hunterbishop.com

While Saturday's conference at Waikoloa basically outlined the blueprint for Big Medicine and Big Government's top-down approach to solving the health care "crisis" on the Big Island, a more grassroots effort at local problem-solving is under way in Puna.

>
State Rep. Josh Green (D-Kona) talks with Hawaii Academy of Arts and Sciences charter school director Steve Hirakami (back to camera) at Saturday's health care conference in Waikoloa. 

Green spoke of legislation he will propose to overcome dire shortages of almost everything related to health care on Hawaii Island system, which affects not only lives but the economy as well. Much of Green's plan targets financial incentives for doctors to establish practices here. Green also wants to establish health care enterprise zones to promote new facilities, and he called on the County of Hawaii to establish a health care "czar" to take charge of the county's needs with a dedicated fund and the power to spend it without a lot of oversight.

Meanwhile Domizio has his own big dream, cobbling together an non-profit organization to raise funds to help people living in an area of the island one conference-goer described as a health care wasteland.

KHBC 1060 AM talk radio hosts Mel "Mynah Bird" Medeiros and Gary Safarik had interesting interviews with both Green and Domizio on the air this week about their plans following the conference.

One of Domizio's ideas is to promote the use of more physician assistants like himself, and more nurse practitioners, to ease the critical shortages of doctors and nurses. Qualified PAs and NPs, who get much but not all of a full doctor's training, can be a boon to expanding health care especially in primary and urgent care. Green said good PAs can double the workload of a physician but that they are as difficult to recruit and keep in Hawaii as doctors and nurses. Most patients don't even know the difference between doctors and PAs, he said. However the level of supervision is different . "A PA tends to have all of their charts signed off by a doctor," he said.

But while Green praised the contributions of PAs and NPs, nothing in his proposed legislation would encourage more to practice in Hawaii, only full-fledged doctors and nurses. 

Green also said the czar's dedicated health fund would be an easy opportunity for the "billionaires in Kona and Kohala" to get their money into the community. A fund like that, controlled by someone familiar with the local communities, could be where Domizio's project could get direct help without spending years working through the state health care planning bureaucracy, he said.

Domizio said the Puna Community Development Plan working group on health, which encouraged new corporate entities be formed to create health care opportunities in Puna, inspired him to begin his project from the ground up. Domizio's proposed Puna Community Medical Center is "simply a quick response to a need that is growing daily and nobody is really doing anything about it," he said.

Still, it's a gargantuan task. "We need money big time," he said. "We are waiting for our blessing from the IRS saying (we) are a non-profit organization."