Candidate Jack Lewin Interview in 1994
Price of Paradise · Hawaii Public Radio · aired 1994-04-01
Guests: Jack Lewin (State Director of Health; 1994 Democratic candidate for governor)
Duration: 01:08:16

[00:00:03] Randall Roth: Good morning. I'm Randy Ross and this is a special Price of Paradise radio show. I'm sitting here with Dr. Jack Lewin who currently is director of the Hawaii State Department of Health and a possible candidate for governor. Dr. Lewin's resume is long and our time is short, so I'll just summarize his background. He got a medical degree at the University of Southern California, spent eight years in the U.S. Public Health Service working with the Navajo Nation, was a family physician in Kula, Maui and for the last eight years has been Director of Health here in Hawaii. Dr. Lewin has asked that I call him Jack and has agreed to keep his responses as short as possible, so we can get to as many of your calls, your questions as we possibly can. Our lines are open and the number is 955-8821.

[00:00:50] Randall Roth: Jack, welcome to the show.

[00:00:52] Jack Lewin: Thank you, Randy. I'm a big fan of yours and this Price of Paradise issues campaign. I think it's going to make this this year's election a great one.

[00:00:59] Randall Roth: Well, thank you. The big question everyone is asking about Jack Lewin. Are you going to run for governor?

[00:01:05] Jack Lewin: Randy, um my wife and I and the kids just came back from Hana, contemplating that for for the week together. There are about a couple hundred people that have asked me to run and and I am going to spend the next few weeks out in the community talking to people and and listening to people to uh really get from people, you know, more understanding as to what I might offer. I believe I have some issues I'm going to put on the table and I'm really excited about Hawaii's future. But I haven't really decided whether, you know, whether it's absolutely right for me and whether I can overcome the obstacles of starting this lay. I'll tell you though, uh I definitely want to be a major part of uh shaping Hawaii's future in in this process.

[00:01:43] Randall Roth: What are you hearing from the community right now about the type of leadership, the type of future it wants?

[00:01:48] Jack Lewin: Well, I'm hearing that people want some choice. I'm a Democrat and, you know, and I think that many Democrats and many independents are are wandering these days because people feel we are wandering as a society without really, I mean, I'm not sure if I love the word vision, but we need a blueprint for tomorrow, something that tells us where we're going in 30 years so we so we know what we're doing next year. Certainly, we need a lot of a more a lot of boldness in this process because government itself has become in a way the obstacle to the progress for private sector endeavors, um too much centralization of power. I think people are looking for a new concept of government, of community and of economic development, and and I'd like to at least be part of that process.

[00:02:30] Randall Roth: Great. Phone lines are open. The number is 955-8821. Neighbor Islanders are invited to call collect. Again the number, 955-8821. Well Jack, we had some people who submitted questions in advance. Bill from Honolulu asked, what can or will you do about the size of government in the state of Hawaii?

[00:02:51] Jack Lewin: Bill, I agree that the government at this point has gotten too big to really to serve people in the way that it was intended. Really originally, government's purpose was to assess problems, set policies and then provide assurances to people. And what's happened is government has actually got in the service delivery business to the point it's competing with the private sector. I think therefore, um government needs to get back to setting public policy, bringing the private sector and the public sector together and really working on advocating for public policy, but not delivering all the services it currently operates. Just in the health department alone for eight years, I've wanted to get the hospital system, which is now self-supporting, out into community-based operations.

[00:03:32] Jack Lewin: The same thing could happen with mental health. A lot of environmental permitting, a lot of permitting in general in all the departments of government, could move out of the confines of of a centralized government into more community-based operations as has been proposed with education. So I'd like to see us bring some people into government who are who are really familiar with the the business world and the private sector, um bring the policy people from the academic side and the business side in to help create the policy and decentralize the service delivery side.

[00:04:04] Randall Roth: You know what I'm hearing sounds like privatization. Is is that a a bad word?

[00:04:09] Jack Lewin: It's not a bad word at all. In fact, government shouldn't be competing with the private sector, frankly. Um I think though there are ways that can allay the fears of public unions and civil servants. Uh in the community hospitals we're talking about an agency for community hospitals that works precisely like Queen's or a private sector system would work, even though the existing civil servants and the arrangements with the public unions would go with the organization. It would be freed up of the entanglements of the the bureaucratic management and micromanagement that occurs in central government. It would go out and compete as a public-private corporation.

[00:04:45] Randall Roth: Okay. In case you joined us late, you're listening to the Price of Paradise radio show. I'm Randy Ross and my guest is Dr. Jack Lewin, Director of Health here in Hawaii and a possible candidate for governor. He's here for the specific purpose of answering your questions. Your calls are welcome. The number is 955-8821. Well Jack, we have another question from Steve from Waianae. He says, our schools in the Waianae area are in a downward spiral as far as standardized testing can show. What do you propose specifically to overcome this problem?

[00:05:19] Jack Lewin: Applying some of the principles I alluded to already, um Steve I think that we need to decentralize the operations of schools. The Board of Education ought to set policy. Um the operations, the hiring and the firing and the management of schools ought to get decentralized as close to your community of Waianae as possible, so that you can have a real role in shaping it. I think that one of the key issues in education today that I hear from teachers is let us teach, which means to me that our education system will will drastically improve if we reduce the classroom size, get some more teachers, fewer administrators, and let teachers actually teach. I would hate to think that we're going to replace families with with the schools. And when people say let's teach parenting at school and let's add 12 new items of curricula to schools, I would hope that in Hawaii we will build on the strength of community, and in fact try to get parenting back in homes and families and communities and try to get teachers to be able to teach [unintelligible — audio glitch] reduce the classroom size.

[00:06:21] Randall Roth: You were suggesting that we have fewer administrators and and more teachers. Is that just a reshuffling or or do you think that the system needs more funds than it currently has?

[00:06:30] Jack Lewin: Oh, it definitely needs more funds. I don't know that it needs as much funds as has been proposed by some other candidates because I believe that we we really basically would find ourselves without without any other government services if we just try to shift everything in that direction. Uh I I think that to get the funds education's going to need, we're going to have to stimulate small business and the economy and as the economy picks up, then we need to shift resources and the increased tax revenues that come out of that economic lift into education. And at the same time, by attrition, we need to shift people and the administrative posts, fill those posts as teachers, and get the classroom size down.

[00:07:10] Randall Roth: Phone lines are open. The number is 955-8821. Well Chuck from Kaimuki has this question. Do you support some form of sovereignty? And if so, what model do you prefer?

[00:07:23] Jack Lewin: Chuck, I think that um everybody in Hawaii ought to support Hawaiian sovereignty. Um this is an issue that Hawaiians have to determine and and the rest of us who are not Hawaiian need to find a way to be non-defensive, non-reactionary and supportive of the process. Hawaiians welcomed all of us here to these islands and and they are the glue that holds the rest of us together in many ways, culturally. We all benefit from much of that but you know, and if you look at the the benefits of the trust assets of the ceded lands and of Hawaiian homelands, Hawaiians ought to be the richest people in America and instead they they suffer from inordinate numbers of health problems and so forth.

[00:08:03] Jack Lewin: I think Hawaiians ought to be encouraged to go with consensus um and and government ought to take a non-defensive, non-reactionary means of supporting. But I see in the future, when Hawaiians have reached that that consensus, that our state government can really go to bat to make sure that we pull in additional federal dollars for a whole lot of support services in addition to the land you know that will come with sovereignty. Everybody in Hawaii is going to benefit. I don't think we need to fear it. I think it's going to be great.

[00:08:32] Randall Roth: Okay. We have several people on the line. First, Paul from Honolulu. Paul, you're on the air.

[00:08:36] Caller: Uh good morning.

[00:08:37] Randall Roth: Good morning.

[00:08:38] Caller: Um Dr. Lewin, isn't it true that uh Medicare, Medicaid, CHMPUS, and those programs were set up by the government to provide universal healthcare for everyone and isn't it true that they've kind of failed us and that's why we're in this healthcare um crisis?

[00:08:55] Jack Lewin: Paul, you know, you you make a good point. A lot of people in Hawaii don't actually realize which is the best part of healthcare, the most efficient part of healthcare in Hawaii is the private sector part. We passed the law um 20 years ago, a lot of bold people, Senator Yoshinaga, Representative Takamine, some very bold legislators, got the first employer mandate passed in Hawaii. And a lot of people are still in business are still frustrated by that. But we have healthcare costs that are 35% lower in the private sector. It's the federal side that has really been the most inefficient and the least likely to promote prevention and wellness and give people up-front the services they need.

[00:09:34] Jack Lewin: I think therefore, that Hawaii, I mean, I'm I'm grateful that the Clintons have put health reform on the agenda. It's it's embarrassing that America has so many people, mostly women and children, lacking coverage. But the idea is, here in Hawaii, we've already got some leadership, we're out in front. Let's not have the Feds totally dominate our system. That means we need to get the 30 or 40,000 people, relatively small number left covered. That means we need to get fairness in the insurance industry so that everybody's treated fairly, and that means we need somehow to find a means of cost containment for small small businesses and families so they can deal with that. We can do that ourselves, but we've got to take action this year in the legislature, we didn't uh we proposed a lot of those things and not much happened.

[00:10:16] Randall Roth: What do you think, Paul?

[00:10:17] Caller: Well, I was wondering the you answered a different question than I asked which was, wasn't the the federal programs supposed to originally provide universal healthcare?

[00:10:29] Jack Lewin: No, they weren't, Paul. Actually, Medicaid provided just a limited coverage, it varies in each state for the very low-end poor, and Medicare for the for certain disabled populations, but people basically who retired. Um, we that still doesn't cover the unemployed, the part-time employed, self-employed, students, and and people who fall through the gaps because they're the dependents of workers who aren't covered. So, even in Hawaii, we only have 3 or 4% of our total public not not covered, which is great, and I want everyone to be covered and and we all should move in doing that. But in America at large, 17% of the public is not covered even with Medicare and Medicaid.

[00:10:59] Caller: I see. Well, thank you very much, Dr. Lewin.

[00:11:00] Randall Roth: You're welcome. We have uh Tom from Manoa on the line. Tom?

[00:11:14] Caller: Yes, I'm here.

[00:11:16] Randall Roth: Welcome.

[00:11:17] Caller: Thank you. Thank you. There were several things I wanted to uh mention. Uh first was that you were talking about uh the bloated uh oh, I guess maybe that's critical. I don't mean to say that, but the uh DOE, Department of Education. And we keep hearing this call about, oh we must get class sizes down, we must get class sizes down, and intuitively that seems like that's a very wise idea. But when you look around the world, for example, you look in in Japan, uh their typical class size is well over 50 pupils. Ours is something like 34, 35, and they don't have anywhere near the kinds of difficulties and problems that we have. In fact, their elementary schools are considered to be uh uh quite wonderful, uh where ours are considered to be uh less than wonderful. And so it's really not the inherent class size, as it really is, I think, a reflection of cultural and societal attitudes towards schooling. That was the first thing.

[00:12:13] Randall Roth: Tom, let me get uh let me get Jack's reaction to that.

[00:12:16] Jack Lewin: Sure. Hey, Tom. Uh, hi. Tom, I think that, you know, you raise a very good point. Uh basically, if we don't get back to to recreating community and supporting family then obviously teachers can't do it all. No, they certainly can't. But given the moment and the the moment in time we're in, I mean, I certainly think we need more vocational opportunities and for kids who who are disruptive in classrooms, we need to give those kids, get them the basic reading, writing, arithmetic skills, but all and give them some place they can excel if they're not heading to college, and that may take some of the disruptiveness out of some high school level classes. But I hearing from teachers, uh teachers basically when when kids come to school unprepared to learn or from dysfunctional families and and with a lot of stress is elsewhere, then teachers do need time to be with them, to lift them up. And and frankly, uh if if that is the investment instead of more administrators. We have 50% of some of our school agencies are administrative staff, not teachers. Yeah that And and and the point is if we shift it in that direction, it's got to help a lot and it will provide some caring, but you're right, there can be no substitute for building stronger families. And I think to do that, we've got to refocus on community and and frankly, government has been unwittingly dismantling the sense of community and community government for years.

[00:13:14] Caller: Yeah, I think so. In fact, if you look at several large studies, uh for example, Professor Harold Stevenson compared elementary schools in Tokyo, in Taiwan, uh in Hong Kong, etc., and in in Seoul, as well. And when you actually interview say the mothers of the students in these schools, uh it turns out that uh for example, American mothers, over 40% of them are satisfied with the education their child is receiving in elementary school. In Tokyo, it's less than 10%. And when you ask say these mothers, well what's your most important task, uh they consider their most important task that their child get a good education. And their cultural attitude is that it's not really individual ability that counts or whether you have some great genetic gift, but it's hard, hard work. And in fact, they take a great role in supervising and making sure that the child actually does the work.

[00:13:30] Randall Roth: Tom, do you have another question for Jack?

[00:13:32] Caller: Okay. Yes. The other question was it's from a total different domain and that was the issue of health care. And one of the things that seems to me is lacking in the general debate is the uh enormous uh salaries that uh many of the medical practitioners make. When you have anesthesiologists making over a third of a million dollars, uh why isn't that a larger portion of reducing health care costs?

[00:14:57] Randall Roth: That's probably even more than a director of uh of health makes, huh Jack?

[00:15:02] Jack Lewin: Yeah, I think if I stayed in my my medical office, my family would have benefited financially. I mean, my medical practice in Maui. Um, Tom, here's here's my answer to that. I think that, you know, to a certain extent, physicians and nurses and other health providers um who increasingly have high salaries as they become specialized. To some extent, they deserve these salaries after working 16 years in education and so forth and and postponing a whole lot of of employment. Um and we do pay stockbrokers and attorneys and business execs and we don't seem to, you know, be worried about the fact that bank execs make, you know, twice that much. But you know, I think you're right. The real issue is there's the there's a it's disproportionate pay. Family practitioners, pediatricians, general internists, country doctors are making $65,000 or $85,000 a year and working twice as many hours. I think that really if we can make a consumer-based health care system where consumers make choices and competition works between health plans where the quality of care is controlled by government, by standards, so you so everybody at least has a certain decent quality of care and decent controlled outcomes, something we don't have now, then consumers will be able to make choices of health plans that don't pay exorbitant salaries and really attend to some of those efficiencies you're talking about, specifically by focusing on wellness and prevention rather than more sophisticated treatment.

[00:16:28] Randall Roth: Good idea. Thank you, Tom.

[00:16:29] Caller: Thank you very much. Bye.

[00:16:32] Randall Roth: I'm here with Jack Lewin, a member of Governor Wahee's cabinet and a possible candidate for governor himself. Your calls are welcome. The number is 955-8821. Neighbor Islanders are invited to call collect. Just give your first name and the area of the state that you're calling from and we'll have you on the air in no time. Again the number is 955-8821. Well Jack, we have a question from Bob from Manoa. He says, what is your position on gun control, and if elected, what would you do to achieve that objective?

[00:17:04] Jack Lewin: Well, Bob, I live in Manoa and I've um I I might, as a public health professional, I I basically, my biggest position is to somehow reduce the uh 200 or so deaths a year in this state that are preventable related to guns. Um the unnecessary suicides and family violence and those kind of things. I think there certainly is a constitutional right to ownership of guns, and I I can understand and agree with the responsible gun owners out there that we're infringing upon for them a recreational issue and something that relates to self-defense. I think [unintelligible — audio glitch] certainly semi-automatic weapons should be banned, totally. There's no need for those in our society. Um automatic semi-automatic weapons and the and the paraphernalia that goes with those should be removed from society. As far as handguns go, I think the registration law that that we have with perhaps some extensions of it in some areas where it's not working, and education, are really represent a good first step with gun control. But I'd like to reserve my judgment with handguns because, you know, I don't know that the recreational opportunities with handguns and the self-defense side really really outweigh all the harm and damage that comes out of in moments of passion and violence in families. It's not the the risk is not really from the outsider or the random person with a gun, the risk is from somebody you know. And until we can address that, we really need to look at more peaceful societies that have eliminated a lot of unnecessary carnage with guns.

[00:18:35] Randall Roth: We have a question from Cory from Hawaii Kai. She asks, what can be done to prevent and reduce incidents of domestic violence in Hawaii?

[00:18:44] Jack Lewin: Well, specifically we need more services uh for outreach for domestic violence. We need more places for people to call, more agencies around the state for a safety net type thing. That's that's that's a band-aid approach. What we really need is a refocus on community. If this this is a tough one for us, but we have gotten very technological, very sophisticated. We've we all drive in cars. We have houses that have look like fortresses with garages in front instead of porches. And we no longer have a village. It still takes a village to raise a kid. And I think that we need to redesign community so that we know our neighbors and care for our neighbors again. And in that way, we're going to have an Ohana, a network so that basically people at risk of abuse have support systems in their own family and neighborhood and community to rely on.

[00:19:36] Jack Lewin: If we can build family and community with child care, with support services, with parks, with recreation, with the ability for for people to get to know and trust each other again, that support reduces the root causes of violence. And obviously, poverty and substance abuse and other things go hand in hand with this, but all of these, these other social problems, you know, are magnified by the breakdown of community. Having healthcare coverage in South Central Los Angeles is not going to solve the problems there. The community is completely destroyed. We still have communities in Hawaii and and if we can strengthen them, that'll be the biggest preventive factor for family violence.

[00:20:18] Randall Roth: You're listening to the Price of Paradise Radio Show. I'm Randy Roth and my guest is Dr. John Lewan, Director of Health here in Hawaii and a possible candidate for governor. He's here for the specific purpose of answering your questions. Your calls are welcome. The number is 955-8821. Well, Nancy from Kailua has this question. Do you think that the Hawaii Supreme Court is the proper body to appoint Bishop estate trustees?

[00:20:45] Jack Lewin: Well, it certainly seems like that's an outmoded kind of selection process. And I think that it needs to be weighed carefully and I I haven't spent a whole lot of time thinking about that as a main focus for for me and I and I don't think are that anybody we elect is going to have all the answers. But I do sense that the public's unhappy with it. I think we ought to take this process to a more public forum of discussion and and figure this out because certainly um there's enough dissent with it. There's enough concern that the Hawaiian community is not benefiting as as much as uh um the founder intended and I really believe this that we need to take this as more of a social and public concern in the future and and bring together some people and and discuss this openly.

[00:21:27] Randall Roth: Okay. We have several callers on the line. First, Chris in Makiki. Chris, you're on the air.

[00:21:33] Caller: Hi. Let me just ask the question. Um your department and all departments in the state use emergency hires, and one part of being an emergency hire is that no social security is paid by the state, and there are no health benefits, or the health benefits that are offered are almost twice the cost that they would be if one were employed in a more typical employment.

[00:22:05] Jack Lewin: Chris, you're absolutely right. You know, why should government require businesses to cover everybody and then provide a loophole for itself for emergency hires? It took me a number of years, eight years I've been Director of Health, but you know, it took me quite a few years to realize that being director doesn't mean I really get to run the department or these mega agencies. I mean, there's a lot of administrative rules, regs, and administrative agencies to determine what you can and can't do. But emergency hire positions that go on beyond their intended function, which was to fill in for family leave and so forth, shouldn't be allowed, and we're going to need extensive change. I have advocated though all the way through that every single employee should have health insurance and that I want all emergency hires in the health department, basically given instructions that we they can't work past a month if they're not covered.

[00:22:57] Jack Lewin: You know, I find that that's not the way it works because there are loopholes and people can fill those positions. You're right, every single person ought to have health benefits, period.

[00:23:08] Caller: Well, I'd like to go back to one, no social security, and two, the type of health insurance that is available to the emergency hire is so expensive. It's almost twice that of typical of typical employees in other situations doing the same work, i.e., the same risk level.

[00:23:33] Jack Lewin: Well, you know, actually, um the the health insurance isn't twice as expensive because I I buy health insurance and I also know what we provide. It's it's about the same price but the but where you're where you're right is that coverage is much, much less with the ship program that was offered to emergency hire people. You're right in this issue all the way through, and I agree with you. To fix it, what we need to do is eliminate the emergency hire position that goes beyond one month or emergency hires could be in a position that for which there's no eligible individual. Then a retired person with benefits could come in and fill a spot for a while, but other than that, we shouldn't have these emergency hire positions because you don't have vacation leave, sick leave and it's just plain unethical and not right.

[00:24:19] Randall Roth: Thank you, Chris. Now we have uh from Connie Ohe, Terry. Terry, you're on the air.

[00:24:24] Caller: Yes, I'd like to know um Dr. Lewan's position on the uh recent ruling on the lease to fee conversion and um if he has any ideas on how to resolve the situation.

[00:24:37] Randall Roth: Good question, Jack, what do you think?

[00:24:38] Jack Lewin: Well, I think this is a this is a tough one and I again, I I really like to have some more some more input before I make a a final determination in terms of how I feel about lease to fee. General feelings, you know, certainly it's worked to go from lease to fee with houses. We did that we made that transition in the state well. And I realize there are some landowners in the state for whom lease to fee um right now as far as condos is they look at it as a major disservice to them in terms of um their their future. You know, I I know there's got to be a win-win solution.

[00:25:11] Jack Lewin: We certainly have to find some way for people currently in uh in leasehold facilities to own their facility in the future and not go broke. Um [unintelligible — audio glitch] do believe that in the next few years together we ought to be able to find a way to be fair to landowners and fair to those in leasehold and and have them convert to fee.

[00:25:45] Caller: Okay, thank you.

[00:25:47] Randall Roth: Thank you, Terry. I'm uh here with Jack Lewan, a member of Governor O's cabinet and a possible candidate for governor himself. Your calls are welcome. The number is 955-8821. Jack, I've got a question from Ryo from Pearl City. What will replace sugar as sugar is phased out?

[00:26:08] Jack Lewin: Well, hopefully not crops of condominiums, um Randy, that that, you know, the Hawaii has a certain carrying capacity in its environment. And I think that what happens on the on the land that sugar leaves is is going to be very critical to all of us. Diversified agriculture has a role. It's not going to cover all of the land that we have out there, um presently in terms of sugar. But you know, Francis Oda had the and wrote an article in the in the Price of Paradise and there are other people out there looking at sustainable environments where we combine housing, forests, and uh and green space and diversified agriculture in in communities of an appropriate size so that people can can know their neighbors and be involved in self government.

[00:26:53] Jack Lewin: In other words, if we build clustered housing of maybe uh 1000 families or so surrounded by forest burms and then diversified agriculture and maybe even in there some golf course land and so forth, we might cover some of that land in a beautiful fashion instead of a sardine city housing project that looks like the future home of gangs. And I I think that we can spread housing, diversified agriculture, forest tree products and so forth out in a way to cover this land beautifully and not leave it as a dust bowl.

[00:27:26] Randall Roth: Phone lines are open. The number is 955-8821. Well, we have Jim from Honolulu. He asks he he says the state government is the only growth industry in Hawaii and then asks, what concrete steps would you take to reduce both the state's payroll and its spending habits? He says specifically, which wasteful programs would you eliminate?

[00:27:48] Jack Lewin: Well, you know, I don't know that that it's it's so much wasteful programs that we will eliminate because when you ask the the candidates this, they the list gets real short real fast. Have you noticed that? Um and I think that what I'd like to suggest is there's a whole lot of direct services: hospitals, mental health, permitting, environment, all sorts of permit operations in state government that could be decentralized out to community-based operations and to the private sector. Where government's job is to provide the accountability and the overall policy and assessment to make sure the policies are fairly carried out. That's what government's supposed to do. In the health department alone, you know, alone, over the eight years, I came from Maui where I was a family doc, a member of Maui Memorial's hospital staff. It's really been tough trying to sell the idea of moving the hospitals out of state government.

[00:28:38] Jack Lewin: It's scary to unions, it's scary to civil service. It's change, but we've got to make those changes. You know, in this in my department alone, we could take go from from 6,500 employees we currently have. We would drop to something like 2,500 if we just decentralized those kinds of services. That kind of stuff can happen in quite a few department areas and I think that's the way we're going to we're going to right size government over the next few years.

[00:29:07] Randall Roth: Phone lines are open. The number is 955-8821 and neighbor islanders are invited to call. Collect. is 95 invited to call. Collect. We have Henry from Honolulu. He says, how would you alleviate traffic congestion in Honolulu?

[00:34:23] Jack Lewin: Well, I you know, I sometimes have to admire Bermuda where they set a quote on cars, but uh I don't know that we could we could pull that off politically here. I I believe that, you know, I I'm one who will take the the uh risk of just saying that I believe we need a light rail system, a transit system that's linked to buses, that becomes a faster, more efficient system. I think the one that we had on the on the planning stage in the past was lousy because it didn't even bring in the commuters. I mean, if we're going to have a system, it's got to get all the way out to, you know, to either almost to Nanakuli, it's got to get up to Mililani, it's got to get to Hawaii Kai, it really ought to get to Kailua and Ohai, and ought to be connected to handicapped, accessible, uh minibuses and vans and so forth, and maybe even create a kids business with cabs from those those destination points.

[00:35:11] Jack Lewin: Transportation um could help us create the new community. A lot of people coming to Hawaii in the future might come along transportation hubs because they choose the option of not having to own a car. Wouldn't that be great if we could get people out of cars? Wouldn't it be great if we could we could really implement bike ways and and uh showers and lockers and offices so more people would ride to you know, ride to work on their bikes? Um I really believe we're going to need a variety of solutions. The neighbor islands are going to need you know, bus systems and and to begin with. But we've got to look to the future and transportation could be over the next 20 years, a $5 billion industry as we build transportation systems that keep our construction workers at work. We we've got enough hotel rooms. I don't know how many more hotels we want to build. It wouldn't be advisable. Let's fill the ones we have.

[00:36:02] Jack Lewin: Let's keep our construction workers working at and have 50% of the money coming from the Feds. I was very disheartened when we lost that federal money. Um but we can go back and do it again this time with a better plan.

[00:36:14] Randall Roth: Okay, we have uh Just from Kaua'i. Just, are you Welcome.

[00:36:19] Caller: Oh, good morning. No, I just wanted to ask uh um Dr. Lewan um about uh his position on um the environment versus economic development. I know that um um when he was on the uh platform committee of the Democratic Convention a number of years ago, he uh didn't feel like uh they had an equal place in the balance and I just wondered if uh he's had any uh change of heart uh since then.

[00:36:49] Jack Lewin: I really haven't just, and calling from Kaua'i, that's pretty much of an honor. In fact, uh just I have to tell you, I'm not very thrilled about the space port out there in Kaua'i because, you know, 200 jobs and an awful lot of involvement that the community doesn't want is isn't a great idea. I think that the environment, you know, remains, it's a high priority in in our kid's minds and in the minds [unintelligible — audio glitch] all of us when we talk about it because protecting the Aina and protecting the environment of Hawaii has got to be our number one economic priority. Um Tourism isn't going to survive if we continue to pollute the water and and congest our highways. Who's going to want to come from Tokyo or Los Angeles to vacation in Hawaii when to a traffic quagmire or to an environmental uh environmentally less than pristine environment.

[00:37:35] Jack Lewin: I think that the issues are these: One, land and water use. We got to make land decisions long in advance. We not wait until the end stage for environmental permits to make our decisions. Land and water use got to be planned with a sustainable thinking of in the future with green space and with protection of our ecosystems in mind. Um two, I think we need a Department of Environmental Protection. It shouldn't be in the health It's too big, too important, and believe me, for peanuts at the state level, $5 million, we could have enough environmental monitoring people to do a decent job. And that means shifting from two attorneys working on the environment to ten or so, so that we can really enforce environmental laws.

[00:38:17] Jack Lewin: Next, I think that for industry who's really upset about this balance, that's what you brought up just, industry, you know, industry may, you know, needs to be held accountable with the threat of lawsuit if they don't follow the laws. But then we ought to offer industry the presumption of innocence instead of the presumption of guilt for everything they do, reduce the red tape and let industry move ahead. If they if they violate the law, then industry is going to get busted, but you know what, industry won't, they'll follow the law, you know, 19 times out of 20 and that other person we need the attorneys to make sure that we get that straight. That will move development ahead, make Hawaii business-friendly and keep our environment pristine.

[00:38:55] Jack Lewin: Finally, I think pollution prevention is a big big issue and that means conservation of water, conservation of of fossil fuels, reduction of fossil fuels, recycling. I mean, it's a it's pathetic how how slow this state is to recycling given our fragile environment, and and real importantly, source reduction. Don't bring hazardous materials into the state in the first place, unless absolutely necessary. And if you if we do bring them in, we need to have the safe disposal factored into the cost when we bring them in. Just, what do you think?

[00:39:27] Caller: Oh, well, I wanted to find out about some specific issues, like, why aren't we growing sugar for ethanol right now and making that happen. I mean, there's a company all ready to go over here on the Big Island, but the big sugar guys just want to convert their land into money.

[00:39:50] Jack Lewin: Well, let's ask Jack, what are a couple specific steps that that you would be interested in taking or supporting that could lead to a more protected environment? Okay. Well, I think I think that in terms of, you know, energy conservation, is is a is in a just a large-scale issue is a huge one that we need to employ. We're talking about bringing more fossil fuels in, building more power plants, building more more intrusive power plants and and frankly, we haven't done very much at all to reduce the the energy consumption. There's so much we could do in energy consumption. We could probably come up with 20% or 30% efficiency and that would prevent all the growth that's planned in the future that's going to threaten our ecosystem.

[00:40:31] Jack Lewin: So that's very important. And I mentioned recycling and source reduction and so forth. In in terms of your question with sugarcane, um, you know, it's not just it's not just uh ethanol fuel that could come from cane. The possibility even exists of creating hydrogen fuel with with biomass and there's a there's a company in the Maui high-tech park over there that's working on that and that is really exciting. They're going they're talking about using biological agents that would metabolize um cane and produce hydrogen instead of methane. Um, you know, bacteria that would fix the that would create hydrogen as a as a gas. That kind of research, that along with ethanol and whatever else is there, um is needed.

[00:41:12] Jack Lewin: I mean, it's great that we're using bagasse for 30% of our fuel and some of the neighbor islands, but um still pollutes. It still pollutes and it's still tough and and but we don't want crops of condos and just open uh soil erosion either. So it's we're talking very tough stuff. Uh, I'm I think maybe investing some time and energy into exploring the the alternatives is the way we ought to go. Thank you, Jack.

[00:41:34] Caller: All right. Thank you.

[00:41:36] Jack Lewin: We have Barbara in Nuuanu on the line. Barbara.

[00:41:39] Caller: Hi. I'd like to know what what kind of uh, breaks uh small business are going to get. I mean, the all this government red tape is just too much.

[00:41:49] Jack Lewin: Well, you know, um, Barbara, let's, let me just put it this way. I think that small business is my wife's a small business person. I used to be a small business person when I ran my family practice in in Maui. I I think that small businesses would first benefit from red tape being heavily reduced. We've become a business unfriendly state over the years with a lot of good intentions and regulations, but we we started protecting uh the some some businesses at the at the expense of others. Removing the presumption of innocence with with the threat of action if people break the law, taking the the regulations off, number one is important. Secondly, getting healthcare costs leveled off in our state, and keeping small business um, contributions at a level they can afford.

[00:42:36] Jack Lewin: And third, fixing workers' comp, folding the health benefits of workers' comp into traditional health benefits, finding better ways to utilization control the existing and and get those costs down are probably three big things I'd like to do right off the bat for business.

[00:42:50] Caller: What about government helping uh, helping small business with some loans and things like that?

[00:42:55] Jack Lewin: Well, I think that technical assistance is also a great idea. Again, that's the presumption of innocence instead of presumption of guilt for business. Why not get out and offer business some advice as to how to handle the problems [unintelligible — audio glitch] are in front of them rather than wait until uh to come in and find them or tell them no later. I think loans for small business, great idea. We need to invest to look carefully together, though, at what areas of investment um, we want to put our precious um, public dollars toward. But, but certainly, strengthening some aspects of tourism and some aspects of small business that have wellness, for example, it has a real chance of catching on, or ecotourism, these things would make a lot of sense.

[00:43:36] Caller: Okay.

[00:43:37] Jack Lewin: Thank you, Barbara.

[00:43:37] Caller: Thank you.

[00:43:38] Jack Lewin: In case you joined us late, you're listening to the Price of Paradise Radio Show. I'm Randy Roth, and my guest is Dr. John Lewin, Director of Health here in Hawaii, and a possible candidate for governor. He's here for the specific purpose of answering your questions and your calls are welcome at 955-8821. Neighbor Islanders may call, collect, and again the number is 955-8821. Well, Jack, we have a question from Thomas in, let's see, it's Honolulu. Says virtually every state in the Union today is creative and aggressive in seeking to attract new technology businesses, all except Hawaii. Are you prepared to lead the way to making a real difference? I think it's a great question. Uh, we talk we always talk about diversifying jobs and yet uh and and yet we do very little.

[00:44:26] Jack Lewin: And that's because we, again, we wander into the future. We have not invested in that. When when you look at what happened in California and Stanford around Stanford, around Irvine, around UC San Diego and the UC campuses, the state invested in a future. It built a university infrastructure, it then invested in some other facet of of the infrastructure to bring businesses like magnets to that location. Um, we could do the exact same thing here. Just just medical research. We could be the medical research center of Asia and the Pacific for cancer research and new therapy, for infectious disease research and new therapy for our own people. We could be doing all that, we could be providing cures and education and training and outreach and that kind of high technology, pharmaceutical R&D.

[00:45:13] Jack Lewin: The new drugs and and new medical breakthroughs. There's $20 billion of of new development in Asia and in the West Coast of America. If we just tapped into three or 4% of that, we'd have a massive industry that would be our third or fourth biggest industry. But to do it, we need to invest in in the medical infrastructure, the medical school, the research base and then we've got to make land available without all the barriers we have to bring these folks in if we want to do it. We maybe ought to let people have very low-cost land leases for that kind of business in exchange for hiring locally high-tech and science jobs. Phone lines are open, the number is 955-8821.

[00:45:56] Jack Lewin: We have a call, Michael from Waipahu. Michael, you're on the air.

[00:45:59] Caller: Hi, Dr. Lewin. Uh, I just have a question on, um, I'm a resident of Village Park and um we're having a problem out there with uh large power lines being built in our community. And the community was pretty strong in our words, you know, that we did not want this to happen up there. But uh as it's turning out, it looks like the Hawaiian Electric's going to get their way. I just like your view on, um, on this situation.

[00:46:26] Jack Lewin: Michael, I'm I'm familiar with the situation and I do think that you folks have one legitimate issue and that there are other communities in the state in which these power lines are at their community's request being buried or or somehow diverted away from the community area. And it appears that you you didn't have that clout in Waipahu. Uh and you know, I don't know why that is, but I will say this, that the the medical research on power lines is not really in. I worry about it, I I wonder about it, that Sweden study that came out implies that there was there were more leukemia cases among kids who lived in close proximity to power lines.

[00:47:02] Jack Lewin: It was a very big study, the whole nation. And I think we ought to presume that that we don't want to, if we can avoid that kind of thing, a prudent avoidance would make sense. And therefore keeping power lines away from residential areas and schools would be smart. But at the same time, a lot of scientists are going to say, and they're right, that we don't know the answers, there's conflicting information. My my sense is, you folks as a community, um, your organization, um, really has merit and I think that maybe you can turn this around. I I don't think we're going to go back later and bury all the lines that get built. But but I do believe that in the future, prudent avoidance would make sense.

[00:47:42] Jack Lewin: Are these lines already up?

[00:47:44] Caller: Well, no, but they're already said that Hawaiian Electric is going to go ahead with the plan. It's been approved by, uh, I guess the utility commission.

[00:47:52] Jack Lewin: Well, my sense is that the community ought to at least make sure that all the alternatives have been explored before that happens because prudent avoidance makes sense and I'm not trying to be alarmist. It may turn out in five years that we find that there's there's really no scientific evidence of concern.

[00:48:06] Caller: But the have to look at the aesthetics too. It's just, you know, we've got a great view up there and all of a sudden, we're going to have these 100 foot power lines, you know, to look out into our view, you know, the ocean.

[00:48:18] Jack Lewin: Hey, I agree with you on that 100%. I think it's worth it to bury power lines. I mean, I was on when I went to Kauai after Aniki and I saw them repot we I saw us all when we had the potential for federal money to bury the at least the main power lines and instead putting back the poles, I thought, are we crazy? You know, I mean, if we can any chance we can to bury power lines just to keep the vistas and the openness of Hawaii there, we ought to do it. I fully agree with that.

[00:48:43] Caller: Right, I there was some, um, friends came from the mainland and we went down Cam Highway and she said, I don't believe these power lines, you know?

[00:48:51] Jack Lewin: Yeah. I I see that all the time and it it makes me cringe. Thanks a lot, Michael. We really appreciate your call.

[00:48:57] Caller: Sure, thanks. Bye.

[00:48:58] Jack Lewin: We have another question, this one is from Dick from Manoa. He asks, what plans do you have for affordable housing in Hawaii? Well Dick, I think that, um, one thing we've learned in the last few years and that is that that government, uh, is not real successful at building affordable housing itself. And and that our 60-40 rule, which was a great idea, and I I really thought that was going to work, hasn't worked anywhere near as well as we wanted in terms of having developers build 60% affordable housing in order [unintelligible — audio glitch] come up with a 40% um, expensive housing. What's happened is they're not building any housing uh in some areas because they can't can't get the buyers and sellers.

[00:49:39] Jack Lewin: I think that I guess for me, this is a tough one and there's no guru here, and I hear all kinds of different views on this. My the general things I can give you that I believe now are as follows. You know, government doesn't need to build housing. Um, government really ought to spend more time on infrastructure. I think in the Price of Paradise there was a compelling couple essays, one that said where where property taxes are low in Hawaii now and foreign investors are paying are getting by real real cheaply. We ought to raise property taxes in some way that doesn't hurt local residents, either by giving some kind of income tax deduction or something, um, or reduce just our income tax a few points and and lift property taxes to pick to to collect from foreign investors in Hawaii.

[00:50:24] Jack Lewin: And then divert that money to to the county governments to build infrastructure. Just building infrastructure in the right areas and in some of the the poor ag land and so forth is is going to be a way to foster new housing and the marketplace will take care of itself if we do that. Okay, uh, you're listening to the Price of Paradise Radio Show. I'm Randy Roth, and my guest is Dr. John Lewin, Director of Health here in Hawaii, and a possible candidate for governor. He's here for the specific purpose of answering your questions and your calls are welcome, the number is 955-8821. We have a call from June in Kani Ohe, June you're on the air.

[00:51:01] Caller: Yes, Dr. Lewin, I'm a senior citizen and I'm concerned about long-term care insurance. Um, what do you think? Uh, is it uh good likelihood that uh senior citizens can look forward to something like that soon?

[00:51:18] Jack Lewin: June, um, thanks for asking about that. I think that's very important and and I think that we do need to have universal long-term care coverage in some way. I think it needs to be competitive rather than a single-payer type solution where it's all one agency. But I believe that we can do that in Hawaii and we can afford to do it. Um, I I know we ought to start I've listened to small businesses' complaints about this and the chamber's complaints, and they point out that they'd be willing to go for an extension of long-term care services that includes daycare, community care, and home care, the things that are missing right now. If we could get that kind of care going immediately with a very small across-the-board shared um, expense to all of us, we'll save a whole lot of taxpayer dollars.

[00:52:04] Jack Lewin: This is a tough one, but for all those out there that don't feel we can afford it, we're paying for it right now, every year our taxes go up. So I think we've got to get a universal long-term care solution. One other point though, let's see what Clinton and the and the Congress does this year with national healthcare reform before we lock into our solution. Let's get as many federal dollars as we can in this process and then figure out what else we need to come up with and do it because keeping seniors out of institutions, which are expensive, that's our solution now. We ought to get away from that and move toward prevention and community-based long-term care for everybody.

[00:52:44] Jack Lewin: What do you think, June?

[00:52:45] Caller: Thank you, yes. I think that answered my question at this time. Thank you.

[00:52:50] Jack Lewin: Thank you for your question. I have another question, this one is from Mildred in Manoa. She says, would you support a constitutional amendment to ban gambling in this state? Well, I don't think we need a constitutional amendment, um, but I really don't think we need gambling. I think that people from Las Vegas who come to Hawaii, come here because we don't have gambling and I think a lot of people worldwide think that Hawaii is special because of the aina and the people and that's why most of us live here. And let's build on that special and protect that special part and let's fix things like traffic [unintelligible — audio glitch] overpopulation and congestion of buildings and let's move new development back from the coastline and make a park out of Hawaii, let's protect the oceans, let's open green spaces, let's protect our streams and make Hawaii the beautiful playground of the future that no place else can be.

[00:53:46] Jack Lewin: And frankly, we won't need gambling. Phone lines are open, the number is 955-8821. My guest is Dr. John Lewin, Director of Health for the state of Hawaii. We have a question from Akiva from Kailua. He says, what is your position on same-sex marriage? Well, you know, I I do think that for all the heterosexuals out there that are that are scared when this issue comes up, one thing ought to come up front and that is that, um, heterosexuality is not threatened. It's here it's here for the future and it's going to be the predominant choice of uh of of humanity. Um, I don't know though how people could would want to deny rights to a segment of our population uh for for their private behavior when it doesn't infringe on anybody else's rights.

[00:54:32] Jack Lewin: And in that sense, I think that gays definitely deserve the same civil rights as heterosexuals. And, um, the idea that domestic partnerships may do that is is what I'm leaning toward at the moment. Because churches currently will marry people of same sex in in some instances, and I think people have that option through a church of their choice. But I do believe that, at least in terms of civil rights, domestic partnerships is the minimum step our state should take, and and maybe that's the only step that's really needed. I'm here with Jack Lewin, a member of Governor Waihee's cabinet and a possible candidate for governor himself. Your calls are welcome, the number is 955-8821. Well, this question comes from Karen and Larry in Kailua.

[00:55:17] Jack Lewin: It says, by what process will you define, refine, and implement the citizens' preferred vision for the future of the state of Hawaii? Wow, Karen and Larry, that's that's a great question. How are you going to get the citizenry involved in this? I guess I really believe that we need to create a, um, instead of the existing community association approach, we need to have something like neighborhood or town hall or community governments form again, and we need to have those formed by by virtue of people getting elected. Decentralizing big government to some community-based type arrangement, and SCBM in schools is is an attempt to get there. Decentralizing community hospitals, community mental health center services, purchase of services to communities, all that is really going to be involved.

[00:56:10] Jack Lewin: But you know, Karen and Larry, even in in my my own agency, the Health Department, nurses get up in in Hawaii Kai and drive to Ewa to be the public health nurse and another one gets up in Waimana and drives to Ewa to be the school health nurse. If we could give the community some of that control back, they could hire nurses who live in their community, go to their PTO meetings, actually get involved in churches and and community associations and groups, and really create a sense of community again. I don't want to go to any more community association meetings where we have no power and whatever we do is just a matter of quote input.

[00:56:45] Jack Lewin: I don't like input anymore. Let's participate in government. I think we need to create new units of government at the local level and then government itself needs to recognize that Hawaii's strength comes from communities, not from central. government. We have another question. This one this one from Peter in Manoa. He says, please name your three closest political advisors, your three largest contributors, oh my, this is quite a question, and the three people you would most like to appoint to cabinet positions if they would accept. Well, I'm not sure you can answer all of those, but uh anything about your political advisors or people you would appoint to the cabinet or contributors that you can be specific about.

[00:57:29] Randall Roth: Well, you know, as far as political advisors go, um who are they? Um gee, you know, I I'd have to say that there's there's many, many people that are that are the key political advisors. I don't have like a guru that is a political advisor. If there's anybody that's a real advisor to me, it's my wife Sandy, and and she has been part of the process to you know, for me since since I came here as director of health in terms of just talking over issues and and thinking together as to what might work better and I think that that's true of my kids. But the people that I use as my advisors right now, um are are the team of people I brought together at the Department of Health.

[00:58:07] Randall Roth: Um there's a there's about there's really maybe 30 or 40 people that have been appointed that most radical changes can happen in government, frankly, by virtue of bringing people into new positions or moving them around, giving new blood a chance to try new ideas. And I get most of my ideas from my from my team right there. The rest of what I've gotten as as the the kind of message I'm giving you today comes from from going out to meetings and communities and just talking to people and hearing them in some cases, tear down and bash the the uh government structure even the one in which I work. So I don't have three names of people. I haven't even declared myself as a candidate for governor.

[00:58:51] Jack Lewin: Do you have any contributors yet or does that come after a declaration?

[00:58:54] Randall Roth: You know, I don't I don't have any contributors to a campaign, but there is a group of people that numbers about 200 called People for a Healthy Hawaii. Um and there's a gentleman by the name of uh of Mike Middlesworth who is the treasurer of that group and he could tell you because they have been collecting money and their their purpose is to draft me as a candidate, democratic candidate for governor. Uh so they have been collecting money from people um who wish to donate to this cause. And and I've only recently even met with the group to talk to them and to explore with them. And what I told them is, I need a couple of weeks to go really out in the community and just hear from people and feel in my heart whether it's right. I'm not worried about the risk and I really believe in the Democratic Party and I'd like to whatever I do isn't going to divide people. It's going to be supportive of the of the party but also supportive of bringing outsiders in.

[00:59:46] Jack Lewin: We have a caller, Janette from Hickam. Janette, you're on the air.

[00:59:50] Caller: Hi, yes. Um my nephew got a uh piercing and I was wondering if the piercing people have to have licenses.

[00:59:59] Randall Roth: You know, I'm not really sure where that is right now. Um they should [unintelligible — audio glitch] are supposed to have some kind of I think DCCA, Department of Commerce and Consumer Affairs, has some kind of license. But the reason they should, Janette, is because dirty needles can spread hepatitis B and AIDS. And so, therefore, this is uh you know, it does have to be, it is a sanitation issue. So either my sanitation folks or somebody in Department of Commerce and Consumer Affairs um does that, but you know, frankly, I don't know. I know somebody does watch over it.

[01:00:30] Caller: Okay, thank you.

[01:00:31] Jack Lewin: Thank you, Janette. We have another question. This one from Michael, let's see, Michael in Mililani. He says, do you favor more taxes, less taxes, or keeping taxes at current levels?

[01:00:45] Randall Roth: Uh Michael, you know, I do not favor more taxes and of course, you know, nobody does today because we're we're so pressed, you know, if if boom times are here, people don't worry about it. I guess that basically I think that taxes ought to be held at constant. Government ought to be reduced in size and therefore we have we'd have some money to create new programs like long-term care and transportation and education and the things that, and environmental protection, things that we need to do that we can't do, we we can do by contracting government and reallocating resources. But there are some places where I do think, and this may not be popular, but I just put it out there to you.

[01:01:24] Randall Roth: I think we probably ought to put, you know, gain some more resources. And that's from user taxes. In other words, for substance abuse treatment services, we need more. Let's get all of us that that socially drink to chip in a little bit in the purchase of alcohol to pay for treatment of alcohol. Um just like we're trying to do with cigarette taxes and and smoking cessation. And I think that pollution taxes, for [unintelligible — audio glitch] you put taxes out for polluting and discharging into waters and into air and into the environment, then you provide incentive for industry to convert to more environmentally sound approaches.

[01:01:57] Caller: Those kind [unintelligible — audio glitch] taxes there are maybe some room for in the future, but with this caveat, if we are collecting like that, then we ought to put the money directly back toward the purpose for which the tax was collected, not just off somewhere else willy-nilly.

[01:02:13] Randall Roth: Uh otherwise, I think taxes need to go down and government needs to shrink for resources. Finally, you know, if we can build the economy small business up, we'll have more resources at the current tax levels to do the things we need to do.

[01:02:26] Jack Lewin: I've got one last question and and if you simply don't have the time to answer it, then don't even try because we've only got about 30 seconds. But Philip from West Maui just called and asked what's your position on medical use of marijuana and legalizing marijuana.

[01:02:40] Randall Roth: Well, medical use, I think [unintelligible — audio glitch] uh is I'm okay with. Um legalizing um I think it's very low on the social priority and if we if we ever get to it, we'll have solved the hundreds of social problems first um uh it's not a big issue for me.

[01:02:53] Jack Lewin: Well, we hope that you've enjoyed this special version of the Price of Paradise Radio Show and that you'll tune in our regular program each Saturday morning at 9:00 on this station or Sunday morning at 8:00 on KHPR 88.1 and KKUA 90.7.

[01:03:03] Randall Roth: Sunday morning at 8:00 on KHPR 88.1 and KKUA 90.7. The producer of today's program was Susie Roth with help from Shelly Dosani and technical assistance from Jeff Ilarte. I want to thank my guest today, Dr. John Luen for sharing his time and thoughts with us. Jack, good luck in whatever it is that you do decide to do.

[01:03:22] Dr. John Luen: Thank you, Randy.

[01:03:23] Randall Roth: You've been listening to the Price of Paradise radio show. I'm Randy Roth, Aloha.