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    Demystifying Hawaii’s doctor shortage

    It’s no secret that Hawaii has a healthcare problem

    The state is short more than 1,000 doctors, which means some patients cannot get care, and the ones who do have to wait a long time. 

    According to one recent survey, nearly six in 10 Hawaii residents have endured long delays in receiving medical care in the past year; for many patients, that can result in permanent harm or even death.

    Doctor shortages are especially severe in the neighbor islands, where there are very few specialists. On Kauai, for example, there are no endocrinologists, psychiatrists, oncologists or outpatient neurologists. Anyone who needs these services must travel to Honolulu on the main island of Oahu, or even possibly to a mainland city, which means extra costs for airline tickets, hotel reservations and other necessities as well.

    So why aren’t doctors moving to Hawaii? 

    There are a host of reasons, but the state’s general excise tax, stringent licensing requirements and high cost of living all make it harder to be a frontline healthcare worker. 

    >> The general excise tax

    Unlike many states, Hawaii does not have a sales tax, which is levied on consumers only at the retail level. Instead, it has a general excise tax, which is a tax on the gross receipts of businesses.

    The GET is applied at every transaction level,which means it pyramids in value as it proceeds to the final stage — the consumer — at which point the effective rate is actually greater than whatever the nominal rate might be. 

    In Hawaii, the nominal rate is 4% tax, including for healthcare clinics. Three of the state’s four counties also add a surcharge of 0.5%. In the counties where the combined rate is 4.5%, the nominal rate consumers end up paying is 4.712%, due to a quirk in how the rate is calculated.

    Hawaii is one of only four states that taxes healthcare in this way.

    Sometimes, doctors can pass along the GET to patients, but not to those with Medicare, Medicaid and TRICARE, according to a spokesman for the Hawaii Physician Shortage Crisis Task Force. This means doctors can make more money by moving their practices to another state.

    According to a Grassroot Institute of Hawaii study, exempting medical care from the GET would save doctors and patients more than $200 million a year, which could encourage doctors to stay in Hawaii and possibly attract more doctors to the state. 

    In an attempt to alleviate Hawaii’s doctor shortage, the Grassroot Institute recently launched a petition asking lawmakers to exempt medical services from the GET. The petition will be presented to the Legislature before its 2023 legislative session.

    >> Occupational licensing laws

    Every state requires doctors to have a license to practice medicine. Licenses are meant to ensure that unqualified people do not practice medicine. But in some cases, licensing laws do more harm than good. 

    For example, Hawaii’s licensing laws make it impossible for a doctor with a license from Oregon to practice in Hawaii without getting a license from the state of Hawaii — even if that doctor has a perfect medical record and wants to serve in an area that desperately needs physicians. 

    That’s why some other states have created interstate licensing compacts, which allow licensed healthcare workers from member states to practice in other member states. For example, a doctor from Arizona who wants to practice in California could do so without having to spend thousands of dollars in fees or countless hours to receive a new license. 

    Compacts exist for physicians, physician assistants, nurses, radiation therapists, emergency medical services workers and other healthcare professionals. Unfortunately, Hawaii is not a member of any of these compacts. Joining any or all of them would make it easier for healthcare workers from other states to practice in Hawaii. 

    >> Hawaii’s high cost of living 

    Hawaii’s high cost of living makes it hard for everyone — even doctors and nurses — to afford basic necessities like housing and electricity.  

    The median home price in Hawaii is well over $1 million, which makes it hard for recent medical school graduates to afford to live here. Saddled with hundreds of thousands of dollars of debt from medical school, many graduates look elsewhere for their first job. 

    Doctors also suffer from Hawaii’s high income taxes — the second highest in the U.S. Compared to states such as Nevada and Florida, which do not have income taxes, Hawaii is a relatively unattractive landing spot for healthcare personnel, despite its natural beauty. 

    Conclusion

    Hawaii is one of the worst states for doctors to practice, according to the personal finance website WalletHub. Hawaii’s healthcare workers are saying the same thing. 

    At a recent forum on the state’s doctor shortage, James Winkler, president and CEO of the Kauai Community Health Alliance, asked: “Why is it hard to retain and recruit [medical personnel]? What are the financial obstacles?” 

    “Well,” he answered, “you just can’t pay people enough to live here. It really is that simple.” 

    So what can Hawaii do to attract and retain healthcare professoinals? Obviously, lowering the cost of living — and the cost of doing business for doctors — would be a good way to do it. 

    Specifically, lawmakers could:

    >> Exempt medical services from the state GET.

    >> Lower the state’s personal income tax rates.

    >> Liberalize the state’s medical certificate-of-need laws, which restrict the introduction of new medical facilities and medical services.

    >> Let certified medical personnel from other states practice in Hawaii without having to spend time and money to obtain a Hawaii occupational license.

    >> Reduce land-use and zoning regulations to enable more homebuilding, which would make housing more plentiful and affordable

    These and many other actions are critical to eliminating Hawaii’s acute shortage of doctors and medical personnel. The longer they are postponed, the longer will Hawaii have to endure its healthcare crisis.

    “By right” zoning would streamline building permit process

    By Keli‘i Akina

    I’ve been playing a new online game, but no matter what I do, I can’t seem to win.

    It’s a real-life simulation about getting authorized to build a house for your family. But I keep getting tripped up by Honolulu’s permitting process.

    The creative folks at Honolulu Civil Beat have put together an interactive game that takes you on a permitting journey. In it, you navigate delays, missing emails and bureaucratic difficulties. 

    You have to choose whether to spend more money in the effort to speed things up or whether to save your money for the $800,000 in construction you have planned. 

    The problem is that the game is a little too real. Try as I might, I always end up frustrated and thousands of dollars over budget — just like far too many Honolulu homeowners.

    The Civil Beat game is a great way to understand the effects of Honolulu’s permitting backlog. It also gives you some insight into how permitting delays and bureaucracy contribute to Hawaii’s acute housing crisis.

    Unfortunately, the problem is more fundamental than bureaucratic inefficiency. Hiring more inspectors or pouring more money into high-tech software might help to some degree, but those are just cosmetic.

    The fundamental issue is that there are too many things in Hawaii that require government permission. That is why my colleague at the Grassroot Institute of Hawaii, Ted Kefalas, testified before the Honolulu City Council this past week in favor of Bill 56. The measure would remove the requirement that homeowners obtain a permit for certain repairs costing more than $5000 a year. 

    In practical terms, this means homeowners would be able to renovate their kitchens or replace their outdoor decks without having to wait months and spend thousands of dollars on permits.

    It also would reduce Honolulu’s scandalous permitting backlog, because suddenly a lot of permits would not even be needed anymore.

    Further, if as a law it could show that permitting is unnecessary for home repairs, perhaps Honolulu lawmakers could take the next logical step and streamline permitting for new home construction as well.

    They could achieve that by instituting “by right” zoning, under which any proposed project that meets all existing zoning codes and various community plans will automatically be issued a permit.

    It’s a concept currently being considered by the Maui County Council’s Affordable Housing Committee for affordable housing projects of fewer than 150 units. The Grassroot Institute of Hawaii testified in favor of that too — though why stop there? 

    Even better would be to remove political reviews for all proposed home construction that meets the existing legal requirements. We would hear less from the “Not in My Back Yard” crowd and start to see more housing.

    Pending removal of the vast array of permits required, another way to trim the permit backlogs would be for our state and county permitting agencies to work more with the private sector. 

    The Hawaii County Cost of Government Commission expressed interest in that idea just last week after hearing testimony from my Grassroot Institute of Hawaii colleague Joe Kent. 

    Kent said he had recently visited John’s Creek in Georgia and saw a man apply for and obtain his permit in a single day. He said when a backlog develops in John’s Creek, or a permit is complex, the civil servants there outsource the work needed to a private company. 

    It’s an approach similar to Honolulu’s provision allowing for third-party review, but in this case, the third party is working for the county, not the property owner.

    Kent offered the idea as a follow-up to testimony presented by Institute policy researcher Jonathan Helton, who discussed how Hawaii County could take advantage of legal exceptions to the infamous “Konno decision” to improve its delivery of public services.

    The 1997 state Supreme Court decision basically said local governments cannot hire private sector workers to perform jobs that “customarily and historically” have been provided by civil servants. But the Legislature has carved out some exceptions, one of which is a one-year exemption for “special or unique” services that are “essential to the public interest” and cannot be filled by civil servants. 

    Kent suggested the county could use that exemption to hire a private contractor and help reduce its permit backlogs. 

    Of course, reducing Hawaii’s permitting backlogs won’t alone solve its housing problem entirely, but it’s a good first step. 

    Ultimately, the one unassailable fact is that government regulations are the most significant contributor to Hawaii’s high cost of housing. That’s why reducing those regulations is critical.
    _____________

    Keli‘i Akina is president and CEO of Grassroot Institute of Hawaii.

    HIFF Notes #4 — Movies to watch at the Film Festival

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    Editor’s note: This is the fourth installment of an ongoing blog on films to see at HIFF–The Hawai’i International Film Festival

    Pacifiction

    I really wanted to see this French-language production, by Catalonian film maker Albert Serra. The main theme, as critic Nicholas Bell wrote, “concerns the cancer of colonialism in a tropical Tahitian paradise.” That sounds about right.

    Tahiti is a place I’m quite familiar with. However after viewing it, I was not keen on writing a review. The HIFF program called it “deliberately paced”. I call it glacially paced and after 3 hours, perhaps an hour too long, I was running out of patience.

    I took a step or two back and realized, I was a bit hasty in my judgement. Perhaps I was in a position to add something to the equation.

    As someone who has lived and worked in French Polynesia–I suspect I knew more about the place than most movie critics (outside of Papeete, the capital of French Polynesia).

    I’ve written two guidebooks French Polynesia and as a stringer for the San Francisco Chronicle Foreign Service decades ago, covered the French nuclear testing program, a subject mentioned in the film.

    High Commissioner De Roller (Benoît Magimel) at a dance rehearsal.
    High Commissioner De Roller (Benoît Magimel) at a dance rehearsal. He likes to hang out in the dressing room with the crew.

    So, now that I’ve established my Tahiti bona fides, on with the show…

    The film opens with a hazy sunrise over Papeete Harbor. The sky is an apocalyptic orange, as the camera pans the waterfront. There are massive stacks of shipping containers dockside and huge cranes looming over them. In the distance are the towering, silhouetted peaks of Moorea.

    This paradise is clearly dependent on the outside world. No free lunch here.

    We cut to a zodiac raft with half a dozen French submariners and their commanding officer, an admiral no less, heading to shore. The guys tie up to the dock and we cut to a bar filled with hunky Tahitian waiters, dressed in white briefs, and scantily clad vahines serving drinks. Everyone is bathed in artificial light which makes the waiters’ briefs glow bright white. (For the record, there’s nothing close to a bar like this in Papeete with guys running around their jockey shorts that I’m aware of, but this is Serra’s movie, not mine…)

    We soon meet our protagonist, High Commissioner De Roller (played superbly by Benoît Magimel) at his favorite bar, “Paradise Now”, owned by his buddy, Morton (Sergei Lopez). De Roller is clad in a white linen suit that defines his persona—the big white boss in paradise. He’s the very image of the entitled white man but he’s not an egomaniac; he seems to have it under control. He mixes just as adroitly with Tahitians as he does with the expats and the military folk.

    He especially enjoys schmoozing with the half-naked dancers, who gather the dressing room.

    Cockfights and Dancing Girls

    The ruins of the Tahara'a Hotel  perched on One Tree Hill named by Captain Cook
    Decadence is a big theme. De Roller seems to gravitate to these places like the ruins of the Tahara’a Hotel perched on One Tree Hill named by Captain Cook just outside of Papeete.

    He’s particularly interested in one of their routines, a cock fight reenactment and, after a rehearsal, he inserts himself into the mix suggesting that the mortally wounded rooster, portrayed by a muscular tane, be dispatched by the vahines with alacrity. “It’s beautiful to see such violence, “he says. The dance sequence is juxtaposed with footage of a real cockfight.

    The message is clear; there’s tension and perhaps violence beneath the surface of this society. The Tahitians are colonized and have a good reason to be steamed. Evidently the white folks seem have their own rage bottled up inside.

    On the surface it would seem the Tahitians have a good deal. Despite the advantages of being part of France (the Tahitian government is highly subsidized) locals are ambivalent about the relationship. They love their Veuve Clicquot and their French fashions, but it comes at a great psychic cost.

    They carry French passports but who are they? French? Tahitian? Something in between? This ambiguity is realistic in my experience.

    The anger inevitably surfaces when De Roller is warned by a powerful demi (part Tahitian) community activist (Matahi Pambrun) that the locals will raise hell about the alleged nuclear testing program. There’s going to be violence.

    Who can blame them? Tahitians were impacted by generations of nuclear fallout from Mururoa (in the nearby Tuamotu Islands) where the bombs were tested, between 1966 and 1974. They are not going to be complacent about this new development.

    Trouble in Paradise

    A light moment with De Roller
    One of the few true intimate moments in the movie. De Roller can be himself.

    Panbrum, who in an earlier scene indulges the High Commissioner in a business meeting, does a brilliant job evoking the latent hostility that many Tahitians feel towards the French. He does such a good job one wonders how much he is acting.

    The High Commissioner reacts angrily to the threats from Tahitians, but he realizes he’s powerless. He’s just a cog in the machine.

    The real power seems to be with the elfin Admiral (Marc Susini) from the sub commander, who in between drunken visits to the nightclub (where he seems particularly interested in the hunky waiters) spouts off diatribes such as, “they will see by the way we treat our own people exactly how we will also treat our enemies”.

    It seems all De Roller can do is spy on a dinghy, full of vahines, which clandestinely leaves the shore in the evenings to rendezvous with the submarine. The High Commissioner is convinced the women who visit the submarine are being abused and he wants to know what the hell is going on. He goes on a wild goose chase in a boat to catch them but is left chasing ghosts.

    Shot in a smoky sort of film noir milieu, decadence (or “decadencia” as writer/director Albert Serra might say) is always present. Whether De Roller is in the boozy light of his favorite bar, Paradise Now, or the empty, decaying ruins of the Tahara’a Hotel, the moral decay is omnipresent.

    De Roller rambles around the dilapidated Tahara'a Hotel.
    De Roller rambles around the dilapidated Tahara’a Hotel. A metaphor for French Polynesia? In the background is Moorea.

    In one scene De Roller walks into a dark, cavernous bar that’s nearly empty. The DJ is a topless vahine of a certain age (with enhanced features) who looms over the controls, blasting a mindless, throbbing techno beat. It’s sexual but vacuous. Meanwhile at the same establishment, on the outside patio, an obese Tahitian man is seated on a bench seemingly choking a half naked vahine who sits at his feet. No one pays attention to them.

    Is this where the latent Polynesian anger gets channeled or is it simply consensual fun? Or both?

    As De Roller leaves the place the vahine DJ stands motionless at the door like some aging Aphrodite. He passes her without a look.

    Just another evening in paradise.

    De Roller appears not to be interested in women anyway. Which brings us to another theme.

    Who needs women anyway?

    There’s more than just a touch of homoerotism in this film. More often than not, the men are more interested in men than the ubiquitous, sensuous vahines. The traditional, Gauguinesque of Paradise seems to be turned on its head.

    There’s also wonderful scene where the Admiral from the sub prances around the Paradise Now dance floor with an assortment of muscular Tahitian waiters and submariners.  “Who’s the new handsome waiter?”, he asks.

    De Roller meets with the community organizer at left (Matahi Pambrun) and his angry cohort ready to protest against the resumption of nuclear testing.

    De Roller seems to be a fellow traveler in his preferences. His main female interest is a mahu (a transvestite) Shannah (Pahoa Mahagafanau) is the dancers’ choreographer. (She’s a wonderful actress who seems constantly bemused by the goings on. She’s worth the price of admission).

    She becomes a trusted advisor and confidante but you don’t see much physical intimacy between them. It’s not clear if they are lovers but they’re definitely tight. She’s around him often—whether it’s a visit to her bungalow or a business lunch on Tetiaroa (a resort that Brando established in the 1970s) to talk turkey with Tahitian politicians.  

    Real Tahitians

    Shannah is likeable and believable, which brings me to an important point. The Tahitians in this film are portrayed realistically. What you see, for the most part, is what you really get. The locals are natural, their dialogue is believable, and they don’t have to play too hard at acting. In effect, they are not cartoon characters.

    So what’s missing in paradise? There are no scenes that depict men and women pleasuring each other unless you count the depraved fat guy choking the vahine. Another thing you don’t see, ever, is the traditional Tahitian greeting–a peck on each cheek. Everybody does this in Tahiti but not once in this film do we witness this charming convention.

    And what’s with the hazy shooting technique that permeates this film (beginning with the dockside sunrise)?

    To quote Albert Serra “Everything is hazy in Pacifiction […] I think that current films tend to be dreadfully explanatory and didactic. I feel as though they’re addressing children who ceaselessly need to have everything explained to them.”

    There’s a helluvalot going on in this film but the haziness belies the stark messages. You’ll figure it out.

    So how does the movie end? I won’t give it away but think Dr. Strangelove, without the mushroom clouds.

    HIFF Notes #3 — Movies to watch at the Film Festival

    Editor’s note: This is the third installment of an ongoing blog on films I enjoyed at HIFF–The Hawai’i International Film Festival

    The Lost King

    As mentioned in an earlier blog, HIFF is to be commended for its wide-ranging taste in choosing the submissions, which include European films.

    One of HIFF’s selections this year is The Lost King, a UK production based on a true story about an amateur historian-sleuth, Philippa Langley (Sally Hawkins) who is obsessed with finding the remains of the much-maligned King Richard III. The film is directed by Stephen Frears, a highly regarded Englishman who often depicts real life stories.

    Frear’s protagonist, Philippa, is convinced the King has been given a bad rap—even disputing Shakespeare’s depiction, where Richard describes himself as “scarce half made up, and that so lamely and unfashionable that dogs bark at me.”

    After she digests a biography of Richard III that underscores the disparity between his disparaged reputation (a deformed, depraved usurper to the throne) and his “true” character (none of the above) she wants to set the record straight.

    Whilst Philippa ponders where King Richard may be, her marriage is on the rocks. John (Steve Coogan) has moved to his own flat, dating women online. In the meantime they both need to attend to their adolescent boys and he’s not exactly supportive of her extracurricular activities.

    As if her plate isn’t full enough, she’s got serious health issues (Myalgic encephalomyelitis/chronic fatigue syndrome) and at the office her life is miserable. At age 40 the glass ceiling is all too present–she been passed over for younger, more attractive women. (The patriarchy up to their old tricks).

    Phillippa Langley (Sally Hawkins) as the vulnerable heroine in The Lost King.
    Phillippa Langley (Sally Hawkins) as the vulnerable heroine in The Lost King.

    What’s Philippa to do?

    She joins a group of fellow Richard III fanatics – misfits and eccentrics — self anointed Ricardians who meet at a local pub. The group inspires and supports her.

    Another inspiration are the “visions” Philippa is having of Richard III, portrayed by Harry Lloyd, whose ubiquitous presence haunts her night and day. Fortunately he’s become her muse and helps her endeavor, sometimes on horseback.

    The more research she does, the more convinced she’s become that Richard III is buried under a parking lot in the city of Leicester (which also happens to be the movie director, Stephen Frears’ hometown).

    In addition to empirical evidence, Philippa is driven by her “feelings”, her spot-on intuition which is criticized (of course) by the “patriarchy” –men from the City Council, who must give her permission to dig and the University of Leicester, whose support she needs to find the iwi. (Yes folks, this film will appeal to the hearts of Hawai’i residents. It’s an archetypal iwi hunt).

    Philippa's muse, none other than Richard III, helps her find the way to his burial site.
    Philippa’s muse, none other than Richard III, helps her find the way to his burial site.

    Philippa doesn’t let the patriarchy rule the day.

    She is on a “Truth Quest”, a spiritual journey, as West Oahu Professor Louis Herman explains in his seminal memoir, Future Primal. Nothing will stop her and ultimately, at the risk of a spoiler alert, she finds Richard III’s remains. This is one of those true stories where you can’t help but root for the spunky heroine who overcomes a host of obstacles to win the day.

    Despite her successful quest, she’s not given credit by the University for her efforts. In this movie, University management is the bad guy.

    The films suggests in a BBC article, that “she had to battle the university every step of the way – whether to dig, where to dig, what to do with the remains after the dig – and that the academics tried to sideline her, even preventing her from speaking at one press conference.”

    In response, the university says that’s simply not true and that the film contains ‘many inaccuracies’. They claim to have “worked closely with Philippa Langley throughout the project”.

    Whatever the truth is, this doesn’t impact the film’s evident dramatic appeal.

    Hawkins is spectacular as the downtrodden, vulnerable character who overcomes adversity proves to the world that she should be taken seriously.

    FWIW most of the critics weren’t wild about the film (mostly given it a paltry 3 stars) but I would have to disagree. I loved it.

    HIFF Notes #2 — Movies to watch at the Film Festival

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    Editor’s note: This is the second installment of an ongoing blog on films I enjoyed at HIFF–The Hawai’i International Film Festival

    EO

    One of the great things about HIFF is the eclectic nature of the films chosen for the festival. Not only do you get primo productions from Asia and the Pacific, but also wonderful submissions from Europe and elsewhere.

    EO, is a case and point.

    Made in Poland by 84 year old, film director, screenwriter, dramatist and actor, Jerzy Skolimowski, the film premiered at this year’s Cannes Film Festival where it won the Jury Prize and the Soundtrack award. (The movie is loosely inspired by Au Hazard Balthazar a 1966 French drama film directed by legendary director Robert Bresson).

    EO lands at a petting zoo…for a while.

    EO follows the journey of a gray donkey named appropriately enough, EO.

    Following his removal from a traveling circus, he begins an epic road trip across the Polish and Italian countryside encountering both cruelty and kindness.

    EO is assisted and hampered by a cast of characters including a young Italian priest (Lorenzo Zurzolo), a Countess (Isabelle Huppert) an unruly Polish soccer team and other random individuals–both human and animal.

    The story begins in a Polish circus, where the animal is doted upon by his trainer and fellow performer, Kasandra (Sandra Drzymalska). Life is pretty good but that ends when animal rights activists close down the circus. EO ends up at a petting zoo which seems like a great place to land but it’s not completely to his liking and he busts out. That’s when the fun begins…

    He enters a deep dark forest at night.

    It’s a spooky, foreboding foray into a netherworld where there are howling wolves, foxes, owls, menacing hunters and rugged terrain that he stumbles through.

    It’s anything but Mr. Roger’s neighborhood. There’s even an allusion to the Holocaust (hey it’s Poland) as the animal walks through a graveyard with tombstones inscribed with Hebrew characters. Not an accident me thinks. The director’s father fought for the Polish resistance and was executed by the Germans. His family also hid Jews during the Nazi occupation.

    The star, EO, doesn’t disappoint.

    EO emerges, and inevitably wanders into a subterranean storm drain, complete with screeching bats. Is he entering the bowels of hell? Maybe.

    Somehow this intrepid donkey makes it through this hellish landscape. There’s daylight (literally) at the end of the tunnel but don’t let up your guard EO. Your real challenge will be with homo sapiens on the other side.

    Life for a donkey is tough enough on the road but people put him to work as a beast of burden. (That’s his job, isn’t it?)

    It seems it’s the men (vs. the women) who present the most vexing challenge. EO wanders into a soccer match where he becomes the mascot of the winning team. He’s exalted for a while and then nearly bludgeoned to death by the hooligan-like rival soccer team who blame the donkey for their defeat.

    Naturally.

    More trials and tribulations confront EO as he’s put on a truck bound for a slaughter house. The truck driver, a long-haired heavy metal freak, is later “slaughtered” randomly at a truckstop and EO is adopted by a good looking Italian priest, who we find out, has a gambling problem.

    The two make their way to Italy and they end up at a villa. However, it’s not exactly a Roman holiday for this donkey. The villa, belonging to countess (Isabelle Huppert) is connected to the priest’s family and they both find at least a temporary home. The studly priest gets sexually entangled with the countess.

    Time for EO to bolt…

    In essence, the film allows the viewer to see the world from the perspective of the donkey. What he sees is hardly edifying—dysfunction, societal ills and more often than not, callousness. Once in a while a kindly human is there for him.

    It’s not a pretty picture but the cinematography (by Mychal Dymek) is phenomenal.

    This compelling tale, combined with visual excellence, is a winner.

    The Empty Homes Tax

    One of the ideas that has been kicking around in the state and county legislatures for a couple of years now is the idea of an “empty homes tax.”  The idea seems to be gaining steam now since our federal court has struck down Honolulu’s recent ordinance clamping down on transient vacation rentals.

    Basically, the idea is that if you own a house or condo, you don’t live in it, and you don’t allow anyone else to live in it, then you need to pay a hefty tax. The version of the tax now before the Honolulu City Council, Bill 9 (2022), sets the tax at 3% of the property value, per year.  So, a single-family home worth $1 million (which happens to be the median value of such homes) would face a $30,000 tax, in addition to the regular real property tax, for each year it is unoccupied.  Proponents of the bill say it’s a fair price for taking that property out of the housing supply and thereby contributing to our housing shortage here. 

    According to testimony submitted in support of the bill, a similar empty homes tax now in effect in the city of Vancouver, Canada, resulted in a 26% reduction of vacant homes and $106 million in new tax revenues since 2018.

    It certainly seems like the devil is going to be in the details, however. How are tax authorities to know whether a property is occupied or not?  The law provides that all property owners need to fill out an annual declaration form to tell tax authorities about whether the property was occupied.  But—and this should be no surprise to most folks—not all taxpayers tell the truth on such forms.  How do lawmakers expect that the City would know when a house is occupied or not?  Would the property tax folks need to stake out each property to see who goes in and out?  Or can they get an idea from the property’s water bill (or lack thereof)?

    Worse, honest, law-abiding property owners might not even know about the form, miss the filing deadline, and then could have a problem because the law provides that if you don’t file a form, the property is presumed to be an empty home.  When Honolulu adopted its “Residential A” property classification some years ago; folks didn’t file the form necessary to get their home exemption, found themselves with a huge property tax bill when the property was reclassified, and came crying to the City and the Council to get relief.  The Council found itself passing a couple of rounds of relief because good, honest folks were getting legitimately confused.  Then, the problem was with people who lived in their homes and hadn’t already filed a home exemption form.  People who filed a home exemption form generally didn’t have to keep filing it again every year.  With an empty homes tax, the form is required every single year, so the amount of pandemonium city officials can expect will be orders of magnitude larger than that of Residential A.

    The City’s Department of Budget and Fiscal Services, after speaking with Vancouver officials and doing some research about how to enforce this kind of law, urged the City Council to put the brakes on the proposal until they could figure out what they would need to deal with it.  “As currently staffed and configured,” they said, the [Real Property Assessment Division] is not a property management agency and does not have the expertise, staffing, nor the needed resources, to properly implement and administer Bill 9.”  That seems to be one reason why the bill seems to be on ice at the moment. 

    This idea was also taken up in the state legislature, where some creative lawmakers proposed to attach the empty homes tax to the conveyance tax system.  At the time, we pointed out that there really was no conveyance of the property that was taking place.  It is a tax on usage of the property, which is what property tax is, and our state constitution says that property tax is the kuleana of the counties exclusively.

    Our new legislative session will be here before long, and we might be able to see this drama unfold a bit more.

    HIFF Notes #1 — Movies to watch at the Film Festival

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    Editor’s note: This is the first installment of an ongoing blog on films I enjoyed at HIFF–The Hawai’i International Film Festival

    Noise

    This was my inaugural film for this year’s HIFF and it’s a doozy. It’s entitled, Noise but it may well be “What is the price of truth?”

    Noise is a Japanese production set on a remote island. It’s tight knit, rural community – a peaceful, idyllic place, at least at the very outset of the film. The tranquility belies a dark underbelly. As Carl Jung would say, there’s always the shadow that we must contend with. This film explores this facet of society and human nature.

    The story line goes like this…Keita (Tatsuya Fujiwara, BATTLE ROYALE) supports his family with the assistance of his childhood friend, Jun (Ken’ichi Matsuyama, NORWEGIAN WOOD) farming black figs. The figs are huge, beautiful and sweet. Keita passes them around like candy and operates a little roadside stand.

    We learn the very future of this island is riding on his unpretentious fig farm. The powers that be are counting on a big grant from the Japanese government based on Keita’s agricultural prowess. The island needs this infusion, many of the young people have left the community and growing figs are the key to revitalizing its economy.

    The creepy stranger, Omisaka, meets his fate in Noise.

    When a rather creepy stranger, Mutsuo Omisaka, shows up on the island, all kinds of bad things happen. As we learn, it’s not all the fault of the Omisaka, although we know he’s no saint. He’s the trip wire that sets off a chain of events.

    When Keita’s daughter goes missing from the family home, he confronts Omisaka, believing that the stranger is responsible for her disappearance. Keita, Jun and their friend Shin, a local cop confront the stranger and in a tussle Keita accidentally kills him.

    Jun and Keita try to cover things up, but to no avail. Events continue to spin out of control and before too long other members of the community fall like dominoes.

    As the bodies stack up, a couple of detectives from the mainland show up. The cops mean business and are relentless in getting to the bottom of things. The once idyllic community begins to unravel.

    You might say that the theme of the film, or at least one of the messages is that no good deed (or bad deed for that matter) goes unpunished. The local folks are determined to hide the crimes from the police for the sake of the community but this is not a formula for success. No matter how “good” the intention, the cover up gets even more convoluted and suddenly unravels.

    Officer Shinichiro Moriya, aka Shin, the rookie cop, faces a moral dilemma.

    I really enjoyed this movie. It’s cleverly written–as all manner of things happen that are least expected. That’s what you want in a movie.

    There are some good laughs as well.

    The screenwriter, Sho Kataoka, has a wry sense of humor, but this is no comedy. It’s more of a Greek tragedy.

    In addition to the protagonists, there are some wonderful secondary characters–the cynical detective from the mainland (Nagase Masatoshi), the bossy, bitchy mayor lady and her unctuous second in command, the grumpy old doc and others.

    I’m not going to give the ending away of course but suffice it to say, it’s not a storybook conclusion.

    You may think you know whodunnit but it’s not that simple. Nothing in life, or this movie, is.

    Local students direct dance fundraiser for Kenya November 25 -26

    SEASONS (Change in Motion) is a student created and led production using the elements of dance, acrobatics, music and poetry to reveal how life’s inevitable changes mirror the natural change of the four seasons. Each piece depicts a natural occurrence and how God created the natural world to illustrate supernatural truths. His presence is found in the scarcity and the abundance, in the drought and the harvest, and there is purpose and beauty in every season. As Ecclesiastes 3:1 states, “There is a time for everything, and a season for every activity under the heavens.” 

    This performance is serving as a fundraiser to support Camp Ohana’s dance and music program that is providing FREE dance and music lessons to children’s homes (orphanages) in Kenya! This performance will be able to provide hundreds of orphans with an opportunity to experience dance, ukulele, drumming, and photography!

    Nicole Lam, Director of Prisma Dance, has been to Kenya over 7 times since 2014, and has taken multiple groups of Prisma dancers, parents, and teachers to Kenya. During Fall Break, Nicole flew to Kenya to film the Camp Ohana children singing and dancing. Their performance will be creatively woven into this production.

    Backgrounder

    Prisma Dance was founded in 2014, by Nicole Lam. With locations in Kalihi, Kailua, Ewa Beach, and Miliani, Prisma Dance offers training in ballet, lyrical jazz, contemporary modern, acro dance, and partner acrobatics to ages three through adults. Prisma Dance provides artistic and spiritual development in a Christian environment that is safe, positive, and tons of fun!

    What: SEASONS (change in motion)
    Where: Paliku Theater 45-720 Keaahala St. Kaneohe, HI, 96744
    When: November 25 -26, 2022
    Tickets: $30-$40, to purchase tickets visit www.prismadance.com/seasons

    The Obama Appeal – Part 2

    by Manfred Henningsen

    Editor’s note: This is the second of a two part series on the Obama – Hawaii connection by Manfred Henningsen, Emeritus Professor of Political Science at the University of Hawaii at Manoa.

    Maybe the explanation for this mysterious social and political distance between Obama and Hawaii can be found in his autobiographical book, Dreams from My Father (1995). In this book with the revealing subtitle ‘A Story of Race and Inheritance’, he describes the traumatizing impact of American racism on both his parents. His white mother, S. Ann Dunham, grew up in the late 1940s and the 1950s in the ‘Jim Crow’ atmosphere of the mainland. His father, Barack Obama Senior, joined the University of Hawaii in 1959 on a scholarship for economics. Ann and Barack Senior met in 1960 in a Russian language class, dated and got married. When he graduated in 1962, a year after his son was born, he was interviewed by the Honolulu Star-Bulletin.

    After all, he was the first student from Africa at the university. His son’s comments on the interview are intriguing and point in the direction of his own unsettled identity: “…he appears guarded and responsible, the model student ambassador for his continent. He mildly scolds the university for herding visiting students into dormitories and forcing them to attend programs designed to promote cultural understanding – a distraction, he says, from the practical training he seeks.

    A family portrait with his sister, mother and grandfather.

    Although he hasn’t experienced any problems himself, he detects self-segregation and overt discrimination taking place between the various ethnic groups and expresses wry amusement at the fact that ‘Caucasians’ in Hawaii are occasionally at the receiving end of prejudice.” Obama Junior ends the narrative about his father on a positive note, when he quotes a concluding statement, his father made in the interview with the newspaper: “One thing other nations can learn from Hawaii, he says, is the willingness of races to work together toward common development, something he has found whites elsewhere too often unwilling to do.”

    This account of Obama’s father’s views by the son is preceded by reflections that may hint also at his own misgivings about playing a symbolic role he refuses to inherit. He mentions how it took some time for the initially stereotypical racial attitudes of his grandparents to change. He places the love story of his parents in the “…fleeting period between Kennedy’s election and the passage of the Voting Rights Act: the seeming triumph of universalism over parochialism and narrowmindedness, a bright new world where differences of race or culture would instruct and amuse and perhaps even ennoble. A useful fiction, one that haunts me no less than it haunted my family, evoking as it does some lost Eden that extends beyond mere childhood.”

    Young Barry in Hawaii

    Obama acknowledges Hawaii’s exceptional story without denying: “The ugly conquest of the native Hawaiians through aborted treaties and crippling disease brought by the missionaries; the carving up of rich volcanic soil by American companies for sugarcane and pineapple plantations; the indenturing system that kept Japanese, Chinese, and Filipino immigrants stooped sunup to sunset in these same fields; the internment of Japanese-Americans during the war – all this was recent history.” When his family arrived, he writes, “it had somehow vanished from collective memory, like morning mist that the sun burned away.

    There were too many races, with power among them too diffuse, to impose the mainland’s rigid caste system; and so few blacks that the most ardent segregationists could enjoy a vacation secure in the knowledge that race mixing in Hawaii had little to do with the established order at home.” And then comes a sentence that begins to explain Obama’s existential distance: “Thus the legend was made of Hawaii as the one true melting pot, an experiment in racial harmony.”

    A former Obama residence in Honolulu.

    For Obama the story of Hawaii as recovered Eden had a missing link, the absence of his father. He wasn’t told why he had left and surmises whether the Eden story could have been a trigger event. He didn’t want to become “a prop in someone else’s narrative. An attractive prop – the alien figure with the heart of gold, the mysterious stranger who saves the town and wins the girl – but a prop nonetheless.” Obama doesn’t blame his mother or grandparents for having designed an almost mythical narrative like this and concedes that his “father may have preferred the image they created for him – indeed, he may have been complicit in its creation.”

    Obama’s Hawaii was a legend for him that did not represent America’s historical and political reality. Yet it socialized him in an un-American way, turned him into an “alien” yet extremely appealing “stranger” for a large section of the US population. The African dimension of his person that connected him with his absent father made it impossible for him to accept Hawaii as his political lifeworld. That may also be in the final analysis the reason for having chosen Chicago as the location for his Presidential Center.

    ***********************

    Manfred Henningsen is an Emeritus Professor of Political Science at the University of Hawaii, where he taught from 1970 until 2020. 

    Auditor warns licensing could drive away community health workers

    By Jonathan Helton

    A proposed certification scheme for community health workers would burden the workers and raise prices for everyone, according to the Hawaii Office of the State Auditor.[1]

    The report, “Sunrise Analysis: Regulation of Community Health Workers,” issued in September, follows a long string of state auditor reports that show Hawaii’s occupational licensing laws do more harm than good.

    Between 1985 and 2017, the state auditor conducted 44 reviews on various occupations — from mixed martial arts timekeepers to social workers — and 73% of them recommended that new regulations were unnecessary.

    Nevertheless, state lawmakers rarely listened to the auditor: In 46% of the cases, they created a new license or kept the existing one anyway.[2]

    Occupational licensing has been around for decades in Hawaii. In fact, Hawaii has the strictest occupational licensing laws in the country, according to a 2017 study from the Institute for Justice.[3]

    Moreover, proposals to extend licensing to additional occupations continue to be put forth, despite a growing body of research showing that it does little to enhance the quality of work or protect consumers.[4]

    Little wonder that so many Hawaii residents find it hard to get a good job in the islands and leave for greater job opportunities elsewhere.

    In the case of community health workers, of which there are more than 200 in Hawaii, the state auditor’s office examined the trade in response to a licensing proposal considered during the 2022 legislative session.

    State law requires the Office of the Auditor to review bills that would create new occupational licenses, so the Legislature passed a resolution directing the auditor to do that,[5] and the bill, SB2882, was shelved for the time being.[6]

    There is no agreed-upon definition of a community health worker, but the federal Centers for Disease Control and Prevention defines them as individuals who are “effective at connecting the community to needed health and social services and improving the quality and cultural competence of health service delivery.”[7]

    The proposed certification would have mandated that all people trying to get a job as a community health worker pay a $1,000 fee and complete a university community health worker program, or work 3,000 hours under supervision.[8]

    The auditor wrote that the burdensome requirements of mandatory certification “could inadvertently force existing community health workers out of the field and make recruitment from underserved communities a greater challenge.”[9]

    The auditor noted that a CDC report that such certification also does not necessarily benefit those in need of care.

    “There is no empirical evidence showing that [community health workers] with certification perform their job better than CHWs without certification,” the CDC reported.[10]

    In lieu of mandatory certification, the Hawaii Public Health Institute, a nonprofit focused on improving health and preventing disease, testified before lawmakers in March that there be some sort of optional certification program.

    “At this time we would prefer the certification program be optional for [community health workers] and for employers to decide if they will require certification,” the Institute said in written comments to the House Committee on Health, Human Services and Homelessness.[11]

    Optional certification, the Institute said, would allow individuals and businesses flexibility. A mandatory certification or license would deny flexibility, and could be too rigid to adapt to the cultural differences of many community health workers.

    For example, three health policy researchers writing in Health Affairs, a national peer-reviewed health policy journal, noted in July that “the CHW workforce is largely composed of women of color, [and] this racial diversity also brings linguistic diversity, which may prove to be a barrier in seeking CHW certification.”[12]

    Considering all the evidence against occupational licensure laws, probably the best tactic for state lawmakers in the coming legislative session would be to heed the state auditor’s findings and fully reject mandatory certifications for Hawaii’s community health workers.

    Then they could perhaps go back and reconsider their decisions regarding those other licensing laws that the Office of the Auditor recommended against.
    ____________

    Jonathan Helton is a policy researcher at the Grassroot Institute of Hawaii.
    ____________

    [1]Sunrise Analysis: Regulation of Community Health Workers,” A Report to the Governor and the Legislature of the State of Hawai‘i, Report No. 22-08, Sept. 2022.

    [2]Hawaii’s Auditor Produces Some of the Nation’s Strongest Sunrise Reports,” Institute for Justice, accessed Oct. 28, 2022.

    [3]License to Work: Hawaii,” Institute for Justice, accessed Oct. 28, 2022.

    [4] Joe Kent, “Permission to Work in Hawaii,” Grassroot Institute of Hawaii, Sept. 14, 2017.

    [5]SCR2 SD1,” Hawaii State Legislature 2022 Session, accessed Oct. 28, 2022.

    [6]SB2882 SD2,” Hawaii State Legislature 2022 Session, accessed Oct. 28, 2022.

    [7] “Sunrise Analysis,” p. 3.

    [8]  Ibid, p 11.

    [9] Ibid, p. 9.

    [10] Ibid, p. 12.

    [11] Testimony before the House Committee on Health, Human Services, & Homelessness, Hawaii Public Health Institute, March 15, 2022, p. 8.

    [12] Megan Coffinbargar, April Joy Damian and John M. Westfall, “Risks And Benefits To Community Health Worker Certification,” Health Affairs, July 7, 2022.