Big Island Map

Chilumba cha Hawaii chimalandira ndalama zatsopano za federal kuti zithetse kusowa kwa chithandizo chamankhwala. Kodi izi ndi zokwanira?

Jim Sisler anali ndi nkhawa. Anatengera mkazi wake, Sharon, ku Queens North Hawaii Community Hospital madzulo pambuyo pa ulendo wanthawi zonse wachipatala womwe udawonetsa nkhawa za mtima wake. Atalimbana ndi kuchuluka kwa magalimoto kuti akafike ku Chipatala cha Big Island, anamva kuti mkazi wake anali ndi matenda a mtima ndipo ankafunika stent.

Big Island Map

Koma opaleshoni isanayambe, Sisler adanena kuti adauzidwa kuti inshuwalansi ya Kaiser Permanente ikufuna kuti amuchitire opaleshoni pamalo otchedwa Oahu. Ndi momwe Jim adadzipeza atakhala kumbuyo kwa ndege yapakati pausiku, Sharon pa machira kutsogolo kwake, akupita ku Mwanaloa Medical Center ku Kaiser ku Oahu. Kumeneko, anakachita mayeso olowera kusukulu yofanana ndi imene analembera kale pachilumba Chachikulu. Simudzalowa opaleshoni mpaka pambuyo pa 7am

Kuchedwaku kunali kokhumudwitsa kwa Sisler, wazaka 79. Iye anati: “Tinali m’chipatala chimene tikanatha kumusamalira. Anali wokondwa kuti Sharon, wazaka 81, adatha kupeza chisamaliro chomwe amafunikira, koma ntchitoyi inali yovuta komanso yowononga nthawi kuposa momwe amayembekezera.

Nkhani yovuta komanso yowononga nthawi ikufotokoza mwachidule momwe Sisler amamvera ponena za kupeza chithandizo chamankhwala pachilumba cha Hawaii, pamene akukhala m’nyumba ya Kailaba ku Hawaii. Kumeneko amasangalala, koma nthawi zonse amakambirana ndi anzake za mmene zimavutira kupeza akatswiri oti azisamalira matenda awo. Pafupifupi kamodzi kotala, Sisler ndi mkazi wake amapezeka paulendo wa pandege wothandizidwa ndi Kaiser kupita ku Honolulu kuti akalandire chisamaliro chosapezeka kwanuko.

Kaiser anakana kuyankhapo pa mlandu wa Cislers, potchula zachinsinsi, koma adati odwala ambiri aku Hawaii amalandila chithandizo pachilumbachi, popeza akatswiri amapita pachilumbachi pafupipafupi.

“Zisankho za momwe angaperekere chithandizo ndi komwe angapereke zimachokera pazifukwa zingapo ndipo amapangidwa ndi madokotala a Permanente pofuna kupeza zotsatira zabwino zachipatala,” adatero Kaiser Laura Lott. “Mukaganiza zopitilizabe kusamalira odwala omwe ali ndi thanzi labwino ku Moanalua Medical Center, mamembala athu atha kuyembekezera chisamaliro ndi ntchito zomwe zapambana.”

Nicole Kailipaca, namwino wolembetsa komanso woyang’anira pa Hawaii Island Community Health Center, amathandizira wodwala pamwambo wodziwitsa anthu. Posachedwapa likululi linalandira ndalama ku boma kuti lipitilize ntchito zofunika kwambiri pachilumba chachikuluchi. Hawaii Island Community Health

Odwala a Kaiser si apadera. Sisler ndi m’modzi mwa odwala ambiri omwe nthawi zambiri amayenera kupita kukalandira chithandizo chamankhwala ku Oahu, likulu la anthu ku Hawaii. Boma lonse liri ndi kusowa kwa akatswiri azachipatala, vuto limene makampani a zaumoyo ndi olemba malamulo akhala akuyesera kuthetsa kwa zaka zambiri.

Koma kuchepa kwa akatswiri azaumoyo komwe kulipo kumakhala kovuta kwambiri kuzilumba zoyandikana, makamaka chilumba cha Hawaii, ndipo ngakhale akatswiri akapezeka, pangakhale zoletsa za inshuwaransi kapena kupezeka komwe kumachedwetsa kupeza chithandizo.

Opanga ndondomeko adazindikira. Yunivesite ya Hawaii posachedwa idalandira pafupifupi $ 1 miliyoni kuti akhazikitse pulogalamu yatsopano yofufuza zaumoyo wakumidzi, yomwe idakhazikitsidwa ndikugwira ntchito mwezi watha.

Congress idaperekanso ndalama zokwana $4.6 miliyoni kuti zithandizire Hawaii Island Community Health Center, yomwe kale inali West Hawaii Community Health Center isanaphatikizidwe ndi Zipatala za Bayview, kummawa kwa Oahu.

Ntchito zambiri

Ndalamazi zithandizira ndalama zothandizira odwala omwe alibe inshuwaransi, adatero Richard Taff, mkulu wa bungweli, ponena kuti 90% ya odwala omwe amathandizidwa ndi malowa ndi omwe amapeza ndalama zochepa.

Jim ndi Sharon Sisler akumwetulira kunyumba kwawo pachilumba cha kumpoto kwa Hawaii. Mwachilolezo: Jim Sisler

Vuto lalikulu ndi ogwira ntchito. Hawaii Island Community Health Center tsopano ili ndi mwayi kwa asing’anga, anamwino, othandizira madotolo, ogwira ntchito pa desiki yakutsogolo, ndi zina zambiri. Monga gulu, adatero, Chilumba Chachikulu chikulimbana ndi kusowa kwa akatswiri kuphatikizapo koma osati kokha kwa rheumatologists, psychiatrists, otolaryngologists ndi gastroenterologists.

“Tikukakamiza anthu kuti apite ku Honolulu kuti akagwire ntchito ndipo izi zimafuna kuti wina, nthawi zambiri wochita bouncer, apite nawo,” adatero, ndikuwonjezera kuti kuyenda kukukakamiza anthu kuti atenge nthawi yambiri kuntchito. “Zitha kutanthauza kuti anthu sakulandira chithandizo, ndipo akuchedwetsa chisamaliro chawo, kotero pali zotsatira zosiyanasiyana.”

Othandizira zaumoyo akuti pali zambiri zoti zichitike kupitilira ndalama. Zina mwazothetsera zomwe zingatheke ndi monga kulimbikitsa maphunziro a zaumoyo akumidzi kwa madokotala ndi akatswiri ena azaumoyo; kuonjezera mitengo yobwezera inshuwaransi yaumoyo; Kupereka kusakhululukidwa misonkho poletsa msonkho wamba pazachipatala.

Kuthana ndi kusowa kwa nyumba ku Hawaii ndikuchepetsa mtengo wamoyo wonse kungathandize kuwonjezera malipiro a Medicare.

Dr. Kelly Withey wakhala akuyesera kwa zaka zambiri kuti athetse vutoli kudzera mu ntchito yake ku Hawaii / Pacific Region Health Education Center, akuyang’anira ntchito zachipatala pachaka.

Ngakhale adayesetsa – kuphatikiza iyeyo – kuti apititse patsogolo ndikukulitsa maphunziro kumidzi, adati kuchepa kwa akatswiri azachipatala sikunapite patsogolo kuyambira pomwe adayamba mu 2010, mwa zina chifukwa cha kukwera kwamitengo ya zinthu komanso kukwera kwamitengo yopangira bizinesi. boma.

Iye anati: “Zikuipiraipira.” Zimenezi n’zokhumudwitsa kwambiri.” Kafukufuku waposachedwapa apeza kuti Maui ndi chilumba cha Hawaii anali ndi zolakwa zazikulu kwambiri.

Hilton Rathel, Purezidenti ndi CEO wa Hawaii Health Care Association.Hilton Rathel, Purezidenti ndi CEO wa Hawaii Health Care Association.
Hilton Rathel, Purezidenti ndi CEO wa Hawaii Health Care Association, akuti mliriwu wachulukitsa kuchepa kwa akatswiri azaumoyo ku Hawaii. Corey Lom / Civil Beat / 2020

Hilton Rathel, wamkulu wa bungwe la Hawaii Health Care Association lomwe limayimira zipatala zaboma ndi zipatala zina, akuti mliriwu sunathandize.

“Tabwereranso ku mliriwu chifukwa chakukwanira kwa ogwira ntchito yazaumoyo,” adatero, pozindikira kuti akatswiri azachipatala apuma pantchito ndikuchoka m’boma. “Tsopano tili ndi vuto lalikulu kuposa momwe tinalili mu 2019.”

Nonna Wilson, namwino wopuma pantchito yemwe amakhala ku Vulcano, akuti kuchokera ku zomwe adakumana nazo kuti kukonza bwino ntchito ndi kusunga anthu ndizomwe zimafunikira kuti vutoli lithe. Akuyembekezera kuwona momwe Bwanamkubwa wa Hawaii a Josh Green, yemwe ndi dotolo wachipatala cha Big Island, athana ndi vutoli ali pantchito.

Lachitatu, Green adanena kuti monga bwanamkubwa, atsatira ziwongola dzanja zapamwamba za Medicaid kuti akope madotolo ambiri kuti alandire inshuwaransi yazaumoyo kwa anthu omwe amapeza ndalama zochepa. Akufunanso ndalama zambiri za boma ndi boma kuti alipire ngongole za madokotala kuti azilimbikitsa madokotala kuti azigwira ntchito kumadera akumidzi monga Big Island ndikuthandizira kusintha kwa malamulo a chilolezo chachipatala ku Hawaii kuti alole madokotala ambiri kuti azichita telehealth m’boma.

Ananenanso kuti adalimbikitsidwa ndi zaka zopitilira makumi awiri zomwe adakhala akugwira ntchito yachipatala pachilumba cha Hawaii komanso kufunika kothana ndi kusiyana kwaumoyo pakati pa anthu osauka ndi a ku Hawaii.

“Amamwalira zaka zisanu ndi zitatu m’mbuyomo kusiyana ndi ena chifukwa chakuti alibe chithandizo,” iye anatero. “Akhala akudwala kwa zaka 10 chifukwa chosowa chithandizo.”

Bwanamkubwa wosankhidwa Josh Green akuti amalimbikitsidwa ndi zomwe adakumana nazo ngati dokotala wachipatala kuti achitepo kanthu kuti ayesetse kupeza chithandizo chamankhwala kwa anthu aku Hawaii. David Croxford / Civil Beat / 2022

kusowa kwa chithandizo chamankhwala

Raithal adati madera akumidzi ambiri amakumana ndi zopinga pazachipatala chifukwa kulibe anthu okwanira – motero kufunikira kwa odwala – kulungamitsa zambiri zapadera.

Raithal adati chilumba cha Hawaii chili pachiwopsezo kwambiri chifukwa madera ake ndi omwazikana kwambiri, zomwe zimawonjezera zovuta zamayendedwe komanso zovuta zofikira odwala ambiri.

Ziwerengero ndi zowopsa: Kafukufuku yemwe adachitika mu 2021 adapeza kuti County ya Hawaii inali ndi kusowa kwachitatu kwakukulu kwa akatswiri azachipatala mdziko muno.

Lipoti la 2022 lidapeza kuti 75% ya zipatala zakumidzi yaku Hawaii zili pachiwopsezo chotsekedwa, kuchuluka kwambiri kuposa dziko lina lililonse.

Lipoti lochokera ku Community First mu July linapeza kuti pafupifupi asanu ndi mmodzi mwa odwala 10 ku Hawaii adanena kuti akuchedwa kupeza chithandizo chamankhwala, ndipo 34% ya anthu a ku Hawaii omwe ali ndi zaka zosakwana 55 akufotokoza kuchedwa kwawo kukhala kofunika.

Scott Grosskreutz, katswiri wodziwa matenda a radiology ku Hilo, amakumbukira pamene anali mkulu wa ogwira ntchito ku Hilo Medical Center ndipo anapuma pantchito wothandizira wamkulu wa banja lake ali ndi zaka 75. Ngakhale kuti anali wogwirizana kwambiri ndi madokotala, kupeza wolowa m’malo kunali kovuta.

Izi ndi zomwe wamva kwambiri kwa zaka zambiri, ndipo zingatenge miyezi kuti mupeze njira zina mukangosiya dokotala wanu.

“Mmodzi mwa amayiwo adandiuza kuti adalumikizana ndi madokotala osiyanasiyana 18,” adatero. “Chofunika kwambiri ndi chakuti zimakhala zovuta kupeza wothandizira zaumoyo ngakhale mutakhala ndi matenda aakulu komanso oopsa kwambiri.”

Pulogalamu yatsopano yazaumoyo yakumidzi yaku University of Hawaii ili ndi antchito atatu anthawi zonse komanso wofufuza wamkulu wanthawi yochepa. Pazithunzi kuchokera kumanzere kupita kumanja ndi Amy Ma, Renee Gerets-Goh, Amy Malia Grace, ndi Chad Wolke. David Croxford / Civil Beat / 2022

ndalama zambiri

Groskreutz akuganiza kuti chuma ndi gawo lazovuta. Dziko la Hawaii ndi limodzi mwa mayiko omwe amakhoma msonkho wa chithandizo chamankhwala kudzera mu msonkho wamba, ndipo izi, kuphatikiza kukwera mtengo kwa moyo ndi kubweza ndalama zochepa, zimalepheretsa akatswiri azachipatala kuti atsegule zipatala zapadera.

Adathandizira kulemba chikalata choperekedwa ndi Senate kuti athane ndi izi, koma zomwe zidachitika zidafa. Zina mwazovuta ndizakuti zikadawononga boma $200 miliyoni pamisonkho wamba, atero a Bradley Koe, namwino yemwe amayendetsa kampani ya telehealth ndipo amalimbikitsa izi.

Nkhani ya msonkho wamba wamba ndi imodzi yomwe Green akufuna kuyiyankha ngati bwanamkubwa, komanso ndi imodzi mwazinthu zambiri zomwe pulogalamu yatsopano yazaumoyo yakumidzi yaku University of Hawaii ikuyembekeza kuphunzira ngati gawo la ntchito yake yowunikira zotsatira zomwe ndondomeko za boma zili nazo. . Zofunikira pazaumoyo ku Hawaii.

Amy Grace, wofufuza wamkulu pa pulogalamuyi, adati cholinga choyamba cha gululi ndikuyang’ana ndondomeko za boma, monga kubweza ndalama za Medicare zochepa. Boma la Biden posachedwapa lalengeza kuti izi zitha kupitilira.

Sisler akukhulupirira kuti thandizo lowonjezereka silingabwere posachedwa. Anali kuyang’ana dokotala wamankhwala, geriatrician, ndi ophthalmologist. Anadutsa akatswiri atatu a urologist – awiri a iwo anamwalira ndipo wachitatu. Dokotala wa maso posachedwapa anasiya ntchito.

Amasiya maulendo afupipafupi ndi mkazi wake ku Honolulu, koma nthaŵi iriyonse amayenera kuyendetsa makilomita 30 kupita ndi mtsogolo kukatenga ma voucha a taxi kuti akagwiritse ntchito kumeneko.

“Ndatopa ndikusaka ndikupeza kuti ndiyenera kupita ku Honolulu ndipo kutumiza ndi masitepe awiri kapena atatu,” adatero.

Kaya ndi nthawi yopuma msonkho kapena ndalama zambiri kusukulu ya zamankhwala ku Hawaii, akuganiza kuti pali china chake chomwe chiyenera kusintha kuti alimbikitse akatswiri azaumoyo kubwera – ndikukhala.

“Ziyenera kukhala zokongola, nthawi,” adatero.

Kuthandizira zaumoyo wa Civil Beat kumathandizidwa ndi Atherton Family Foundation, Swayne Family Fund ya Hawaii Community Foundation, Cooke Foundation, ndi Papa Ola Lokahi.

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