 I'm Marcia Joyner and we are navigating the journey. Navigating the journey is dedicated to exploring the options and choices for the end of life care and to assist people to talk about their wishes. It's time to transform our culture so we shift from not talking about dying but to talk about it. It's time to share the way we want to live our lives at the end of our lives and to communicate about the kind of care we want and don't want for ourselves. We believe that the place for this to begin is not in the intensive care unit. Together we can explore the various paths to life's ending. Together we can make these difficult conversations easier. Together we can make sure that our own wishes and those of our loved ones are expressed and respected. If you're ready to join us we ask Navigate the Journey. Over the past months we have invited members of various religions, traditions, as well as politicians to talk to us about the end of life customs in their culture. Today I'm delighted to talk to Alex Satyago. As you know we've been supporting the medical aid and dying bill through the legislature. The bill is one of many which did not pass out of the House of Representatives Health Committee this session. Therefore we have asked Alex to talk to us about the various issues and bills that were bottled up in this year's legislature. Alex is a licensed social worker, former legislator, and now currently he is at the University of Hawaii and he is also project manager for No Vote, No Grumble. And so who better to talk about what is going on or not going on as a legislator than someone who has been in it all of these years. So welcome Alex, thank you, thank you, thank you, Alex has been a friend for I don't know how many years now. We're not going to talk about how many years. Thank you Alex, thank you for coming. Thank you for inviting me on the show and to share some of my observations of what's been occurring in the legislature for the last couple of years now. To say that I'm not pleased or not happy would be an understatement. I would believe that you're in the majority, that almost all the people I've talked to, people in line at Safeway people, I turned the corner at Costco and bumped into a woman and she said, you're a devil. I was taking her back and she said, you are not doing your job. I wish they would be so adamant with some of the politicians. Having been in and around that square building on Baratanya Street for the last 30 plus years, I am able to say today that never in all of those years have I seen such dysfunction at such a deep level as what we're seeing going on today. And for those who have said to me when we talk about this that oh it's always been like that, I have to correct them and I say let's look at the facts. I don't believe it's always been like that. I mean there's been times when that institution has suffered because of the individuals who were put in a position of making those decisions in the institution. I don't believe that there's been such disarray, such lack of leadership, such lack of courage as what we've seen in the last few years. And I say that with a really, just a sad heart because I believe so much in the institution. I've spent so many years using that institution to do good things for the people of our state, especially those who I believe I've been put on this earth to serve and that would be those who are quote less fortunate, those who haven't had all of the opportunities that some of us have had. As a social worker I just believe that that was my role as an advocate. So I see the possibilities and I've seen the wonderful things that that process, that institution allows to occur. But I've also seen some of the really not so good things that it's allowed to occur. And so I come to the conclusion and I am saying to everyone that the institution is hurting. The institution is only as good as the people we elect to run it. And if we've elected a group of individuals who put forth their own personal agendas and do not understand that they're only there temporarily and to check their eagles when they get in, we have problems and that's where we are today. We have problems. We do have problems and for anybody that's been listening, I've been complaining that 51 House members, that's what we have, 30 of them ran unopposed. That is just wrong. Yeah. That's wrong. And yes, they're all Democrats, except those that are Republicans who decide to run as a Democrat because that's the way of getting elected. I think that the Republicans have dropped the ball, that they have not put up candidates that can get elected that are worth anything. We cannot have. So that's part of the problem. If you're running unopposed, there's no penalty for it. Well, let me tell you what I've, and no vote, no grumble, I have gone out and talked to thousands of people. We do what we call our civic engagement training program and we teach them about the process. And we asked them repeatedly, you know, do you vote? And if you don't vote, why don't you vote? And repeatedly, we receive, I get very clearly people who have stated, don't tell me that if I don't vote, I can't grumble. I'll tell you why I'm not voting. And the reason that many of them say they're not voting is, number one, there's nobody that they see on the ballot worthy of their support. Absolutely. So if they say that this person who's running unopposed, if you look at the blank votes and you look at the fact that we're last in the nation, last. I mean, this is a horrible place to be when it comes to voter turnout. This is a shame compared to where we were at one point, where we were the highest in the nation and we had pride. Today, we have a lot of people who have walked away, who are withdrawing from this process because they don't believe it serves the necessarily the people. They believe, and I think they have justification to believe, that the special interest groups in the high paid lobbyists are running everything in that square building. And so they are withdrawn. I have come to that conclusion also. I hate to say it, but yeah. Well, there's evidence to show that people, I know anyway, that we've continued to try to get people involved in why people aren't involved. And so I go back to what Obama said when he was leaving, and I'm not trying to be partisan or anything, and if people take it the wrong way too bad. But one of the things he said when everybody was in such an uproar about Trump being elected is he said, if you don't like what's going on at the national or the local level, and he, you know, he motioned, get the petition out, get some signatures, put your name on the ballot and run. And I have stated it from day one, and I do this with no vote, no grumble, and I'm going to do it in much more as we go forward. We need people who understand what ponopolitics really means to put forth their servant heart and serve, truly serve, not win an election and think all of a sudden I want this right to be served. And you go down into that building and you all of a sudden get seduced by the power. And the next thing you know, these individuals who we thought were there to serve have an attitude, and that happens really quickly. It does. I've seen it. Yes, we've seen it happen. And it's really unfortunate, again, because as someone who has served, who understands how seductive that power can be to individuals, many of whom will probably never be able to do much more than that, they want to hold on to that so badly that they're willing to really sacrifice what ideals and values and integrity they may have come into this position with in order to hold on to it. And that's the sad part. Well, even not looking at the quote integrity, but you're from Makaha's side. Well, no. I represented the North Shore during my time, and I'm from Khaleesi. But right now, your young man, Cedric Gates, proposed another road in and out. And everybody in the world that has Google, Matt, can see that cars stacked up on each other for hours, 21 miles, two hours. And the very next day, the Department of Transportation says, we don't have money for you. Immediately, what kind of a process when the Department said, no, the legislator in all good faith representing the people, and we know all of them, agreed that we need another road. I don't live there, but I agree you need another road. And yet the Department can come out and say, no. What is that about? How is it that a department can do that when we elect someone to do the bidding of the public? And this is what happens. Well, a number of things, as an observer of this process, having supported when I was in office, the then legislator, who was Merwin Jones, get funds to design. This is 25 years ago. Representative Jones came to me as a member of the Finance Committee and asked me for support to look at an alternative road in and out. And we did. We funded it 25 years ago. It was millions of dollars. And subsequently, Merwin was kicked out. Now, for whatever reason, I don't know if this was the reason, although there's some people who say that there were people on that coast that did not want an alternative road. There were afraid of the over-development, gentrification, if you will, of the area. And they say, no, we don't want it. And they believe somehow that by not doing that, people will stay away. Well, that hasn't happened. 25 years later, myself included. I've moved out there 15 years ago, but I've seen it in the last 15 years get from bad to just incredible. I mean, it is inhumane what we go through on a daily basis, and I'm one of those. So remember, though, that the administration, which is the transportation department, they do not set policy. The transportation department, as well as the governor's office, cannot... They do not introduce bills. That is the sole purview of the legislature. They set policy for the legislature to roll over and to simply say, well, you know, they said we can't do it. So it is, again, irresponsible. You set the policy. If there is a will, they will get it done. Unfortunately, as a former candidate for a council seat out there, there are very limited numbers of individuals who vote in that district. And as a result, the tremendous neglect that has been foisted upon that coast is really injustice at an incredible level. It is really sad. So, you know, my response is, I hope that whether it be Cedric or Miley or Kim are three elected officials from that area and are congressional members, will they have the courage, will they have the strength, will they have the time needed to get those things done? It remains to be seen. Cedric is new. He's so green and he's so young. Yeah. But that entire coast needs advocacy at a deep level. Very, very much so. Yeah. And I was just horrified that the next morning after it was announced what he proposed, the Department of Transportation in the next morning, without taking a breath, nope. It's like, wow. Yeah. And it's probably one of the most needed areas in our state, not just on this island in our state. I mean, I worry every time I get in the car whether I'm going to be able to get in or not, because if there's an accident or anything along that coast, it is just really, really sad. Biggest problem that we have, and that requires a great deal of effort. Yeah. We need to take a break, a minute break. And when we come back, we really want to get into what is going on at the legislature, the bills that we didn't get to. Sure. Okay. All right. Aloha. I'm Kaui Lukas, host of Hawaii Is My Mainland every Friday at 3 p.m. on Think Tech Hawaii. We talk about things of interest to those of us who live here, and my past blogs can be found at kauilukas.com. Okay. I didn't listen. You're watching Think Tech on ThinkTechHawaii.com, which broadcasts five live talk shows from noon to 5 p.m. every weekday, and then streams our earlier shows all night long. Great content for Hawaii from Think Tech. Aloha. My name is Steven Phillip Katz. I'm a licensed marriage and family therapist, and I'm the host of Shrink Wrap Hawaii, where I talk to other shrinks. Did you ever want to get your head shrunk? Well, this is the best place to come to pick one. I've been doing this. We must have 60 shows with a whole bunch of shrinks that you can look at. I'm here on Tuesdays at 3 o'clock every other Tuesday. I hope you are too. Aloha. Aloha, and we're back with my dear friend, Alex Santiago, and we are going to talk about what should be, Pono is politics, and it is not. Alex. No, you know, one of the things that I saw happening this past session, especially actually, it's been going on for years, is this idea that the members are there to protect the members, and it's like they're protecting them from the public, and the way they do that is by not allowing the public to know where they stand on issues. So whether it be this bill, which was held in committee and not allowed to be fully debated on the floor, or the prescriptive authority bill, which I've been working on for many years now, or the pesticide bill, or any one of these really big issues where almost a single legislator decides who has the power, that we're going to protect the members by not allowing the public to know where they stand on this particular issue. The prescriptive authority bill is the one that I'm most familiar with, and I just want to share, if I can, just take a moment. We're facing a mental health crisis in our state. I mean, you don't have to go far to know that we have seriously ill people who are not getting the care that they need. Especially if you live on the neighbor island. Correct. In the rural communities, even those who would like to get the help that they need can't get at them. There's a serious shortage of psychiatrists that's been well documented, etc. Well, many, many years ago, the military started it, and five other states have moved in this direction. They took psychologists who were already licensed in practicing, had their work clearly well educated in the area of mental health, and they had them go back and get the psychopharmacology education that they needed to be able to prescribe a very limited formulary. Now, they're not talking about prescribing for diabetes or anything else, but a very limited formulary that would have allowed them to take an individual who was having a mental health issue, stabilize the individual so that they could engage in the talk therapy, which is what they're good at. This is good medicine. Ten years ago in 2007, we got the bill passed in the legislature. 13 mental health, 13 community health centers with their physicians came in. We got the bill passed. I thought, great on us. Now, I was at that time working for the psychologist. The bill went up, Governor Lingo vetoed the bill. We were working on trying to get a veto overwrite because obviously, Democratic-controlled legislature, former party chair, we thought we had it. Well, what the docs did was very clever. They had a person who had been their nemesis for many, many years, Bob Toyofuku. Bob Toyofuku, the head of the trial attorneys, had kept tort reform at Bay for so long because he had the power to do that. Well, they hired him. So Bob came in, got the legislature to not do the veto overwrite, and has since really almost single-handedly, along with Dr. Jeff Fakaka, been able to kill the bill every time. And at some point, I just got to say, as a lobbyist myself, it's one thing to play the game and win because he's really good at winning. But it's something else when, even in light of the fact that you had physicians, you had psychiatrists, you had nurses, social workers, the Mental Health Association of America, the advocates, the families. I mean, everyone coming in saying, we need this. We really need this bill. And on the other hand, you had Dr. Fakaka, Bob Toyofuku, and Dr. Kreegan, who works in the House, who's an elected official, be able to simply say that this is too dangerous, that these guys are not qualified. It's a turf war, and we're not going to let them do it. And they kill it every time. Last year, I had received 31 commitments, 31 of the 51 members of the House saying that they would vote for this bill. Speaker Suki introduced the bill. It went through the whole process. Individuals with mental health needs flew in from the neighbor islands and begged the legislators and their legislators to please pass the bill, because loved ones were committing suicide, self-medicating themselves, and having the most horrific stories you can imagine. Civil beat endorsed it. We thought it was ready to go. The bill goes all the way through the legislature, goes down to the floor for the final vote. It gets deferred and deferred as it comes up on the agenda. Until the last bill, everything else is done. There's no one sitting in the gallery, except me, a few of the people that I was with, and Bob Toyofuku. So what happens is the vote's about to be taken, and the majority of your Scott Psyche comes up and tells the then acting speaker that was John Mizuno, recommit the bill, recommit the bill, gavel out, sign to die over. This is an indication, and I was livid. I remember the Sergeant at Arms was ready to tackle me, but I was very upset, because the legislature, that institution that I talked about earlier is there to level the playing field. It's not there to allow the mighty and the well-connected and the well-financed to invoke their power over the less powerful. As a social worker, I was not advocating for one profession. This is not about psychologists, because less than 5% of the psychologists will ever go back to get the two years master's psychopharmacology degree to get all the training to be able to do this in a very limited capacity in only rural areas, which is what it was called for. So it was really, I thought, interesting, sad, very, very sad, and that none of the 31 members had the courage to stand up to Mr. Psyche. I call him Mr. Psyche, or Scott, and say, let's have a roll call vote on your recommendation to recommit the bill. Had they had a roll call vote, it would have at least allowed those people in the rural communities to know where their legislators stood. They have the greatest needs. Those on Oahu could care less. I mean, they should care, but do they or not? I don't know. No one will know. And then this year, the same thing happened with the pesticide bill. They did all this shenanigans, and then afterwards, they threw what's his name under the bus, McKelvie, all of this shenanigans going on, and so there's someone like me watching this. It's almost as if it breaks my heart. It breaks my heart to see the institution being run by individuals who don't have the respect for the institution that it deserves. Well, let me tell you one now. This was my observation, okay, with the healthcare and medical aid and dying, Della Albelate is the chair. And everybody had told us from the beginning that that was going to be the mountain too high to climb. That was going to be the problem. Well, the testimony, our side had the majority of the testimony, great testimony. 800 pages of testimony. The other side had this one doctor, woman doctor, and she was the lead in the anti. Well, she is the wife of Della's employer, because she's an attorney, so she works for the, but this is the wife, and he is sitting outside of the hearing room through the whole thing. And I'm watching this, it's like, this does not look good at all. And then upon further investigation, all of the medical people that testified against came from the same fax number on my way. So, you know, this is a real setup. This isn't real people. And it just breaks your heart to see this kind of like you call it shenanigans. Yeah, and what needs to happen is that there needs to be accountability. When you don't have accountability, then, individuals in these positions become so emboldened, they become arrogant, to the point where they feel that they can actually call people up, like my former clients, and say, we don't like Alex. So, if you take Alex out of the picture, we'll pass your bill. Well, so that happens, so I said, I'll just remove myself, they don't like the fact that I'm an advocate and a rather strong one. So I said, okay, that's fine. I don't need this, it's not about me. So I removed myself this past year, and they still killed the bill. And so why I'm sharing this with you is because I've chosen after 30 years, plus of doing that, to say, it's time for people like me to acknowledge that when you have an institution that's being run by individuals who fail to understand and withhold the integrity of the institution, they have to be replaced. So I have chosen to use the stage of no vote, no grumble to encourage servant leaders to step forward. We will train them, we will encourage them, we will teach them what policy is and how it should be done. We will also ask that they abide by a code of ethics, and we need to change some of this leadership that's going on right now, because it's not leadership. No, and they get to decide what bills, and I saw last year one, or resolution, which was an innocuous resolution, nice to have, but it was bottled up in committee because they had made a deal. If you pass yours, I'll pass this. But some of that's been going on for a long, long time, and the question that I have for our viewers and for everybody is, where is the media? If the media were still to, and if the watchdogs, where are the watchdogs and the advocates and the media to allow for the transparency that once occurred? When I first got elected in 1990, they didn't even have votes in the committee, the chairs decided, well, we worked hard, I remember a bunch of us, Bena, myself, Suzy Chun, a group of us, Jackie Young, we said, that's not right, people should know where we stand. So we required and got the house rule change to require voting in committee. That was earth-shattering back then. You think about it today. Now, the question then becomes, where is and how does the community become aware of all this shenanigans going on? See, I know because I've been in and around, right? But where is it for the community to know? And that's where I think there needs to be a change and there needs to be more light shine on it. And that's where our media is supposed to be doing it. Well, now, I remember a time when, of course, we had two newspapers, when they were in the office, in the building. Right. Yeah, and you could see the reporters walking up and down. But this group of reporters, first of all, they are young. They don't know the history. They don't know who's who. Well, not all of them. I mean, some of them, like the one Kevin Dayton's been around for a year. Oh, Kevin, yes. But what happens is- But the paper doesn't even pay them to be there. But what happens is the house hires a publicist, a media person, the Senate does to it. They create the copy and they give it to the media and then the media alerts it from there. This takes it. That's not reporting. And then you don't have any of the TV media people there unless they're called to come down and cover something. And it really goes back to the responsibility that they have as journalists to invest the time and energy. And I've confronted them on it and they say, the people don't really want to know. It's not sexy enough and people lose interest in this stuff. It's boring. That's what they've told me. And I disagree with them. I think they're really selling the public short. Because there's last year 2,700 bills. Now, of course, nobody can read 2,700 bills, but surely the public is interested in some of those bills. And you watch the news and all they talk about is who got killed and who they get the police blotter and just read from it. And there's nobody that talks about, and I'm sure there's, somebody was interested enough to propose 2,700 bills. Somebody, some organization, some group was interested enough to say, let's do this. And it had some importance somewhere. Right. I want to share one more thing because I know we just got a few more minutes, right? The other thing that I just wanted to share as an observation is after all of these years, I have never seen the place more empty than it has been in these past few years. There was a time when that building would become alive and it would be around the clock because I lived on the North Shore. I'd sleep in my office all the time. And I mean, people would be there working around the clock and there was always people on the hallways and you never find parking. Well, I know technology today has allowed people to send in their testimony and they no longer come down as often as they should. However, there has been this withdrawal of the public's involvement in this process. This withdrawal really allows these legislators to again feel so emboldened that nothing that they say or do has any consequences. So do whatever they want. And that's what's got to change. So if we say to the community that you guys got to get involved and they ask, how? How do I know? And that's where people like Noble McGrumble and others get involved. So. Sorry. No, no, no, no. Will you come back and visit with us again? Anytime. Because we have got to make change and the only way we make change is with conversation and emboldened other people. Now tomorrow morning, there will be sign holding at the Capitol at seven o'clock a.m. and all of these groups who are also dissatisfied. So if you want, please join us tomorrow at seven a.m. and please come back again. Thank you so much for having me on, you know, for what it's worth. Yeah, I'll rant anytime. Bye.