On August 18, 2023, the Internal Revenue Service announced “expansive tax relief” for Hawaii wildfire victims in Maui and Hawaii counties. Generally, what that means is that if a tax filing or payment for an affected taxpayer is due between August 8, 2023, and February 15, 2024, then the filing or payment can be made on or before February 15, 2024, to file the returns or make the payments.
Quarterly estimated income tax payments normally due on Sept. 15, 2023, and Jan. 16, 2024.
Quarterly payroll and excise tax returns normally due on Oct. 31, 2023, and Jan. 31, 2024.
Calendar-year partnerships and S corporations whose 2022 extensions run out on Sept. 15, 2023.
Calendar-year corporations whose 2022 extensions run out on Oct. 16, 2023.
Calendar-year tax-exempt organizations whose extensions run out on Nov. 15, 2023.
For individuals who extended their 2022 returns until Oct. 16, 2023, and are impacted by the disaster, those returns can be filed on Feb. 15, 2024. But the tax was due on April 18, 2023, before the wildfires started. Remember, an extension of time to file a return doesn’t extend the due date of the payment, so a good faith estimate of the 2022 liability does need to be paid in if it wasn’t already.
The IRS also gave folks a magic code – “DR-4724-HI” – which needs to be written on any return claiming a casualty loss. (This is actually the FEMA declaration number for the Maui wildfires.) IRS also reminded folks that disaster relief payments are generally excluded from gross income, so income tax doesn’t need to be paid on payments for living expenses, funerals, or home rehabilitation.
This relief, of course, is granted only to taxpayers affected by the fires. Taxpayers whose address is within the disaster zone, namely Maui and Hawaii Counties, including the islands of Lanai and Kahoolawe, generally qualify. Taxpayers outside the zone should explain why or how they are affected in a statement attached to the return. Acceptable explanations include: (1) the taxpayer is a relief worker affiliated with a recognized government or charity and is assisting in the disaster area, (2) the taxpayer’s records were maintained in the disaster area, or (3) the taxpayer is an individual who was visiting the disaster area and was injured or killed.
The Hawaii Department of Taxation also came out with Tax Announcement 2023-03 to give tax relief. The Department, however, only said that it will consider relief on a case by case basis. “2023 Wildfire Relief” should be written in the top center of the return. As with the federal returns, if a taxpayer’s address is outside the affected area, the taxpayer should explain how the disaster impacted it in a statement attached to the return.
Some folks have asked me why the Department isn’t offering blanket extensions like the IRS is. It’s not because the Department is overly stingy. It’s because there is a federal law, Internal Revenue Code section 7508A, empowering the IRS to grant these extensions. That federal law was enacted as part of the Taxpayer Relief Act of 1997 and was signed by Bill Clinton. Hawaii has nothing comparable. So, the Department’s hands are tied a bit more when it comes to doling out relief. If people think that the authority the Department has been given isn’t enough, they can speak with their legislators to have appropriate legislation proposed.
“Security Starts with the Soil” is the title of the 33rd Hawaii International Tropical Fruit Conference Oct. 5-7 at the Neal Blaisdell Center in Honolulu. The 2023 conference offers a full lineup of educational offerings, panel discussions, a trade show, and the Famous Friday Fruit Tasting.
Geared to farmers, educators, orchard managers and proponents of sustainable agriculture, the conference is presented by the statewide Hawaii Tropical Fruit Growers (HTFG) and open to the public. Enjoy an early bird discount of $50 through September 1.
Research updates will be provided by Dr. Marisa Wall of the US Dept. of Agriculture on avocado lace bug, a team from the UH College of Tropical Agriculture and Human Resources and Director Sharon Hurd of the Hawaii Dept. of Agriculture. Senator Mike Gabbard will also present a Hawaii legislative update.
Conference attendees can attend a variety of panel discussions on local fruit access, soil health and practices to improve fruit production. Break-out sessions will focus on soil health, food preservation, going organic and Go Farm, plus grants and funding opportunities.
In addition, there will be Oahu tours at Lokea Farms and the Wahiawa Produce Development Center.
The conference is made possible with the support of the Hawaii Department of Agriculture, D.R. Horton, Waianae Comprehensive Health Center, Go Farm, Sodexo, Hawaiian Earth Recycling and HTFG members from across the state.
Marking its 34th year, HTFG was incorporated in 1989 to promote tropical fruit grown in Hawaii. It is a statewide association of tropical fruit growers, packers, distributors, and hobbyists dedicated to tropical fruit research, education, marketing and promotion; www.HTFG.org.
Have you or someone you know been harmed by wearing bras? If so, then you could possibly become a co-plaintiff in a future class action lawsuit against the bra and cancer industries.
Product liability applies to garments, as well as other consumer products. Bras are known to cause health problems, from headaches and back pain, to nerve compression and tingling in the hands. Bras have been shown to affect digestion, breathing, and even menstruation, since bras also interfere with the sympathetic nervous system. Bras constrict the lymphatic system, which is the circulatory pathway of the immune system. This causes reduced lymph and blood circulation, toxin accumulation, and reduced immune function. This leads to breast pain, cysts, and cancer.
The degree of damage from bras depends on the bra material and its toxic chemical content, the tightness it is worn, the length of time it is worn daily, and the number of years it has been worn.
According to the 1991-93 US Bra and Breast Cancer Study, documented in the book, Dressed to Kill: The Link Between Breast Cancer and Bras, bra-free women have about the same risk of breast cancer as men, while the tighter and longer the bra is worn the higher the risk rises, to over 100 times higher for a 24/7 bra user compared to a bra-free women. Since that groundbreaking study, numerous other studies worldwide have confirmed a bra-cancer link. (See below)
Bras are also used as medical devices, worn tightly to stop lactation. And while a tight bra can cause breast lymphedema, bras are also used as a compression garment to manage lymphedema. Clearly, bras have an impact on breast function and circulation.
Despite the fact that bras affect the health of the breasts, bras are sold without any wearing instructions or warning labels. While manufacturers provide sizing charts, these do not mention the problems with wearing ill-fitting bras. In addition, many styles of bras are constrictive and tight by design, such as push-up and strapless bras, even if worn at the recommended size. There is no mention of maximum recommended wearing time for these garments.
Some bra manufacturers have responded to the consumer demand for more comfortable and healthy clothing, developing less toxic materials and a more comfortable, less constrictive designs. However, the lingerie industry may still be found liable for the harm caused by its products, and bras may be required to have instructions about tightness and limiting time worn.
Unfortunately, the American Cancer Society insists that bras are not a cause of cancer in any way, and never can be. They discourage any further research into this issue. And they sell mastectomy bras to show their commitment to the garment. The ACS also ignores worldwide studies which show a cancer link.
It’s been thirty years since the first study into the bra-cancer link, and the US breast cancer industry still continues to ignore the impact of tight bras on immune function and cancer development. Tight clothing is fashionable, even if it causes disease, and medicine treats the diseases of fashion. It doesn’t change fashion. There is only liability for cancer organizations in admitting that bras are the leading cause of breast disease, after having denied that it can be true for decades despite the evidence.
It’s very much like the history of the tobacco-cancer link. It was denied by cancer societies and doctors, since everyone smoked. It took 30 years for consensus that a cancer link existed. And then the lawsuits began.
Will this lead to litigation anytime soon? Not if the lingerie and medical industries can continue to cover-up this information with a flawed study and censorship. But women discover the discomfort and pain of bras for themselves, which is why Gen Z is bra-free. Women are wanting comfort. This is making them ditch the bra. It may also help them avoid breast disease.
P.S.
The ACS says this: “Online and social media rumors and at least one book have suggested that bras cause breast cancer by obstructing lymph flow. There is no scientific or clinical basis for this claim, and a 2014 study of more than 1,500 women found no association between wearing a bra and breast cancer risk.”
Fact Check:
The 2014 study, done at Fred Hutchinson, did not include any bra-free women, so there was no control group. Also, the only women in the study were over 55, so the results cannot be generalized to women not yet in menopause.
This 2014 study is the only evidence used to disprove the bra-cancer link, and the only study not finding a link.
Studies that were done that support a bra-cancer link:
1991 Harvard study (CC Hsieh, D Trichopoulos (1991). Breast size, handedness and breast cancer risk. European Journal of Cancer and Clinical Oncology 27(2):131-135.). This study found that, “Premenopausal women who do not wear bras had half the risk of breast cancer compared with bra users…”
1991-93 U.S. Bra and Breast Cancer Study by Singer and Grismaijer, published in Dressed To Kill: The Link Between Breast Cancer and Bras (Second Edition, Square One Publishers, 2018). Found that bra-free women have about the same incidence of breast cancer as men. 24/7 bra wearing increases incidence over 100 times that of a bra-free woman.
Singer and Grismaijer did a follow-up study in Fiji, published in Get It Off! (ISCD Press, 2000). Found 24 case histories of breast cancer in a culture where half the women are bra-free. The women getting breast cancer were all wearing bras. Given women with the same genetics and diet and living in the same village, the ones getting breast disease were the ones wearing bras for work.
A 2009 Chinese study (Zhang AQ, Xia JH, Wang Q, Li WP, Xu J, Chen ZY, Yang JM (2009). [Risk factors of breast cancer in women in Guangdong and the countermeasures]. In Chinese. Nan Fang Yi Ke Da Xue Xue Bao. 2009 Jul;29(7):1451-3.) found that NOT sleeping in a bra was protective against breast cancer, lowering the risk 60%.
2011 a study was published, in Spanish, confirming that bras are causing breast disease and cancer. It found that underwired and push-up bras are the most harmful, but any bra that leaves red marks or indentations may cause disease.
2016 Brassiere wearing and breast cancer risk: A systematic review and meta-analysis World J Meta-Anal. Aug 26, 2015; 3(4): 193-205 This systematic review and meta-analysis aimed to evaluate the association between 8 areas of brassiere-wearing practices and the risk of breast cancer. Twelve case-control studies met inclusion criteria for review. The meta-analysis shows statistically significant findings to support the association between brassiere wearing during sleep and breast cancer risk.
2018 Lymph stasis promotes tumor growth Journal of Dermatological Science “(t)hese findings come as no surprise to us who for a long time have been aware that alterations in regional lymphatic flow may produce dysregulation in skin immune function and consequent oncogenesis. In fact, since 2002, our team has held the view that lymphedematous areas are immunologically vulnerable sites for the development of neoplasms as well as infections and immune-mediated diseases. In recent years, increasing evidence has confirmed this assumption.”
2018 How Bras Cause Lymph Stasis and Breast Cancer Academic.edu “Recent studies are showing that lymph stasis causes cancer by reducing immune function. This article draws on these studies to further explain how constriction from tight bras results in lymphatic impairment in the breasts and an increased incidence of breast cancer.
2019 Wearing Brassiere – A Less Well Known Factor Associated with Breast Cancer in Women Nurs Midwifery J 2019, 16(12) 891-901. Wearing of brassiere is also a lifestyle-related habit that has sparked many debates today as a risk factor for breast cancer in women. This study was conducted to determine the behavioral Habits of wearing brassiere in women with and without breast cancer. Conclusion: The findings of this study revealed differences in some behavioral habits of wearing brassieres in women with and without breast cancer. So, in preventive interventions for breast cancer, women’s education should be considered in order to be aware of the proper behavioral habits in wearing brassieres.
Clearly, more research is needed, despite ACS denial of any merit to the link. Can the ACS save face and explain 30 years of denying women this information? According to ChatGPT, the ACS is in trouble.
But you don’t have to wait. Just try being natural for one month without a bra, and feel the difference. You can join the International Bra-Free Study, where we have already shown the positive results from tossing the bra.
For more information:
Sydney Ross Singer
Medical Anthropologist
Director, Institute for the Study of Culturogenic Disease
Editor’s note: Manfred Henningsen is a frequent contributor to Hawaii Reporter. His latest book — a coming of age memoir that spans WWII and postwar Germany is also a trenchant political commentary that reminds Americans that they need to come to terms with their own racist past. Henningsen, who came to the U.S. in 1969, doesn’t mince words when it comes to “American Exceptionalism” which he contrasts with Germany’s Vergangenheitsbewältigung–which means the effort to analyze, digest and learn to live with the past, in particular the Holocaust.
The Russian invasion of the Ukraine on February 24, 2022, has updated one of my major motivations for writing this book: why did the violent record of Russian history in the 20th century not prevent Putin from ordering his so-called “special operation”, and why did most of the Russian people become the willing bystanders of this war? Talking to a very diverse selection of Ukrainian citizens on a 2-week journey from Lviv to Kyiv and Odessa in 2016, the then occurring military operation in the Donbas region made it clear to them that Russians hadn’t changed.
Again and again, my brother and I were confronted with the insight that the Germans had learned from their violent history, including their terror regime in the Ukraine from 1941 to 1945, and therefore could be trusted. Yet the Russians had not recognized the legacy of the Stalinist terror in the Ukraine and therefore behave today as they had before.
Russians had not recognized the legacy of the Stalinist terror in the Ukraine and therefore behave today as they had before states Manfred Henningsen. Depicted above is a Russian missile strike on 10 October 2022 at the intersection of Volodymyrska Street and Taras Shevchenko Boulevard (Courtesy Wikipedia)
The unique nature of my manuscript stems from the fact that in the long introduction I attempt to reconstruct how I became slowly aware of the monstrous past of the society I was born and growing up in since 1938 during and after the war. The formative experiences of my childhood are characterized by an unspoken compact of silence Germans practiced on almost all levels of society, including the family. In early 1945 I observed the change in the small town of Gluecksburg in the northern-most art of Germany when Nazi and Wehrmacht uniforms became suddenly replaced by the uniforms of the British occupation army. The seven-year-old boy didn’t understand what it meant because nobody explained it to him. Yet it became obvious to me that something extraordinary had happened because the people in the new uniforms spoke a language I didn’t understand.
I saw thousands of refugees that were coming from the eastern parts of the country (East Prussia, Pomerania, and Silesia), fleeing the approaching Soviet Army. They were seeking refuge in this region in the North that had seen almost no destructive impact during the entire war. But I didn’t see the hundreds of surviving concentration camp inmates who were arriving in late April and early May by train from Neuengamme near Hamburg and by ship from the camp Stutthof in East-Prussia in the harbor of the nearby city Flensburg. By that time, Flensburg had become the last capital of the Third Reich with Grand Admiral Doenitz as Hitler’s successor.
Manfred Henningsen was a young child and a witness to history when these three members of the Flensburg Government, General Alfred Jodl, Dr Albert Speer, and Grand Admiral Karl Dönitz, were arrested by the British. He clearly remembers seeing them march past him near the castle where they were incarcerated. (courtesy Wikipedia)
These sick and emaciated survivors must have been seen by many people but were never mentioned when they reminisced about the end of the war. I never heard about these experiences until I read about them in a book that was published in 2015, covering the final days of the war in Flensburg. Recovering these suppressed experiences of historical reality, had to wait a long time until the social prohibition of questioning had been lifted. I don’t know whether all the bodies that were buried in mass graves in 1945 have been by now excavated and identified.
The pervasive silence about the Nazi past that determined my childhood and high school years in Flensburg ended for me when I entered the University in Munich in 1958, studying history, philosophy, and political science. It was the time when critical historical and political studies about the Third Reich began to slowly appear. Yet reflections on the past were often characterized by self-pity about the loss of home and property, experiences of suffering and death on the flight from the east and during the Allied bombing raids on German cities.
The Allied bombing raids on German cities, as this shot of Hamburg illustrates, fomented a kind of “self-pity” among Germans says Professor Henningsen. Hamburg was not far from Flensburg, Henningsen’s hometown and he remembers seeing the firestorm in the distance. (courtesy Wikipedia)
The processing of the past, the by now famous Vergangenheitsbewaeltigung, had not yet started, though the activities of institutional apologies and payment of reparations had been started by the West German government in negotiations with Israel and the Jewish World Congress in the early 1950s. Pressure from the Truman and Eisenhower administrations had facilitated these moves.
The book retraces the stages of the process of German civil society, slowly coming to terms with the record of evil. I have watched this development from the 1960s onward, first from inside Germany and then since 1969 from the USA. As a German living in the USA, I was regularly questioned about the past and couldn’t escape the presence of Nazi Germany as a permanent feature in the American culture industry. Everything connected with Germany had a moral question mark attached to it. As a result of this constant exposure, I became curious about the question of how other societies, including the USA, had processed the negative aspects of their history.
Professor Henningsen cites Henry Louis Gates’ 2019 PBS documentary and book on the Reconstruction Period (Stony the Road. Reconstruction, White Supremacy, and the Rise of Jim Crow, 2019) as a case in point of America’s intentional amnesia
Living in the US since 1969, first in Stanford, and then since 1970 in Hawaii, and getting married to a young African American woman in 1974, the focus on American historical denial became a parallel inquiry to my German quest. Why was the story of America told as an exclusively White experience, ignoring the economy of evil that slavery and Jim Crow constituted, and refusing to listen to the counter-narrative of meaning Black writers, preachers, gospel singers and musicians had to offer?
The books by Ta-Nehesi Coates, We Were Eight Years in Power (2017) and Between the World and Me (2015) and the documentary film by Raoul Peck about James Baldwin, I’m Not Your Negro (2016), which is based on Baldwin’s unfinished manuscript, Remember This House, tell the story of white racism in the US as it still impacts American life today. Henry Louis Gates’ 2019 PBS documentary and book on the Reconstruction Period (Stony the Road. Reconstruction, White Supremacy, and the Rise of Jim Crow, 2019) underline the intentional amnesia that has been socially dominant.
I try to use a similar approach in my book when I compare German and American experiences.
Professor Henningsen reckons that the Japanese political class don’t win any responsibility awards for the record of evil perpetrated on China, Korea, the Philippines. The illustration above shows the bodies of victims along Qinhuai River out of Nanjing’s west gate during Nanjing Massacre. (courtesy Wikipedia)
Yet as much as I was preoccupied by the German and American parallelism of forgetting and attempts at overcoming this syndrome, encounters with Asian students at the University of Hawaii made me also look at scenarios of terror in Asia. Since Imperial Japan’s attack on Pearl Harbor on December 7th, 1941, triggered the American entry into the war, the Tokyo Trial (1946-48) as its conclusion opened the perspective on the terror committed by the Japanese Imperial army in China.
The still pervasive unwillingness of the Japanese political class to take responsibility for the record of evil perpetrated on China, Korea, the Philippines, and other Asian countries by the empire follows a pattern that one could call the norm of denial and memory suppression. Comparing the Japanese with the German story and then also dealing with the Khmer Rouge regime in Cambodia from 1975 to 1979 and the Indonesian violence of 1965-66 provides a global comparative perspective on regimes of terror and memory.
Professor Henningsen cites Timothy Snyders’s Bloodlands as a book that influenced his approach to going “Beyond the Uniqueness of the Holocaust”.
When it comes to books that received popular acclaim in the area I am talking about, I would mention Timothy Snyder’s studies, Bloodlands (2010), Black Earth (2015) and The Road to Unfreedom (2018) that have influenced my comparative approach. Yet Ian Buruma’s, The Wages of Guilt. Memories of War in Germany and Japan (1994) and especially Iris Chang’s The Rape of Nanking (1997) may come closer to my attempt throughout the book to use my personal experiences as the existential connection to understand the manifestations of evil in Germany, America, and the rest of the world.
The subtitle of Iris Chang’s book on the terror the Japanese army unleashed on Nanjing in December 1937, The Forgotten Holocaust of World War II, emphasizes the comparative dimension when she confronts the failure of the Japanese political class to the terror record of the empire with the successful processing of the past in Germany.
Ken Burn’s “The U.S. and the Holocaust” brought front and center the U.S. government’s lack of interest in rescuing European Jews prior to the outbreak of WWII. American Exceptionalism wasn’t so exceptional in those days.
The subtitle of her book provoked some angry responses in the US because it seemed to relativize the Holocaust. Yet contrary to this charge (which will predictably be raised against Ken Burn’s 2022 PBS-documentary “The U.S. and the Holocaust”), she wanted to provoke her American readers to finally recognize the economy of violence the former WWII ally, the Republic of China, had endured during the war. The subtitle of my book, “Beyond the Uniqueness of the Holocaust”, has already provoked even more angry responses since I dare to question the notion that the perpetration of evil on a grand genocidal scale depends on Germans as perpetrators and Jews as victims.
Speaking about the universal potential of this kind of action doesn’t take anything away from German responsibility for the terror they perpetrated. Yet it allows the world to look at history in a much less Holocaust-centric way and imagine, based on the knowledge of genocides that have happened in Europe, Africa, and Asia since 1945, a future when Holocaust-like scenarios will emerge without Germans as perpetrators and Jews as victims.
Professor Henningsen visited the at Tuol Sleng Genocide Museum in Phnom Penh where thousands of photos taken by the Khmer Rouge of their victims can be seen. (courtesy Wikipedia).
To experientially substantiate this notion of the universal potential for genocidal terror, I visited sites where this terror has already been acted out:
Dachau (1956, 2010), Buchenwald (1991, 1995, 2016, and 2018), Auschwitz (1997), Tuol Sleng, Phnom Penh (1997), Nanjing (April and December 2012), Babi Yar, Kyiv (2016). In addition, I visited museums and memorials in Washington, D.C., Los Angeles, Berlin, Munich, St. Petersburg, Beijing, Tokyo, Jerusalem (Yad Vashem) and Cape Town to get a fuller exposure to the universal record of crimes against humanity. These visits made me also realize how the universal presence of evil in human nature enables political regimes of all stripes in all parts of the world to weaponize this disposition.
Instead of “here today, gone to Maui,” it really was, “here today, [Lahaina is] gone tomorrow.” It is a tale of devastation and heartbreak that is still unfolding as residents and authorities gradually pick up the pieces.
We in Hawaii tend to be generous people. Across the news and social media, there are many heartwarming tales of people opening their hearts to the victims, of coming together as a community to be helpful.
But there is a darker side.
Whenever people are motivated to give, there are others who are motivated to take.
Those of you with generous hearts need to keep some things in mind to make sure that you don’t become another victim.
First, donate to charities you know and trust. If you think you know the charity but haven’t dealt with them before, you can search on the Exempt Organization Search tool on IRS.gov (https://apps.irs.gov/app/eos/). Your charity has to be on “Publication 78” for you to be able to take a deduction for your charitable contribution on your income tax returns (federal and state). There are reputable and well-known organizations, such as the Chamber of Commerce of Hawaii, that can be found on the Exempt Organization Search but are not on Publication 78. You need to know that if you make a contribution to such an organization, it does not qualify as a charitable contribution and can’t be deducted on that basis. (If you are a business, you might be able to deduct a contribution made to a non-charity as a business expense under some circumstances. Check with your tax professional.)
It goes without saying, then, that if the “charity” you are being asked to donate to doesn’t even show up on the list, you should ask a few more questions before you open your wallet.
Be alert when giving to individuals on crowdfunding sites. Depending on the site, crowdfunding campaigns can be set up by anyone. The “disaster victim” who set up the campaign might not in fact be a disaster victim, and the name on the campaign might be fake.
And then, be extremely cautious if the so-called donee insists that the contribution be made by cash, gift card, wired funds, or cryptocurrency. Making payment by one of these methods pretty much guarantees that you’ll never get the funds back even if the donee is scamming you. If you want to donate, pay by credit card. That form of payment gives you more protections. (And maybe a few more award miles.)
And, finally, if someone does try to scam you, report it whether or not the scammer succeeded in taking your money. A good place to start would be ReportFraud.ftc.gov, which goes to the Federal Trade Commission and is then shared with more than 2,800 law enforcers. Reporting the issue increases the chances that the perpetrators will be caught and prevented from scamming others.
For some of the big-hearted of us, it’s “here today, and some money, or goods, or other necessary things are gone to Maui.” Let’s make sure they go where they’re supposed to.
State lawmakers recently made some inroads into addressing Hawaii’s doctor shortage, but the state’s healthcare crisis, especially in our most rural communities, is far from over.
In fact, among the heartbreaking losses earlier this month in fire-ravaged Lahaina were three healthcare clinics that served approximately 30,000 patients.
That leaves few healthcare options for the residents on West Maui, where the drive to the Maui Memorial Medical Center in Kahului can take one to two hours.
Keli’i Akina
In addition, it was announced this week that the Kauai Community Health Alliance, which operates the North Shore Wellness Center and Hale Lea Medicine and Urgent Care, will be ceasing operations over the next few weeks.
The nonprofit medical provider’s president and CEO, Jim Winkler, told The Garden Island: “Even with extremely generous charitable organizations from our community, KCHA is simply unable to generate enough revenue to meet its payroll demands and keep its doors open.”
Winkler said reasons the clinics can no longer afford to operate include low Medicare, Medicaid and HMSA reimbursement rates, as well as changes brought on by the COVID-19 crisis.
It’s a story that has become all too familiar to those who are keeping an eye on Hawaii’s healthcare situation.
Statewide, Hawaii is short almost 800 full-time equivalent physicians. Bed shortages are also a problem, with one in 10 hospital beds occupied by patients who are on waitlists for beds in nursing homes or assisted living facilities. Meanwhile, there aren’t enough medical professionals to care for patients who need long-term care.
Emergencies highlight such shortages, but our lack of adequate healthcare services existed well before COVID-19 and the Maui wildfires came along. These shortages are the result of policies that go back decades and have left our state ill-equipped to handle day-to-day operations.
For example, the state general excise tax on medical services has made it near-impossible for private practices to flourish. Hawaii is one of only two states that charges a tax on your doctor visit or medical procedure — and the only one that taxes Medicare and Medicaid patients.
Hawaii also has overly restrictive medical certificate-of-need laws, which require government permission to provide new services or build new medical facilities. Such laws are being rolled back elsewhere in the nation because they have been linked to higher costs and fewer healthcare facilities.
Thankfully, state lawmakers passed legislation this year to raise Medicaid reimbursement rates to match Medicare rates.
The Legislature and governor also allowed Hawaii to join the Interstate Medical Licensure Compact, which will make it easier for doctors from participating states to practice in Hawaii.
These are good moves, but we need stronger action to significantly improve healthcare access in the state.
Looking forward, state lawmakers should enter Hawaii into more interstate medical compacts, covering everything from nurses to psychologists.
They also should exempt medical services from the GET to make it easier for private medical practices to stay in business.
Finally, lawmakers should remove the state’s CON requirements that inhibit the growth of much-needed medical facilities, such as dialysis centers, substance abuse facilities, hospice centers, psychiatric facilities and ambulatory surgical centers.
Hawaii’s healthcare crisis is not a problem that can be solved overnight. Even if the Legislature were to jump into action and pass broad reforms, it would still take many years for us to see the effects of those changes.
That’s all the more reason we shouldn’t wait. Hawaii’s healthcare crisis is only going to get worse until we work together to change the policies that created it in the first place. __________
Keli‘i Akina is president and CEO of the Grassroot Institute of Hawaii.
‘The Island In Me’ – Talcual Films’ feature-length documentary about the atoll of Pukapuka – premieres this week at Cinequest Film and Creativity Festival in Mountain View, CA. The screening coincides with the release of an evocative music album composed by the People of Pukapuka and Nassau in collaboration with GRAMMY Award-winning composer and producer Todd Sickafoose. ‘The Island In Me (Original Motion Picture Soundtrack)” was released on August 11, 2023, by Secret Hatch Records and available on all digital platforms. Music lovers, ethnomusicologists, and aficionados of a cappella hymns will find themselves delighted with sounds rarely heard outside the archipelago.
Sickafoose, who composed the score for the film, shared “we aspired to create a feeling of openness that was oceanic – a sense of infinity – because that’s what you see in these images.” The album came out of a community collaboration and desire to showcase the voices of the atoll alongside Sickafoose’s score. The production team places vital emphasis on staying true to the historical traditions of Pukapuka’s musical culture.
For the film and album, Hawaii-based Director/Producer Gemma Cubero del Barrio worked closely with the island. “The whole project—from organizing a sports day to using drone and underwater footage from local cinematographer Kolee Tinga—involved the full collaboration with all the villages, island chiefs, and government officials,” shares Cubero del Barrio. “The whole island got behind the project and wanted to showcase the best of Pukapuka to the world.”
Towards the end of filming, a few local musicians came up to her and said, “we have composed music for the film.” This track became ‘Homecoming Song,’ an emotional ballad sharing the love for land and home, accompanied with a stunning music video of images from Pukapuka.
The film touches on themes of remembrance, longing, and missing home, which wove its way into the soundtrack. Sickafoose shared: “The tone of the film is very musical. There’s a lot of space for just being in a spot and staying there for a while, lingering in an emotion. There’s a lot of longing in the film, and I think that quality is especially suited to being expressed in music.”
“Everyone in Pukapuka is a musician,” said Cubero del Barrio. For more than 2000 years, Pukapukans have been using their unique language and music to preserve their storytelling across generations with makos (old chants), and to celebrate their communal spirit with tilas (wrestling chants). While listening to the soundtrack, one can be transported to this unique atoll never captured on film and tape before.
The church bell in the track titled Imene Apii Sabati reveals the spiritual nature of the people and place. In the Elder Makos “Ulu Ia Meli ia Waleeu,” thevoices of elders joyfully pass wisdom to new generations. Younger voices are also present in the album – through the performance of National Anthem by children of the Niua School, and a Tila.
The story of the film, spanning across many generations, evokes questions about identity, belonging, and much more. Gemma Cubero del Barrio captures these complex ideas with the subtlety and nuance. “I’ve always believed that the language of cinema and sound allows us to connect with the heart of people, across space and time.
My intention is that viewers will be touched by the magic and beauty of the indigenous people of Pukapuka, and by the emotion and humanity in the stories we tell, that resonate from the personal to the universal. By the end of viewing the film or listening to the soundtrack, the island will be in you as well.”
Before its premiere at Cinequest this week, the documentary won the Special Jury Prize at the Festival International du Film Documentaire Océanien, in Tahiti, travelled through major cities in New Zealand with sold out venues during DocEdge Festival and celebrated its home premiere at the Hawai’i International Film Festival.
The film’s soundtrack is now available on Spotify, Apple Music, and all major digital platforms. Two of the album’s songs have full music videos taking listeners on a poetic musical journey.
All proceeds from the album will benefit the Kau Wo Wolo (Island Chiefs)/ Pukapukan People’s Fund directly benefiting the atoll.
As we continue to learn more about the tragedy in Lahaina, the priority should be clear: We must continue to help the victims of the fire.
Cleanup and aid — among the hardest tasks of all — are already underway, and will continue to be the center of emergency efforts for some time to come.
Yes, many of us want to know more about the cause of the fire and what might have gone wrong in the response. Eventually, the facts will come out. But for now, we need to focus on the most immediate problems.
Gov. Josh Green and Maui Mayor Richard Bissen have announced a series of measures to help Lahaina families. I especially want to praise the mayor for waiving property taxes for the affected property owners — including giving back the money from those who already paid. This is a practical and generous measure that will provide real financial relief to victims of the wildfires.
The governor, meanwhile, has used his emergency powers to help bring medical care to Maui and find places for displaced families to live. I especially appreciate the way in which he cleared the way for out-of-state medical professionals to attend to the needs of those affected by the tragedy.
Moreover, the governor has been very responsive to concerns about scams targeting Lahaina property owners and possible complications in rebuilding the area.
In response to those concerns, the governor has instructed the state attorney general to impose enhanced penalties on anyone who tries to take advantage of the victims while purchasing property in the affected area. This is a reasoned and focused approach that should help protect Lahaina property owners from fraud or predatory real estate schemes.
Some people have advocated a moratorium on all property sales in the affected area, but that would be overly broad and risk hurting the very people it intends to help. Many of those people are going through the worst days of their lives. Any moratorium could put them through more pain and difficulty. That’s not what anyone wants.
Looking ahead, we should take the time to think about the best way to ensure that a rebuilt Lahaina is prosperous and safe.
My colleagues and I at the Grassroot Institute of Hawaii already are researching and discussing recommendations we will make — especially regarding state and county policies that could help Lahaina and the rest of the affected areas on Maui recover.
But meanwhile, let’s stay focused on the cleanup and aid efforts on Maui, to help the survivors of this terrible tragedy regain their footing and rebuild their lives.
As I mentioned in my column last week, if you are looking for ways to help, Honolulu Civil Beat has posted a list of organizations that are actively involved in the recovery efforts, which you can see here. __________
Keli‘i Akina is president and CEO of the Grassroot Institute of Hawaii.
Ms. Kawamura is interviewed by Dr. Henrik Syse of PRIO and co-editor of “Journal of Military Ethics” about Women Peace and Security (WPS) in North Asia – namely Okinawa, Japan and the Korean Peninsula.
As a survivor of GBV gender-based violence, she has worked internationally to empower other survivors, especially those of Asia-Pacific origin through instruments including UN Security Council Resolution 1325 on WPS women, peace and security. Her presentations and workshops in Europe, Asia and US have been geared toward raising personal voices of GBV survivors including those of North Korea for political policy changes toward peace. The topics often cover parts of history that are obfuscated due to geopolitical concerns.
She has an MBA in international relations from San Francisco State University, and a BBA in business management with an art minor from the University of Hawaii (Manoa).
Her previous experiences in the corporate sector have complemented her holistic approaches for survivors’ well-being programs. Her active global network helps forward awareness of WPS issues from grassroots levels, all the way to UN offices and to the International Criminal Court in the Hague.
As we journey through life, the passage of time leaves its mark on us all. Just as a horse’s gums recede with age, making their teeth appear longer, our teeth can also undergo changes over the years. If you’ve noticed your teeth looking longer than before, you might be witnessing the effects of receding gums which expose the root surface. As your dedicated Honolulu Dentist, I recognize the significance of these transformations and the role they play in our overall health and well-being.
The Growing Concern of Aging in Hawaii’s Baby Boomer Generation
Every encounter with my parents, who are squarely part of the baby boomer generation, serves as a poignant reminder. The realization is that by 2035, as the final wave of baby boomers crosses into retirement, nearly one-third of Hawaii’s population will have surpassed the age of 60. This evolving landscape brings to light a series of challenges, including housing shortages, a lack of caregivers, and the specter of high inflation rates. As a Honolulu Dentist, my concerns naturally gravitate toward the realm of dental care. Embracing the role of a family dentist, my preoccupation extends to the holistic well-being of the community I serve.
The Interconnected Web of Oral and Overall Health
Oral health directly affects overall health and quality of life. In fact, dental disease is a common cause of medical and emergency room visits, according to the American Dental Association. Medications and common chronic illnesses in older adults, such as diabetes or heart disease, put seniors at an increased risk for dental problems. Although my parents are still “young” 60’s and 70’s. their regular visits are a priority…. I look at their oral hygiene visits as their first line of defense, as our team of dental hygienists check for those exact reasons and clues that would indicate that more and attention is needed in their daily lives.
Safeguarding Senior Smiles: Unveiling the Importance of Regular Dental Care
As the sands of time inevitably reshape the landscape of our smiles, vigilance in senior dental care emerges as a shield against age-related challenges. Here are seven compelling reasons to prioritize this vital aspect of well-being:
Tooth decay. Tooth decay, scientifically referred to as dental caries or cavities, is a prevalent oral health issue marked by the gradual breakdown of the protective outer layer of the tooth, known as enamel. This deterioration occurs due to the production of acids by bacteria in the mouth. These acids weaken the enamel, resulting in the formation of small openings or holes within the tooth’s structure. If left unattended, these openings can deepen and penetrate the inner layers of the tooth, causing discomfort, sensitivity, and even potential infection. An additional factor contributing to the heightened risk of cavities among older adults is dry mouth. Saliva, a natural defense mechanism, helps shield the teeth by curbing bacterial growth. However, dry mouth, often caused by certain medications commonly taken by seniors for conditions like depression, asthma, and high blood pressure, can compromise this protective function.
Gum disease. Gum disease is prevalent among seniors, with two out of three individuals aged 65 and older affected, as reported by the Centers for Disease Control and Prevention (CDC). Termed periodontitis, severe gum disease can trigger issues like inflamed and bleeding gums, difficulties with chewing, and even tooth loss, along with other health complications. A challenging aspect is that gum disease often remains symptomless until it has progressed significantly. To counter this, prioritizing senior dental care and frequent dental check-ups proves pivotal in preventing the onset and advancement of gum disease.
Tooth loss is common in older adults. In fact, one in five adults 65 and older has lost all their teeth, according to the CDC. Tooth loss can affect nutrition because seniors with missing teeth may not be able to eat or enjoy fresh food options, like fruits and vegetables.
Heart disease. Inflammation caused by gum disease increases the risk of heart disease, according to the American Academy of Periodontology. Gum disease can also make certain heart conditions worse and may be associated with a higher risk of stroke.
Diabetes poses a heightened risk for dental issues, particularly among those with poor blood sugar control. Elevated glucose levels in saliva create a conducive environment for bacterial growth in the mouth, leading to problems like inflammation and gum disease. Intriguingly, there’s a reciprocal relationship: gum disease can impact blood sugar control in individuals with diabetes. Maintaining optimal oral hygiene and seeking dental care can mitigate these risks and promote overall well-being, especially for those managing diabetes.
Pneumonia. Older adults with poor dental hygiene, especially those who smoke, are at increased risk of bacterial pneumonia. This is because, as someone breathes, bacteria in the mouth can travel to the lungs. Maintaining good dental hygiene in elderly adults who can’t care for themselves may help lower the risk of this type of pneumonia.
Oral cancer. Older adults are at higher risk for oral cancers. The risk is higher for people who chew tobacco or smoke cigarettes, pipes, or cigars. Regular dentist appointments can help detect problems early.
Empowering Seniors: The Role of Dental Professionals
The culmination of a regular oral hygiene visit sees dentists collaborating with dedicated hygienists, pooling their expertise to ensure optimal dental health. Amidst the flurry of an active senior life, the simple acts of brushing and flossing can sometimes take a back seat. I know taking two minutes to brush and floss seems like an eternity when the zoom meeting with the orchid society is beginning, or the dog is whining to go on a walk. Yet, these small, steadfast routines are the guardians of our oral well-being, a shield against the ravages of time. Just as aging is a collective experience, the dental team forms an integral part of this journey, fostering oral health and celebrating the beauty of each senior smile.
Tax Deadlines on Maui
On August 18, 2023, the Internal Revenue Service announced “expansive tax relief” for Hawaii wildfire victims in Maui and Hawaii counties. Generally, what that means is that if a tax filing or payment for an affected taxpayer is due between August 8, 2023, and February 15, 2024, then the filing or payment can be made on or before February 15, 2024, to file the returns or make the payments.
Examples given in the IRS news release include:
For individuals who extended their 2022 returns until Oct. 16, 2023, and are impacted by the disaster, those returns can be filed on Feb. 15, 2024. But the tax was due on April 18, 2023, before the wildfires started. Remember, an extension of time to file a return doesn’t extend the due date of the payment, so a good faith estimate of the 2022 liability does need to be paid in if it wasn’t already.
The IRS also gave folks a magic code – “DR-4724-HI” – which needs to be written on any return claiming a casualty loss. (This is actually the FEMA declaration number for the Maui wildfires.) IRS also reminded folks that disaster relief payments are generally excluded from gross income, so income tax doesn’t need to be paid on payments for living expenses, funerals, or home rehabilitation.
This relief, of course, is granted only to taxpayers affected by the fires. Taxpayers whose address is within the disaster zone, namely Maui and Hawaii Counties, including the islands of Lanai and Kahoolawe, generally qualify. Taxpayers outside the zone should explain why or how they are affected in a statement attached to the return. Acceptable explanations include: (1) the taxpayer is a relief worker affiliated with a recognized government or charity and is assisting in the disaster area, (2) the taxpayer’s records were maintained in the disaster area, or (3) the taxpayer is an individual who was visiting the disaster area and was injured or killed.
The Hawaii Department of Taxation also came out with Tax Announcement 2023-03 to give tax relief. The Department, however, only said that it will consider relief on a case by case basis. “2023 Wildfire Relief” should be written in the top center of the return. As with the federal returns, if a taxpayer’s address is outside the affected area, the taxpayer should explain how the disaster impacted it in a statement attached to the return.
Some folks have asked me why the Department isn’t offering blanket extensions like the IRS is. It’s not because the Department is overly stingy. It’s because there is a federal law, Internal Revenue Code section 7508A, empowering the IRS to grant these extensions. That federal law was enacted as part of the Taxpayer Relief Act of 1997 and was signed by Bill Clinton. Hawaii has nothing comparable. So, the Department’s hands are tied a bit more when it comes to doling out relief. If people think that the authority the Department has been given isn’t enough, they can speak with their legislators to have appropriate legislation proposed.