Most homeless have options

Bill 54 is just what we need to help keep our public spaces open to all the public.

The homeless who might be affected have options.

The City and County of Honolulu does a monthly survey of shelter space available and it averages about 200 spaces each night. At the Institute for Human Services, for example, we average some 40 empty beds for men and 30 empty beds for women each evening, in addition to the hundreds of beds that we fill.

And although our family section is often full, if we cannot take a family in need of shelter, we work with other providers to find an appropriate accommodation. The state and city are working together with providers and the entire community to address homelessness.

We all need to separate fact from fiction. The fact is that virtually anyone living in our public spaces has other options and choices.

Jim Steiner
President, Institute for Human Services

Medical care hard to measure

Philip Foti is only partially correct in his criticism of quality improvement in health care ("‘Medical industry’ ran afoul when it adopted manufacturing ideas," Star-Advertiser, Island Voices, Dec. 27).

I agree that health care is far too complex to be appropriately or effectively managed by non-medical bureaucrats attempting to measure "outcomes" and impose "best practices," forcing doctors to fight the bureaucracy on behalf of their patients with complex and unique problems.

Less than a quarter of health care is amenable to valid quality measures anyhow, and at least a quarter of a typical primary care doctor’s practice involves patients rated as "complex."

Incentives based on measurement of outcomes drive doctors to avoid treating sicker, more complex patients. However, this does not mean quality improvement is futile. Real gains in quality and cost effectiveness have been achieved in programs led by physicians who appreciate the limitations in measurement of quality, while seeking improvement in care wherever possible.

Stephen Kemble
Makiki

Costs determine premium rates

Democrats believe that state health insurance exchanges will lower health care costs through competition.

Republicans believe that selling health insurance across state lines will lower health care costs through competition.

Both are wrong.

The market for health insurance is a separate and distinct market from the market for health care.

It is in the health care market that costs are rising, forcing health insurance premiums to go up.

As any businessperson knows, while competition may reduce prices, it cannot reduce the underlying costs that went into running the business, because the costs arise in different markets.

Only increased competition in health care could reduce health care costs.

Lloyd Lim
Makiki

Coqui frogs help limit mosquitos

As a resident of Puerto Rico, I was offended by your inaccurate article on coqui frogs ("Loss of inspectors aids influx of coqui on Oahu," Star-Advertiser, Dec. 25).

Yes, these animals are exotic to your island, but to label them a problem is an overstatement. I have never had anyone mention their song as irritating. It is rather birdlike, and in warmer temperatures they will sing from dusk until about 1 a.m., also during rain. I have not known them to sing continually through the night.

Puerto Rico is one of the few places on Earth with no abundance of mosquitos, particularly where coqui are abundant. Many tropical plants hold water. Coqui are in these mini pools to eat mosquito larvae.

Be happy we sent you one of nature’s delights. You may lose more pesky insects because of them, and their natural lullaby will soothe and put to sleep true lovers of nature.

Richard A. Vlasic
Maricao, Puerto Rico

Chow could put UH in top 20

A few years ago, an ESPN football analyst said if all the top high school football athletes stayed home and played for their Hawaii Warriors football team each year, Hawaii would be ranked in the top 20.

Unfortunately, just about every year, these kids select mainland schools instead of playing for the Warriors.

Norm Chow, in his introduction as the new football head coach, said, "For years, I’ve come here to recruit and I’ve been telling all these young kids to leave home. No more. We’re going to tell them to stay home and make us proud."

With Norm Chow at the helm and the Hawaii football team taking another step forward by entering the Mountain West Conference for the first time, the Warriors might be ranked among the top 20 football teams in the nation.

Melvin Partido
Pearl City

Leash law seems to favor hunters

A group of unleashed pig hunter’s dogs attacked and nearly killed a hiker’s dog, who was also off leash.

Now the state Department of Land and Natural Resources steps in to post signs reminding hikers that their dogs must comply with the law and be leashed — but this same law does not apply to hunting dogs.

If I am out hiking, am I more likely to be attacked by a gentle golden retriever running up the hillside with his owner, or a vicious dog trained to kill? If a young child had been hiking that fateful day with his parents, would he have been attacked?

Once again we have a law on the books in Hawaii that penalizes the innocent law-abiding citizens and allows the minority to do business as usual. Thousands of people hike daily in Hawaii. How many pigs are caught annually?

Lane Woodall
Hawaii Kai

Isle hotels could help collect food

There are millions of visitors who come and go year after year and they buy a lot of food, which at the end of their stay is discarded.

The food could probably be saved and turned in to the hotel front desk and given to a charity, such as a food bank, the Red Cross, Salvation Army and other like organizations.

Hotels could let their guests know that they can leave at the front desk non-perishable canned or packaged food that could be passed on to a charity for distribution to people in need of food. Think of how many people could be fed with all this food that would otherwise be discarded. Not just in Hawaii, but all over the world.

Henry P. Kahula Jr.
Paia, Maui