Hawaii needs a tax to fund education

Aloha members of the Hawaii State Senate. With the recent Hawaii Supreme Court decision invalidating the constitutional amendment, it is our understanding that the court has sent this question to the Hawaii Senate for consideration.

We write you today to consider a fair, and needed, Hawaii Educational Property Tax levy to all property owners in Hawaii. While there are many educational needs here, we believe at the top of the list is student housing for our post-secondary system in Hawaii’s outer islands.

My college dorm experience was in a small Wyoming college, where in 1980 I met then-Maui resident Ken Miranda, who now owns a fence company in Upcountry Maui. Ken was enrolled in the Ranch and Equestrian Studies program there. Lifetime friends now from a world away.

College student housing had a great impact on my experience there in Wyoming, being from Minnesota. The experience brought great ideas and people into my life – diversity, with a greater understanding of others, in a place of education.

Hawaii needs post-secondary housing for our students – living in a community with others – as well as in a place where housing falls short.

With this, our enrollment numbers and retention would increase, making our island’s community strong.

LEO THINER-BRICKEY, Honokowai

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Americans must stand up to President Trump

Donald Trump is an embarrassment as president. Did you see the televised encounter in the Oval Office?

It’s the Trump wall again – his great big beautiful wall – and if he doesn’t get it, he will shut down the government. It’s the Republican way. How can one angry Republican despot shut down the U.S. government and deprive 330 million Americans of a happy holiday?

Americans must stand up to this petty thug! And actually Trump cannot shut down the government without Republican politicians’ help. He continues to play to his Republican religious base. What happened to, “I will be president for all Americans?”

Let’s hope Donald Trump is just bluffing as usual. The man is a megalomaniac.

RON LOWE, Santa Monica, CA

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How to lower surgery costs

Imagine going to the grocery store, picking up the items you need for the week, but not knowing how much anything costs until the store sends you a bill two weeks later.

Sadly, that’s how our healthcare system works every day.

Healthcare costs now represent one in every five dollars spent in our country. Patients’ deductibles and co-pays are rising. Prescription drugs are often unaffordable for many Americans.

We must do something about rising costs, and one key is to empower patients with the information they need to drive costs down and quality up by making the healthcare system compete for their business.

That’s why Medicare recently launched a new online tool that allows consumers to compare Medicare payments and patient co-payments for certain surgical procedures that are performed in both hospital outpatient departments and ambulatory surgical centers.

The Procedure Price Lookup tool displays national averages for the amount Medicare pays the hospital or ambulatory surgical center. It also shows the national average co-payment amount a beneficiary with no Medicare supplemental insurance would pay the provider.

Working with their doctors, people with Medicare can use the Procedure Price Lookup to consider potential cost differences when choosing among safe and clinically appropriate settings to get the care that best meets their needs. And cost differences can be substantial.

The lookup tool is needed because the law requires Medicare to maintain separate payment systems for different types of healthcare providers. That means Medicare pays sharply different amounts for the same service, depending on the locale of the care. It also means that people with Medicare pay different co-pays for the same service, depending on where it’s delivered.

Unfortunately, this is a prime example of Medicare’s misaligned financial incentives, under which providers can make more money if they treat patients at one location as opposed to another.

Here’s an example: a Medicare beneficiary needs knee surgery, and her surgeon offers her the choice to have the surgery in the local hospital’s outpatient department or at an independent surgery center. With the Procedure Price Lookup tool, the beneficiary can type in the type of surgery and see an estimate of the difference in out-of-pocket costs between the two settings.

It would take an act of Congress to change Medicare’s payment systems. In the meantime, patients have the right to at least know what they will be charged. The Procedure Price Lookup makes that information easy to access.

Procedure Price Lookup is part of our eMedicare initiative and joins other patient-oriented transparency tools, including an overhauled version of our drug pricing and spending dashboards. These new tools provide patients with Medicare and Medicaid spending information for thousands more drugs than ever before and, for the first time, list the prescription drug manufacturers that were responsible for price increases.

We launched the eMedicare initiative to empower beneficiaries with cost and quality information. eMedicare also offers a mobile-optimized out-of-pocket cost calculator to provide beneficiaries with information on overall health plan costs and prescription drug costs.

The case for price transparency throughout the healthcare system is clear. The need for consumers to comparison-shop is growing as high-deductible plans become the norm. We also need to integrate quality information with price transparency, so consumers are empowered to seek out high-value care among providers competing on both cost and quality.

GREG DILL, Medicare’s Regional Administrator for Hawaii