bringing produce from the village to town. Bus station, downtown Savusavu
Rob: How did Savusavu businesses and restaurants weather the Covid tourism downturn? What about the vaccination process?
Delia: Fiji closed its borders to international tourists in March 2020, and remained closed for nearly 2 years, reopening this week, on 1 December 2021. With borders closed, there were two phases of Covid in Fiji. For the first year, there was no Covid in the community and Tourism Fiji was active in promoting Love Our Locals packages offering stays and activities at excellent prices. Savusavu ran a successful marketing campaign encouraging locals to “Come Overseas to Savusavu”. During this period the luxury resorts closed down, but the others stayed open with reduced staff hours, and managed to weather the downturn. The activity providers were harder hit although none of them have closed.
In the second phase the Delta strain entered Fiji via repatriation flights, and quickly spread through the community. This phase has been much tougher – inter-island travel was halted and there has been a significant downturn of business. To rebound, we focused our efforts on supporting the local health and welfare of citizens, while laying the groundwork for a global re-opening.
The Savusavu Tourism Association has been active in supporting the vaccination drive in our province. The Association teamed with local businesses to raise funds and organize transport and drivers for the hospital medical teams to get out to the remote areas.
Meeting local people is part of the Savusavu experience. Here locals get together to perform a meke, a traditional Fijian art form.
Here are some more figures behind the efforts of the last 4 months:
94 and 82.8: as of November 19, 94% of Cakaudrove’s population has received its first dose of the vaccination, and 82.8% has received its second dose. (Cakaudrove is the province in which Savusavu is located.)
20+: We have called on the services of over 20 individual drivers: Kiriata, Sarvan, Adi, Ally, Jay, Vijay, Soko, Deb, Delia, Tukai, Leanne, Suresh, Abed, Matthew, Nathan, Aundre, Paul, Ritesh, Sanjesh, Ledua….and very probably others who stood in when called upon.
15,000: One of those drivers, Kiriata, has been on full time duty throughout, and has covered over 15,000 kilometres in his vehicle.
113: The drive started on July 2 and finished last Sunday November 14: approximately 113 days (we didn’t go out on Saturdays but we did go out on many Sundays).
3,000: We used approximately 3,000 litres of fuel – the exact amount is impossible to calculate as some drivers donated their fuel, but we had roughly 2,400 from Total (paid for), a further 300 litres donated by Total, special contributions of 70 litres from Savusavu Hardware, and a fantastic weekly allowance of 200 litres from RPA.
Wasawasa Lodge, Inn, & Conference Center is a brand new property.
Rob: Anything new in town? Properties, eateries, cafes, new construction, etc.
Delia: Wasawasa Lodge and Restaurant has opened; it’s on the estate belonging to Namale but runs separately. It offers great accommodation and a restaurant with a beautiful view of the ocean, an ideal place for a meal just out of town.
Pettine Simpson at Vaga Gardens has turned her immense cooking skills to a pie business: once a week she delivers her chicken and beef pies to her customers all around Savusavu.
Ethan’s Coffee Heaven: a new coffee shop and restaurant.
Construction continues on Nawi Island; I don’t really have details but it’s all going ahead.
Rob: What’s happening with the creative/artistic community on Vanua Levu?
Monica: Only today (December 1) a pop-up market shop has opened.
A pop up art fair is now regular event in Savusavu.
The shop will be carrying items from a number of local artists: Lynne McLaren, Mayvian Popese Smith, Iretta Micskey, Asenaca Luisa, Katrina Brown, Anaseini Laweibau and Maria Simpson, and covers a range of media: acrylic paintings, fabrics, hand crafted jewellery, locally made villagers’ handicrafts, Katrina Brown’s beautiful mosaics and Lynne McLaren’s signature pieces of hand-crafted concrete.
Lynne is the driving force behind the project. “There are a number of us in Savusavu who sell our work on Saturdays, and we’ve been looking at ways to establish a more permanent display. This is a first step towards that: it’s a pop-up market for the month, using space generously provided to us by the non-profit organisation Love In Action (Fiji), and it will give us the chance to see what the market will bear in Savusavu.”
Lynne has also been travelling out to some of the farther flung villages of the district, encouraging the women to bring her their creations. “It’s not as easy as you might expect,” she says. “Many women in the villages have considerable responsibilities within the village and finding time to make mats or baskets or masi cloth for a market that is a long way from home is daunting for them. We’re trying to show them a path to economic opportunities but it will take time.”
Meanwhile, the artists of Savusavu will be bringing their items in and the shop opens on Wednesday December 1. It will be open from Tuesday to Saturdays from 9.30 – 2.30 each day, and could be the perfect place for you to find a rather special Christmas gift.
Monica: As we found ourselves without the option option to welcome international guests, wethought it the perfect time to tackle some projects and further enhance our guest experience.
Here’s what we did:
created an organic herb and veggie garden, including fresh tomatoes, green onions, mint, eggplant, cucumbers, lemongrass.
got creative in the kitchen and styled our menus, adding more dishes inspired by international chef Yotam Ottolenghi and a bit of playfulness like the morning “Pop-mosa”, a spin on the mimosa, but with an icy popsicle dunked in champagne.
upgraded our pizza oven and perfected thin crust pizzas inspired by a trip to Rome.
lovingly refinished the hardwoods and decks in the villa, stripping, sanding and returning the natural and gorgeous luster.
refurbished our fiberglass long boat, so it’s sparkling and ready for fishing and snorkeling excursions with guests.
teamed with a local conservation initiative to plant coral nurseries, making this unique underwater experience available to our guests.
explored the island of Vanua Levu, discovering new waterfalls and adventures to share with our guests.
became certified with the Care Fiji Commitment so we can welcome international guests.
Vista of Savusavu Bay from Tavola is stunning.
At the outset of the pandemic, we packed meals and delivered them to local families, along with notes of hope and encouragement. We feel most fortunate to live in our tight-knit and supportive community. This is a place of resilient and good-hearted people.
Rob: How did you end up in Savusavu and come to acquire Tavola?
Monica: I had the good fortune to be inspired and mentored by my uncle Richard Evanson. He was a maverick and eco-visionary who pioneered tourism in Fiji in 1980 and created the sustainable, 5-star, luxury private island resort Turtle Island. I spent a lot of time with my uncle, both learning and laughing, and over the years I came to think of Fiji as my soul’s home. Fiji is a natural and wild place where I feel free, creative and simply happy.
Accommodations at Tavola are both luxurious and minimalist.
I find those qualities allow me to be my best in life and in all my entrepreneurial endeavors. I wanted to share this special place with other creative visionaries, giving them a place to come home, rejuvenate and connect with what is true and meaningful in life. To power down in order to power up.
In all of Fiji, I chose the island of Vanua Levu for my quest as it is remote and still natural. Savusavu is called “the hidden paradise”, and that it truly is. We are less populated than the busy tourism destinations of Denarau, Mamanucas and Yasawas. We move with the rhythm of nature. We slow down. We chat. We laugh. We are present to the moment. So, I searched all of Vanua Levu before discovering Tavola Villa, an exquisitely designed, boutique resort stunningly situated on 8 private, waterfront acres overlooking Savusavu Bay. It felt like home, and that is exactly how I want my guests to feel.
Daku’s property is just steps away from Savusavu Bay.
Delia: We have remained open throughout the pandemic. In 2020 we welcomed many visitors from Suva, Nadi and other parts of the main island, and hosted a number of conferences with government agencies and NGOs and local groups. We are a fully CFC certified property and have now started to welcome back our first international guests.
We drew on our experience of running workshops to do a series of our own workshops and retreats. We brought over yoga teachers from the main island and held some successful 5 days retreats. Liti Miller, Fiji’s pre-eminent Zumba teacher, ran some high energy sessions which left us all breathless and happy.
We also offered a couple of wonderful one-day workshops to the local community: Angie Rakai-Niumataiwalu taught a day of fabric art, and Katrina Brown taught a mosaic workshop. Not only were these fun, and provided an income to the artists, but they also gave new skills to some of the women attending.
Shane Bower, a local sculptor, is a shining star of the Savusavu art community, which is supported by Daku.
Most did it as a hobby but a few have used it as a new source of income, and Angie in particular was so encouraged by its success that she spent the next 3 months running sold-out workshops across Fiji.
Our support for the local artists’ community has continued: last October (2020) we had an exhibition of local artists’ work which brought together a lot of the local community. Since then we’ve been involved with talking to various national arts’ bodies about an event for the North, although the clamp down on inter island travel has put that on hold.
Within the resort, we have re-furbished most of the accommodation and upgraded the central area which has the restaurant, lounge and swimming pool. We have also built a new two-bedroomed house on the estate which is for sale to anyone who falls in love with Savusavu – as so many do!
Rob: How did you end up in Savusavu and come to acquire Daku?
Yoga is a big deal at Daku.
Delia:I first came to Fiji as a tourist in 1988. I was driving across Vanua Levu with my husband in a hired car, and we came to a crossroads: straight on to Labasa or turn right to Savusavu? On little more than a whim, we turned right – and Savusavu has been part of our life ever since.
We stayed at Daku Resort which had only just opened – we were some of its first guests. In those days it was owned by the Anglican church. We loved it – and the following year we came back. It was then that the manager suggested we build a house on the property and gift it to the resort, but would have annual use of it for the rest of our lives. That house, built for US$14,000, still stands. We fell into a happy pattern of bringing the kids over for school holidays until 2004, when the property came up for sale. Concerned that we’d lose our house, we bought it! And that’s how we fell into the tourism business.
Since then, we have expanded the property, building new bures, improving the old ones, and adding villas with private pools.
Daku has a variety of accommodation including the above Beach House.
Rob: Do the two of you have anything else to add?
Delia & Monica: The Savusavu Tourism Association has been active in its marketing efforts and during 2021 has developed a campaign “Experience a Different Fiji”. As international travel resumes, we realize that many travelers will be looking for a way to enjoy nature and connect with the people of the country, seeing what makes them tick and embracing a different experience. It’s not the “Fly and flop” holiday that Fiji does so well; it’s a market seeking something more. We are ideally placed to offer that with our stunning scenery, soaring mountains, pristine reefs, vibrant village culture and inimitable friendliness. When we encourage people to experience a different Fiji, we’re encouraging them to step out of the easy packages and come to a place where they will connect with all those experiences that make it a deep, rewarding and resonating vacation that lives with you for years to come.
The Savusavu area is chock full of wonderful things to experience.
One other area worth mentioning:OceanVentures Fiji in Natewa Bay have a coral conservation project. They have established 10 rope nurseries on 5 reefs; 3 – 4,000 corals have been planted; the community engagement aspect of the project is a work in progress with varying levels of community participation.
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Delia Rothnie-Jones spent her twenties in London in advertising, her thirties and forties exploring the world with her husband (they covered over 80 countries) and bringing up her kids, and since then has tumbled into tourism. It was never a plan but has yielded fascination and fun. Daku Resorthas gone from being a tiny 8 room property to a thriving mid-range resort with 35 rooms. Delia has also developed Paradise Courses, vacations offering week-long art, writing and singing courses and yoga retreats, and occasional three week yoga teacher training courses.
Delia Rothnie-Jones
Monica Laurence is a serial entrepreneur and conscious explorer with a passion for life. After decades as a leader in global enterprises, Hollywood entertainment and Silicon Valley technology startups, Monica launched into hospitality withTavola Fiji, her luxe private villa and inspiring venue for creativity retreats. As well, Monica is the creator of Quantum Surfing, a community and creation method that teaches purpose-driven entrepreneurs to combine neuroscience, applied enlightenment and quantum mechanics to predictably create lucky outcomes and accelerate venture impact.
Monica Laurence
Getting there:Fiji Airways, the national carrier, has re-established weekly, direct service from Honolulu to Nadi.
Several times in this space, we have discussed the Governor’s emergency powers. Our laws (chapter 127A, HRS) give the Governor broad powers to deal with emergencies.
One of those powers is to: “Suspend any law that impedes or tends to impede or be detrimental to the expeditious and efficient execution of, or to conflict with, emergency functions, ….”
But a “state of emergency,” which causes the Governor’s powers to kick in, is supposed to terminate automatically after sixty days.
Our Governor has gotten around this limitation by proclaiming a continued emergency just before the sixty-day clock runs out, thereby restarting the sixty-day clock. Most of us have lost count of the number of emergency proclamations. The “Twenty-First Proclamation Related to the COVID-19 Emergency” was posted on June 7, 2021; the suspension of laws in that proclamation was continued by the “Emergency Proclamation Related to the State’s COVID-19 Delta Response,” posted on October 1, 2021. Apparently, some folks were not comfortable that the proclamation number had gotten as high as 21, so they changed the title to restart the count. But make no mistake; we have been under chained emergency proclamations since the “Proclamation Related to the COVID-19 Emergency” on March 5, 2020. It’s been an emergency for 21 months and counting.
The recent discovery of a new and dangerous Omicron variant of the virus in South Africa isn’t going to help matters. We can expect the state of emergency to continue for a while longer.
Legislators, understandably, are getting perturbed that they are being left out, and will be introducing measures to give the Legislature a veto power over all or a part of an emergency proclamation.
The Governor, on the other hand, says that Hawaii is doing better than most states because of the emergency powers he has wielded. “I would say this: Virtually every single state that tied the governor’s hands has regretted it,” Ige is quoted as saying.
State law (section 127A-27, HRS) already gives the judiciary the power to review emergency proclamations in an expedited manner. But to get the judiciary involved normally requires a person bringing the suit that has been injured in some manner by the proclamation..
Some of the earlier proclamations in the COVID series, as we have written about before, were questionable in that they suspended entire chapters of the Hawaii Revised Statutes, such as the Sunshine Law, Uniform Information Practices Act, or the Collective Bargaining Law, where the emergency only seemed to require nudging some of the laws rather than wiping them out entirely. Fortunately, many of those wholesale suspensions have been lifted. One of the suspensions simply shut off the flow of transient accommodations tax revenue to the counties altogether, and legitimately raised the question of whether the suspension was more harmful than helpful – after all, the local governments are supposed to be better poised to deliver emergency services, and they have the traditional first responders (police, fire, ambulance).
For these reasons, we welcome the efforts by the Legislature to bring some reason and sanity back into the process of governing. “No man is an island,” wrote John Donne. This includes when the man is the Governor of Hawaii.
President Barack Obama regularly referred to his home state of Hawaii as a big, harmonious community, where he was born and spent his boyhood and adolescence. In fact, his Hawaiian background is, in many ways, a key to understanding who he really is.
There are other important parts of Obama’s past that also provide insight into his values and his modus operandi, but Obama says the “aloha spirit” remains his personal and political inspiration. He stated that “I do think that the multicultural nature of Hawaii helped teach me how to appreciate and navigate different cultures out of necessity.
Obama’s friends and associates say his upbringing in Hawaii is much closer to the experience of everyday, middle-class Americans. Even though he stood out, Obama seemed to fit in happily with his peers. Teachers and friends from that era say he was affable and good-natured and never showed the inner turmoil that he wrote about in his memoir, ‘Dreams from My Father’.
He was born in Hawaii on Aug. 4, 1961, to a Kenyan father, Barack Hussein Obama, for whom he was named, and Dunham, a Caucasian woman from Kansas. They met while students at the University of Hawaii. The couple eventually divorced, and his mother remarried. The family moved to Jakarta for a while, then they moved back to Hawaii with Barack and his half-sister.
Museum Director Deloris Guttman discuss the mission of the institution to honor the birthplace of the 44th U.S. President and 200+ years of Africana history in Hawaii
IN THIS INSIDER EXCLUSIVE NETWORK TV SPECIAL, “Obama Hawaiian Africana Museum” our News team is on location in Honolulu meeting with, Deloris Guttman, the Museum Director, and her colleagues who will share its history, its purpose, and how you can help them achieve their goals.
Their mission is teaching Hawaii schoolchildren in pre-K to 12th grade about diversity and the history of people of African descent in Hawaii, and to establish a permanent home for their museum.
Deloris served on the committee that in 2014 submitted a proposal for a Barack Obama presidential library in Honolulu, and is now seeking a permanent home for her nonprofit museum, originally founded as the African American Diversity Cultural Center Hawaii in 1997. For a possible permanent site, they are looking at places where Obama lived.
Please contact Deloris Guttman, the Museum Director, at the Obama Hawaiian Africana Museum: 1-808-597-1341 https://kanuhawaii.galaxydigital.com/agency/detail/?agency_id=121273
Once upon a time there were some property developers on Oahu.
They thought that agricultural development would be a good thing. There were lots of tax incentives associated with agricultural development.
Then they got the idea that putting some solar panels on the land would be a good thing too. There were lots of tax incentives associated with renewable energy.
So, they put some solar panels on the agricultural land too.
We have agriculture. And we have renewable energy. Are these two great tastes that taste great together?
Come on. Let’s be real. We’re talking about property tax, not a peanut butter cup. It turned out to be a recipe for disaster.
Clearway Energy Group, for example, submitted testimony to the Honolulu City Council of their plight. These folks built two solar projects on agricultural land, and, they said, incorporate compatible agriculture into their ongoing operations. Solar energy generation is an allowable use on agricultural zoned land under the city’s Land Use Ordinance, they argued.
But the real property tax folks saw the situation a little differently.
To get the special ultra-low property tax rate for agricultural use, the landowner had to make a “dedication agreement” with the tax authorities. Basically, the landowner promised to use the property for agriculture for a certain period of time. The tax folks saw solar panels on the properties and said, “Uhm, that’s not agriculture.” So, they took away the ultra-low tax rate, and, while they were at it, they took away the property’s agricultural classification. It’s industrial property, they said, which happens to be taxed at a rate more than double the agricultural rate even without any dedications.
At the end of the day, Clearway had a real property tax bill of $30,154 for the 2020-21 tax year (they go with a fiscal year ending June 30), but for the 2021-22 tax year the bill jumped to an eye-popping $835,710.
Clearway’s tale of woe attracted a lot of attention, so much that the Council is now considering Bill 39, which is supposed to address this problem, and state agencies aplenty, including the Governor, the State Energy Office, and DBEDT, have weighed in.
One of the reasons behind this kerfuffle is that this is not just Clearway’s problem. Any solar project that is located on agricultural land is subject to this kind of reclassification, and the financial impact would vary depending on how much solar went on the land and how much of the land was previously subject to the ultra-low rates for land dedicated to agriculture.
And then, of course, there is the issue of who is going to pay the enhanced tax if the real property tax folks’ methodology is upheld. Clearway and the other power producers have long-term agreements with power buyers such as Hawaiian Electric. If this enhanced charge becomes Hawaiian Electric’s problem, it then becomes a problem for all of us who pay electric bills. If the enhanced charge impacts the developers, it will send shock waves through the industry of people who finance renewable energy projects because of the risk of a property developer getting overwhelmed by this tax surprise and thereby going into default on its financing.
What a mess!
Ultimately, the City might legislate itself out of this situation, making some allowances for solar and agriculture peanut butter cups. But for the rest of us the moral of the story is that two great tax-favored tastes won’t always taste great together, and one must be extremely careful when mix-matching tax incentives.
I recently had a chance to connect with my old friend Roberta Davis, who has spent the last two years at her B&B-style property called Makaira on the Garden Island of Taveuni. Located in the north of the Fiji Archipelago, it’s far from civilization and remains unspoiled. The Honolulu-born Davis and her husband, John Llanes, a Hawaii Island native, enjoy life in Fiji which they liken to Hawaii generations ago. The property consists of four bures (cottages) perched on four acres of a hillside, once the site of an ancient village. Located a few miles from an old dirt airstrip, the resort on Taveuni is a 45 minute prop flight from the international airport in Nadi. In this interview Roberta shares her experiences of the last two years and happily offers news of Fiji’s reopening in December.
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1. Now that tourism is opening up in Fiji, how do I go about visiting Makaira? What are the protocols that must be followed to get to Taveuni?
The New Normal is here. Of course regulations will change as time goes by. Right now guests must have a PCR test within 72 hours of departure to Fiji. Travel Insurance is mandatory or you can’t board your flight. Arrivals must stay for the first 3 days in an Certified Fiji Care (CFC) facility. During those initial 3 days they can go anywhere within the CFC corridor like diving, fishing, snorkeling and CFC stores.
After 48 hours they are required to take a “rapid test” at the resort. They can bring their own test or purchase one at the resort.
They must have a staff member witness or administer the test and view the results. If guests test negative they can go where they please on day 3 but will be advised to avoid low vax areas as some resorts might not let them come back in.
Roberta Davis, owner of Makaira
If a guest tests positive some of the larger hotels on Viti Levu have reserved quarantine rooms. On the outer islands, with the smaller boutique resorts, no one will want to accommodate a guest who has tested positive at another resort. (So far there are no quarantine rooms designated on Taveuni).
Those who test positive will need to quarantine in their room. Incoming guests will need to find other accommodations, hence the need for travel insurance as the quarantine is 10 days. If some members of the group or family test positive and others test negative, the negative ones have a choice to return home or spend 10 days in quarantine with the ones that tested positive and hope they don’t contract Covid during that period.
Restoration of the reefs by replanting coral is practiced at Makaira by guests and management.
During their stay the same public protocols are in place of mask wearing, social distancing and hand sanitizing and avoid low vax areas. Every conceivable precaution has been taken to insure everyone’s health and safety. There is not more that can be cone short of everyone becoming bubble people.
2. How has Taveuni handled the pandemic and the vaccination process?
Fiji should be commended on how they have handled the vaccination process. I don’t think any place in the world has done better. By December 1st 97% of the target population, 18 and over will be double vaccinated mostly with AstraZeneca. Right now 90% are double jabbed. Although we might get a handful of cases a day, there have been no deaths for a while.
The bures at Makaira are spacious and offer privacy.
They are working on teenagers right now so they can open up the secondary schools. 16-18 year old are mainly vaccinated and back in class. Now they are working on the 12-18 year olds, the policy is no jab no job, no school, no church, no travel. That just about hits everyone on one level or the other. Here are a couple of the aside funny stories. We got the first load of vax’s in April this was before the no jab no job mandate.
Some of my staff was reluctant to take it but I had to tell them as much as I care about them, “no jab no job”. This is for their own and the guests safety. So I dragged them to the hospital. Some tried to hide in the hallway but I corralled them up. My Karma was I could have written the brochure on the side effects of the shot. Luckily Rosie, who runs the restaurant, got the last dose that they had.
Views from the property are stellar.
When the death toll started to rise and we were all ahead of the vax game they were so happy to be part of the few percent that was double jabbed. One woman wanted to go to church and you have to show your vax card which she didn’t have went to the hospital and told the nurse since she needed both jabs to give her one in her right arm and one in her left. She was told it doesn’t quite work that way and everyone had a good giggle at her expense.
3.How has Taveuni weathered the economic downturn? Have businesses and restaurants survived?
Taveuni is an interesting place and everyone here is resilient. But this had to be the toughest economic time ever. We had the cyclone before Christmas so there went all the bush food and farms. Then in January was the international lock down that has been for two years. Resorts had to lay the majority of their staff, this meant the locals had no money to buy food and no foods growing in the wild. I kept all of my staff on a part-time basis so they would have enough money to buy the basics and they all live in the staff quarters.
Isoa and Rosie run Rosie’s Sea View Dining, the restaurant on the property.
Since I am on my own and have a huge area for a veggie garden, we shared out sections to each staff member and myself as a victory garden. Finding seeds was nearly impossible. Luckily I had a stash of some seeds and we have a lot of second generation veggies from the first batch. Not ideal but okay, it is something. But it was in fits and starts because we had to wait for the first harvest to start all over again for the second batch to grow.
Only in the last couple of months has the island started to get papayas and bananas and watermelon. During that lean time all we were lacking were blood sucking zombies to add to the scene to make it a trifecta. For me it has been one heck of a diet plan haha. But really not fun juggling the finances to keep everyone going and surviving. There was no way I could completely lay off my staff in good conscience their loyalty deserves my loyalty.
They don’t call it Sea View Dining for nothing.
4. Anything you’d like to share about yourself and what you may have learned during this period?
Sure. One of the nice things since we were isolated Covid never really hit Taveuni thanks to the diligence of our Health inspector who did a great job. BUT we were completely isolated and had to rely on ourselves and the island. Luckily supply ships were still allowed in without passengers. We NEVER had a toilet paper shortage, people were more worried about where their next meal was coming from rather than the luxury of stocking up on toilet paper or anything for that matter. None of us could afford it and there were no stimulus checks either. You are on your own.
The rooms are comfortable and cozy.
Citizens who live in countries of abundance have no idea how lucky they are where the government will support them and if no one got greedy they would never run out of toilet paper.
One of the things I learned while looking after the Makaira family and myself is how little anyone needs to survive. A lot of people in civilization waste a lot and some are self-entitled. What really floors me is the percentage of anti-vaxxers and how gullible they are. According to them we should have all been dead by now from having taken the vax.
Big Island native and Roberta’s significant other, John Llanes, doubles as a charter boat captain, at home in Taveuni.
Another nice thing is we had no communicable diseases on the island like colds, flus, pink eye etc. I would guess that during this two year period our immune systems had a chance to revitalize. That is a good thing since guests bring in all kinds of little contagious bugs.
5. Anything new with Makaira?
Captain John Llanes, who runs the charters, should be starting his operation by the first of Feb. He needs to do some things to get the boat back in the water. Hopefully sometime during the first quarter or so we can finally take delivery of the 24’ center console boat for up to 2 anglers that are more budget minded.
6. Anything else you’d like to add?
We can hardly wait to welcome guests back to Makaira and Fiji. I hope they are patient because after two years we might be a bit rusty as we dust off our businesses. This is why we aren’t opening until Jan 2 so we can get everything as near perfect as possible and see how the New Normal goes, hopefully without a hitch.
For more information visit Makaira online email Roberta at makaira@connect.com.fj.
You might not know this, but our tax workers enjoy all kinds of special privileges.
Suppose, for example, a tax auditor told all your customers you were a tax cheat, rifled through your garbage, asked embarrassing questions of your friends and maybe some enemies, and even called you a “lazy Hawaiian.” Could you haul the auditor’s tushie into court to be vigorously sued?
Apparently, the answer is no. Hawaii Revised Statutes section 662‑15(2) says that state actors are immune from liability for “[a]ny claim arising in respect of the assessment or collection of any tax.”
In more recent years, the Hawaii Supreme Court has been giving the tax office even more help and protection.
In a case called Medical Underwriters of California, 115 Haw. 180, 166 P.3d 353 (2007), a taxpayer associated with an insurance company was assessed 4% general excise tax, while the taxpayer contended that it was an insurance company and should be taxed under the special 0.15% rate that applies to an insurance solicitor or agent. The taxpayer argued strenuously that it was licensed by the Department of Commerce and Consumer Affairs as an insurance company, so that the Department of Taxation should not be able to classify the company as something else. Our supreme court rejected the argument, saying that the doctrine of equitable estoppel, which the taxpayer was trying to use, “may not be used in such a way as to hinder the state in the exercise of its sovereign power.” The power to tax is a sovereign power; therefore, taxpayer loses.
In the 2019 decision Priceline.com, Inc. v. Director of Taxation, the court was faced with assessments against online travel companies for allegedly underpaid general excise tax for facilitating car rentals. The companies noted that they already had endured punishing litigation over general excise tax for the same periods for facilitating hotel stays, and that litigation was resolved by final judgments already entered in the tax appeal court. The court reasoned “that the actions of a specific government official may not deprive the State of Hawai‘i of its sovereign power to collect the taxes it is legally due,” and held that the termination of the hotel stay litigation did not preclude the car rental litigation, even though it was for the same tax and the same years.
That language is broad, perhaps several degrees broader than it needs to be. It remains to be seen how far the Department of Taxation will push this get-out-of-jail-free card, and whether the courts will allow it to do so. If, for example, the Department makes a deal with a taxpayer, such as allowing the taxpayer to settle five years of back taxes by paying four of them in full and skipping the fifth, is the Department going to be able to come back a few years later and say that they didn’t like the deal and the taxpayer needs to cough up the money for the fifth year too?
We don’t think that any agency should be allowed that much latitude. There is a fundamental difference between saying that the government can be spared from acts of a well-meaning employee having unintentional or inadvertent consequences, and saying that the government can get a do-over on decisions it makes purposefully and intentionally. Yes, the government needs revenue and it relies on the Department of Taxation to collect it, but it needs to remember that the Department needs to do so fairly and not tyrannically. Government is supposed to wield only as much power as the people give to it, and needs to respect where that power came from.
Gracing hotels, resorts and high rises around Waikiki and throughout the Aloha State, there’s nothing more iconic than the coconut palm.
However, when the corona-virus pandemic forced hotels and the tourism industry to shut down, it threw into stark relief the coconut palm’s importance not as an ornament for tourists but as a source of food and sustenance for Hawai’i’s residents.
In any Polynesian diet, it’s a staple.
Thus for islanders, that swaying palm is more than just some South Seas motif. There’s a cultural and even spiritual element to this tree which for For Polynesians, is the tree of life.
This awareness is seen through the eyes of Vili Hereniko, a Pacific Islander from Rotuma, a Polynesian outlier in the Fiji Archipelago. Vili is also a Honolulu-based filmmaker and Professor at the Academy for Creative Media at the University of Hawai’i.
Given the litigious society that is America, it’s understandable that hoteliers don’t want coconuts falling on the heads of visitors. However, this is a virtually non existent problem in island cultures. People know it’s not a great idea to spend a lot of time under fully laden coconut trees. They are taught this from a young age. It’s called common sense.
Thus, one doesn’t generally see mature coconuts still on the trees.
However, Vili noted, that changed during the Covid shutdown.
Seeing them in their proper place struck a nerve with Vili who became an activist, arguing for the return of a thriving niu culture in Hawai’i.
He became involved with NIU NOW! whose goal is to reclaim the sustaining properties of NIU for Hawaii’s residents and to prepare for the future.
His little video goes a long way in understanding the Polynesian point of view when it comes to the plight of the coconut tree in Hawaii.
Bold change needed to fix Hawaii healthcare
Photo by Charley Myers
By Keli’i Akina
Even before the COVID-19 pandemic, we were warned that lack of healthcare capacity in our state was a deepening problem. The last two years have revealed that things are even worse than we thought.
As I discussed in my Wall Street Journal commentary published last weekend — “Hawaii Is No Paradise if You Need Medical Care” — Hawaii’s healthcare crisis includes a growing doctor shortage, lack of specialty care in rural areas, high emergency room wait times and the fact that we have among the fewest hospital beds per capita in the nation.
These are problems that have been highlighted by the pandemic, but they did not pop up overnight. They are the result of decades of regulations and policy decisions, including high taxes, extensive regulations and Hawaii’s notoriously high cost of living.
According to Lisa Rantz, my guest on this week’s episode of “Hawaii Together” on ThinkTech Hawaii, many people are still waking up to the reality of the state’s healthcare shortages.
Rantz is the executive director of the Hilo Medical Center Foundation, which has been conducting a comprehensive study of community health needs. She noted that while the state has done “a great job” at ensuring that people have health insurance, “having health insurance does not equate to having access to healthcare.”
If anything, Rantz said, the numbers understate the depth of the healthcare crisis in Hawaii. While we usually hear that the state is short about 820 doctors, Rantz says that the real shortage, at this point, is over 1,000 physicians. And it’s not just more doctors that we need. The nursing shortage is also growing. Hawaii County has the third-largest nursing shortage in the country, followed by Maui at No. 5 and Kauai at No. 13.
The shortage of specialists has long been a problem on neighbor islands, where people have to fly to Oahu or the mainland for care. But now, even Oahu is starting to notice the effects.
“I think as we’ve seen more neighbor island folks getting care on Oahu, as our shortages increase across the neighbor islands, we’re starting to feel that on Oahu,” said Rantz. “When you call your doctor and they’re like, ‘Oh, you can’t get in for two weeks,’ or ‘We can’t see you for three weeks because we have appointments from neighbor island community members,’ then all of a sudden it hits home. I think as the shortage increases, we’re starting to see more of the impact on Oahu.”
The shortages restrict possible solutions to the problem. Rantz said that when speaking to legislators about the lack of doctors, they’ll suggest using nurse practitioners or physician assistants to provide primary care. But that won’t work when the shortage exists across all medical positions.
Why does this shortage exist?
Rantz says it’s the result of a “perfect storm” of factors, many of which will be familiar to anyone who has followed our “Why We Left Hawaii” series. The state’s high cost of living — including housing costs — is especially discouraging to medical students who are already struggling with heavy debt. Combine this with the high taxes and low reimbursement rates for doctors and it becomes very difficult to recruit young medical professionals to Hawaii.
In other words, the same problems that contribute to our state’s overall population loss are exacerbating our healthcare woes.
Clearly, the first thing that lawmakers ought to do is embrace policies that will reduce the overall cost of living, like lowering taxes and making more land available for residential development. But there are other reforms that could directly address our state’s healthcare capacity issues.
We could start by liberalizing Hawaii’s so-called certificate-of-need laws, which are among the strictest in the country. A study from the Mercatus Center found that states with certificate-of-need programs have 30% fewer hospitals per 100,000 residents and 13% fewer rural ambulatory surgical centers per 100,000 residents.
Rantz also singled out Hawaii’s low Medicare rates as a problem that could benefit from the attention of our congressional delegation. At the state level, she said, the general excise tax is a significant problem for private-practice physicians. Though most people perceive the GET as a small charge, it is imposed at every transaction level and ultimately totals two to three times more than its face value of 4.5%. Combined with the state’s low Medicare reimbursement rate, that leaves private-practice doctors in Hawaii scraping by with very low margins.
Rantz said that between the high cost of living and the GET, it is very difficult for Hawaii doctors to maintain a viable practice.
“We actually just lost three providers here in East Hawaii on Hawaii island that are closing up their doors and moving to the mainland, because they can’t make the numbers work. They just can’t do it,” she said.
If policymakers are serious about improving healthcare access in our state, addressing the GET and low Medicare reimbursements are just the beginning. Other avenues to explore include reexamining licensing laws, exploring the potential of public-private partnerships, improving telehealth and, of course, repealing or reforming the state’s CON laws.
What we cannot afford to do, however, is stick our heads in the sand and hope the problem will go away. If we want to be prepared for future emergencies, we need bold changes to encourage and facilitate the provision of healthcare.
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Keli’i Akina is president of the Grassroot Institute of Hawaii. This commentary was his weekly “President’s Corner” column for Dec. 11, 2021. If you would like to have his columns emailed to you on a regular basis, please call 808-864-1776 or email info@grassrootinstitute.org.