Research
Research and Work
Every piece here rests on figures that carry a source, a retrieval date, and a label. Where a figure has changed since publication, the piece carries a note and the Corrections Log has the current value.
- Articledavidisei.comMay 2026
Geography Is Not a Billing Code
Neighbor-island patients pay more for the same care than Oʻahu residents with identical insurance. It is pricing design, not geography.
Read - Articledavidisei.comMay 2026
You Are 644 Doctors Short. The Number Is Getting Worse.
Hawaiʻi has 12,688 licensed physicians but only 3,044 practicing FTE, a 644-physician shortfall driven by retention, not recruitment.
Read - Articledavidisei.comMay 2026
The Directory Is Lying to You
What ghost networks actually cost Hawaiʻi patients and why no one is held accountable.
The 412-listing reachability sample is retired; the current directory figure is the +107 percent overstatement measured against a verified truth set. See the Corrections Log.
Read - Articledavidisei.comApril 2026
The 776-Physician Gap
Why Hawaiʻi's doctor shortage is a federal math problem, and what a state-of-the-union fix actually requires.
The 776 FTE shortage figure is superseded by 644 FTE direct and 832.6 FTE island-adjusted (JABSOM AHEC 2025). See the Corrections Log.
Read - Articledavidisei.comApril 2026
The Hidden Tax on Hawaiʻi Medicine
How the general excise tax on medical services quietly drains primary care capacity statewide, and the structural reform on the table.
Read - Articledavidisei.comApril 2026
Network Adequacy Theater
Hawaiʻi's network adequacy rules are paperwork, not access. What the data actually shows.
Read - Articledavidisei.comMarch 2026
The Neighbor-Island Surcharge
Geography is not a billing code. The hidden cost of treating Hawaiʻi like a single county.
Read - Articledavidisei.comMarch 2026
The $2.3 Billion Question
Where the money already goes, and why the system keeps starving the front line.
The $2.3 billion figure is a triangulated range of $2 to $3 billion, not a fixed value. See the Corrections Log.
Read - Articledavidisei.comMarch 2026
Merger Math
The arithmetic behind the latest health-system consolidation and what it means for patients across the islands.
The measured statewide commercial HHI is 3,138 (NAIC 2024). See the Corrections Log.
Read - Op-edHawaiʻi Healthcare Task ForceAugust 2026 external
Hawaiʻi Island Has Enough Mammography Machines. What It Does Not Have Is a Way to Reach Them.
The first Hawaiʻi measurement of how distance to a certified facility affects screening: 0.068 percentage points lost per mile across 26 Hawaiʻi Island ZIP areas, ecological and labeled so.
Read - ArticleHawaiʻi Healthcare Task ForceAugust 2026 external
Invisible Twice: The Behavioral Health Network Hawaiʻi Never Measured
147 adult civil acute psychiatric beds, 10.2 per 100,000, and the state's own external quality review excluding members with serious mental illness from network validation.
Read - ArticleHawaiʻi Healthcare Task ForceMay 2026 external
The Price You Don't See: How Pharmacy Benefit Managers Shape Hawaiʻi's Healthcare Costs
How pharmacy benefit managers set what patients and plans pay.
Read
Task Force publications
Institutional pieces published in the Task Force's voice, many with my analysis behind them, are at hawaiihealthcaretaskforce.org/blog.