David Isei — Articles https://davidisei.com/articles Long-form essays on Hawaiʻi healthcare policy, workforce, and structural reform. en-us Wed, 27 May 2026 02:23:48 GMT Geography Is Not a Billing Code https://davidisei.com/articles/geography-not-billing-code https://davidisei.com/articles/geography-not-billing-code Neighbor-island patients pay more for the same care than Oʻahu residents with identical insurance. It is pricing design, not geography. Policy & Strategy Wed, 27 May 2026 00:00:00 GMT You Are 644 Doctors Short. The Number Is Getting Worse. https://davidisei.com/articles/644-doctors-short https://davidisei.com/articles/644-doctors-short Hawaiʻi has 12,688 licensed physicians but only 3,044 practicing FTE — a 644-physician shortfall driven by retention, not recruitment. Workforce Tue, 26 May 2026 00:00:00 GMT The Directory Is Lying to You https://davidisei.com/articles/directory-is-lying https://davidisei.com/articles/directory-is-lying What ghost networks actually cost Hawaiʻi patients and why no one is held accountable. Network Adequacy Mon, 25 May 2026 00:00:00 GMT The 776-Physician Gap https://davidisei.com/articles/776-physician-gap https://davidisei.com/articles/776-physician-gap Why Hawaiʻi's doctor shortage is a federal math problem — and what a state-of-the-union fix actually requires. Workforce Sun, 19 Apr 2026 00:00:00 GMT The Hidden Tax on Hawaiʻi Medicine https://davidisei.com/articles/hidden-tax-hawaii-medicine https://davidisei.com/articles/hidden-tax-hawaii-medicine How the GET on medical services quietly drains primary care capacity statewide — and the structural reform on the table. Policy & Strategy Sun, 12 Apr 2026 00:00:00 GMT Network Adequacy Theater https://davidisei.com/articles/network-adequacy-theater https://davidisei.com/articles/network-adequacy-theater Hawaiʻi's network adequacy rules are paperwork, not access. Here's what the data actually shows. Policy & Strategy Sun, 05 Apr 2026 00:00:00 GMT The Neighbor-Island Surcharge https://davidisei.com/articles/neighbor-island-surcharge https://davidisei.com/articles/neighbor-island-surcharge Geography is not a billing code. The hidden cost of treating Hawaiʻi like a single county. Rural Health Sat, 28 Mar 2026 00:00:00 GMT The $2.3 Billion Question https://davidisei.com/articles/2-3-billion-question https://davidisei.com/articles/2-3-billion-question Where the money already goes — and why the system keeps starving the front line. Funding & Capital Sat, 21 Mar 2026 00:00:00 GMT Merger Math https://davidisei.com/articles/merger-math https://davidisei.com/articles/merger-math The arithmetic behind the latest health-system consolidation and what it means for patients across the islands. Healthcare Systems Sat, 14 Mar 2026 00:00:00 GMT