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Friday, April 18, 2014         

Health and Money Premium

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.

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.

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.

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.

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.

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.

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.

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.

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.

The U.S. Supreme Court recently heard a case that is likely to expand the power and reach of a U.S. patent.

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.

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.

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.

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.

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.

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.

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.

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.

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.

In conjunction with rapidly growing epidemics in obesity and insulin-resistant diabetes, obstructive sleep apnea, or OSA, is also very much on the rise.

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.

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.

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.

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.

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.

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?

During a recent trip to New Zealand, I had the opportunity to interact with the indigenous Maori culture. The people call their country Aotearoa.

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.

Sixty percent of Hawaii residents will need a blood transfusion at some time in our lives.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.



POLL QUESTION
Should gubernatorial candidate Sen. David Ige be allowed to speak about the Democratic Party’s platform progress at its convention?
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UH Senior Fashion Show
The 48th annual University of Hawaii Senior Fashion Show is set for April 27 at Waikiki Beach Marriott Resort & Spa, featuring the designs of seven senior and seven junior designers. Read More »
 
BRUNO MARS
BRUNO MARS AND traveling party are in town, here after their final night in Japan and ready for three nights in Hawaii at the Blaisdell beginning Friday. Welcome home, Bruno! Read More »