Yup. You read right. I’ve had a facial.

It happened like this.

The Hawaii Performing Arts Festival invited me to emcee its Rodgers and Hammerstein concert last Friday night, and put me up at the Four Seasons Hualalai. Bernadette and I decided to do as little as possible other than my concert commitment and just relax otherwise.

My idea of relaxing is sleeping. Her idea of relaxing is shopping. So the day after the concert, after driving to Waimea-Kamuela and Hawi, I did something I haven’t done in many years — drew a really hot bath in a really nice bathtub and fell asleep in it. Bernadette went shopping.

I awoke to find her taking a little brown jar out of a bag.

“What’s that?” I asked.

“This,” she said, “is clay, mixed with chocolate. I am going to give you a chocolate facial.”

“I have a confession to make,” I said. “I’m not sure I even know what a facial is. Is that where you put clay on the face and it dries and when you take it off you’re supposed to feel better?”

“Correct,” she said. “Actually, your skin should feel smoother. And, it will smell like chocolate.”

“Okay,” I said, because it meant I didn’t have to get out of the bathtub yet.

And she applied cocoa-scented, cocoa-colored mud to my face. It needed to set, which was fine because it meant I could remain in the tub even longer.

“This is Peruvian chocolate,” Bernadette said.

Okay. Heaven forfend someone would paint me with Icelandic chocolate. I thought Peru was only known for Lima beans (joke).

Skipping to the end, my skin actually did feel smoother, though I have to admit I had not realized it was insufficiently smooth before. I also felt a passing sentiment that this was a waste of perfectly good chocolate, Peruvian or otherwise.

The jar and the applicator cost $25.

If ever you’re offered a facial/ Your response ought not to be glacial/ Your skin will feel new/ When you wash off the goo/ But it helps if your bathtub’s palatial.

This is what high-end realtors tell me: that mainlanders who want to retire to neighbor islands, often change their minds and retire to Oahu, after checking out the quality of health care on other islands. They prefer the slower pace of life on other islands but settle for Oahu because they want to survive their first heart attack.

That comes to mind as two Big Island hospitals cut staff to try to control their ballooning operating deficits.

The little hospital in Kealakakua is on the verge of cutting more than 50 jobs and the hospital in Waimea-Kamuela has already done the same thing, so upsetting the community that I heard reports someone threatened the new head of the hospital, who tried to fix but didn’t create the problem. (He’s resigned.)

Doctors have been telling us for years that medical care on neighbor islands is threatened by soaring malpractice insurance costs, insufficient compensation for treatment of Medicare patients, and limits to state and local financial support for hospital operations. They weren’t making it up.

Malpractice insurance costs are driven by lawsuits, which I assume increase when the quality of medical care suffers. The gap between Medicare compensation and the actual cost of treating Medicare patients has been growing for years, and for years no one did anything about it except to soak others to make up the difference.

Congress did vote this month to bar any cuts to Medicare compensation. Governor Lingle agreed to a plan to increase state compensation, triggering a federal match, but backed out of a plan to make it retroactive to the just-ended fiscal year, citing tighter state finances. This same factor is likely to put limits on what the state can do to resolve the hospital crisis.

Kaiser Permanente has been trying to control costs through smarter procedures in its system. The jury is out on that one. As a 30-year member I can tell you it has never been harder to get in to see someone for a non-emergency matter, though emergency treatment does not seem to have been adversely affected.

This is already a major issue, but it will get even bigger. Hawaii has an aging population, and to some extent represents where the rest of the country will be in a dozen years. Older people need even more health care.

In fact, a local health care executive — he comes from the bean-counting side of the house, not the knee-thumping one — told me people are surviving so many illnesses that used to kill them, now they’re living to a ripe off age and then suffer wholesale health collapse leading to expensive care through their final days and months. 

 

President Bush asked attendees at a Republican fundraiser in Houston to turn off their cameras. Someone didn’t. A Houston TV station got hold of video.

“Wall Street got drunk,” Mr. Bush said. “And now it’s got a hangover. The question is, how long will it sober up and not try to do all these fancy financial instruments?”

A very good analysis.

One little-mentioned factor in the subprime mortgage debacle is that financial instruments have indeed grown so complex that even the experts don’t understand them well enough to accurately foretell all their effects.

Look at the financial giants who’ve lost tens of billions of dollars in bad debt writedowns and lost investment opportunities: companies Lehman Brothers and Merrill Lynch are supposed to be the smart ones. They owe their very existence to the public perception that they know how to invest better than the rest of us do.

But when subprime lending returned fast profits and others dove into the mortgage-backed securities business, they followed. They went on a bender. Now they have the mother of all headaches.

The president, who by the way must have known someone would have recorded what he said, is totally right about this one.

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