Friday, April 17, 2015         

Health and Money Premium

For articles before August 3, 2011, see the Free Archives »

Hawaii is on the cutting edge as a national leader in clean energy. More than 12 percent of Hawaiian Electric's customers have already "gone solar" and now enjoy clean power and lower electrical bills.

After their surprise and stunning victory against Monsanto and the big agrochemical companies in the Maui ballot initiative in November 2014, the Center for Food Safety and the entire anti-GMO, anti-pesticide movement decided to pursue their policy agenda aimed at environmental health and safety with initiatives that establish pesticide buffer zones around schools and hospitals in Hawaii and require notification disclosure of restricted-use pesticides near sensitive populations.

Simplicity is underrated. Instead, modern civilization is habituated to productivity and consumption. We send our children to school and ply them with extracurricular activities while maintaining a view toward higher education and good jobs.

The ancient trend of human movement from rural life to urban centers may now be upended by emerging technologies. Low-cost desalinization, highly efficient battery storage, renewable energy and mobile communications all serve to reduce dependence on the world's cities for water, power and human interaction.

During the long course of evolution, human beings gradually developed an exquisitely sensitive immune system. Designed to protect against disease, one of its main jobs is to distinguish between foreign agents and one's own healthy tissues, a job that in modern society has become much more difficult.

During a recent medical mission to Asia, I held several clinics for a small, extremely remote village of ethnic Tibetans living at high altitud

Last week as I was returning from China, its central bank cut interest rates for the second time in roughly three months, and Premier Li Keqiang lowered the economic growth target to 7 percent for 2015.

I recently had an opportunity to visit a fledgling, yet remarkably successful, Waldorf School and biodynamic farm in Pokhara, Nepal. Biodynamic farming is founded on the principle that bringing vitality to the soil causes plants to thrive and nourishes people and animals living on the land.

Recently, while en route to Kathmandu, Nepal, for a medical mission, my nephew lingered a few extra days in Bangkok because of civil unrest in Nepal. Legislators in the Nepalese Constituent Assembly had been throwing microphones and breaking desks. During the ensuing scuffle, several security officers were injured.

En route recently to Nepal for a medical mission, I stopped in Bangkok and had an opportunity to view Bumrungrad International Hospital, long known as a first mover and market leader in medical tourism.

En route to Katmandu, Nepal, for a medical mission, my nephew and I had to take pause in Bangkok because of civil unrest in Nepal.

Tobacco continues to be big business — a $35 billion market — but electronic cigarettes are burning away at the market share. E-cigarettes are booming. New technologies claim reduced adverse health effects compared with tobacco smoking.

Doctors estimate that 18 million to 20 million Americans have moderate to severe sleep apnea, which is characterized as pauses in breathing during sleep. Of these, 80 percent are unaware that they have it.

Prescription drug monitoring programs are an essential way to prevent illegal diversion of controlled pharmaceuticals and a keystone in curbing the prescription drug abuse epidemic.

Among the landmark issues affecting the health of the blue planet in 2015 is whether the fracking boom will be leveraged to develop sustainable energy resources for the long run.

A fresh window of opportunity is open for the health of residents and visitors in Hawaii. Although much remains to be done, the greatest challenges faced by health care reform, Obama­care, are now behind us. The aim of improved access to quality care combined with cost containment is within reach.

You finally get home after grocery shopping and you suddenly hear your grandson shout, "Papa, your foot is bleeding!" You turn your eyes to the floor in disbelief only to realize that your foot is indeed bloody and that you have left a trail of blood all along your kitchen floor.

As tasty pastries and sugary holiday cheer is exchanged throughout the workplace in Hawaii, I am reminded that diabetes andobesity are directly and indirectly among the leading causes of illness and reduced productivity.

This Thanksgiving marked the 15th year I felt the heat of the imu as we lifted 500 turkeys onto steaming banana stalks at the Kua­loa-Heeia Ecumenical Youth Project. Among my earliest memories as a young child was the sense of awe I felt as many hands worked together amid the savory steam.

To avoid damage to communications from working satellites, the NASA Orbital Debris Program tracks half a million pieces of space junk that orbit Earth. The debris is an accumulation of flotsam and jetsam dating back to the first space programs.

The Great Recession appears to have awoken a sleeping giant: Shriners Hospitals for Children, Hono­lulu. Prior to 2010, Shriners Hospitals — which is based in Tampa, Fla., and operates 22 medical facilities in the U.S., Canada and Mexico — relied strictly on endowment.

During the last legislative session, Senate Bill 2054 was introduced to require the Insurance Commissioner to analyze the projected costs of providing insurance coverage for screening, diagnosis and treatment of autism spectrum disorders. This column came out in favor of the bill.

Deaths resulting from narcotic overdoses now exceed the number of those who die from car accidents in Hawaii. Throughout the United States, narcotic abuse, diversion and addiction are on the rise.

Buildings are no longer simply comfortable, functional shelters to live and work in. Empowered by technology and in response to climate change, buildings are increasingly becoming highly adaptable intermediaries between our interior space and the environment at large.

A prominent researcher from the National Institutes of Health once told me that the best health care is "everything I choose to prescribe, order and do for my patients," according to physicians.

If grandpa complains of chest pain we call an ambulance, but if he complains of leg pain while walking to the mailbox, we tell him he's getting old. Cardiac chest pain, also called angina, typically results from blockage in the coronary vessels that feed the heart muscle.

Why do some people live long healthy lives while others seem to fall ill early and often and then succumb to chronic disease? Dan Buettner, founder of Blue Zones and National Geographic Fellow, traveled across the globe to find the secret behind longevity.

Fracking has rapidly begun to move the United States toward energy independence, but at what price? Given the current state of affairs, in which the Middle East is in tatters, the Cold War with Russia looks to have returned and both India and China boast an accelerating appetite for fuel, this technological breakthrough could not have come at a better time.

UnitedHealthcare, the nation's largest managed-care insurance company, was taken to task last year by the assistant secretary of defense for causing delays in medical treatment.

To serve as a caregiver for a family member is, for many, an important chance to give back. Yet whether caregiving is offered out of love or obligation, it tends to take its toll. Caregivers often decide to stick it out until the person they care for has passed.

B.K.S. Iyengar died Aug. 20 at the age 95 from a viral illness. He had been the dominant figure behind the modern yoga movement for decades.

Patients are beginning to share their increasing concerns about the recent spread of Ebola in West Africa. While it is prudent for the people of Hawaii and the Department of Health to remain vigilant about global trends of any infectious disease, there is no imminent cause for alarm.

Gilead Sciences recently brought to market a product called Sovaldi, a breakthrough treatment for the most common form of hepatitis C. The total medication cost is roughly $84,000 per patient, or $1,000 per day for 12 weeks. The new medication works well and cures the disease in about 90 percent of cases.

Imagine if one of the nation's largest fast-food chains merged with a major pharmaceutical company. The alliance would ensure a robust supply chain of high-fructose corn syrup, saturated fat and salt into the stomachs of consumers and optimize sales of medication for obesity, diabetes, high blood pressure and heart disease.

Integrative medicine -- which calls for a patient-centered, culturally sensitive, whole-person, multidisciplinary approach to care -- has the potential to become a cornerstone in the national effort to increase access to quality health care at a reasonable cost.

The sight of a beggar, paralyzed from the waist down by polio, dragging himself through the muddy streets of India is a memory not easily forgotten. Yet, there is a world of difference between an impoverished society and a fractured nation.

Imagine using gene therapy to grow a new biological pacemaker for your heart. That's right. No operation. No implanted device. No batteries. No electrodes.

As the United States began downsizing its military and Vladi­mir Putin's Russia swallowed the Crimea with only nominal opposition from the West, China has decidedly toughened its stance in the China Sea.

Rangi was built to test the commercial viability of carrying freight and passengers for short hauls within the Pacific. It is a part of the heritage of the indigenous peoples of Polynesia who sailed across the oceans using non­in­stru­ment navigation.

One is totally isolated when sailing across the most remote parts of the deep blue ocean on a traditional-style Polynesian voyaging canoe, unless you have R2D2 on the back of your canoe. Actually, we do.

Hikianalia, Hokule‘a's sister canoe, which was built for the vessels' worldwide voyage, is distinguished by her solar-powered electric motor and large bank of lithium batteries.

The quest for cultural harmony on Island Earth is central to malama honua (caring for the earth), the mission of the worldwide voyage of Hoku­le‘a and Hikianalia, two traditional-style Polynesian voyaging canoes whose navigators use non-instrument, star navigation.

The Ocean Elders variously represent royalty, rock ’n’ roll, private business and academia. Several members have served in high-level government posts. They are the real deal, unlike some others who are trying to capitalize on climate change.

Medical officers selected to care for crews aboard Hoku­le‘a and Hikianalia during the international portion of the Worldwide Voyage prepare to practice austere, blue-water, wilderness medicine.

Keen awareness of environmental challenges faced by our blue planet must be combined with creative and practical solutions that bring prosperity. The greatest obstacle to sustainability is immediate self-interest.

As my father took his final breaths this week, he said, "Let my passing be a celebration of the worldwide voyage."

The resurgence in Polynesian voyaging throughout the Pacific was made possible by the rediscovery of the ancient skills of the navigator. It created the opportunity to revive the traditional role of the kauka (doctor) on board.

No question, fatigue impairs productivity, erodes safety, increases risk and affects company morale. Fatigue is the final common denominator for a human system that is off-form and out of balance.

Among the health professions, occupational therapists are poised to be highly impactful allies for families, workers and employers. They are trained to help people achieve the highest potential possible by playing to their unique strengths as they relate to specific environments and desired activities.

Not all health providers accept Medicare insurance, the federal program for seniors. The vast majority of those who do are completely ethical and bill as accurately as possible for services rendered.

Despite the surge in attractive, high-quality assisted-living facilities, most people would much prefer to live independently and remain in their own homes as long as possible. The houses in which we have raised our children, however great or modest, are our palaces.

It seems there is no end to ambitions for more high-rises built with capital organized from some of Hawaii's largest stakeholders. Is Honolulu destined to become like Singapore, which has a land mass half the size of Oahu but more than five times the population?

Our family was heartbroken when we heard of the closure of Barnes & Noble at Kahala Mall. Printed matter, respectfully bound or carefully folded, offers a unique relationship to the reader.

Hawaii has yet to craft a functional law that addresses medical marijuana for chronic disease. Progress to date has been incremental but in the right direction.

Patients with autism spectrum disorder are fragile and vulnerable members of our society and should have access to necessary medical care. In recent years, the majority of American states have passed legislation which ensures that this population receives basic mental health services.

About $3.6 trillion is what the United States spent on health care in 2013, 3.7 percent more than 2012. Projections for 2014 anticipate a further increase of 6.1 percent. This expanded insurance coverage is made possible by the Affordable Care Act.

Today the ideal home is far more than a convenient layout of bricks and mortar. Prospective buyers have begun to look at the place they live as an opportunity to create a healthy, environmentally friendly, sustainable lifestyle for the family from cradle to grave.

Imagine an electronic device that knows whether you've taken important medication and reports that to your health provider. Although our soon-to-be elderly are healthier, more active and better educated than the previous generations, aging still comes with disabilities.

This is the third of three columns I've devoted to health care in Myanmar. The previous two articles covered the dire state of health care in Myanmar and described one hospital that survives on donated resources.

Health care in Myanmar, also known as Burma, depends upon donated resources. I just returned from the interior after evaluating strategies for medical and humanitarian service.

Myanmar, also known as Burma, is ranked at the very bottom of 190 countries for overall health system performance, according to the World Health Organization.

Chelating agents were originally used to treat heavy metal poisoning from chemical warfare during World War I. Since then these treatments have been found useful to manage elevated levels of heavy metals from other causes.

The National Institutes of Health's Centers for Disease Control and Prevention is charged with the mission of reducing disease not only in the United States, but also across the globe.

How are those New Year's resolutions holding up? Tips: The first ingredient to success is to set goals that are realistic and achievable. They must be not only humanly possible, but also logistically feasible. Does it fit in the schedule? How long is the drive?

Accelerating numbers of Chinese visitors to the islands represent a refreshed and unprecedented opportunity for health tourism.

Socioeconomic inequality is among the greatest ills of modern society. Disparities in health, education and crime share a common root. Our collective ability to close this great divide is a prerequisite to peace on earth.

It's hard to imagine a more tumultuous year for the Wealth of Health in Hawaii than the one about to end. This column highlights the hottest stories of 2013 based on the volume and intensity of comments from our readers on both sides of key issues.

If dementia were a country, it would be the world's 21st-largest economy, ranking between Poland and Saudi Arabia, according to the Alzheimer's Association.

Nearly 1 in 5 high school boys and 11 percent of all schoolchildren have been diagnosed with attention-deficit/hyperactivity disorder, or ADHD, according to The New York Times. This represents a 16 percent increase since 2007 and a 41 percent rise in the past decade.

Ten thousand dollars was raised by the KEY Project this year to send a local high school student to nursing school. The 500 imu turkeys that generated these scholarship funds also made a profound contribution to the many hands that prepared them and the many mouths that enjoyed them.

Accountants are sometimes disparagingly called "bean counters," but the truth is that counting beans is much like counting money. Body weight is the result of calories consumed minus calories burned just as net income is revenue less expenses.

Ira Zunin has turned today's column over to his son Brandon Zunin. Brandon, a junior at Punahou School, is opinions editor of Punahou's student-generated newspaper, Ka Punahou, and editor of Ka Wai Ola student magazine.

The most dangerous drug-drug interaction, joked an old professor during a med school pharmacology lecture, is testosterone and ethanol. The class cracked up as he conjured up images of young men binge-drinking and doing crazy things.

Robotics has the potential to revolutionize the art of medicine. Today at the nation’s elite universities, teams of students are harnessing the emerging science of robotics to create prototype designs that could solve some of today’s most baffling medical problems.

"Fear is hugely more important than euphoria," according to Alan Green­span, former Federal Reserve chairman who served for nearly 19 years.

Hawaiian Electric Co. continues to be under fire for its Sept. 6 procedural changes for new solar installations. Two weeks ago, this column covered concerns on the part of consumers that had contracted to install solar systems and on the part of industry leadership.

Last week a woman waiting to check out at a local health food store observed a buff figure in front of her making a hard sell to the cashier. "If I give you this coupon, would you come to my yoga class?"

To combat climate change and move away from fossil fuels toward energy independence, several years ago the federal government rolled out a 30 percent tax credit for solar installations.

Some supplement manufacturers would like their customers to think otherwise. Patients now often ask about "pre-workout" supplements, wondering whether they are safe and effective.

The call from his medical director came as we touched down in New York in April 2003. My consulting firm, Global Advisory Services, had been contracted by the largest manufacturer of Chinese herbs outside of China to help the company establish four integrative clinics in Australia and two in Singapore.

This time last year, I was on the open ocean serving as medical officer on a traditional-style Polynesian voyaging canoe sailing from New Zealand to Tahiti. Our stalwart captain charted a southern route to capture the most reliable yet fierce winds.

My father suffers from end-stage Parkinson's disease and associated dementia. Several weeks ago he was admitted to the hospital with a severe case of pneumonia. One week after discharge my family elected to withdraw his remaining IV and initiate him in home hospice.

Financial pundits continue to study how the Accountable Care Act (ACA), the manifesto for health care reform, will affect health industry stocks as it continues to roll out.

In recent years, the state Legislature has been party to several failed attempts at passing a soda tax despite well-constructed bills and, most recently, a priority commitment on the part of Gov. Neil Abercrombie to get it done.

In the United States, treatment for the mentally ill is underfunded and resources are poorly allocated. Misguided policies at the state and national level result in tremendous human suffering and increased homelessness at a high cost to society.

Truth be known, I was raised by a psychiatrist. My father, Leonard Zunin, author of two books, had an illustrious career. Some of my fondest memories of childhood were when I would accompany him on his speaking engagements around the country.

UnitedHealthcare, the nation's largest managed-care insurance company, was recently taken to task by the assistant secretary of defense for causing delays in medical treatment.

After years of encouragement, investment and incentives, hospitals and more recently a critical mass of community physicians have made the transition from paper charts to electronic health records (EHR).

Regenerative medicine is a rapidly emerging field that aims to replace or regenerate cells, tissues or organs to restore normal function.

Beginning in October, Americans will be able to register with new state health insurance exchanges to purchase their health insurance.

In the days before insurance, doctors were far more connected to the community. During times of emergency, a neighbor would run to the doctor's house for help: "Come quick, Mom is in labor again!" or "Old man Sasaki fell off his tractor.

Need a kidney transplant? No problem. I'll just print one out. It is now possible to run living cells through a 3-D printer and engineer a transplantable kidney.

We know in the back of our minds that life does not last forever, but for most of us it's difficult to look mortality in the face.

It used to be that when children wanted to play a game of kickball, they would walk around the neighborhood, knocking on doors and asking their friends if they wished to play. This simple act took initiative and leadership.

In 1972 President Richard Nixon traveled to the People’s Republic of China to initiate detente and successfully changed the course of the Cold War. In advance of this visit, American journalist James Reston also visited China and, while there, had appendicitis. His postoperative pain was successfully treated with acupuncture.

As hunter-gatherers over the millennia, our movements and life rhythms were guided by the seasons, the sun and moon. In the transition to agrarian society, our daily activities continued to follow the pace of the natural environment and demands of the farm.

Over the years, Global Advisory Services has consulted not only in wellness and integrative medicine, but also for supplement product development including Zip Fizz, which is still carried at Costco.

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.

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).

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.

Most Popular
RECIPE: Homemade Saimin Soup
We are very fortunate in Hawaii to grow up eating saimin — Hawaii’s version of ramen, which continues to gain worldwide popularity. Read More »
Hawaii World Class Wedding Expo
Planning a wedding? Then you’ll want to mark your calendar for Hawaii World Class Wedding Expo XXXIV April 24 and 25 at Hawaii Convention Center. Read More »