 Aloha, welcome to Think Tech Hawaii's Movers, Shakers, and Reformers. I'm your host, Carl Kempanya. This series that we're running right now is called Politics in Hawaii, and there's nothing more political these days than health care. It's been a huge issue from federal to state and multiple states for that matter as well. The conversation is Medicare for all, universal health care, it's Obamacare, it's the repeal and replace of Obamacare, and all of the derivations thereof, and it's been a huge issue. Now one thing we seem to have had a, we'll call it a relative win with regards to Trump care 1.0, which wasn't really much in the way of a health care plan as much as it was really let's gut health care for almost everybody and give a whole bunch of money to the top 1%. Fortunately, that didn't pass. However, there are issues that need to be really addressed, whether or not we are maintaining Obamacare, whether or not it ever gets repealed and replaced for anything. Many people believe that actually the only improvement to it is to turn it into a universal single payer health care. That would actually be what most people think is well you want to prove on something, you want to prove on that, that's the only next best step, but in fact Trump himself said he wanted health care for everyone, then he did something completely different. Anyway, my guest today is Mr. Dennis Miller, he has been leading the charge for the past several months, year, he'll tell us how long, he's been leading the charge here locally to make sure that the state of Hawaii has the opportunity of converting once and for all towards universal single payer health care. We had the opportunity a number of years ago, several things happened, including Obamacare, if you've watched some of our previous episodes, we've talked about this a bit, but he's been leading the charge and everything from sign-waving, to talking to our electives, to phone banking, you name it, he's done everything possible to try to make sure this conversation is happening and he's going to continue to do that work. So I will first of all welcome Mr. Dennis Miller to the show, thank you for joining us. Hey, thanks for having me on. Absolutely, absolutely. Thank you for your work and your efforts, I've been seeing email strings, I've been seeing Facebook posts, I've been seeing all the work that you're doing. Thank you for finding, was it 11 senators to introduce a bill for single payer in Hawaii? Congratulations, you got 11 senators to introduce a bill for single payer. 12 co-sponsored that particular bill, it was a Senate bill, was a Senate bill, yeah Senate bill 1199, 12 state senators co-sponsored that bill. Anchored by Ruderman. Anchored by Ruderman. However, the interesting thing is when we add, because I know that you also had one. And when I did a comparison between the 12, the co-signed mine and I think the 10 that co-signed yours, there were three additional ones that you had that I didn't have. Which meant we had 15 senators that were all for this. Good point. But what happened? But before we go into that, we were going to go into a little bit about what happened because that's an interesting thing. But I gave a little bit of an intro about you. But if you would please tell us more about yourself, what got you here today, what have you been doing that has led you up to this fight? So tell us about yourself. Sure. I'm just a business owner, a baseball owner. I teach beach yoga, fairly non-political, up until all of a sudden something happened in May of 2016. Bernie Sanders said he's going to run for president. I was aware of him from watching the liberal media, MSNBC when it was liberal. So I knew about the guy already. He said he's going to run for president. I thought that is what we need. I was peripherally aware of how corrupt our nation is. I was following the national politics, not the state at that time. So I began to try and campaign for Bernie, tried to hold meetings, tried to make a Facebook page, tried to figure out how do you help a political candidate and meet other interested people who joined like a tsunami of activism for hope in our country. And Bernie Sanders was the symbol of that hope. So that was an inspiration for you. Yes. About a year ago. Yeah. About a year ago is when you decided, you know what, it's time to go get involved. It's time to get involved. Excellent. Yeah. It's just something clicked. It's time to get involved. Okay. So you start to do that, then you need to explain why. Okay. So explaining why began my little evolution. Explaining why and learning more about it online, there are several great sites that explain his policies. Okay. All right. They're not in my mind right now. Many websites, many Facebook pages, a lot of people. Learning about him, one thing leads to another, including state politics matter, including city politics matter, understanding the development of how money is spent became very important to me. Public. From a public perspective. Yes. How much money is spent. At all levels. Yeah. Right. I'm talking about taxpayers. Yeah. How our money is spent by government. That's important. It is. We do not need homelessness. We do not need poverty. And we do not need to pay twice as much as every other nation for healthcare. We do not need 500,000 Americans per year going medically bankrupt. And we do not need to spend $1 trillion per year on the administrative costs of health insurance. That has been one of the big increases, hasn't it? Yeah. A lot of this, so let's jump back into this a little bit. Our current system, well, our current system has been changed a little bit as well, but our current system, we are currently operating, most of our states anyway, but this state is currently operating under Obamacare. Has that actually helped this state? No. We were better with the prepaid healthcare act. We had a prepaid, so prior to Obamacare, so prior to 2010 or 11 when it got, when we did our transition. Yes. Prior to that, we operated better. Yes. Employers paid less for healthcare than they pay now. Okay. So therefore we had the transition, and it didn't actually make things better. It made things more expensive and more challenging. Yes, and kind of no. Okay. The Medicaid expansion is going to help. However, two years ago, we had a Republican senator, Rubio Torpedo Obamacare, the ACA. He did it by getting a law passed, he said, to save the taxpayers' money. He took away the safety net. There's a safety net for Obamacare. If the insurance companies can't cover their costs, the government promised them it'll pay. That safety net is what persuaded insurance companies to sign on with the ACA. And that safety net was about $2 billion a year, maybe $2.4 billion a year, something like that. So Rubio leads a bill to wipe out the safety net down to $400 million. As a result of losing that safety net, insurance companies said no to the ACA, and that is why we have seen a spike in insurance premiums and insurance companies refusing to participate, which has worsened the problem. Absolutely. Add to that not all of the states across the country have engaged in the exchanges. Which is even worse. So the whole purpose of it, it's the rule of big numbers, the more people who are involved, the less expensive it becomes. Fun fact, the Center for Disease Control studies things like healthcare outcomes, one of which is whether or not babies survive. It's called an infant mortality statistic. USA ranks 29th on an average. Let's take a look at states, 29th on an average. Alabama and Mississippi are on par with Yemen and Somalia for infant mortality. Coincidentally, their governors refused Medicaid expansion funds. If people don't have healthcare, they get sick. So the basic premise that I'll offer, that I've read a lot about as far as the Republican perspective on this, is we don't want to just give something away to people. We want people to have to earn it. And so that's one thing that they say, and okay, there's a commendable thought in that. But they tie that whole thing into this concept of socialism, and socialism is bad. Well, the thing that's fascinating about that is they're not recognizing everything within our country, within our states, within our counties, that are socialistic. In how they operate. We are democracies, but we operate within a socialistic concept with what we do. And for example, even with healthcare, it's already, it already has a degree of socialism in it. Some of your thoughts on this to go on about it. The socialist aspect is corporations provide healthcare. They actually get to write off their taxes, some percentage of that healthcare. Which means who's paying for whatever percentage they're writing off, the American people. So therefore the American people are already paying for the healthcare that is being provided to their people. And from their perspective, from the Republican perspective, if you have a good job, a good job that provides you with healthcare, then you deserve to have healthcare. But that's it. Because socialism is bad. Well, they're not acknowledging the part where, well, we get to write this part off. So in your studies, in your readings, and in your time that you have spent advocating for this, have you been able to engage that conversation? Absolutely. Two things about that. Number one, if you want to talk to a Republican while you're waving a sign for Bernie or talking about anything progressive, you have to change their mind immediately on how they see you. So you start off by saying, I like money, and I believe in profit. And they do a double take, and they are shocked. They're shocked to understand that you could support Bernie Sanders and like making a profit for your own business. So that's what's an individual. But I want to talk about the national narrative that you brought up that these things are socialism. It's absolute, I won't use profanity, it's absolutely false, okay? It's completely false. Here's the Republican ideology, defund to discredit and then destroy with the post office. The Republicans have this bald-faced lie that it's bankrupt because they passed some law requiring it to have 80 years of retirement savings in the bank today, whereas it only had 50 years of retirement pay in the bank. 50 years of retirement pay for their employees in the bank. That's incredible. That is not bankrupt. The Republicans passed a law saying, no, we want you to have 80 years in the bank. They don't have it. Therefore, the Republicans lie and say the post office is going bankrupt and they're going to have to cut their costs and shut it down. It's the same thing they do with Social Security. It's the same thing they do with it, which is also a completely ludicrous thing. Social Security is paid for by the people who pay into Social Security, and they get it as a result of what they paid into. The fact that you in any way call that an entitlement, yes, you are entitled it because it's your money, first of all. To use that terminology negatively is a falsehood. They seem to, in many cases, use falsehoods or twist the conversation to have it sound like, well, I'm really for the people because this is going to cost you money. This is negative because of this reason and that reason. Back to health care. Back to health care locally. What have you been working on for the past couple of months? Yes, the bills that are out there. Tell us about what has been going on here locally. One teeny brief thought back up over there on the national scale. Why do you want government to take care of your health care, that socialism? Well, let's just reframe that. Why do you want a for-profit corporation or even a non-profit? Why do you want a private corporation taking care of your life and death decisions? I'll take that and jump. Yes, exactly. Why should we have any public service providing entity be a for-profit entity? Why should there be a profit-based organization running a public service operation? And that's across the board, whether it's utilities or health care or any other program or any other industry where it is providing a service to people in a public, more in a public sense. Now, Meritino Cherry on that. So Medicare prior to the privatized add-ons, so let's go back maybe 2005-ish, worked beautifully. One to 3% overhead. Private insurance is a 35% administrative overhead. Medicare government, one to 3% administrative overhead. Medicare on its own with its problems beats the crap out of insurance companies in terms of efficiency. Yes, but you just pointed out the issue. The issue is the insurance companies don't win. The insurance companies which are for-profit entities that are not in it to actually provide health care, they're in it to make a profit for their shareholders. They're the ones. But HMSA is non-profit, so we can't use that for-profit is bad. They're a non-profit organization with a highly paid CEO and a lot of employees, they're not working for the public good. What HMSA is doing is participating with this whole paradigm of micromanaging physicians and that's where we waste our money. And that's the current, the managed care system that we have at the moment. And that was actually implemented by the Clinton in the 90s. The managed care situation we have, which is what has created, you talked about the trillion dollar increase of administrative fees. Since the mid-90s, that has been the biggest jump, that and then pharmaceuticals. So the administrative fees have been a huge spike upward to what the costs are. And that's because we transitioned it from a fee for service and doctor-patient care to the insurance company saying, we'll pay for this, not for that, you have to do this, you have to do that, you have to prescribe this drug, not that drug. So the doctors spend most of their time going through filling out forms so they can get paid. So therefore administrative costs go up and the actually amount of time that the doctors have to spend with their patients has actually gone down. That's the disaster. So that's unfortunate in that regard. That is unfortunate. Think about this. Trump said his wall is going to cost $25 billion. We spend $1 trillion a year unnecessarily at administrative costs of overhead. If Trump wants to build many walls every year, all he has to do is support Medicare for all. And with the savings and administrative savings, he could buy many walls. But coming locally, so let's talk global. Let's take a quick break and then we'll come back and we'll dig into the local thing. Sounds good. Thank you so much for joining us. This is Think Tech Hawaii's Movers, Shakers, and Reformers of Politics in Hawaii. I'm your host, Carl Campania. And thanks again to our guest today, Mr. Dennis Miller. We're talking about healthcare. See you in one minute. Okay. Aloha, Kako. I'm Marcia Joyner and I'm inviting you to navigate the journey. We are discussing the end of life options and we would really love to have you every Wednesday morning at 11 a.m. Right here. Aloha. I'm Senator Russell Ruderman representing Puna and Ka'u on the Big Island and the host of the Ruderman Roundtable. We're here at Think Tech Hawaii every other Tuesday at 2 o'clock. You can join us on ThinkTechHawaii.com and you can find links to our YouTube channel for past episodes there. I want to thank Think Tech Hawaii for hosting us and we'll see you again on the Ruderman Roundtable. Mahalo. Mahalo. Welcome back to Think Tech Hawaii's Movers, Shakers, and Reformers, Politics in Hawaii series. Once again, our guest today is Mr. Dennis Miller. We are talking about healthcare. Healthcare across the country, healthcare in Hawaii. This segment is going to be all about what's been going on for the past three months here in Hawaii. The healthcare conversation that's been happening at the legislature. So let's begin and we touched upon it a bit in the last segment where, okay, yes, there were a number of bills that were introduced this session. Three or four of them, I believe, that were introduced and some resolutions that were introduced that I'm not even sure those are getting heard either. But let's engage that and say, okay, again, Dennis, you've been at the forefront of this. You've been trying to drive it. You've been pulling people along with you, some kicking and screaming. So what, from the beginning of this year, what can you tell us about what was introduced? Okay. A bill to fund the Hawaii Health Authority was introduced. What is the Hawaii Health Authority? The Hawaii Health Authority was passed in 2009 here in Hawaii. It's a bill which establishes an agency of nine volunteers plus a couple of paid staff who design a universal healthcare system for Hawaii. So that's what it would do if, A, it was funded and if, B, a governor would support it. The governor appoints people to the board. This legislature adds some input but the governor effectively chooses them as well. Abercrombie chose not to support the HHA. EGAY, during his campaign, had Dr. Steven Kimball on his campaign committee, his health committee, EGAY, during his campaign, candidate EGAY, was a supporter of the Hawaii Health Authority. Elected Governor EGAY has turned his back on the Hawaii Health Authority and is no longer supporting the platform of the Hawaii Democratic Party or the current legislative agenda of the Hawaii Democratic Authority. In fact, Governor EGAY is completely ignoring my group and every other people, person who has contacted him, requesting him to state some reply to our assertions of how to lower the cost of healthcare on this topic last week. There have been a number of things that actually happened on that. So just to catch up a little bit, the bill was passed under former Governor Linda Lingles administration is when the bill was passed. She vetoed it, then the Congress overturned her veto. So therefore it became law. But then she didn't fund it because our governors have that authority here. They can line item, I'm just not going to fund that and I don't care if it's a law. So she didn't fund it. Well, the very next year we have Abercrombie coming in who ostensibly would be for it right up until Obamacare came around. And then as a result of Obamacare being there and the governor wanting to, you know, Governor Abercrombie at that time wanted to support his good friend Barack Obama, he decided, you know what, we're going to transition and we're going to take on. So we didn't want to be one of those states that was going to say no to the exchanges. So he made this gesture which impacted the state. But it didn't actually help anything. The funding that was supposed to go to HHA, if I understand correctly, instead went to support the exchange. So a couple of $150,000 dropped into the $200 million bucket. Exactly. So to do what to sort of help the exchanges which have been really fraught with challenges in a number of areas. So that's actually the history leading up to then this session where we had these bills introduced to try to fund HHA to say, OK, $150,000 to $250,000, just fund HHA so that we can continue on that path to create the universal health care for the state of Hawaii. So we can take care of that final 8%, which is part of the Democratic Party platform, which is part of what the state of Hawaii has been talking about for a couple of generations. I want to disagree just a little bit. It's not about taking care of the extra 8% only. It's about lowering the cost. We pay way too much. The cost of health care, if you're an elected official, if you're in a union, if you've got health care as a job benefit, this is not an urgent issue to you. If you are paying for health care and you can't afford it, it is a very urgent issue. So it's a combination of an individual who's paying for their own health insurance or a small business, whether it's a single, proprietary, or large businesses that they hate it too. There are different bits and pieces of how things work with that, but they have to pay for it. And there's some tax credits to get out of that as well. But some of that got revoked this year. So I've been in conversations with a number of business owners who said, well, you know what? They recently revoked some of the tax credit availability. So therefore, their rates tripled. And Governor Yegay hadn't done anything to correct that. Or comment. To my knowledge at this point, and please help us learn, has anything happened to that? Or have just those rates gone up? Has anything occurred to address that little puke? Yeah, HMSA is coming up with a new rearrangement of how they pay their physicians, which is effectively making the situation worse. So instead of the tax credit, so the tax credit went away. Oh, as far as the tax credit. I don't, on that level, I'm not aware of anything. I'm only aware of how HMSA is attempting to deal with the situation. And they made a change in how they pay physicians, which very literally has made the situation a little bit worse. How, what was the change? OK, they're sticking with paper value. But they tried to change that in a subtle little way. And essentially, what they're still doing is allowing pre-authorizations. They're still allowing full micromanagement of doctors. And they're still requiring doctors to have too much reporting time. So why did they make this change? What was the purpose of the change? I mean, what is the stated purpose? You have to ask. Yegay or ask HMSA. Well, OK. Let's go back to the bills. So in addition to the let's fund, let's actually do what we were supposed to do, the law that is in the statute at the moment. Let's actually fund HHA. That was introduced, I think, in both the House and the Senate. Yeah, John Mizuno on the House, Ruderman and friends in the Senate side, Roz Baker in the Senate declined to give it a hearing in the Health Committee. You didn't get a hearing. Didn't not get a hearing. And in the House, Representative Della Albulati also declined to give it a hearing. Didn't even get a hearing. Did not get a hearing. That would be an interesting conversation to have why. It didn't get a hearing. Because, again, they're Democrats, right? They're Democrats. And it's part of the platform. So that would be an interesting conversation to find out, OK, we'd like to know what's going on. So is anybody asking them these questions? Yeah, they're not replying. However, Representative Balati did reply to me briefly. I was at the public testimony on what the state is going to do in the case of ACA repeal. And she saw me standing there. And she very kindly came up to me, thank you, Representative Balati, for that. She said, I see you standing here. You want to ask me some questions? And I said, yeah, I'm interested in promoting the HHA. She said, I read your emails. And I read your stuff. And I'm not interested in the HHA. She said, three things. Number one, why do you want the government taking care of your health care? She said that. Number two, she said, I think patients should take care or design their own health care. She said something patients should take care of their own health care. She said that. And I paused. I didn't know what she meant. OK, so she said one more thing, which is the moment I forget. All right, well, that's all fascinating. OK, again, I'd like to learn more about that. And I think we should dig into that. She said, do you want a bunch of doctors designing your health care? She said the HHA would be staffed by a bunch of doctors. Well, who presumably would know. Anyway, it would be, it's what the law says, first of all. So let's start there. So OK, that's a conversation that I think we need to have more. And we need to try to engage our legislators on that, especially at the committee chairs. Thank you for that, to understand that. One of the bills, so you mentioned what happens if the Affordable Care Act, you know, Obamacare got repealed. There is a bill. And that bill was introduced. And that bill was getting heard. Yes. And on the House side it is. Do you have a status on that bill? All right, the Senate side, it appears to be dead. On the House side, it appears to be the one that they might go with. That one is a little bit dangerous because it's trying to preserve the good things that are in the ACA. One of them is the mandate. On a state level. On a state level. One of them is a mandate that everybody's going to have to buy into it. However, there's not going to be any subsidies in the event of ACA repeal. So how do you require people to buy something without the federal subsidy? That's dangerous. And then what's the fine associated with it? Exactly. OK, so that's what that bill. Do you know what that bill number is? Four, five, and then pick another number. OK, all right. So OK, so all right. So that bill, so it seems to have died in the Senate, but maybe because they know there's one coming out of the House already. It seems to be a vigorous one in the House. We'll see what happens at crossover with that. So OK. Well, I mean, we've already gotten crossover. So if it passed through the House, it should be in the Senate already. And then we'll see where we are with that. OK. There were other bills that were introduced. You mentioned the one that I helped get introduced that was just calling for, hey, let's just do universal health care now. Let's not even worry about studying it. Let's just make it happen. Let's make it a law that this is what's going to happen. And then on the administrative side, we'll figure out how it's going to happen. And again, that one didn't get heard by anyone in that situation. So OK. So what have you been doing about this? All right. Well, throughout the burning campaign, we only have a couple minutes. We've got a lot of people together to have rallies. And we said, you're going to have to go to the legislature. You're going to have to talk to your representative and ask them to explain what they're going to do about health care. And you're going to have to say, here's how we lower the cost. You need to wipe out micromanagement of physicians. This will lower the cost, enabling us to have universal health care, covering that extra 8%. This is simple. And it saves money. I'd like a response. So we've been asking, and we've not been getting a response. Advocacy. Advocacy. So we need to have more people being activists. We need to have more people being advocates. Contacting them. Now, I've heard that having a group, having an entity, is more powerful than having individual testimony in these regards, and so forth. But do you have a petition? Have you done a petition for this? Oh, yes. OK, and people can still sign the petition? Yes. OK, and how do we find that petition? Search for healthcareonchange.org. Healthcare what? Healthcare. It's on the site, change.org. Change.org, OK. On change.org. All right, so OK, health care is an issue. We need to resolve it. We need to find a way to actually cover it. Many people believe that it's a right. It should be a right, and that everybody believes it. They think it should be available to you if you can afford it only. It seems cold, if you put it that way, personally. But I think everybody knows my position on that. So what we are asking for is your opinions on healthcare. Let's make sure that we're having that conversation with our electives. Let's make sure that we are getting together and we're advocating for that. So that's really the question, and that's really what you've been doing is trying to find every way to advocate for that, to have that conversation and bring it to our legislators. Including getting the Democratic Party of Hawaii to make it a legislative agenda. And they have. They have. And they did result in. And they did, exactly. Tim Vandevere, current chair, actually came out and he has made a couple of different comments. And he came out with testimony, and the party testified as much as they could. And delivered a letter to Governor E.D. yesterday. This is all the things. Delivered a letter to the Governor yesterday. So thank you for joining us. This is thank Theka Wise, Movers, Shakers, and Reformers, Politics in Hawaii series. This was a conversation about health care. We need to continue this. We need to fight for this, apparently. So even though we're a blue state, we need to fight for it. So thank you for joining us. Thank you to the staff and crew. Thank you to my guest, Dennis Miller, and we'll see you next time. Thank you. Thank you.