We cannot just keep on developing

Development at Lipoa Point? A new community in Olowalu? We will soon rival Honolulu for the distinction of the worst traffic in the country.

The Lahaina Bypass will benefit Lahaina Town proper – if they don’t screw up the signage and add traffic lights – but it won’t do anything for areas north and south. Traffic to and from the other side will get worse.

The decision to add thousands of condos and timeshares from Kaanapali north was the first slap in the face to those who want to protect West Maui. And now this?

I know I’m spitting in the wind – just looking at Lahaina’s growth over the last 15 years tells me that. It will come regardless of how much we gripe and point out the obvious.

We have no one on the County Council or in government who will stand up and do anything about anything.

If these developments go in – and I’m sure they will – then as absurd as it might sound, we need a good road west from Lipoa Point to Wailuku, and we need our own Wilson Tunnel through the West Maui Mountains to Wailuku. Yes, it would cost millions, but it would have the least impact on native lands and archeological sites.

We simply cannot keep developing! This isn’t rocket science, and everyone in and around Lahaina – except those that will make a buck, or a million – sees it, except our politicians and “leaders.”

Maybe the Lahaina Restoration Foundation, Maui Chamber of Commerce and others with any influence could step up – and speak up – as well.

Seriously… it isn’t rocket science to see where this is going. Waikiki, here we come…

BUTCH FOWLER, Lahaina

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Affordable Care Act not so affordable

The Congressional Budget Office just announced that President Obama’s healthcare law will reduce the deficit by $84 billion more than previously thought, thanks to the Supreme Court’s decision to allow states to opt out of the law’s Medicaid expansion.

Those savings may sound nice. But the law doesn’t do much to address our country’s chief healthcare challenge: spiraling costs. Health insurance is expensive because health care is expensive.

The cost of insurance continues to rise faster than inflation. Average individual premiums rose by 8 percent in 2011, according to the Kaiser Family Foundation. Family premiums rose by 9 percent.

The Affordable Care Act will make insurance more expensive. The law levies new taxes on insurers, medical-device firms and drug-makers that will inevitably be passed along to consumers as higher prices.

New federal mandates are also driving up the cost of coverage. Policies must cover all sorts of medical procedures, whether patients want them or not. The law also limits out-of-pocket spending and annual deductibles.

The law contains several attempts to rein in costs. But most are unlikely to work as intended.

A prime example is the individual mandate that requires every American to obtain insurance. The mandate has no teeth. The penalty for going without coverage is a lot smaller than the cost of an average insurance policy.

According to the government’s Medical Expenditure Panel Survey, annual individual premiums averaged $4,940 in 2010. Assuming premiums increase at the historical rate of 6 percent per year, the maximum $695 mandate fee will account for just 10 percent of an average premium.

So instead of spreading costs across a wider pool, people may pay the fine and wait to buy coverage when they need it. Consequently, those with insurance will gradually become sicker and more costly to insure. As prices for coverage go up, the fine will look more and more attractive. Through this repeating process of adverse selection, health insurance premiums will rise significantly.

Medicare’s reimbursement rates for healthcare providers are also driving health costs up.

Spending in the program is projected to reach $1 trillion by 2022. It will be insolvent by 2024. As more Americans enroll and Medicare’s expenses grow, the primary tool for controlling costs will be reductions in payments to medical providers. The Affordable Care Act will likely slash them by about $575 billion.

Providers are concerned about these reductions. Today, physicians treating Medicare beneficiaries receive just 81 percent of the rate that private insurers pay. According to one survey, physicians’ top concern is whether they’d be adequately reimbursed by Medicare in the future.

These worries have caused some doctors to stop seeing Medicare patients.

Seniors won’t be the only ones who suffer. Doctors who swallow lower Medicare reimbursements may have to take on additional patients, slash visit times or raise prices for those with private insurance. And with America’s population aging quickly, doctors’ patterns of practice in Medicare are likely to spill over to their larger patient pool.

It doesn’t have to be this way. There are several easy ways to alleviate the cost problems plaguing our healthcare system.

Insurance brokers have a critical moneysaving role to play as the healthcare law is implemented. Many individuals and small businesses struggle to find affordable coverage on their own. The market is only growing more complicated.

A broker’s expert counsel can therefore be invaluable. No less an authority than the Congressional Budget Office reports that brokers generate substantial savings for small businesses by finding plans and negotiating premiums.

Demonstration projects that change the way Medicare reimburses providers should also be quickly advanced into actual use.

Take bundled payments, which link payments for the multiple services patients receive during a single episode of care. This coordinated payment structure provides incentives to deliver healthcare services more efficiently.

Value-based purchasing represents another way to reduce costs. This approach rewards efficiency – and punishes inefficiency and waste – by holding providers accountable for the quality and the cost of care that they deliver.

The healthcare law’s efforts to improve access to insurance are admirable, but they will be wasted if coverage remains unaffordable. Addressing the system’s cost drivers is crucial to preventing that unfortunate outcome.

JANET TRAUTWEIN, National Association of Health Underwriters

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Speed limit too slow on Kula Highway

Once again, Hawaii government proves Mrs. Gump right! The state Department of Transportation is resurfacing Kula Highway. Unfortunately, they are also reducing the already ridiculously low speed limits from predominantly 45 to 35 mph and eliminating every passing area along the entire length of the highway!

Now this completely ignores the federal 85th percentile speed recommendation, which says that the safest speed limit for a given section of roadway is the speed at which 85 percent of the drivers travel. It’s about 50 mph on Kula Highway. I drive it twice a day. The lower speed limit also ignores the fact that the highway is the primary artery for cement trucks, 18-wheelers and other slow vehicles going Upcountry.

The problem with that, of course, is that by reducing entrance speed onto an incline, the speed to which the truck slows is reduced even more, thereby backing up more and more cars behind them. The truck drivers are usually pretty considerate and try to move to the right to allow backed-up cars to pass where passing is allowed. Unfortunately, the state Department of Transportation has eliminated all of the passing zones.

See! Mrs. Gump was right!

AL RABOLD, Kula

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Fight development at Olowalu

I attended the special County Council meeting yesterday and listened to seven speakers, who all spoke against the Olowalu Town project and its impact on our most important coral reef.

The meeting was listed as a discussion about the Maui General Plan, and the segment of that was listed as “…#125.” At the end of those speakers, the council voted to accept the committee report.

There will be a public hearing coming up, and I encourage as many people on the West Side that are able to attend to do so.

It is VERY important that we show force on this, because it is our keiki and moopuna and haumana that will burden the brunt of it.

I just made a rough estimate of the number of units included in the West Side growth boundaries. That number is nearly 7,000! That means, potentially, 14,000 more vehicles on our highway between Kapalua and Ukumehame. You think it is fun now?

Of course, we’ll need more infrastructure and highway space, but are you and I and our families supposed to pay for it?

Nothing in all the discussions has been said about how much the developers are going to chip in. I know they’ll be “laughing all the way to the bank,” because our “powers that be” have not laid down the rule that “they have to pay.” It’s not cheap. Fifty million dollars here, $100 million there, all adds up.

But the bottleneck will be the Pali. That is expected to cost many hundreds of millions.

We simply cannot allow all this development on the West Side until we can be sure that we can collect the impact fees from all these developers.

So, ladies and gentlemen of the West Side, get behind your council person and fight against all this development. You MUST start attending meetings, communicating with the entire council or whatever you can contribute to this major problem.

GORDON C. COCKETT, Lahaina

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Teachers hurting from pay situation

As a teacher, this Thanksgiving I have little to be thankful for. I’m thankful for my wife and child, and the fact that I have a roof over my head and generally good health.

As for everything else, I am NOT thankful that teachers don’t have a contract for two years now, I am NOT thankful that I must work three jobs to make ends meet, I am NOT thankful that the Department of Education has yet to pay me for attending a workshop in early October, and I am NOT thankful that, as a result of the other two, I must eat only rice and beans for Thanksgiving this year.

THOMAS FOLEY, Lahaina

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Loss of driver’s license tragic

It is a tragedy when a man loses his driver’s license. My wife, Sara, now drives me whenever I need to go places. I watch Sara stopping at a traffic light. She stops at too many lights. In fact, she is a boring driver. I was an exciting driver.

When we men get in my position, we don’t dare complain or criticize, or we will end up walking.

I feel like a pet dog sitting in the passenger seat – very emasculating.

The difference is that I don’t have a leash on my neck, so I am able to jump out.

I should encourage other men to rebel with me. But I don’t have a driver’s license. Maybe I could qualify for a dog license. Woof, woof!

ARSENE “BLACKIE” GADARIAN, Lahaina