Wednesday, May 31, 2023
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    It’s Time for a Change:

    People With Diapers Deserve DEI, Too

    They’re not just for babies anymore. People with diapers, or PWD’s, are a growing segment of society. However, a cultural stigma against PWDs, and adult diapers, is hampering diversity, equity, and inclusion at the workplace and other social environments. It’s time we liberate the people with diapers from the pins and needles of social ridicule and scorn, and include PWDs as valued members of society.

    To help you get some empathy for PWDs, keep in mind that fighter pilots, and others who are too busy working to take a needed nature-break, sometimes use diapers as a convenient way to eliminate waste when desired, on their own personal schedule, in a way that can be stored conveniently for later disposal. And let’s face it. Sometimes it’s just too far to the restroom. 

    Of course, diapers are also great for people with health issues, like incontinence or leakage. But they are useful for more than that. According to Medical News Today

    People may need to use adult diapers or pads in a variety of situations including when they are:

    • having trouble using or accessing the bathroom
    • struggling with bowel or bladder control
    • working in jobs that require long periods of time without being able to go to the bathroom
    • living with conditions such as Alzheimer’s disease that affect their ability to remember to go to the bathroom

    There are also people with a diaper fetish, or PWD-Fs, who need to be respected for their brave lifestyle choice. You have to admire their courage in living true to their inner feelings, despite negative judgments from others.

    All together, there are lots of adults wearing diapers for one reason or another. According to Fortune Business Insight, “The global adult diapers market size was valued at USD 11.55 billion in 2018 and is projected to reach USD 19.77 billion by 2026.”  Disposal diapers, including those for babies, is currently a USD 71 billion industry.

    The bottom line is that there are hundreds of millions of people wearing diapers, and adults constitute about 20% them. That’s a lot of people who feel ashamed of being PWDs, and who stay in the closet, holding in their true natures. 

    It’s time this diapered minority stop being oppressed for their diaper usage. There is nothing about diapers that deserves ridicule, and we all need to feel more inclusive of PWDs at office meetings and luncheons. 

    Here is a guide to help people who do not wear diapers to better engage PWDs in a more equitable and inclusive manner. 

    • Try to show acceptance of the PWD by announcing your diaper status when making introductions, as you do for pronouns. For example, you can say, “Hi. My name is Todd, my pronouns are he/him, and I wear a diaper.” You might then say, “Hi Todd. My name is Susan, I go by he/him, too, but I don’t wear a diaper.” 
    • Be sensitive to not make fecal or urinary references in your language. For example, avoid saying “I’m pissed off”, or “You’re full of shit”. These can be trigger words for PWDs. 
    • Avoid commenting on any poopy-pants smell. PWDs can’t help the way they smell when their pants are full. If the aroma is uncomfortable, suggest a breath mint, which dulls the sense of smell.
    • Make sure bathrooms have disposable diapers available, and a hygienic place to dispose of soiled diapers. All bathrooms, regardless of gender, should have tampons, condoms, pads, and diapers. 
    • Equip public restrooms with adult diaper changing rooms, which are furnished with bidets or water hoses for cleaning.
    • Consider higher wages for PWDs, to compensate them for cultural oppression, as a form of reparations. Also, PWDs take fewer bathroom breaks, and are typically more dedicated workers. 
    • Remember that just because someone poops on the job, it doesn’t mean that they are not doing their part. Respect for diversity means accepting that some people practice alternative waste elimination, and that’s okay. It has nothing to do with job performance whether someone is in a diaper or not, unless they haven’t been changed for a while. 
    • Hiring committees should give priority to applicants who are not only the traditionally-oppressed gender and racial minorities, but also the diapered minority. We need more diapered leaders and role models.  
    • Remember that even you, dear reader, can one day be a PWD. Diapers may be in any of our futures. If you’ve poo-pooed diapers all your life, then it’s time to change. 

    As our culture gets past the stigmas and taboos which have oppressed and marginalized people, our world becomes a better place to live. Hopefully, we can all stand together, hand in hand, and rejoice in our common bond of humanity, regardless of race, ethnicity, religion, gender, or diaper usage.

    Government overreach hides behind ‘pay transparency’ bill

    By Keli‘i Akina

    Every year we see a handful of bills at the Legislature that put good intentions ahead of practical experience. 

    Even when the people who would be most affected by the proposals explain that they are unworkable or counterproductive, those good intentions still keep the bills moving forward. 

    Happily, many of these bills are usually dropped or fixed during the last weeks of the legislative session. 

    Keli‘i Akina

    But sometimes, there is so much ideological support for a proposal that the dissenting voices don’t get the attention they deserve.

    Such is the case with SB1057, a bill that would require all job listings to include the hourly rate or salary range so as to promote “transparency and equal pay for all employees.” 

    The sponsors claim that “initial experiences” with such a law in California, Colorado and New York City have “benefited employers, current employees and prospective employees.”

    But that is hardly sufficient evidence or justification for the state to further meddle in the affairs of private businesses. Hawaii is already considered one of the least business-friendly states in the nation, and this would only make it worse. 

    Groups such as the Chamber of Commerce Hawaii, the Retail Merchants of Hawaii, the National Federation of Independent Businesses and the Society for Human Resource Management have all made it clear that the wage-disclosure requirement could lead to major problems for both employers and employees.

    Pay, after all, is only part of the picture when you’re looking for a job, and the pay disclosure requirement could hurt job seekers more than it helps them by taking away their ability to negotiate their own compensations.

    For example, some people are willing to take a lower salary in exchange for a better benefits package, a more flexible schedule, more vacation time or a company vehicle. Others might be happy to trade away benefits or take on more responsibilities in exchange for higher base pay. 

    This is as it should be. No one else knows what compensation package is best for you better than you do. 

    Other considerations weighing against this bill are that it would:

    >> Be an administrative headache for small businesses, where job titles and roles can be imprecise and evolve according to the business’ needs.

    >> Hinder the ability of employers to offer higher or lower salaries than those of existing employees in response to the economy, issues within the business or other concerns.

    >> Give a competitive advantage to large mainland corporations over small local businesses because they could offer higher pay rates.

    >> Fuel personnel difficulties if all the employees know each other’s salaries. 

    Finally, it would effectively ban a valuable way for employers to find new talent — and for less qualified workers to get their foot in the door. That’s because employers would not be able to offer a lower salary to someone who doesn’t meet all the qualifications but shows potential for growth.

    Yes, this bill has good intentions. Yes, it sounds like it’s about fairness. But all that doesn’t necessarily matter when it comes to the real world.

    The only thing that matters is that SB1057 would hurt the people it is aiming to help by hamstringing those who are best able to help them — their potential employers.

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

    It Isn’t Over Until It’s Over

    We’ve come to that part of our legislative session where all the public hearings are done.  From here on out, lawmakers in the House will be chatting with their counterparts in the Senate to hash out any differences between their respective versions of bills. Most of that will be done behind closed doors. Then, when a deal has been struck, lawmakers will dutifully file into a conference room to vote on and pass out final versions of bills called Conference Drafts. 

    In the meantime, lawmakers have been figuring out how to bypass conventional learning about when a bill is dead. Here is one example. 

    House Bill 1327, as introduced, proposed giving teachers a tax credit to essentially pay them back for classroom expenses that they paid out of their own pockets.

    The bill sailed through the House, crossed over to the Senate, and was there referred to the Education and Ways & Means Committees, in that order.  A couple of weeks went by, and the deadline for bills to advance through their first committees came and went. Senate Education did not hear the bill.  So, it looked like the bill was dead. 

    On April 4th, however, the Senate President’s office re-referred the bill solely to Ways & Means, which immediately scheduled the bill for a hearing on April 5th (giving the public fewer than the normal 48 hours’ notice) and passed the bill out on the 5th, one day before the deadline for filing final committee reports on bills. 

    We are not saying that anything improper was done here. There is a procedure for re-referring bills and for approving hearings with short notice. All those procedures were properly followed, we assume.  Nor do we have any particular objections to the teacher tax credit bill. 

    We are using this bill to illustrate that bills that seem to be dead aren’t necessarily so. 

    There are also other techniques to advance the ideas in “dead” bills.  Their content can be spliced into other bills that are still alive, for example, if the recipient bill has a broad enough title and the other contents of the recipient bill are similar enough to the “dead” bill so that it can’t be termed a “gut and replace.”

    “Gut and replace” may be tougher to pull off these days, but there are still techniques available to do interesting things. At the Legislature, then, it’s not over until it’s over. 

    Free Fall — Gone

    There is no doubt that our familiar world has undergone significant change in recent years and continues to change at a rapid, accelerating rate. Viewed from the perspective of geological time, the  brief moment of human history on earth seems, to us, an eternity. The relative and temporary environmental stability that we experienced seemed definite and permanent . . . and we grew used to it . . . comfortably adjusted to it. We built our civilization . . . the “social order” around our expectations of permanence and relative predictability of the earth’s patterns and resources. We took it for granted.

    The expectation of predictability that was built into just about every aspect of human enterprise and activity has diminished markedly and continues to evaporate at a rapid pace. It is the glue that holds our world together and unites our collective perception of reality. Now, it is gone.

    The results of the current environmental meltdown are significant, unsettling and often deadly.

    People are as much a part of the planet’s environment as

    anything else and as such are subject to the same unbalance and destabilization that is affecting the entire ecosystem. Individual awareness / perception as well as the collective consciousness are deep in troubled waters. We are not exempt from the chaos that we have produced.

    Pandemics, famine, fires, water disasters on both ends of the spectrum – dry and wet, increasing catastrophic weather events, massive contamination of the air, land and sea, war, desperate politicians trying to shore up an unraveling social order . . . all at epic levels. No safe havens left . . . increasing danger and difficulties with travel. It gets worse every


    When will our world return to normal . . . to the way it was?

    Never. It can’t. “Water under the bridge”, (as the saying goes).

     A new balance  will settle in. When and how it will look are unknown, unknowable and unpredictable. The incalculable forces of nature are in play.

    The unsettling effect of core element destabilization of the global environment is undeniable and very apparent. It is playing out in the behavior of individuals and in the collective actions of the social order . . .  a marked increase in anxiety, depression, suicide, aberrant (often violent) behavior and general disfunction at all ages, at all levels of the social spectrum.

    Wishing to go back, struggling to reinstate times past are unfortunately futile . . . an effort to achieve the impossible. At best, we can, as individuals, take responsibility for our actions and adjust our personal lifestyles to more sustainable practices in an attempt to mitigate the ongoing degradation of the global ecosphere . . . the platform on which rests all life . . . including ours.

    As the window for halting or reversing environmental free – fall  closes, another  window is opening. What will be revealed is unknown at this point in time, but as nature seeks and eventually finds its balance, a different world will emerge.

    Evolution is, basically, the ability of living organisms to make positive, adaptive change / adjustment under the pressure of changing environmental conditions.

     Perhaps, it would be a more successful choice to focus on navigating and calibrating our energy on the “now,” rather than staying fixed on the receding view in the rearview mirror. “Water under the bridge” is gone and cannot be reclaimed. At best, we might be able to  slow it down and minimize destabilization.

    Maybe, upon reflection, the past is best left behind. Why strive to return to something that clearly failed . . . a way of life that resulted in an inability to sustain life . . . a world view based on fictions that resulted in a path to extinction? Were they really “the good old days”? Are we really longing and struggling to go backward? To repeat failed choices?

    Joe Carlisi


    Joseph Carlisi – Biography     

    Born and raised in New York City, he earned BA and MA degrees in Philosophy at Hunter College of the City University of New York and then continued his graduate studies in Philosophy and Artificial Intelligence at Massachusetts Institute of Technology working under the mentorship of Marvin Minsky. Joseph worked as a part time content and copy editor for Harvard University Press (science and medicine) while attending M.I.T.     

    After ten years as a university lecturer, researcher and administrator, he started and managed an advertising / public relations firm in San Diego, CA that handled a wide range of commercial accounts. On the academic side, he published a series of seven articles on animal behavior for Harvard Magazine and two books: “A Guide to Personal Power” and most recently “Playing God on the Eve of Extinction”.

    Joseph Carlisi creates oil on canvas paintings that can be described as vivid, surreal and unexpected. His paintings have been exhibited and sold in: Honolulu, Los Angeles, Las Vegas, New York City, Miami, Tokyo, Yokohama, Amsterdam, Berlin and Salvador Brazil.

    Joe’s art is available for purchase.

    Contact him at

    Taste of Tourism: Can the Visitor Industry Transform Hawaii’s Food System?

    What is regenerative tourism and how can it support local agriculture?

    Friday, April 21st, 5pm-8pm HST

    Location: Ka Waiwai1110 University Ave Honolulu, HI 96826


    About this Event:

    Presented by The Hawaiʻi Institute for Sustainable Community Food Systems at University of Hawaiʻi – West Oʻahu, Honolulu Civil Beat, UH Better Tomorrow Speaker Series, and Waiwai Collective, this series is meant to generate key opportunities for community dialogue among a diverse audience, aiming to achieve a healthy, equitable, resilient and sustainable food system for Hawaiʻi.

    Featured Speakers:

    Dexter Kishida, Food Security & Sustainability Program Manager, Office of Climate Change, Sustainability & Resilience, City & County of Honolulu.

    Pomai Weigert, AgBusiness Consultant with GoFarm Hawaii, and advisor for the Hawaii Agritourism Association.

    Stewart Yerton, Reporter, Honolulu Civil Beat


    Doors open at 5 p.m. for booths, music and a complimentary pupu. Speakers will start at 6 p.m, followed by an optional post-discussion community forum from 7 – 8 p.m.

    Parking Directions: Ka Waiwai Parking is located on the makai side of the Varsity Building. The entrance to the lot is located off of Coyne Street. Parking is $6.

    ***if you park in any of the lots located on the mauka side of the building you will need to self pay at the self pay station. They will ticket/tow in these lots if you do not pay.

    Counties can afford, should prioritize property tax relief

    By Keli‘i Akina

    No one likes the idea of our county governments profiting from Hawaii’s high cost of living. 

    But that’s what is going to happen soon unless we engineer some property tax relief.

    Thanks to higher property assessments statewide, Hawaii homeowners and others are facing massive increases in their property taxes. That’s because the taxes are tied to property valuations, so if property values go up, so do property taxes.  

    Keli‘i Akina

    We could just adjust the property tax rates to offset the increased valuations, but for some reason, politicians seem to think that’s just too simple. 

    More reasonably, they say that rate cuts might put them in financial jeopardy if property valuations go down in future years. But if that unlikely event should ever occur, they could just move the rates back up again.

    One reason it has been difficult to make any progress on this issue is that many people tend to get distracted by why Hawaii housing prices are so high to begin with.

    Two week ago, I was on PBS Hawai‘i’s “Insights” program, the theme of which was supposed be about whether there might be any relief for “rising property taxes on Oahu.” 

    Unfortunately, it seems there was more talk about whom we should blame for Hawaii’s high property valuations — whether out-of-state investors, empty homes or other convenient scapegoats — than any focused discussion about how to provide meaningful taxpayer relief. 

    Just to be clear, the main reason for Hawaii’s high home prices is that we do not have enough homes. Further, the scholarly evidence is virtually unanimous that the state’s acute housing shortage is the result of too many regulations on homebuilding. 

    Then there were the often-heard claims that our property tax rates in Hawaii are the lowest in the nation, so why all the complaining? 

    Well, yes, as I’ve explained before, Hawaii does have low property tax rates, but that’s only half of the story. The other half is that because of high property values, the amount Hawaii residents pay in property taxes is closer to the middle of the pack on a state-by-state basis.

    But to the point about the low rates: Why are they so low in Hawaii?

    Mainly, it’s because Hawaii is the only state in the nation that funds its public schools through the state general fund. Everywhere else, they are funded through local property taxes. 

    In other words, Hawaii’s four counties do not have to spend their property tax revenues on schooling for Dick and Jane. They have to worry about only the usual county functions, such as police, firefighters, infrastructure and a few other things. The fewer things they do, the lower the property tax rates can be. 

    Finally, there is the belief that property tax increases can be structured to affect only the wealthy. However, that’s not how an economy works. When you make something more expensive, whether it’s a house or a bottle of soda, everyone experiences the impact. 

    Consider Oahu’s “Residential A” property tax classification. Enacted in 2013, this category applies to non-owner-occupied homes valued at $1 million or more. 

    A popular sentiment back then was that anyone who owns such a home should have to pay a higher tax. But if that second home is being rented out, guess who is going to end up paying the higher tax bill? 

    And now, too, of course, thanks to inflation and the housing shortage that keeps pushing up home prices, even the average Oahu home is worth about $1 million. 

    So the Residential A tier doesn’t apply anymore to just wealthy investors with second homes. It also covers longtime Hawaii residents who might be renting out their late parents’ homes to local families on a long-term basis. 

    And since the property assessments for Residential A just went up by 39.9%, the Hawaii residents — just like the more wealthy investors — probably will have little choice but to pass along that new cost to their tenants who already are struggling to make ends meet. 

    And we wonder why so many Hawaii residents have been leaving for the mainland.

    Amazingly, there are some good ideas floating around at the various county councils right now. My colleagues at the Grassroot Institute of Hawaii have testified before all of them in favor of property tax rebates, exemptions, credits, budgetary restraint and, yes, even lower tax rates. Many of those proposals look like they are going to go through.

    Despite talk that the counties can’t afford to cut taxes right now, the truth is that they can. The key is to hold tight on the spending — just as most Hawaii residents have had to pull their belts tighter as well. 

    Our counties certainly should not be looking to spend more because of anticipated revenue triggered by the higher property assessments. A housing crisis and soaring property values should not be an excuse for a spending spree. 


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

    Hope for Tax Relief Still Alive

    In the fast-paced, chaotic world that is the Hawaii Legislature this time of year, it is difficult to make any predictions about anything.  But there seems to be a glimmer of hope that some pieces of the Governor’s income tax relief bill, part of what the Governor’s office calls the “Green Affordability Plan” or GAP, will indeed cross the finish line.  But, and let’s not kid ourselves, there’s plenty of distance to travel and plenty of work that we all have to do if we want to make sure that the bill gets to the right place.

    Let’s first take stock of where we are.  One of the pieces in GAP was an exemption from the General Excise Tax for food and medicine.  That proposal is now on the floor gathering dust.  The Senate bill, SB 1348, was heard by the Health and Human Services Committee but got deferred.  The House companion bill, HB 1050, was heard and passed out by the Economic Development and Health & Homelessness Committees, but didn’t receive a hearing in the Finance Committee. 

    The GAP centerpiece bill, however, was a complex bill combining movement in the income tax brackets, increases in the personal exemptions and standard deduction, and boosts to a number of different tax credits that are available to lower income folks.  The Senate bill, SB 1347, was referred to the Senate Education Committee but was not heard by that committee.  The House Education and Economic Development Committees passed out the House companion, HB 1049, and House Finance basically cut the bill into three pieces.  The income tax relief provisions and the Hawaii earned income tax credit boost were spliced into HB 954.  The food/excise credit provision went into HB 493.  The other credits were left in HB 1049.  All three bills crossed over into the Senate, and all three bills received a single referral to WAM, meaning that only one Senate committee, Ways & Means, will be entrusted with the fate of all three bills.

    Civil Beat recently reported that when Senate Ways & Means chair Donovan Dela Cruz briefed his members on the State budget, he said that the Senate would support a sizable slice of the Governor’s proposed tax changes.  Ways & Means has scheduled hearings on April 3rd for HB 954 and HB 1049, and has yet to schedule a hearing on HB 493.  It’s now hard to say which of the many parts of the GAP proposal will get through the Senate.

    And, even though broad-based income tax relief is still contained in HB 954, there is no guarantee that it will survive a House-Senate conference even if it passes the Senate intact.  The Civil Beat article reported that House Speaker Scott Saiki is not a great fan of broad-based tax relief, saying that the House wants a simpler tax fix (whatever that might be) and is favor of a plan benefiting Hawaii’s neediest taxpayers rather than all taxpayers.

    So here is where the people of Hawaii need to make their views known if they have a position on broad-based tax relief.  If simply left to their own devices, lawmakers could very easily say that revenue projections have been trending downward so it might not be prudent to pass tax relief for the “wealthy.”  By the way, if you are not in truly desperate circumstances (like, for example, the homeless person who recently died in front of The Queen’s Medical Center), congratulations, you’re wealthy.

    To us, lawmakers also need to be concerned about the census data trending downward.  That tells us that people are jumping on one-way flights taking them away from Hawaii Nei.  That, of course, is a problem because if the cost of government rises, but the number of people who share in the cost of government goes down, guess what happens to the share that needs to be paid by the people remaining (wealthy or not).

    If you have a view on this issue, now is a very good time to let your lawmakers know what it is.

    Downtown Walmart closure an opportunity for more housing

    By Keli‘i Akina

    It seems a lot of people were surprised last week to hear that the huge Walmart store in Downtown Honolulu will be closing this month. 

    It’s tempting to speculate about what this means for the future of retail in the area, but we shouldn’t make broad assumptions based on the closure of a single big box store. 

    Instead, I would like to talk about the opportunities that such a closure represents. 

    Keli‘i Akina

    In particular, Hawaii needs more housing. At the same time — because of changing demographics, more people working from their homes, economic trends, whatever — we are increasingly seeing more empty office and commercial buildings around the islands, such as the soon-to-be ex-Walmart. 

    Why not convert those empty spaces into places to live?

    There’s a name for this practice of transforming buildings for new purposes: adaptive reuse. You take a building that was built for one purpose — a retail space, a warehouse, an office building — and you remodel or renovate it to serve a new purpose, like providing housing.

    Adaptive reuse is a new name for an old practice, but it has been gaining popularity in American cities. Partly, that’s because it makes economic sense. 

    One study found that repurposing an older building to create new housing can save as much as 48% in construction costs compared to building from scratch. Given Hawaii’s high material and construction costs that contribute to the high price of housing in the islands, adaptive reuse is a great way to make housing more affordable.

    It’s also environmentally friendly. Demolishing an older building creates a lot of waste for landfills, and even the new, energy-efficient building that might replace it does not always entirely offset the environmental cost of the demolition.

    And from an emotional point of view, sometimes we grow attached to older buildings. We like the character they give our cities and neighborhoods. We don’t necessarily want to replace them with cookie-cutter apartment buildings. 

    In terms of the economy, creating new housing units in vacant commercial spaces can help revitalize neighborhoods and benefit local businesses.

    So why hasn’t Hawaii fully embraced adaptive reuse? Well, to some extent it has. In early 2021, Hawaii Business magazine wrote about the office-to-residential conversion in Downtown Honolulu of 1132 Bishop Street and the transformation in Kailua of the former Macy’s into Lau Hala Shops. But both involved seeking regulatory waivers that take time and money.

    Hawaii Public Radio noted in an article last month that the developer behind the conversion of 1132 Bishop Street — now called The Residences at Bishop Place — “worked with the city to use a powerful housing incentive called 201H that waives some building requirements to generate more affordable units.” But even that took time to arrange, and was focused on just one segment of the housing market.

    So the problem of inflexible excessive regulations remains.

    Consider the case of the Davies Pacific Center office building in Downtown Honolulu, about 75% of which the Avalon Group is planning to turn into more than 400 condos. Not only is it expecting the permitting to take at least 18 months, it has run into problems with the city’s building code, which could make the conversions financially infeasible.

    Christine Camp, Avalon president and CEO, suggested to Hawaii Public Radio last month that “the City and County of Honolulu should consider changing building requirements to match the evolving nature of acceptable living conditions, such as air conditioning and ventilation in lieu of having windows that open.

    “If we’re clamoring for housing and housing to be built now,” she said, “shouldn’t we look at ways to change our code to reflect our current environment? … Do we really need park dedication in downtown core? Or should we make it so that the downtown units are far less expensive and less expensive to maintain overall?”

    In addition to building code changes, such as one proposed recently by Honolulu Council member Tyler Dos Santos-Tam, we also need to address the permitting backlog, zoning regulations that prohibit residential uses in commercial or industrial zones and myriad other regulations that slow down the creation of new housing.

    Addressing Hawaii’s housing crisis requires a multipronged approach with solutions aimed at encouraging housing growth across different categories. 

    We don’t need just sprawling new developments of single-family homes, such as Ho‘opili in Ewa Beach and Koa Ridge between Mililani and Waipio. We need condos, duplexes, triplexes, studio apartments and a wide range of other options. 

    Not everyone might not be excited about the possibility of buying an apartment in a converted Walmart, but for some people, it could be perfect. 

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

    How to Live Forever

    I am about to ask you a question. Think hard about it before answering.

    How long do you expect to live?  

    If your answer is not forever, then you may be killing yourself.

    You’ve heard of the placebo effect, which shows the power of the mind over the body. Whatever any healthcare provider provides, it includes a pinch of placebo, which is the patient’s belief that the treatment will work. This positive expectation actually helps it work, although sometimes the treatment has no therapeutic power on its own, and is purely a placebo effect, like a “sugar pill” . 

    But what if you have a negative expectation about the treatment? Well, you can then experience the nocebo effect.

    Say you have a fear of doctors and medications, and you typically avoid doctors like the plague, but you feel desperate and get a prescription for a drug. You swallow the pill cautiously, concerned about all the side effects it can cause. Well, due to the nocebo effect, your negative expectations can create the side effects you fear. 

    The nocebo effect also caused some people who feared the COVID-19 mRNA vaccine to experience worse side effects, according to a recent report. 

    It’s clear from these placebo and nocebo effects that our expectations help create our responses to healthcare. The mind is powerful, and sets up our bodily response to things. 

    Put differently, our expectations set us up. They are self-fulfilling prophesies. 

    When I asked about how long you expect to live, you had to think about the fact that you will die. We live our lives based on our expectations about death. And as we get older, we see ourselves approaching the end, and expect our ultimate decay, deterioration, and demise. 

    But what if we’re wrong? What if our belief in death is setting us up for death?

    I know it sounds strange to question death as a fact of life. Amazingly, nobody really knows what death is. We see other people apparently die, but have no personal experience with death, making it’s really hard to get into the head of the dead. But we take on faith that we will someday die, too, and accept that all our plans will end in old age, if not sooner.

    So when we get older, we see certain health problems as irreversible signs of aging. At a younger age, we would have expected to recover quickly. As we get “old”, we expect our healing process will falter, and that we are becoming victims of chronic disease.  

    Our expectation of decline makes us decline. I call this the deathcebo effect, and it puts nails in our own coffin.

    Of course, there is the opposite of the deathcebo effect, which, instead of being an expectation of death, is the expectation of life. I call this the lifecebo effect, and it tells your body, including your immune system, that you are going to get better, and that your ability to heal and recover are strong. It is life affirming, and works with the placebo effect to heal you. 

    This means the placebo and lifecebo effects are both positive, life-affirming expectations which we all need to stay healthy. The nocebo and deathcebo effects put us in a spiral of negative expectations and outcomes.

    Here are some suggestions to help you life forever. 

    1. Stop equating age with health status.  There are people in their 90s who are healthier than some in their 20s. 

    2. Expect to live forever. The more you expect to get better and live, the greater your chances of doing just that. 

    3. Live your life like it is never going to end. This means staying invested in the present and the future. You are as relevant to the times as you expect yourself to be.

    4. Continue to develop yourself, learning new things. Old dogs can learn new tricks.

    5. Keep in mind that the more you worry about decaying and dying, the more you will accelerate that process. See life as endless, which is a lot more cheerful than the opposite.

    If you follow those 5 suggestions and don’t life forever, don’t let me know. I want to keep my positive vibe going until the end, which will never come. 

    Legislative Madness

    In the sports world, we have “March Madness.”  Last week in this space, we wrote about “Credit Madness.”  Now, lest we miss the forest for the trees, let’s discuss madness at the Legislature in general.

    A month ago, Civil Beat interviewed Sen. Stanley Chang, who had introduced Senate Bill 149 with a constitutional amendment to have the Legislature meet year-round, like the Honolulu City Council.  At the Council, the schedule “permitted time for deliberation, consultation with stakeholders and accessibility for the public,” he said.  At the Legislature, on the other hand?  “It’s just four months of chaos – it was very striking.”  (Sen. Chang’s bill was heard and passed by Senate Judiciary, but hit a wall when it got to Ways and Means.  It’s dead for this session.)

    Let me give you a little bit of how that looks from my perspective.

    The Tax Foundation of Hawaii follows bills that deal with taxation or public finance.  This year, there were more than 3,100 bills introduced at the Legislature.  The Legislature normally considers around 2,500 to 2,700 bills a session, so this year’s crop of bills was huge.  Typically, we select about 10% of those bills to follow.  This year was no different.  We were following about 300 bills.

    At the start of the session, bills are normally considered by committees that concentrate on one or more specific areas, such as Agriculture, Education, Energy and the Environment, or Housing.  We call these “subject matter committees.”  The House and Senate have 33 committees between them.  Of those, there are 27 subject matter committees.  Six have a wide purview (Judiciary, Money, and Commerce committees in both chambers) and usually are the last committees to which bills get referred.

    During the first couple of weeks in the Legislature’s 60-day calendar, most of the action occurs in subject matter committees, and with dozens of committees trying to hear bills and move them at the same time, there isn’t much breathing room.  During this period, for example, we were getting 30 hearing notices on bills we were following … on Friday afternoon.  Testimony on bills needs to be submitted 24 hours before the hearing, and a number of the bills were to be heard on Monday.  So much for our nights and weekends.  When the work week rolled around, it wasn’t uncommon for multiple hearings to be held at the same time.  We were triple-set or quadruple-set for a few of them.  Thank goodness that the Legislature allows testimony via Zoom, so we could zip back and forth between hearings as needed.

    In the second two-week period, the bills we follow are considered by House Finance and Senate Ways and Means.  The Senate won’t give a bill a hearing if it was already heard in a subject matter committee; it allows folks to submit written testimony only, and then meets to make decisions on the bills.  In the House, the chair doesn’t crack the whip quite as hard, and generally gives testifiers the time they need and accommodates many questions by Finance members.  As a result, many of the Finance hearings start far later than they are scheduled.  I remember logging in for a 2:00 PM hearing and not recognizing any of the bills being heard – the committee was still on their 11:00 AM agenda.  As a result, some hearings continued well after sunset (I pressed the logout button, but legislators, their aides, and a number of other testifiers attending the hearings didn’t have that luxury).

    The next four weeks of the session are somewhat similar to the first four weeks, but there are fewer bills because lots of bills have fallen by the wayside.

    The last couple of weeks in the session are the scariest.  That is when the Conference Committees meet, ostensibly to resolve differences between the House and Senate but only the folks on the inside know for sure what really goes on.  The public isn’t invited to most of the deliberations, and only is called in when both sides are ready to announce a result and hold a vote. 

    In any event, Sen. Chang certainly has a point, and we perhaps could be thinking about ways to make the legislative process less chaotic and more accessible.