By Ira Zunin The Affordable Care Act is the primary manifesto of health care reform. While its primary focus is to facilitate increased access to the underserved, it is also designed to reduce the cost of health care and improve delivery.
By Ira Zunin The state Hawaii Department of Health recently announced that it will begin to link deaths from prescription drugs to the physicians who prescribed them ("Doctors targeted amid rise in painkiller deaths," Star-Advertiser, May 5).
By Ira Zunin Genuine success in business depends on knowing not only another's intentions, but also understanding one's own motivations, combined with the ability to appreciate the ramifications of an action over time.
By Ira Zunin Last week I had the pleasure of speaking at the 2013 Hawaii Health Workforce Summit focused on improving provider satisfaction and practice sustainability. A 2010 assessment performed by the John A. Burns School of Medicine revealed a shortage of more than 600 practicing physicians, 60 physician assistants and 180 nurse practitioners.
By Ira Zunin In recent years the mass market has seen a remarkable proliferation of services aimed at conditioning, weight loss and wellness. Curves is a streamlined women's fitness club franchise that popularized the 30-minute circuit training workout.
By Ira Zunin The first iPad came out just three years ago and further revolutionized mobile computing beyond expectations. It came on the market Jan. 27, 2010, and sold 500,000 units by the end of the first week.
By Ira Zunin Family Health Hawaii, the newest insurance company to enter the local market, will offer both lower premiums and superior benefits compared with existing carriers, according to Hawaii’s former insurance commissioner J.P. Schmidt.
By Ira Zunin As a result of protracted partisanship in Washington, our country is now unexpectedly undergoing a sequester. What exactly is a sequester? It is an automatic reduction to federal spending for a given fiscal year, made possible when Congress passed the Balanced Budget and Emergency Deficit Control Act of 1985.
By Ira Zunin No one wants to hear the word "cancer" while sitting in a doctor's office. Still, cancer remains the second-leading cause of death in our country, behind heart disease.
By Ira Zunin The death of Hawaii's esteemed U.S. Sen. Daniel Ino­uye, combined with impacts of the sequester, has resulted in a substantial pullback in planned military spending for the islands.
By Ira Zunin It's official. The impact of environmental pollution on the health of its people is now China's leading political problem. Outgoing Prime Minister Wen Jiabao delivered his Government Work Report to the National People's Congress on Tuesday.
By Ira Zunin The U.S. Supreme Court recently heard a case that is likely to expand the power and reach of a U.S. patent.
By Ira Zunin With increasing fervor, citizens across the state are speaking out against genetically modified food (GMO) and demanding legislation that, at the least, requires labeling of these products.
By Ira Zunin The recent shooting spree at Sandy Hook Elementary School in Connecticut, which left 26 people dead, including 20 children, ignited a conversation about gun control throughout the nation.
By Ira Zunin After several failed attempts, it appears that the state Legislature is, at last, truly poised to pass a meaningful and effective bill that levies a soda tax on sugary drinks.
By Ira Zunin Some years ago I had the opportunity to consult for a publicly traded firm in Japan. Their core business was a large chain that carried men's apparel, but they planned to establish a second business line focused on vitamin supplements and herbal remedies.
By Ira Zunin The human placenta is truly amazing. It creates a wonderful, healthy environment to grow new life. Although it has the ability to burrow into the womb, it is not destructive.
By Ira Zunin Despite extensive education in science, medicine and human behavior, most physicians have never received training in how to run a business. This tends not to be problematic if they are employed.
By Ira Zunin Prescribe one pain medicine to a patient with a broken leg and it will work fine. Try that medicine at the same dose on another patient and it's not enough, while a third person complains of nausea and vomiting.
By Ira Zunin Perusing through myriad responses to the 52 columns written last year, one gains a sense of which issues matter most to readers and which ones stir up the greatest controversy. Together they point to those topics sure to capture attention in the coming year.
By Ira Zunin Hawaii is known as a highly desirable place to do research. The unique and diverse makeup of the islands is useful to compare and contrast outcomes for different populations.
By Ira Zunin In conjunction with rapidly growing epidemics in obesity and insulin-resistant diabetes, obstructive sleep apnea, or OSA, is also very much on the rise.
By Ira Zunin Tis the season to count our blessings and give. We have all been blessed, but sometimes it's difficult to see, especially when we are grieving the loss of a loved one or grappling with illness or injury.
By Ira Zunin Hawaii Pacific Health was recently named the winner of the 2012 Enterprise Health Information and Management Systems Society (HIMSS) Davies Award of Excellence. This is the equivalent of winning the Academy Award for health information technology and is the highest national honor that can be received by any health organization.
By Ira Zunin As I was growing up, I had often heard New York City associated with gangs, drugs and violent crime. Today, by most standards, the city is rated one of the safest in the country.
By Ira Zunin Thanksgiving has always been my favorite holiday in the islands. With commercial interests at bay compared with other holidays, Thanksgiving is about the attitude of gratitude and a celebration of community, family and friends.
By Ira Zunin In response to last week's column, which advocated for mandatory labeling of all food containing genetically modified products, the Hawaii Crop Improvement Association registered a sharp rebuttal.
By Ira Zunin On Tuesday, California voters rejected Proposition 37, which would have required labels on all products that contain genetically modified ingredients. Why wouldn't people want to know?
By Ira Zunin During a recent trip to New Zealand, I had the opportunity to interact with the indigenous Maori culture. The people call their country Aotearoa.
By Ira Zunin Many of us have heard the story of gritty Uncle Kimo who lived to a ripe old age even though he ate poorly, never exercised, smoked and drank up until the day he died. Unfortunately, Kimo is an exception.
By Ira Zunin Sixty percent of Hawaii residents will need a blood transfusion at some time in our lives.
By Ira Zunin Back in the day, the survival of indigenous peoples depended on being attuned to nature and the environment. Hunting for food required knowledge of the patterns and behavior of prey on land and in the water.
By Ira Zunin According to a Stanford study recently published in the Annals of Internal Medicine, there is no compelling evidence that eating organic food is healthier than conventional food.
By Ira Zunin As our nation struggles to adjust to the changing face of health care, we should check on the success of other developed countries in maintaining the health of their own citizens.
By Ira Zunin Triggered in large part by health care reform, primary care in Hawaii is still undergoing major change in an effort to provide higher-quality care for more people at a reasonable cost.
By Ira Zunin A recent article published in the Annals of Internal Medicine has caused many health-conscious consumers to question strongly held beliefs that the benefits of going organic outweigh the added costs.
By Ira Zunin Auntie suffers from recurrent breast cancer. While her illness is challenging enough, she also struggles with limited financial resources to cover her medical and living costs.
By Ira Zunin A recent study at the John Hopkins School of Medicine has found that hearing loss in our country is considerably more problematic than we once thought.
By Ira Zunin This column recently discussed a perceived market opportunity to create model homes that bring together efficient use of green energy, water purification, eco-friendly building materials, recycling and edible gardens.
By Ira Zunin Millions across the globe watched Oscar Pistorius, nicknamed "Blade Runner," a double amputee from South Africa, compete in the London Olympics. He used carbon-fiber blades to run his sprints.
By Ira Zunin During a recent trip to visit our large family in Ireland, the entire clan was rooting for Katie Taylor, the homegrown boxing phenom, in her quest for Olympic gold.
By Ira Zunin Greece is truly on the verge of losing its membership in the eurozone. Last week, several key regions in Spain approached their government for financial relief, but there is little to spare as $100 billion was just given to shore up Spanish banks.
By Ira Zunin Living in the middle of the Pacific, thousands of miles from the world's major metropolises, Hawaii continues to find relevance on the global front.
By Ira Zunin The Rim of the Pacific exercises, hosted by the United States this summer in the waters near Hawaii, is the world's largest maritime war exercise. Twenty-two participating nations are now working to refine joint operations.
By Ira Zunin Motivated by political unrest in the Middle East, rising energy prices and global warming, both our federal and state governments now offer attractive tax benefits for solar systems in both the residential and commercial setting.
By Ira Zunin Recently more than 100 physicians attended the Hawaii Health Information Exchange's second annual Health IT Summit at the Hilton Hawaiian Village to learn how their practices can shift to, implement and benefit from electronic health records.
By Ira Zunin Not since Harry Truman went to bed on election night believing he had been defeated has a president grappled with such erroneous news of major defeat.
By Ira Zunin With tears rolling down their cheeks, two patients recently confided that their marriages had failed when they suddenly learned their husbands were secretly addicted to Internet pornography. Both spoke about their feelings of betrayal, rejection and violation.
By Ira Zunin The prognosis for the global economy remains stubbornly flat. News in Europe has been especially disturbing. There is still a serious risk of a "Grexit" from the Eurozone. Spanish banks were just given a $125 billion lifeline.
By Ira Zunin According to the American Hospital Association, Hawaii is one of only two states where hospitals operate at a loss year after year. One key reason is the high cost of treatment versus low reimbursement to care for Medicaid patients.
By Ira Zunin In an effort to garner world attention and protest long-standing repression by the Chinese government of the Tibetan people in their own homeland, this past week two more Tibetan monks engaged in the ultimate act, self-immolation.
By Ira Zunin Carpal tunnel syndrome began to capture the attention of insurers when, back in the late 1980s, treatment costs for repetitive stress injuries started to soar.
By Ira Zunin As I sat with colleagues at a celebratory dinner this week, we had a good laugh as we reminisced about the early days of our careers and the road still ahead.
My teenage son recalls as we train for our second tri­ath­lon the words of Joe Lile­ikis, our swim coach.
By Ira Zunin I am the cloud!" exclaimed the hard-working spouse of a well-known solo practitioner from Hawaii island. A large portion of Hawaii's doctors recently came together to attend the Hawai‘i Physician Workforce Summit: Implementing Patient Centered Medical Home.
By Ira Zunin When I was beginning to establish my medical practice, a woman walked into the clinic with a service dog. She was obviously not blind. We sat down. “Do you have a seizure disorder?” I asked.
By Ira Zunin My first meeting with His Holiness the Dalai Lama was in the '70s in Dha­ram­sala, India, the seat of the Tibetan government in exile, nestled in the foothills of the Himalayas.
By Ira Zunin A fourth-year medical student, asked if she planned to go into private practice, responded, “It can’t be done in this day and age.”
By Ira Zunin The Senate Ways and Means Committee, chaired by Sen. David Ige, essentially shelved two bills this week that would have helped repair the state's workers' compensation system, which is in great need of repair.
By Ira Zunin Several local physicians are under investigation for prescriptive practices, and three of them have lost privileges to treat Medicaid patients, according to a report this week.
By Ira Zunin There is still a fight on to preserve the soul of medicine. While health care reform opens the doors to increased access to care, costs must be trimmed to make it happen.
By Ira Zunin Do you often wake up feeling unrefreshed and remain tired throughout the day? Do you experience morning headaches or difficulty with memory and concentration? Your problem could be sleep apnea. Obstructive sleep apnea causes the airway to narrow and breathing to slow or stop for brief periods, usually many times each night. During these episodes, blood oxygen levels go down and carbon dioxide levels go up. This triggers alarms throughout the body and increases the risk of high blood pressure, heart disease and stroke.
By Ira Zunin Hawaii has a long-standing tradition of insurance coverage for injured workers and those involved in automobile accidents that includes acupuncture, chiropractic, naturopathy and massage therapy.
By Ira Zunin How would you feel about your spouse, parent or child being sent for a medical examination by a strange doctor who is beholden to the insurance industry?
By Ira Zunin A bill to levy a state soda tax was held back by our Legislature for the second year in a row. The support just wasn't there. Opponents argued that the government should not tell us what to do or how to live.
By Ira Zunin One of my longtime patients came in and said, "I need all of the medicines I can get right now because I've been laid off and I am losing my insurance at the end of the month. I have no idea when I'll have insurance again."
By Ira Zunin The state continues to experience ripple effects from the closure of Hawaii Medical Center's two hospitals following its second bankruptcy in recent years. One casualty is its liver and kidney transplant center.
By Ira Zunin I was recently invited to serve on the panel of a new think-tank about health care comprised of physician leaders from the academic, government, hospital, insurance and private sectors in Hawaii.
By Ira Zunin On Martin Luther King Day, physicians and staff at Hawaii Permanente Medical Group, together with community volunteers, dedicated themselves to a day of service.
By Ira Zunin Years ago, as a medical student at UCLA, I had the opportunity to perform research on magnetic resonance imaging (MRI). We studied the feasibility of visualizing the cornea of the eye. As technology advances, MRIs become more powerful but remain relatively safe.
By Ira Zunin Medical facilities cannot rely solely on state-of-the-art technology. They must build relationships to establish a sustainable brand. Some years ago I was invited to interview for medical director of Holistica Hawaii. Housed at the Hilton Hawaiian Village, the facility featured a new ultrafast CT that offered heart scans and total body scans.
By Ira Zunin My older son lives in Portland, Ore. An aspiring artist, out of school, in between jobs and before health care reform, he was among the uninsured. As a result of the Patient Protection and Affordable Care Act (PPACA), known to detractors as Obamacare, I have been able to add him to our family insurance plan until he becomes 26.
By Ira Zunin The bankruptcy and closure of Hawaii Medical Centers' two hospitals is the biggest health care story of the year. Its impact is being felt in waves throughout the islands.
By Ira Zunin Wealth of Health recently covered a landmark change in how providers will be reimbursed. Beginning in October, the Centers for Medicare and Medicaid Services will link $850 million of payments to a new measure: patient survey results.
By Ira Zunin My son arrived home after a visit to the dentist a few weeks ago and announced that he had signed us up for the Honolulu Marathon. This summer we completed our first Tin Man Triathlon, but we had never run a full marathon.
By Ira Zunin It's official. Customer satisfaction scores have become serious business in health care. Beginning in October 2012, the Centers for Medicare & Medicaid Services will link $850 million of reimbursement payments to a new measure: patient survey results.
By Ira Zunin Squinting through ti leaf-infused steam wafting from the glowing imu, I could make out the silhouette of a young, muscular man lifting turkeys into the cooking pit. Since he was a toddler, my son and I have been a part of the local Thanksgiving ritual at the Key Project.
By Ira Zunin This week the National Council of Asian and Pacific Islander Physicians is in Hawaii to study health disparities and to advance initiatives that remove barriers to healthy communities. The council believes that quality, access and cost containment are critical to health and wellness of Asian Americans, Native Hawaiians and Pacific islanders.
By Ira Zunin By the time a person begins to feel ill from high blood pressure, blood sugar or cholesterol, often, the damage has already been done. Even if we feel great, to ensure good health, it is essential that we receive preventive screening.
By Ira Zunin The majority of seniors prefer to age in place. When asked, most people want to remain independent as long as possible in their own homes. The ability to do so depends, in part, on family caregivers.
By Ira Zunin It is hard to imagine anything more painful than the death of a child. What parent would not willingly exchange places with their dying child if only they could?
By Ira Zunin At Grandmaster Cho's tae kwon do studio, approximately 300 elementary school students from East Oahu just began taking classes. They have come for the six-week President's Fitness Challenge Program, an initiative strongly supported by Michelle Obama.
By Ira Zunin My auntie is dying from metastatic breast cancer. This week she underwent surgery to remove one more mass under her arm. She is also scheduled to receive another round of radiation in six weeks. My mother observed that her doctors never spoke about her prognosis or chances of surviving the surgery or the radiation. Auntie is almost 80.
By Ira Zunin Last week, Denmark became the first nation to levy a fat tax at the register. Danes will now pay an extra 12 cents for a bag of potato chips and 40 cents more for a hamburger. People are accustomed to “sin” taxes for alcohol and tobacco. Are we ready for taxes on fat, salt and sugar?
By Ira Zunin On Thursday, Sam's mother called in a panic. "He's punching holes in the wall, Doc. Please do something." When he arrived in the clinic, Sam — not his real name — explained that despite every effort on his part, his TDI (temporary disability insurance) check hadn't come, he couldn't pay his rent and his landlord evicted him with 24-hour notice. About to be homeless, he became frantic.
By Ira Zunin The World Health Organization recently announced that chronic diseases — including heart problems, stroke, cancer, persistent respiratory conditions and diabetes — have now become the world’s leading cause of mortality, representing 63 percent of all deaths. Fully a quarter of these people are less than 60 years old, and 90 percent of early deaths are in the low- to middle-income population.
By Ira Zunin Among the greatest drivers behind the explosion of national resources directed to health care is the cost of technology used for powerful diagnostics, medical equipment and surgical interventions. Reimbursements for doctors who work with this technology in their hands is greater than that for internists who provide primarily cognitive services or psychiatrists who focus on human interaction. This is not because work with one’s hands requires more skill or training than working principally with one’s mind. Instead, it is the result of powerful interest groups comprising manufacturers of medical technology. The right surgery for the appropriate patient at the correct time is of incomparable benefit. Still, technology should serve and not drive the nature of the health care we receive.
By Ira Zunin It is certain that each of us will die, but the time of our death is unknowable. Both providers and consumers of health care fear and resist these truths to no end. Medical training still teaches that the death of a patient is a failure and malpractice carriers remind us that a patient’s passing could result in a lawsuit.
By Ira Zunin Struggling to regain consciousness, I reached back and felt the large bloody gash in my scalp. My son and I had just gotten into Ripstiks.
By Ira Zunin Screaming down the hill on Hawaii Kai Drive from Kalama Valley, the back wheel of the bicycle I was riding suddenly came loose. My right hip and leg crashed to the ground and slid along the wet asphalt for what seemed like an eternity.
By Ira Zunin The Arab Spring has given way to a sweltering summer. Much of the optimism in Egypt has gone stale; Libyan leader Moammar Gadhafi, now virtually surrounded, won't go down until he is taken down; and the European Union has just joined the U.S. in an unbridled call for Syrian President Bashar al-Assad to stop attacking civilians with tanks.
By Ira Zunin Last week, as my son and I tackled Glenn Pass, one of the highest points of the John Muir Trail in the Sierra Nevada Mountains, the food we brought was nutritious and tasty but above all lightweight.
By Ira Zunin Veterans who were exposed to highly traumatic events during deployment to Iraq or Afghanistan and discharged because of post-traumatic stress disorder recently won a class-action law suit entitling them to lifetime disability benefits, including military health insurance. The ruling affects more than 1,000 veterans with PTSD who were denied these benefits upon discharge. The National Veterans Legal Service Program argued that the military services violated the law by failing to assign a 50 percent disability rating to those discharged for PTSD. A 50 percent disability rating entitles the veteran to disability retirement benefits.
By Ira Zunin Not many years ago, patients could expect their primary care doctor to care for them at the doctor's office and, when necessary, admit them to the hospital.