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How Maunakea Teaches Us to Practice Medicine

Brooke Warren
Phuoc Le

By PHUOC LE, MD and BROOKE WARREN

For over a month, Kānaka ‘Ōiwi (Native Hawaiian) elders and community members have stood in solidarity at Maunakea in Hawai’i. They seek to protect their land, sovereignty, and culture from those who want to build the Thirty Meter Telescope (TMT) on Maunakea. Maunakea holds both cultural and spiritual meaning to the Kānaka ‘Ōiwi. Unfortunately, many astrophysicists and TMT investors see Maunakea primarily as a means to make scientific discoveries. The frequent narrative where Indigenous people need to defend the value of their traditional knowledge[1], beliefs and culture to Western scientists is a very familiar story that is often replicated in healthcare, both at home in the U.S., and abroad.

Kānaka ‘Ōiwi elders blocking road to prevent TMT construction (Photo: Caleb Jones/AP)

Traditional medicine, as defined by the World Health Organization, is the “knowledge, skills and practices based on the theories, beliefs and experiences indigenous to different cultures, used in the maintenance of health and in the prevention, diagnosis, improvement or treatment of physical and mental illness”. Looking at this definition, it is clear that traditional medicine practiced by Indigenous people has equivalent goals to modern Western medicine. Therefore, are we harming our patients when we do not incorporate traditional approaches harmoniously to the practice of healing, and instead value Western medicine over traditional medicine?

The arguments for putting TMT on Maunakea follow a similar reflex to reject knowledge that is different from our own. Thankfully, letters and activism rallying against the construction of TMT on Maunakea, from both Indigenous communities and scientists, are highlighting how Indigenous people are not anti-Western science. In fact, they are beginning to envision how collaboration between Traditional Knowledge and Western science is possible, and potentially even synergistic. Similarly, Western healthcare, too, must foster an approach that centers Traditional Knowledge for Indigenous communities.

How can current and future healthcare providers promote the value of both Traditional Knowledge and Western science, and thus promote trust and collaboration between providers and patients?

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Massachusetts and Hawaii Offer the Most Cost-Effective Health Insurance Coverage

What makes a state’s health insurance successful for its citizens? It should be affordable, it should cover a lot of people, and it should manage its members well, keeping people healthy as measured both by preventive care as well as actual health outcomes.

It turns out that, using those criteria, the state with the highest Health Insurance Success Score (HISS) is Massachusetts. One would expect high quality, good outcomes and of course close to 100% coverage in the Bay State, but it also — quite surprisingly — ranks 5th in affordability, as described below.

Hawaii is a very close second. (One could also argue that Hawaii’s circumstances are unique and non-comparable because that state differentially attracts and retains healthy residents, but the analysis eschewed all subjectivity and second-guessing of the data.) Texas is last, one point behind Arkansas. In both the best and worst listings, there is a noticeable gap between the two states at the extremes and their respective runner-up pelotons.

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