2020-02-10 Letter to Rosalyn Baker and Stanley Chang SB 2542 Relating to General Excise Tax Exemptions

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; IF ' SYOi H,w•• Roy Takemoto c.o•• ��'•. lanaging Director Harry Kim +'A!� /, :•• Barbara J. Kossow �rE•oF•N�a►!' Deputy Managing Director County of Hawai i Office of the Mayor 25 Aupuni Street, Suite 2603 • Hilo, Hawaii 96720 • (808)961-8211 • Fax(808)961-6553 KONA: 74-5044 Ane Keohokalole Hwy., Bldg C • Kailua-Kona, Hawaii 96740 (808)323-4444 • Fax(808)323-4440 February 10, 2020 Senator Rosalyn Baker, Chair Senator Stanley Chang, Vice Chair Committee on Commerce, Consumer Protection and Health Dear Chair Baker, Vice Chair Chang, and Committee Members: RE: SB 2542 Relating to the General Excise Tax Exemptions Thank you for this opportunity to testify again on a crucial issue facing our State. "Making Hawaii a nice place to live" is simple to say, and almost too obvious a goal to highlight, but nevertheless that phrase sums up the most important task facing our elected community leaders. For this reason alone, I want to thank and praise any effort to deal with one of the most critical issues that we must confront, and that is the crisis in our healthcare system caused by our healthcare provider shortage. We are justly proud of the Hawai'i Prepaid Healthcare Act, but how valuable is insurance if you cannot find a provider? How can we expect our people, especially our aging population, to live comfortably, if they believe that quality healthcare is only available if they have the time and ability to travel to the mainland? How can we attract more providers when they realize that they will be expected to work extraordinary hours because there is not a reasonable number of other providers to share the burden? And the ramifications are important, too. To what extent do we limit our primary economic driver, tourism, when visitors are warned "Don't get sick in Hawaii"? I am not smart enough to know how to entirely solve our provider shortage. However, I am told, and do believe, that eliminating the General Excise Tax on healthcare services would be a very positive step in improving the economics for healthcare providers, thereby encouraging existing providers to stay in practice and enticing new providers to join us. When I testified before your committee in favor of SB 2327, I noted that I try to use the word "provider" because, in truth, our healthcare crisis goes beyond our physician shortage. For that reason, SB 2542 is the preferred approach if it is not too expensive, because it would create a general excise tax exemption for medical services provided both by physicians and by advanced practice registered nurses acting in the capacity of primary care provider. It seems to me that broadening the exemption to APRNs is a sensible way to go, if the State is able to absorb the initial additional loss of revenue ("initial" because most or all of the loss would be offset as the higher earnings of the APRNs are spent and circulate through the community, generating new tax revenue). Please pass SB 2542 and thank you again for addressing our healthcare dilemma. Respectfully Submitted, -i— Harry Kim MAYOR County of Hawaii is an Equal Opportunity Provider and Employer.