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Can a longtime lobbyist sick with cancer persuade the Hawaii Legislature to pass medical aid in dying legislation?
If anyone can do it, it might be John Radcliffe.
He has represented clients with interests as varied as gambling, genetically modified foods and vacation rentals. After decades in island politics, Radcliffe has a lot of friends in the big square building on Beretania Street.
Now terminally ill, he wants patients like him to have a say in end-of-life decisions. While the proposal has failed several times before, primarily because of the opposition of religious organizations and some medical groups, six states including California now permit an end-of-life medical care option.
It’s one of the high-profile issues sure to draw the attention of lawmakers who convene for the 2017 session Wednesday.
Another certainty is taxes.
Honolulu’s unfinished rail line is strapped for cash, and city officials will be asking to lift a sunset date on the general excise tax surcharge levied on Oahu residents.
But the GET extension — a de facto tax increase — would come as the state faces a revenue shortfall and considers other significant spending proposals.
The Council on Revenues’ latest forecast shrunk the state’s money pile by $155 million. Meanwhile, pay raises for 14 public sector unions could cost taxpayers hundreds of millions of dollars over the next two fiscal years.
And just last week, legislators learned that the state pension system, thanks to weak investment returns and beneficiaries living longer, is short about $385 million annually.
Kalani English, the Senate majority leader, is not enthusiastic about “medical aid in dying,” the latest term used by proponents after bills referring to “death with dignity” and “physician assisted suicide” were snuffed out by previous legislatures.
“It is the right of every individual and group to lobby for particular issues, but we’ve been down this path before,” said English. “I’d rather concentrate on our 2017 legislative program then re-look at an issue we have looked at a number of times before.”
His chamber’s priorities include addressing food and energy sustainability, mitigating climate change, improving public safety, bringing down incarceration rates and providing better health care for Pacific Islanders, including Native Hawaiians.
“We’ll see how it plays out,” English said of medical aid in dying.
More pressing for English is the potential for a rising sea level to begin flooding Hawaii’s top two economic drivers within a generation: Pearl Harbor and Waikiki.
“This is not a concept out in the future, this is right before us now,” English said. He is drafting a bill to mirror the climate change agreement adopted by some 200 nations in Paris a year ago.
House Speaker Joe Souki is more optimistic that medical aid in dying — or “compassionate dying,” as he put it — will be heard.
He described possible legislation as allowing people of sound mind who are told they have less than six months to live to be provided a prescription for life-ending pills they could choose to take or not take.
Will Radcliffe make a big difference in persuading representatives?
“I don’t think so,” said Souki, who called Radcliffe a dear friend. “A lot of my members are going to make a decision based on their religious backgrounds and their personal philosophies. John will have some influence — he’s always been a maverick and will continue to be. That’s why I love the guy so much. I think it will have some effect, but not a major effect.”
What is likely to be of greater persuasion, said Souki, is the fact that more and more people are seeing their loved ones suffer painful deaths.
Just as pet owners will take their animals to veterinarians to put them to sleep, humans, he said, deserve the same option — with the important difference that it is the dying individual who will make the ultimate decision.
“We deserve it,” Souki said of such an option.
The Senate is looking at future development, in particular transit-oriented development along Honolulu’s rail line.
For English, that means having the state maximize the development potential of land along public transportation corridors by collaborating with businesses and nonprofits.
Asked about the GET extension, he sounded a lot like the money committee chairs, Sen. Jill Tokuda and Rep. Sylvia Luke, who have been frustrated with shifting cost projections from the city and its rail agency.
“We will have to see the big picture,” said English. “People are coming up with all sorts of numbers, and it’s hard to make real decisions without real numbers.”
Sen. Will Espero, meanwhile, is working on a bill that calls for a dedicated transportation infrastructure revenue source.
While details are still being worked out, the legislation could extend Oahu’s GET surcharge in perpetuity. Two-thirds of the revenue would go to Honolulu for rail and one-third would go to the state for other projects.
As state Department of Transportation officials made clear this week, there are plenty of roads, harbors and airports that need help.
“In essence, taxpayers are still paying for it, but now we use it as a dedicated funding source,” Espero said of his legislation. “And with the GET we look at tourists paying at least 20 percent.”
Souki, meanwhile, said the House will consider legislation also making the GET surcharge permanent but lowering it from 0.5 percent to 0.425 percent. The 10 percent administrative fee (also called the “skim”) would be lowered to 5 percent.
Neither Souki nor English is worried about revenue shortages. Both pointed out that it happens during many sessions, and Souki said the financial outlook could change for the better once the next Council on Revenues report is issued in three months.
Souki and English pointed out that there is a system in place to pay down the unfunded health and pension benefits for state workers and retirees.
“Although we have that big gap, it’s not as if we have to fund that tomorrow,” said Espero.
Souki wants to see a feasibility study for toll roads. He compared Honolulu to another densely populated island, Singapore, and said toll stations could bring in more money to state coffers. Singapore, which has existing toll roads, plans to implement a satellite-based road pricing system in 2020.
Echoing the Senate’s desire to “explore alternatives to incarceration and options to reduce the recidivism rate amongst our incarcerated population,” which leaders announced in a press release Wednesday, Souki mentioned the appeal of ankle monitors and bracelets for some inmates.
Given that a new jail for Oahu is at least 10 years away, housing nonviolent inmates in their own homes makes sense, he said.
So does committing mentally ill homeless people to the Hawaii State Hospital, he said, adding that courts have upheld the practice and the patients could receive needed care.
And what about pay raises for all those unions?
Souki said it was wise for Gov. David Ige to not put dollar figures in his budget draft. A wise poker player, he said, never shows his hand.
Lawmakers will introduce thousands of bills, and surprises always crop up. Also coming out in the days ahead will be legislative packages from various groups.
They include the Hawaii Women’s Legislative Caucus. Rep. Della Au Belatti said one measure will be in response to reports of infant deaths in child care facilities regulated by the state. Belatti said the legislation was inspired in part by Civil Beat’s reporting.
There will also be follow-up legislation for sex assault testing kits, now that the state and counties have provided more information about the backlog of untested samples.
A proposal that failed last year — permitting birth control to be prescribed by pharmacists — may get new life.
Finally, the Hawaii State Association of Counties — representing the four counties of Kauai, Maui, Hawaii and Honolulu — will push for a bigger share of the transient accommodations tax, also known as the hotel tax.