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Mayor should expect
howls over fee hikes

THE ISSUE Mayor Hannemann has said the city may have to raise fees and impose more of them to keep the city going.

WHILE state lawmakers and Governor Lingle are talking tax cuts, Mayor Hannemann is facing the grim reality of running the city on a tight budget.

Hannemann, a little more than a month into his first term, knew going in that he was inheriting a host of deferred fiscal problems, but he appears to be willing to take the heat if raising fees and imposing new ones on services are necessary to pay the bills.

Honolulu residents, who have seen their property taxes shoot up, may not be pleased with the mayor's initial assessment of the city's books, but should be willing to hear out his proposals.

In a PBS-Hawaii program to be aired today, Hannemann said he is preparing to deal with a "fiscal crisis" as the city faces a deteriorating sewer system that invariably springs leaks during heavy rain storms, pot-holed roadways, unkempt parks and gridlocked traffic, among other problems.

He is considering charging people for park use and increasing sewer fees, but won't have any specifics until a review of the city's finances is complete.

The mayor can expect soccer clubs, Little League and other recreational organizations to resist paying for facilities that they now use for free. He can expect that homeowners will be upset if property taxes continue to climb with no relief. He can expect that residents will protest charges for trash pick-up. If the Legislature grants counties the power to create a new tax or bump up the general excise tax to pay for traffic solutions, Hannemann can anticipate howls from every quarter.

No one wants to give government another slice of a paycheck, but everyone wants smooth streets, clean parks, sewer systems that don't dump raw sewage into the ocean and efficient transportation.

Whatever initiatives he chooses, Hannemann's biggest challenge will be to persuade taxpayers that the money will be well spent. Stay tuned.

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Caps are no easy fix
to malpractice suits

THE ISSUE The state Legislature is considering a proposal to cap non-economic damages in medical malpractice claims.

HAWAII doctors say soaring medical malpractice insurance rates and costly lawsuits are fracturing their practices. President Bush is asking Congress to adopt malpractice insurance rates modeled after a California law, and physicians are asking the same of the Hawaii Legislature. However, rate caps are not an easy remedy, and other measures may be more effective.

If frivolous lawsuits are to blame, Hawaii legislators may want to look to Maryland, which requires that plaintiffs find an expert to certify that a physician violated standards of care before filing a lawsuit. Hawaii's Medical Claims Conciliation Panel reviews complaints and identifies meritless cases but lacks the power to prevent lawsuits. Governor Lingle has proposed that a panel of lawyers and doctors play such a role.

Physicians and lawyers agree on one thing: Hawaii's current $375,000 limit on awards for physical pain and suffering is a farce. Malpractice attorneys merely ask juries to award larger amounts in compensation for such afflictions as mental anguish, disfigurement and loss of enjoyment of life.

They disagree about whether California's $250,000 cap on awards for all non-economic damages has worked. Dr. Jack Lewin, former Hawaii health director and now head of the California Medical Association, told Hawaii legislators that the lid "has been a major part of keeping malpractice rates stable in California for 20 years."

Lawyers maintain that California malpractice rates rose six-fold in the 13 years following enactment of the award cap in 1975. They say insurance rates stabilized after a 1988 proposition rolled back casualty insurance rates and required the state insurance commissioner's approval for any increases.

For whichever reason, Farmers Insurance Group dropped medical malpractice coverage in 2003, even though one-third of its premiums were derived from California. It also provided coverage in 17 other states, including Hawaii, where it had one-fourth of the market.