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    IDavid Isei

    Public Voice

    Shaping the conversation

    Engaging policymakers, media, and the public on the structural forces reshaping Hawaiʻi's healthcare system. Direct, evidence-backed, on the record.

    ▶ Featured Video · ISEI InsightsThe Federal Data Behind Hawaiʻi's Provider Shortage
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    Media

    Media & Conversations

    ISEI Insights on YouTube and the Mai Ka Waha conversations.

    Meaningful change requires direct conversation.

    Conversations on Hawaiʻi healthcare: workforce, insurer directories and network adequacy, rural access, and the figures behind them.

    YouTube · @ISEIInsights

    ISEI Insights on YouTube

    Watch policy analysis, legislative testimony breakdowns, and healthcare intelligence briefings on the ISEI Insights channel.

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    Podcast

    Mai Ka Waha

    Real conversations with leaders across government, healthcare, and the community. Direct dialogue, hard questions, thoughtful perspectives.

    Latest episode

    Episodes

    What Hawaiʻi Actually Needs: Beyond Temporary Fixes

    David Isei — Solo

    Introducing the voice, the tone, and the purpose behind Mai Ka Waha. A direct conversation about what is working, what is not, and what it will take to build something better.

    FeaturedHealthcareLeadershipHawaiʻi

    Building Healthcare Infrastructure That Lasts

    Coming soon

    A conversation about what it takes to build sustainable healthcare systems in rural Hawaiʻi.

    HealthcareHawaiʻi

    Get notified when this episode drops

    The Real Provider Shortage

    Coming soon

    Why recruitment campaigns fail and what structural changes are actually needed.

    WorkforcePolicy

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    Leadership in Complex Systems

    Coming soon

    Operating across healthcare, government, and community — and the leadership it demands.

    LeadershipHealthcare

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    Key Insights

    "Healthcare models must be designed from constraint, not imported from abundance."

    "Workforce retention is a systems problem, not a recruitment problem."

    "Policy without operational understanding produces mandates that can't be implemented."

    Clips

    Short-form highlights from conversations.

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    Perspectives

    Written reflections and analysis on Hawaiʻi's healthcare system.

    Op-Ed No. 6 · April 2026 · Antitrust & Markets

    The Merger Math

    Federal antitrust treats Hawaiʻi as one market. In reality, each island is its own monopsony. A pending health-system consolidation and the federal Protecting Primary Care Act are on a collision course.

    Read article →
    Op-Ed No. 5 · April 2026 · Federal Accountability

    The $2.3 Billion Question

    Hawaiʻi receives roughly $2 to $3 billion a year in federal healthcare funds. No one can tell you, by island, what those dollars actually buy.

    Read article →
    Op-Ed No. 4 · April 2026

    The Neighbor Island Surcharge

    Why a ZIP code outside Honolulu is the single strongest predictor of delayed care in Hawaiʻi. The data shows a measurable surcharge — in dollars, in days, and in lives — paid by anyone who lives off Oʻahu.

    Read article →
    Op-Ed No. 3 · April 2026

    Network Adequacy Theater

    How Hawaiʻi's insurance filings pass compliance while patients wait months for care. Independent reconciliation shows the majority of plan directories do not meet federal access standards.

    Read article →
    Op-Ed No. 2 · April 2026

    The Hidden Tax on Hawaii Medicine

    Federal payment formulas treat Honolulu like rural Mississippi. The state's 4.712% GET on medical services finishes the job. Together they cost Hawaii physicians an estimated $250 million a year.

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    Op-Ed No. 1 · April 2026

    The 776-Physician Gap: Why Hawaiʻi's Doctor Shortage Is a Federal Math Problem

    Federal formulas treat the Pacific Ocean like a county line. The result: a 776-FTE shortage, a tax penalty no other state pays, and a network adequacy system built on paperwork instead of access.

    Read article →

    Topics Covered

    HealthcarePolicyLeadershipHawaiʻiWorkforce

    Speaking & Appearances

    Available for speaking engagements, panels, and conversations on healthcare systems, leadership, and public problem-solving.

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