And now, another tale well-calculated to keep you in... Suspense. Bill Voyage, written for suspense by Murray Burnett. I looked at my watch. It was 6.16 in the Friday evening. I knew I had exactly 17 minutes before Hank Wilson, the night watchman of the bank, would be somewhere near the front door. I took a quick look around the office, turned the name plate, which said, Alec Thompson, face down on my desk, and closed the ledger on the garrison estate for the last time. Then I opened the box containing my new sports jacket, took out the jacket, opened the right-hand drawer of my desk, and proceeded to fill the box with bundles of crisp, new banknotes, totaling $200,000. I packed them neatly in the box, getting a tremendous surge of satisfaction, as each bundle slipped into place. Each bundle represented a neat withdrawal from the garrison estate, which I was handling for the Intercity Guarantee and Trust Company. A withdrawal which would take them a few months to unravel when I didn't return for my two-week vacation. I carefully tied the twine around the suit box, exactly as it had been tied. As I put on the exceptionally loud sports jacket, which the box had contained, I glanced again at my watch, plenty of time. I walked over to the closet door, opened it, and looked at myself in the mirror. I know it was foolish, but I couldn't resist patting myself on the back. The jacket covered my business suit jacket perfectly. No one could see that I was wearing a jacket over a jacket. And then, satisfied that I had left no loose ends, I closed the closet door, turned, walked to my office door, opened it, and started down the long corridor leading to the street and escaped for me with $200,000. I looked at my watch again. It was $6.29. I was four minutes early, but Hank would be with an earshot. I decided I couldn't wait. Hank! As I heard him start down the corridor toward me, his footsteps kept tying with my heart. I had staked everything on my knowledge of Hank Wilson and his habits. Oh, he was supposed to look in the box, had I carried under my arm. Do you work in, Mr. Thompson? All through, Hank. You're all set for your vacation. You're on the same place you did last year, up at the lake. Same place? Wife and kid, too. Oh, they're already up there. I think after five years, I'd be able to put my hand on the right key fast, wouldn't you? You see, you're in sort of a hurry, too. Oh, that's all right, Hank. I've got time. Look, Mr. Thompson, you can't kid me. What do you mean? I've been around here too long not to know exactly what goes on. I know how anxious you are to get out of this place and up to the lake. Well, Hank, I guess I've got to admit that you're right. I found it. Hey, just a minute. Yes? Yes. What you got it? Oh, and this? Well, it could be $200,000. Maybe a million. Yes, it could be. Well, you know the rule. Oh, yes, yes, yes, I know them. You're supposed to examine every package going out of there. That's my job. Bet I've seen your old jacket often enough. You're looking at that new one. You're wearing blinds of me. Oh, you still don't approve? Look, everybody to his own taste, I always say. But that sure is a wild jacket for you, Mr. Thompson. Well, I'll open it if you want. Let you take a peek at my other jacket. Oh, you know, I was just kidding. You're okay, Mr. Thompson. Oh, whatever you say. Like I said before, I've been around here too long not to know just what goes on.  Oh, don't think I don't know it. Bill's a stickler for all the rules. I don't have to tell you. You know how Bill is. Yes, yes, I know just how he is. Well, so long, Mr. Thompson. Have yourself a real good vacation. Well, thank you, Hank. I'm sure I will now. I walked into the night with a box containing $200,000 under my arm. I looked in my watch, 6.33, 20 of time, 11 minutes to my apartment in a cab, 10 minutes more to clean up the apartment, pick up my luggage, transfer the money to a special case I had made for it, and even with traffic, not more than 27 minutes to the dock and the steamship Concordia, which was waiting to take me to a brand new and wonderful life. Attention, please. All ashore that's going ashore. I looked out over the scene from the very topmost deck of the Concordia, liking everything I saw, thinking that in a very few minutes the city would be lost to view in the little wisps of fog that were already beginning to curl about the deck. And as I looked, Celia came walking down the deck. And as always, when I saw her, she created a moment of excitement in me. She stood a few feet away from me and then she said, Exciting, isn't it? I said, it's exciting, a ship sailing. And it's something to live for a moment like this. You're first, Jack? Yes, very first. Then I can't ask you if that whistle means we're sailing. Well, I imagine it's a warning whistle. I won't believe it until we're actually moving. No, it will be in a few minutes. A few minutes. I still can't believe that in only a few minutes those buildings and city will slide away from it forever. And you won't be sorry? No. No. Celia, Celia, stay where you are. What do you do as I tell you? We're alone. There's no one but us here on this deck. Look, we are not supposed to know each other. We're to meet casually aboard ship. Now that is the way I've planned it. I have to know. Is everything all right? Everything is fine. You're sure? Yes, fine. Everything is fine. But I don't mean just the money. Your wife and son. Look, I have told you. I have done all that I can for them. Now that is settled. And you're not sorry. No regrets. No, no regrets. For the past five years I have been mixing up the books of the Garrison Estate so that I could take $200,000 in cash and be sure that the cleverest bookkeeper will take months to unravel it. But when I made this decision I worked everything out, every detail perfect. Now nothing is going to spoil it now. We're on our way. Just two strangers meeting aboard ship. Meeting a little prematurely perhaps. There's nothing wrong with that. We're talking about the sailing. We don't know each other. Well then let's keep it that way, shall we? All right. This is strictly a vacation. Now as soon as we sail we should arrange about our tables in the dining room. Aren't we going to sit at the same table? No, no. It is care that pays off. It's the little things that can trip you. All right, Alec. Anything you say. Celia. Celia, I love you. And we are going to have a life that we want. But only if we remember that it is the little things that count, the tiniest little things. It's because I was so careful, so exacting about every detail that we got this far. Because I figured everything out. Because I... Alec, what is it? Oh no. Alec, what's wrong?  What thing? Alec, tell me please. What can I do? What can I do? Alec, what is it? What? What's the matter? What's the matter? I just happened to think of it. I asked them to my apartment. I was checking over everything for the last and final time. And I put it down on a piece of scrap paper. And then I threw the paper in the basket. That paper? What did you put on it? The cost of our tickets for this trip. The... Only that? You gave me a terrible scare. I couldn't imagine. Celia, you don't understand. They will search my apartment when they find the money missing from the office. They'll search everywhere.  Only numbers on it. No one will know what they mean. The police will. They will figure out exactly what those numbers mean. The price of two one-way trips to France. By that time, we'll be safe. Not as safe as I'd planned. As soon as they find out that we went to France, they are halfway to us. According to my figuring, it would have taken them a month to know that we went first to France. Now that piece of paper ruins everything. That would be wrong, Alec. Maybe you've forgotten it. Maybe you tore it up or burnt it. No, no, no. It's in that basket.  A little thing went back just a little, please. Attention, please. Attention, all passengers. Due to the fog, the sailing has been delayed three hours. Alec, are you... Any passenger wishing to go ashore may do so. But must be back aboard at least one hour before sailing time. Two hours. No, Alec. Two hours. Please, please. It's luck. Don't try it, Alec. Please. Why not? I can get that paper and be back here before... It's wrong. It couldn't be more right for us. Two hours. Plenty of time. Two hours. Celia, I am just going to the apartment and I'll be right back. I was lucky. Everything worked as planned. I congratulated myself for not throwing away the keys to my apartment when I left. I was going to reserve that pleasure until we were far out at sea. I opened the door, and as soon as I did, I knew that something was wrong. The light was on. Boy, what's the matter, Alec? You look... Why are you absolutely white? Were you frightened because all the lights were on? Helen, I... Are you all right, dear? All right? Yes, yes. Well, what are you doing here? Why... I left Ted with some friends. It's a leg. Thought I'd keep you company in the trip up there tomorrow. This is a surprise, isn't it, Alec? Yes, yes, Helen. It is quite a surprise. You sure you're all right? Yes, yes. There's nothing wrong. Stop asking me the same thing over and over. I'm all right. There's nothing wrong. I'm all right. You don't have to shout out. Well, why are you looking at your wife? I am not shouting. I just didn't expect to find you here. That's all. You sound like you're sorry. Believe me, it's not that. Then why? Well, I... Helen, you shouldn't have left Ted up at the lake alone. You ought to get on the next train going back there. Ted's in good hands. With strangers. Friends, I told you. George and Edna's summers. Now, you know how fond they are of Ted. Just the same.  Concerned about the littlest thing. Well, you can't be too careful. Ted's all right. Well, you stop worrying about him. When we get up to the lake tomorrow, you'll see. Helen, Helen. Yes? Helen, I'm not going up with you tomorrow. What? You'll have to go without me. Well, then there is something wrong. Now, what is it, Al? Well, I haven't got all night to stand here and answer ridiculous questions. No. Now, maybe you'll feel better after a cup of coffee. I've got some on myself. No, no, I don't want it. Yes, yes, um... Yes, Helen, maybe you're right. Coffee would be, um... a good idea, I guess. I had an idea now. It would take her a little while to repair the coffee. And at least she was out of the room. I went right to my desk, got the waste paper basket underneath it, and started to look through it. It wasn't there. I looked at my watch again. It was still all right. I had an hour. My time was getting close. And while I was still looking through the basket, Helen came back. Oh, Lake, what are you doing? Did you take something out of this basket? No. Now, here's your coffee. Well, what are you looking for? I'm looking for a piece of paper with figures on it. You sure you didn't see it around? A positive. Now, what can be so important about a piece of paper? Because it's important. Wait a minute. Here it is, under the desk. That's what you wanted. Yes. Well, thank goodness.  What? Well, why do you keep looking at your watch? I have an appointment. Alec, I want to know what's going on. Nothing is going on? I just didn't expect your home, so I made an appointment. I don't mean just that. You said you're not going up to the lake tomorrow. Well, why?  Alec, what is it? All right, all right, all right, Helen. All right. I guess I might as well tell you everything now. There is something going on. It's the office. But you're on vacation. Well, it's 8.20, and I have an appointment. With whom? Who's talking about going into the investment business with me, and I'm supposed to spend the weekend with him at his place out on the island. You never mentioned this before. Well, it's a deal that I've been working on for a long time. I didn't want to say anything until it was all set. You want to surprise me? Yes, yes. I've been on edge about it, too. That's why I was upset when I found you here. And the piece of paper? There are confidential figures that I needed. Well, I won't say I'm not disappointed, but if this deal means so much... It means everything, Helen. It's my one big chance. If this falls through, I'll never have another. I know that.  And Helen, look, just in case, I don't get up to the lake by Monday. Don't you worry. But you said the weekend... Well, it may take longer. I sent you a letter up at the lake telling you all about it. You would have gotten it in the morning. I didn't want you to think that something had happened to me when I didn't show up tomorrow. But, Helen... Helen, Helen, trust me. Believe me. Well, why shouldn't I... Helen, I absolutely cannot be late. I'll get it. No, no, no, let me. Hello. I'm just leaving. Yes, yes, I found it. No, there's nothing to worry about. Who is it? Well, that's right, Mr. Sanders. I'll be there on time. I'm sorry to rush out, darling, but believe me, this is vital. I was out. I was on the street. I had over 50 minutes to get to the boat. The telltale slip of paper was in my pocket. There was no cab around. Right next door was a bar. Would I have time for a drink? I needed one. I looked in. There was only one other customer. That was perfect. I went in. Brandy, please, and I'm in a hurry. Okay, bud. How much are you? 90 cents. I'll keep the change. Thanks. Just a second, fella. Oh, no, excuse me, but... I'll take it. Get your hands on the bar. You guessed it. This is thicker. Now, look, I've got to get out of here. Take my money, but let me go. The guy with the gun gives the orders, pal. Relax and hand over your wallet. All right, but just give me money for cab fare. You sure are nervous. Please, give me a break. I'm giving it to you. You ain't hurt?  What? Don't give me no trouble. Fall for your pants and lay down on the floor. I don't want to be in no hurry when I walk out of here. Now, listen, listen, please, listen to me. You've got to listen to me. I am sailing to Europe. Look, look, here is my passport. I have to make a boat. This is one boat you're going to miss, pal. I can't. Now, look, how much did you make in here? A couple of hundred dollars? Not as good as that.  Well, I'll give you a thousand dollars. What? I swear it. I swear it. I will give you a thousand dollars if you'll just come to the boat with me. How do I know you're on the left? Now, here. Here, you can hold my passport. And here, take it.  I have got to make that boat. A thousand bucks? I promise you. But we've got to get there before the boat sails, or else I won't have the money. Okay, pal. You've got a deal. We walked out of the bar. A man with a gun wouldn't run. I looked at my watch. Forty-six minutes. Well, there was plenty of time. Half hour to the boat, the most. And there'd be time to get him on board, give him this thousand, get rid of him. I even began to enjoy the situation. It wasn't likely that he'd report anything to the police. Only made good time. And then, we were in my stateroom. Okay, pal. Where is it? It's right here. I'll get it for you. I just have to open this bag. Never mind. Just hand me the bag. What? I said, just hand me the bag. But you want the thousand dollars? It's in here. I have to take it out and get it. I'll take your weight for it, pal. Just hand over the bag. Now, look. Look, wait a minute. You can't take this. It's in there, pal. That whistle blow will cover the sound of any shine. Now, are you going to give me the bag? Right here. There it is. Thanks, pal. You're being real smart. On voyage. All right, get me the purse quickly. Hurry! Who is it? Me, Bea. Well, come in. What is it? What happened? I heard voices in you. What are you doing on the phone? I'm not doing anything on the phone. Who was the man in here with you? A hold-up man. A hold-up man? Yes. He took the two hundred thousand dollars. But you were going to stop if you were going to call... Yes, I was, but how do I do it? Do I tell the purser or the captain that there's two hundred thousand dollars in cash and the bag that that man is taking off the ship? No, Celia, we're trapped. We're not going anywhere. You've been listening to a bold voyage written for suspense by Murray Burnett. In a moment the names of our players in the word about next week's story of suspense. Soon to my story, we're Bob Reddick and Alex and Rita Lloyd as Celia with Mary Moore as Helen and Joseph Julian, Dan Ockoff and Alan Manson. Listen again next week when we return with reports from a dead planet by George Bamber, another tale well calculated to keep you in suspense. The King Central next followed by CBS News and have gun will travel on CBS Radio.


Okay, I'm Dave Chambers and I'm glad to see you here. This is the American College of Dentist Ethics Report program on the new profession. I have a little problem with this presentation. First of all, you're the wrong audience. The people who need to hear this thing about ethics are not the people like you who are the most ethical in the profession. Another little problem I have is that ethics takes place in the dental office. It doesn't take place in lecture hall or a Zoom conference and so forth. And the third restriction is that I'm not going to tell you what to do. That isn't how ethics works. And then there's the matter of the conflict of interest statement. This is required for all these courses. And I've been giving ethics presentations for 20 years or longer and no company has ever approached me saying they have some money to support that kind of thing. So there's no conflicts of interest here. That's a picture of the book. The Ethics Report, new professionalism that the American College of Dentist put together. It's 500 pages long, but we'll do the short version here. The project started five years ago when the Board of Regents of the College said to the editor, we'd like to have a book length report on ethics in dentistry. And we want it data-based like Geis did with his report. We also wanted to be positive in the sense of looking for opportunities to elevate the ethics in the profession. And some people got behind that. One person in particular is a late Jerome Miller, and he was so passionate about it. He said, I'll give you a million dollars if you find a million dollars among the others in the college. You are interested in ethics. And we did. And that tells everybody that this is very important to the college. Director Miller always used to say, have you got a little skin in the game? And that's what he was referring to. And so we're going to talk in the next hour about getting some skin in the game. The approach that we took with the project was to listen. We started by listening, and we continued to listen. And we listened to everybody except possibly a few. We didn't listen to experts very much. We did literature searches primarily in professional ethics and organizational ethics. And we did research studies, about 11 of them. And these were published in peer-reviewed journals. You can read them there. And the intent of the project was to diagnose what the problem is. You can read 510 pages and you won't find a single recommendation in there. It's not about asking other people to help us. It's about saying what is the problem and what are we going to do to fix it? So here's the conclusions of the presentation. The context of dentistry is changing more rapidly than dentistry is responding to that. Being individual dentists in ethical theory is fine, but it's not enough. And the profession has to respond with action and as a profession. Here's the plan for the presentation we're doing now. We've just been oriented. We're going to talk about the listening we did. We're going to talk about what it means to practice dentistry. Some of the things that dentists do in terms of ethical behavior. Four approaches to being ethical and then how we might proceed. So Stephen Covey popularized a common story that we tell. And it's about a patient whose eyesight began to fail. And the patient went to the optometrist and said, doctor, I can't see quite as well as I used to. And the optometrist immediately reached inside the desk drawer in front of him. And he pulled out a pair of glasses and handed it to the patient. He says, here, try these. And the patient says, well, wait a minute, doctor. Aren't you going to do some tests? Aren't you going to find out what special problems I have and so forth? And the optometrist says, oh, don't worry about that sort of stuff. These glasses work great for me. So we listened. And we listened to a lot of people in focus groups around the country. We had eight groups of patients, California, Ohio, North Carolina and Oklahoma. And these were put together by the Citizens Advocacy Council. And that's a group in Washington DC that represents state boards in various professions. We had four groups of practitioners, about two thirds of each group being ADA members. We had professional leaders in the various states. And these were selected by organized dentistry itself. We had some opinion leaders like ARP folks in Washington DC. And we filled in with some written surveys. The question we asked in each case was this. When you hear the words ethics and dentistry together, what do you think? Now that was the only question we asked. We didn't say, well, do you think this and do you think that and how many percent are this? We just asked that one question and it wrote down everything people said for about an hour and a half in each group. And the number one concern was over treatment. That wasn't just among patients. That was among the leaders in the profession. It was among the policy makers and so forth. The number two concern is outside values. People outside of dentistry are telling dentists what they ought to do. And some of them are listening. And the number three issue is that individuals practice solo. They practice independently. Now this is my favorite because the very first session I was in was with some young leaders that the association in Ohio said these are the people who are up and coming. And we asked the question of first response was, well dentists are independent. And I said, yeah, I know they're independent, but we wanted an ethical issue. Now surprisingly, the whole room erupted and says, you're not listening. Being independent is an ethical issue. If dentists don't agree with each other and tell patients different things, they don't agree with each other and bad mouth each other. Who are we going to believe? And if dentists want to hide in their own offices, how are we going to make them more ethical? A couple of things that didn't show up. Poor quality dental care was not an ethical issue. Not one person mentioned it. Dentists don't understand ethical theory. It's not an issue. Not one person mentioned it. Young dentists are unethical. And it's not too much of an issue. Some of the older dentists did say that. So the self image, what is the practice? What is licensure? How do people cheat? And so forth. Dentistry is a practice in what is called a professional services firm. Dentists don't add value to the community by selling things. They don't sell toothpaste. They don't go out and discover things like oil refiners do. They don't lecture to people and give them, you know, charge them for their opinion and so forth. Dentists practice and that's a technical term. The Greek word is technae. And it means the combination of art and craft. Art and craft. Dentists are the work that dentists do is skilled work. People can't do it. It's customized work is different for each patient. It's problem solving. It's not always done the same way, but it is done to standards. And dentistry is only done when people need it. People don't say, well, you know, I got some free time this afternoon. I think I'll go get an endo. They wait until there's a problem and then they go and ask for that problem to be attended to. And you can't run up an inventory in dentistry. You can't do 20 crowns this week because you might need a few extras next week. There's an asymmetry of information where the dentist knows a heck of a lot more about what's going on than the patient does. And there's direct contact. I can remember early on a dental student once asked me, doctor, should I touch my patient? I thought for a minute and I said, I hope you do. Relationships. It's not about a transaction. It's about what went on before, what's going to go on in the future and so forth. There is no one best treatment for any individual patient. There's a range. And in that range, all of them are appropriate. But the range is not unlimited. You have to do dentistry that's acceptable to your peers or there's a bigger range if you wanted to do anything that's legal or there's a smaller range if you wanted to do anything supported by evidence-based dentistry. But professional services firms are licensed by states, different licensure in different states. They're not licensed by dental schools. They're not licensed by the profession. They're licensed by states and the state says you can have an economic opportunity to serve the public. These licenses go to real estate agents and building contractors. Anybody where the public can't tell exactly what's going on with the professional services firm. The professional services firm, some of them are good and some of them are bad. But surprisingly, quality is not the issue. Quality is assumed. Every patient we talk to said, well, I go to the dentist because I know the dentist can do the work. That isn't the issue. In fact, the ADA says you better not tell a patient that the guy isn't up to quality. We don't compete on price in professional service firms. If you compete on price, you are going to go to the lowest common denominator and you'll drive your colleagues to the lowest common denominator as well. And we don't compete on size. There's great little ones and great big ones as well. But what does make a professional services firm effective? One reason is they delegate. You delegate to the lowest paid person who is capable of performing the work. You offload as much as you can of the fixed costs like buildings and payroll and that sort of stuff. And you automate your records as much as you can. All of those things are going to add to the value for the dentist and for the patient. Now, here's a funny thing.  And I'd be pretty close to being right too. Because 70% of the difference between one dentist and another in terms of their income is a result of how well they delegate. Now, I recognize this is a problem because now we're beginning to get delegation of dentist to dentist delegation and some of those dentists aren't too happy about that. And we're getting delegation of dentists working for people who aren't dentists. And some people are like myself are worried about that. So I wrote a little editorial in the Journal of the American College of Dentists about that practice and I said beware of that, but it wasn't much of an editorial. It didn't do any good. You can see that that editorial was written in 1995. Another thing professional service firms can do is to find better customers. Resources like chair time are limited. That means you should use them where you can to maximize the benefit to the patient. The best customers are repeat customers. And I did a little mining on the internet to find out in California what the average income per household is and it's $62,000 or it was five years ago. Then I looked to see which census tracks in the state of California had a dentist and which ones didn't. And there's quite a few even counties in California that don't have any dentists at all. But the ones that do have dentists, the median household income is $69,000. In other words, dentists know where the better patients are. The third way that professional services firms thrive is through the monopoly. And that's the practice acts that say what dentists can do and what other people can't do, lobbying and so forth. You see, dentistry is not a free market profession. It's a highly regulated profession. In fact, it's one of the most regulated businesses we have and most of those regulations were put in place by dentistry itself. Let's look at discipline licenses. Now we're getting into some tender area here, but it's an opportunity for finding out how to make things better. Approximately a thousand dentists every year across the country have their licenses disciplined. That means that the state says you can't do that anymore. About 20 times the number are investigated by state investigatory agencies. Formal complaints against dentists are 100 times that. Each state regulates those professional activities differently. But a common denominator is that it's not a lack of ability that leads to a discipline license. It's the abuse of judgment on the dentist part. So I looked at 15% of the dental licenses that were disciplined over a period of time in California, North Carolina, Ohio and Oklahoma. And you can say, now wait a minute chambers, how did you know who had a discipline license? And the answer is that everyone knows who has a discipline license. In every state jurisdiction, it is a law that a discipline license is posted online for everybody in the state to read. And they run into 15, 20 pages, 30 pages of detail about this. And it's not happy reading, but you can read it. The technical issues, about a third of the cases were for technical reasons. Now this isn't underfill and it isn't overhangs. It's failure to diagnose. It's performing work for which there's no record that the patient in fact needs that work and so forth. The graph, and you'll see a couple more like this, the blue bars, the higher the bar, that means the greater the proportion in that age group of dentists who have discipline licenses for technical reasons. That's an unusual curve. It's not a normal curve. It's what we call a bimodal curve.  And these bumps correspond roughly to when one starts their own personal practice starting up the practice and then again ending the practice just before retirement. The biggest area of concern is patient management. And that's where the overtreatment comes in and that's where it comes in from billing for procedures that weren't done and that sort of stuff. The case management, the doing the veneers before the, before the perio. It's a lack of informed consent. It's abandoning patients in the middle of treatment. And you can see that again there's that bimodal distribution, the beginning of practice of one's own practice, not the beginning of practice of dentistry and then towards the end. And then there are personal issues. Dentists are a lot like people and some of them go out and drive their cars when they're drunk and they shouldn't do that. Some of them take drugs and prescribe drugs for their friends and some of them are cognitively impaired and don't know for sure what day it is and so forth.  My favorite was a dentist who impersonated a enforcement officer for the Department of Consumer Affairs and sent notes to her colleagues saying, I'm going to come and visit your office and I want to see your charts. Well, she was blocked from practicing for a little while. But again, the same bimodal distribution. It is age related but not age related in the way one would normally think. Now that dashed line that goes across in the middle is the proportion of dentists in the United States by age. And you can see that there's more young ones and it tapers off as the older ones. Dentistry doesn't kill people, but we're increasing the number of dentists. So the new dentist, of course, is a young dentist. But very importantly, you look at that graph and you can see that discipline licenses are underrepresented in the young group. In fact, that's the same that we found when we looked at medicine and other fields. The average age of a discipline license among professionals is about 57. Now, who does that behavior that they shouldn't? The top line here is an important line because for every discipline dentist I found, I found a match dentist who is like that person in terms of where they are and how they practice and specialties and so forth. So we're looking for ones that don't have a discipline license across the top there and we can see that they don't have a lot of multiple offices and they don't have a lot of those fictitious business names. They aren't Dr. Wonderful or Magic Dental Office and that sort of thing. The ones that have technical and management problems do have multiple offices and they do have fictitious names and they do treat patients who don't have as much money as the other patients. So there's this thing about I think the dentists who aren't doing a good job. No, they're not doing a good job. And they're embarrassed about it and they hide from their patients and they hide by going from office to office and they hide by having a fictitious business name. About 40% of the dentists with fictitious with discipline licenses were ADA members but that's not a good number. The problem is that if you have a discipline license you'll drop your ADA membership or if you don't the ADA will probably drop you.  I also look to see whether any of the fellows of the American College of Dentists have discipline licenses. And of course that will include you so here's the number. Justifiable criticism. The ethicists have said for a long time, it's one of the favorite things they say, is there's this implied social contract. I don't mind that it isn't written down anywhere but the idea is that everybody understands that society because it can't judge the quality of what professionals do grants a privilege to the profession to regulate themselves in exchange for the promise that the profession will police itself. As it's done, I'm not sure, the ADA has an item in the code which addresses that issue. And it says that dentists all dentists are always obliged to report gross and continuous faulty treatment and to inform the patient that there is something wrong in their mouth. It does not say that dentists should avoid criticizing their colleagues because they don't know what the conditions were under which the care was provided. It doesn't say that. But in the advisory opinion, which is kind of an appendix to the code, it does say that if you're not so sure about how this gross and faulty stuff came to be, you should go and talk to your colleague. And I think that advisory opinion is a very strong statement. It doesn't say rat on your colleague. It says go and talk to your colleague and see if we can make things a little better. Now, the patients in the profession don't see this matter the same way. The curve on the right, the one in blue is the response of dentists to the question, should you report gross or continuous faulty treatment? And the dentist kind of bunch up over in there, no way I'm not going to do that sort of thing. And the patients, and that's the orange line on the left, say, well, of course, I assume that all the dentists were doing that. Let's talk about the common good, because there is a common good in dentistry, something that dentists share among themselves. And I can ask, let me ask this question, is ethics an individual thing or a professional issue? And you're going to say, well, no, of course, it's both. And I say, okay, that's true, but you're not going to solve the problem, are you, unless you address the professional issue over and above the individual issue? You have to look to the common good. The way the common good game works, and we've done this in economics and sociology and criminology and all the rest, is that each contributes to the common good. We all do that. We all put in our best or next to best and so forth. And the public sees that and it judges the entire profession, not the individual, but the entire profession. Patients go to dentists because dentistry is good, and they know that it's good. So there's a common benefit, a reputation benefit for the whole profession, and it's equally distributed among all the members in the profession. Okay, there's a problem there, isn't there? Think about it for a minute. Free-riding means that you contribute less than your fair share, but you expect an equal reward. We've done this over and over again. It's all over the literature. I've done it with dentists. I've done it with residents and so forth. It always works the same way.  And then you magnify that a little bit and give it back to everybody and equal shares. And what we find out is that at the beginning people put in pretty good amounts, but gradually they look around and say, wait a minute, I'm not getting what I expect out of this deal. I think somebody else is maybe not doing their fair share. So maybe I shouldn't have to do my fair share either, but I will get the common reward. And what happens over time, and it's usually a very short period of time, is that people stop contributing. That's pretty much every person for himself. That's pretty much that guy in Ohio who said, wait a minute, an ethical problem is that every dentist works for himself. Now we can fix this problem. It's pretty easy, very predictable. What you do is you say to the person you think who is a freerider, I think you're freeriding. I'm going to make it a little tough on you until you put in your fair share. And what happens is that the freeriders disappear and that everybody benefits more than they benefited in the first place.  Well, I didn't quite say that. What I said is that for the good of the profession, you should pay attention to what your colleague is doing and help that colleague be a little better at it. You're not trying to kick the person out of the game. You're trying to show the person how to play the game better. So the common good may not be holding in dentistry. The membership in organized dentistry is going down. We're joining, writing our checks that we're not paying. We're not participating as much. And you say, well, of course, that's the way it is. In America, it's not a joining society anymore. People just don't join. And I say, well, that's true for some, and it's not true for others. For example, nurses are not losing membership. Lawyers are not losing membership. Evangelical churches are gaining membership. What about Amazon Prime? Some organizations are losing and some are holding steady. Every year, the Gallup Company does surveys of the public. It's called a professional trust survey and ask one question. Do you believe that people in this line of work have your best interests in mind? And they do that every four years for the profession. And you can see in the graph on the left what happens when they survey about nurses and so forth. And the nurses are always on the top. I think the nurses are always going to be the most trusted profession and physicians are trusted and pharmacists are trusted. But dentistry is the lowest trust among the health professions. So dentists could say, well, yeah, look, we may not be so bad. What's the numbers for lobbyists and numbers of Congress and PR people and marketers and insurance executives and lawyers? Well, that's on the graph on the right. We wouldn't want to be associated with those kinds of people at all. But as you can see, lawyers are making a run right now. They're on the upswing. The problem with the dental profession is it's becoming professionalized. Now that's a very difficult sentence to unravel. What it means is that the profession appeals to dentists, but it isn't run by dentists. Take a look at the morning huddle. That's, you know, I check every day, but Sunday I check the huddle to see what the profession is interested in. And the stops were not written by dentists. It's written by lawyers, PR experts, lobbyists, consultants. It's written by professionals in other professions. So the question is, is dentistry as an organization answering the profession's need for its identity? Or is it answering the profession's needs for services? And the answer is that they pay for lobbying. They offer the members credit cards, CE courses, spot news, the SELU insurance, and so forth. I was worried about that, so I looked at all of the ADA news since it's been published, and I just measured the amount of space devoted to advertising. And the amount of advertising has gone up. So the more advertising, the less membership. But then look at the identity side of things and say, well, how much of the ADA news is devoted to praising the work of dentists and letters to the editor and that sort of thing. And the more of that there is, the higher the participation. You can see the graph on the far right, that's age and proportion and membership. The number of members that are in the agency, the number of members that are in the agency, that's age and proportion and membership. The highest membership, of course, is the young group and the dental educators. The educators are overrepresented in ADA membership. It doesn't last, of course, because the young ones get a discount on their membership, and then they say, well, the services aren't worth what I'd have to pay in addition to get those. So the difference between recruiting and retaining and the profession has a retention problem right now. The graph in the upper right hand corner is ADA membership 1960 to now. And when I started in dentistry, the proportion of people who says, oh, I'm in an organized dentistry with 94, 95, 96% or something. And now it's down around 65%. I hope you don't think that I'm responsible for that drop. Question. Is ethics a matter of character or a matter of situation? You see, if ethics is a matter of character, it's really easy to fix the problem. You just get rid of the bad apples. And some people said, well, you know, the character was determined at grade school and the dental school should just keep those folks out. Here's the problem. If you put all the bad apples out, there wouldn't be many people left. You see, virtually all unethical behaviors performed by people who consider themselves to be basically ethical. The character they think is ethical, but sometimes the situation makes them unethical. I was, you know, maybe I shouldn't have done that, but you know, there was some pressure and it was a little ambiguous and no one was really hurt. And besides, I do sit darn much for everybody all the time.  Enron, if you wanted to see a really great ethics statement, Google Enron Ethics. It's 42 pages long and it's excellent. Surveys show that over 90% of Americans say they have committed a felony or misdemeanor. They just haven't been caught. 40% say they cheat on their taxes. Two thirds of Fortune 500 companies have been caught by the federal government and they're working on that. White collar crime, that would be insurance fraud and over treating patients and so forth. Accounts for 25%, 25 times the damage to America as all of the street crime put together. Fraud, internal theft and so forth in your practice will be double what you lose due to bad debt. And dental schools do have cheating. There is cheating going on in dental schools, not as much as in nursing or law school and those other places. And it's going down in American dental schools. The peak year for cheating in dental school was 1979. Now, priming. We're still on the topic of is it a matter of character or is it a matter of situation? And of course, it's a matter of both. And we have a technical term in ethics for situational cheating. It's called fudging. And that's giving yourself a little credit because you think you deserve a little credit. And we've studied those things and we find, for example, you give you take students at Harvard and MIT bright young people and you give them a little math test and you say you score this math test and report to us how many you got right and we'll give you a reward. We'll pay you more money if you got a higher score and so forth. But they look and some of those page and some of those students they said, before you take the test, you're going to sign this pledge that you'll agree by the honor code at your school. And some of them they didn't because ethics is situational those who signed the pledge didn't cheat as much. That's pretty good. The problem is there is no ethics. There is no honor code at Harvard. There is no honor code at MIT. So it's not whether the whether it's an honor code is a question of whether you think there is an honor code. We do this more commonly by asking people name as many of the tunes that were popular in high school or name as many as you can of the 10 commandments before we give them one of these fudge tests. And what we find out repeatedly is that Americans don't know the 10 commandments. We did this with the American College of Dentists and at a board meeting we asked the regions to take a little survey on ethics and they did. And then we gave them the same survey a couple of months later and they scored higher on the survey when they were with a group of colleagues who were talking about ethics. And when they were individuals. Now that's something really important. There's a quick way of making sure that people are more ethical. You just put them in situations where they're talking about ethics with their colleagues. So the rule is whether you expect others to be ethical or not, you'll probably be right. Touchstones, ethical touchstones. That's a matter of what you're holding in your hands when you're making difficult decisions. Who do you consult? What do you consult when you're deciding whether you should take legal action against a former associate who's competing at a non-competition clause that are violating or discharging a patient who isn't paying his or her bills and so forth. And so we surveyed people and about half of them said, well, I'm not to talk with my colleagues or I'd like to talk with those people who were cheating on me. And that's good. That's excellent. Now what we see over there on the right hand side is there's some touchstones that people don't pay that much attention to. So what are they? Well, they're codes and principles and experts. The code and the ethical principles as beneficence and justice and that sort of stuff just don't carry that much weight practically. In fact, we surveyed the dentist and found that half of them don't know, we found that the ones we surveyed only knew half of the ADA code and some of them simply said, well, I just don't pay any attention to that anyway. And who knows the principles of bioethics? You don't know which ones you're not following, do you? And then the experts. You're going to stay away from the experts. The last thing you're going to want to do is ask a lawyer or heaven said, don't ask an ethicist. They might know the answer. It might be different from what you want. And they have credibility. Now, what do we pay attention to? The answer is we pay attention to ourselves. We consult ourselves. This is that individualism thing coming up again. So the expert is optional. This is different in dentistry than it is from other fields. I've looked at journalism and business and some other fields. They don't look at ethics the same way dentists do. In dentistry, the dentist is the whole game. It starts with whatever the dentist thinks is a problem in his or her own office, not what other people think might be a problem. And the dentist considers the options and weighs them and then determines whether the result has been a good one or not. Dentists also have the option of dilemmas. Dilemmas aren't popular in bioethics or ethics in general or other areas where people professionals look at ethics. A dilemma is a case where it could be one thing or it could be another and nothing is perfect, but all of them are kind of okay. You just pick the one that you think will work best for you. The Commission on Dental Accreditation made a requirement for dental schools in 1997 and it said that all the dental schools have to teach ethics. And so the young dentists are in fact a little more knowledgeable about ethics than their seniors were. But the dental school curriculum didn't say, what it said is they have to know about ethics. It didn't say they had to be ethical. So in dental schools it's probably not going to make them ethical because there's only 23 hours over the four year period on average devoted to that. And that number is going down. In fact that little graphic on the lower right shows the number of publications on dental ethics and it's less than half of what it was a decade or so ago. Now, I applaud the ADA for creating an ethics hotline. That's a situation where you could phone in to the ADA anonymously and you could get some advice from an expert on dental ethics and they would tell you about what the code said. We don't do it anymore. We stopped doing that. And one of the reasons was that they weren't phoning in with ethical problems. They were phoning in with questions like, can you tell me a good lawyer that I can use to get at this guy who was cheating this other guy? And also it wasn't the dentists who were phoning in. It was the patients and the staff who were phoning in. And surprising that they were disappointing that no one phoned in and said, how can I be more ethical? What can I do to be more ethical? So, is ethics an opportunity? Or is ethics an obligation? Is it something you'd be happy to do? Or something you have to do? And people who've looked at the surveys that we've done and so forth are quick to point out we never asked the dentist whether they were ethical. And that's true. We didn't. Asking a person, are you ethical is not a value question. It's an intelligence test question. Who's going to say, no, I'm not ethical. In fact, I'm probably one of the least ethical people around. This is something called response bias. And on surveys people tend to give the responses that they think others are looking for. So how did we get at whether dentists think they're ethical? Surprisingly, we used bias as the can opener. We use something called attention bias. And it's well known that people pay attention to positive things about what they like and negative things about what they don't like. So if you told me whether you watch Fox News or CNN, I'd be pretty accurate in guessing whether you voted for a man or a woman in the last presidential election. So what I did was make up fake journal article titles. They were titles like the 10 newest advances in technology or the public thinks dentists are not treating everyone fairly. So there are positive things and negative things. And they're about dentists income techniques and dentistry ethics and health outcomes. Here's what we found. Believe it or not. Income is not the major concern among dentists. Here's the second concern and other surveys have confirmed the same thing. Dentists are primarily concerned about technical quality of dentistry dentists like to do dentistry. They would feel better if they took their hands out of the patient's mouth and they looked at that and said boy, I hope the patient appreciates this crown as much as I do because that is a nice looking crown. They are concerned a little bit about money and they would be happy to get more money. That's not that's not a problem. The question now is what about ethics and they're all health of the public. That isn't so that isn't such good news. Not only are those two values lower than the other two, they're a bit negative. So dentists don't want to go and have someone tell them that they're being unethical. They don't want to read another paper that says well there's an access issue. Now the difference between the ones on the left and the ones on the right is qualitative not quantitative. Opportunities are values that can be satisfied indefinitely. More is always better. There's always room for more. Even though dentists are in top two or three percent of income earners in this country, no one is saying well I got enough, you know, no problem. The items on the right side are obligations or what we call motivation factors and that means there's a standard. You'll be up to standard or people will start paying too much attention to you. But if you meet the standard you don't get extra credit for going beyond the standard. So here's the summary. Practice centered ethics based professional service firms model is being threatened by forces outside of the profession. Now let me stop for a second. I'm not going to talk like I'm an ethicist or something. I'm not going to talk about Dave Chambers. I think that's terrible. Personally, I believe the professional service from model is wonderful in terms of dentistry. It's what dentistry should be based on. It's what dentists. It's what made dentistry a profession that serves the public. Well, I'm worried that other people are taking a chip and a whack at it. Okay, now I'm back to the to the person presenting the presentation. The extent to which the profession is honoring the implied contract to police itself is at this point an open question. Organizations are now competing to offer to dentists services. And they're retreating from offering dentists help with their professional identity. It is increasingly being seen as situational bargaining rather than character. And that has some good features and it has some bad features. Dentists are still in a position to self define what it means to be ethically good enough that is still practice individually. And the public sees dentists as technicians. And the profession seems to agree that that's that's okay. Now, what about approaches ethical approaches to address some of these issues? I divide them into two categories. There's the me ethics and the we ethics. The ethics of judgment sounds like this. Here is what you should do. And the ethics of justification says, I know I'm right. On the other hand, the we ethics involves the ethics of engagement. And it says, let's see if we can figure out something here that works better for both of us better for both of us. And then the leadership ethics, which says, can I help you be more ethical? The ethics of judgment here are just a couple screenshots I grabbed from a recent ADA news. It says this, surely everybody, everything would be better if you just did what I think you should do. A problem with that is that it just won't work. Who wants to be told what to do? Who gets to do the telling? How do we resolve cases of conflict between the experts? And what usually is the the ethics of judgment is we want somebody else to do something. And we're going to use threats and power and economic persuasion, a little deception and so forth to get them to do it. But those all sound so negative. We're going to dress it up and make it sound like it's really ethical. What we're asking to do now that guy on the right is Gary Harden. And the reason he gets to be in these pictures is that he wrote probably the most famous of all essays on this problem. It's called the tragedy of the commons. And Harden says, don't count on others to solve your problem. Doing so means acting against their own best interests. I think Harden's kind of right on that. But what about the ethics of justification? This is the default position. This is what bioethics is based on. This is the principles approach. This is the codes approach. This is the dilemmas approach. It won't work. Naming the problem doesn't solve the problem. Now, when you get to the pearly gates, they're going to give you an entrance exam and you have to write up fill out this paper and so forth. The question is going to be, can you spell non-maleficence? No one's going to be denied admission because they can't spell non-maleficence. Now, do we know what is right? A lot of us know what is right, but we don't do what's right. And what about these conflicting experts? The experts, that's how we get paid as we disagree with the other experts. In French, taking a trip down the Dordogne River Valley does not make you a Frenchman. It's a poor mind that can't gen up some excuse for what it wants to do. Now, that was said by William Jennings Bryant. Actually, Bryant won this goldstile. Isn't that amazing? Okay, let's switch to the we ethics. The ethics of engagement. We can always listen to others, usually to our benefit. We should always be allowed to tell others our side of the story, usually to their benefit. Now, I'm going to read this sentence in red because it's very important. It's the whole summary of the whole presentation. We're competent, reasonably informed and uncoerced parties. That's you and your patient and your colleagues. Exchange views about how they believe the world could be made better. We could be better. There is a mutual strategy that neither party has ethical grounds for wanting to change under the circumstances. That's very important. That's my definition of ethics. That's the ethics of engagement. It's a process approach. It's how to be ethical. It's not what you think other people should do to be ethical. And the marvelous thing about it is that it requires no enforcement. If you and the insurance company agree that this is the best that both of you can do, then you won't cheat and they won't cheat. So there's no need for enforcement. Now, if that's chamber's rule for ethics and there's all these other things, chamber's corollary is all the other approaches are less ethical. Now, this picture on the right is one of my favorites. I got this bookmarked. That guy in the middle is my hero. His name is John Nash. He's dressed up really nice and the reason is that they just gave him the Nobel Prize. That's pretty neat stuff, you know? And the reason they gave him the Nobel Prize is that he proved. He didn't suggest. He didn't propose. He didn't argue. He proved that the sentence in red on this slide is always correct under all circumstances. Ethics is unavoidable and it's powerful if you really do ethics. So there's something even better. That's the ethics of leadership. And that's any person in any position who makes it possible for other people to be more ethical. It's the person who befriends another person who's confused, who doesn't know that he or she is really appreciated, but they are. This person who offers a little guidance. Did you see this report about so-and-so? This person who role models. It's the person who does the right thing and expects that a few other people will follow him. It's the person who mentors, who finds and trains up his or her replacement. It's the coach. It's the one who can't do it himself anymore but tells others how to do it. There's a great coach on the bottom right. That's John Wooden, one of the greatest coaches of all time. And John Wooden said, the main ingredient of stardom is the rest of the team. I think he's right. And this person is Nolan. This is Nolan. He's two years old. He's having a good time. But if Nolan stood up very quickly now, he might bump his head on the counter and get himself a big ouchie. Now, there's two ethical approaches being illustrated here. One of them is the me ethics. And it says, Nolan, look out. Nolan, be careful. Nolan, watch what you're doing. Or worse yet, Nolan, I told you so, Nolan. The picture on the right is we ethics. You just set it up so that Nolan is going to do well and you say, hey, Nolan, let's have a good time. So what is the new professionalism? Ethics isn't something you say. It's a syntax for how you live your life. It sounds like this. I like what you just did. Show me how. Or it sounds like this. This isn't working. Let's talk about it. It's the one minute you add to every patient encounter where you listen to the patient and then write down what they said in the chart. It's joining positive groups, your component society, the Rotary Club, church, synagogue, mosque. The book club is being around people who are talking to each other about the better world that they could work on. First, do it and then say what you've done. Now, Confucius said that. I'm not kidding. Confucius really did say that's what ethics was. Do the right thing and then say something about it. It's looking for the common good and incidentally the common good is self-reinforcing. I don't like that man. Abraham Lincoln said that. A lot of presidents have said I don't like that man. But Abraham Lincoln said something further. I think I'll have to get to knowing better. So let's see what we can find about going together. The world is changing around industry. We can't predict and we can't control what will happen. But the quality of the solutions we find will depend on who participates in that conversation and our willingness to listen. The we-ethics has the best chance of succeeding. So let me close with a little story. This story was told by a slave in Turkey, 600 BC. His name was Esap. And he talked about a crow and the crow was hopping along saying, boy, I'm thirsty. I could sure use a drink. He came across the picture and he looked in and low in the hole there was water in the bottom of the picture.  I'm going to use a little me-ethics. I'm going to tip that picture over. But the trouble was if he pitched the picture over or he tipped it over, the water would run out and he wouldn't get any. So that isn't going to work. So he says, well, there's another kind of me-ethics. I got a great beak. I got one of the most fancy beaks. I'll just stick my nose down in there and get it. But his beak wasn't long enough. As an individual, he could not change the world. So he says, well, wait a minute. There was this webinar thing that the American College of Dentist did and Chambers said something about ethics of engagement. I'm going to get some of these rocks here and I'm going to stick these rocks in the picture. The more rocks the crow put in the picture, the higher the water level became and he eventually drank his fill and then shared that information with his murderer or crows or his friends. The moral to the story is very simple. Don't expect to get something out unless you put something in. It's been a privilege sharing this time with you to talk about ethics. Each of you individually is a point of light for dentistry. Together, as we engage those who are outside and don't know what's the right thing and engage those who are within the profession and don't know the right thing and work with them. The profession will rejoice. Thank you.


to resist, to re-resist, yes, we're resisting state overreach. And we're talking to Tom Yamachika on Talking Tax with Tom here on a given Thursday at the 10 a.m. block. Good morning, Tom. Morning, Jay. Glad to be here. It's a very bad fly of you, very bad fly of you to suggest that anyone should resist the state when it overreaches. I guess there's a number of questions here. The first one is, really, is the state overreaching? Can you talk about that? Well, there are a lot of things, I think, where what the state does in practice and what the law says are a little bit different. And sometimes even the laws are a little bit unreasonable, as we found out a few years ago. When we attacked the stop the skim, there was the... I remember the window lingo wanted to get an override on state gross exercise tax, and she took 10% out of it, which was way more than actual state expenses before she gave the balance to the counties, wasn't that it? That's right, but I think it might have been even before governor lingo because I know this was a thing that was negotiated if such is what actually happened between legislative leaders and Mufi Hanuman, who is at that time mayor of Honolulu. But the problem then was that the law that created the county surcharge on GE tax said that the state would keep 10%. And as you mentioned, 10% of the county surcharge went up to be like 25 million a year, which is far, far more than the cost of enforcing it, even at the state level. I mean, you take a look at the Department of Taxation, which was in charge of enforcing it. 25 million was about the size of its entire budget, top to bottom. Yeah, and that was in the newspaper, but it has happened anyway. Nobody was able to stop it. You say you resisted it, how successful were you? Well, we sued. We were hoping that the city and county whose ox was being gored would put up a fuss because 25 million was a lot of money to be taken out of this revenue stream that they would need for building rail unless they thought they were going to get a glut of money, which it turned out it didn't because they had to keep raising and raising and extending the tax. They needed the money. 4.67 billion, 4.67 billion, it sticks in my head like a tattoo. That was going to be the entire cost of rail, 4.67 billion. Ah, where are we now? No, we're close, but what happened there was we the tax foundation filed suit that was in I think the end of 2015. We went into court and the state was kind of sneering at us saying, well, who are you Pipsqueak?  This is a matter between the state and the county.  You know, Mr. Small Pipsqueak, maybe not even a taxpayer to get involved.  Do you pay taxes? We said, yes we do. And that gives us standing. And ultimately, this went all the way up to the Hawaii Supreme Court. They decided that we did have standing, but they found the merits in the state's favor. So we lost the suit. What was the rule of law they enunciated? Well, they said, you know, how are we to know whether that 10% was not an unreasonable estimate of cost at the time it was enacted? We don't know. So we give the legislature the benefit of the doubt. Everybody in the state knew it was way too much. Everybody, I think my puppy knew. I'm sure your puppy knew. But your puppy should have been on the Supreme Court. That would have been at least one vote the other way. Now you're talking. Yeah. But anyway, give us more, go ahead. But the silver lining for this is, because of the surrounding publicity, legislators were feeling the heat because they're constituents were telling them, yeah, this 10% is way too much. So in 2017, they enacted a law that said, okay, we won't take 10%, we'll take 1%. So decreased by one order of magnitude. And it was okay with that. And that's what the law is today. So Chuck went up for the taxpayers, not that perhaps the win that people were thinking about when the lawsuit started, but still a win. That reminds me of a case I had one time regarding an assessment of downtown office building. And the state, according to my appraiser, was like $200 million beyond who value. That's no way out of the way. So we were in the chambers of the judge who was trying to settle this case. And I said, $200 million over. And the state said, okay, okay, okay. We'll drop it down by 150 million. And I said, why did you assess it at 200 million if you would fall over on 150 million in the first settlement congress? Why is that? Do you think the 200 million might have been inflated? Just slightly, huh? But my point in all of this was to say, there should be people other than just us watching government, especially the ones that get hurt. Like in this real skim situation, like the state said, yeah, the people who got hurt the most were the city. So why didn't they kind of step in and do something? It's not a rhetorical question. What is the answer to that question? They can do something if they want to. Do you remember a few years ago when we were considering a ballot measure that would have increased the real property tax or and given control of it back to the state? The city in Kanya Honolulu was the primary party opposing this when they sued in court. Then the other counties kind of like hopped on their coattails, but they sued in court and they were the ones that successfully invalidated the ballot measure. So they can do stuff if they want. Well, they have a big stick. They're directly involved. They're a government agency. You know, what makes the state so significantly more powerful than the county? County has a big stick. That's right. And I think they should be using it more often, especially when the state overreaches. One specific instance, other than real, that I had been complaining about was their position on the transient accommodations tax. Now, as you remember, the shut off of the transient accommodations tax going to the counties didn't start with House Relate 62. It started in March of 2020. I think it was March, could have been May, when the governor just kind of shut off the spigot by executive order. And he said, using my emergency powers, I'm gonna shut off this transient accommodations tax to the counties and any of the other earmarks that it's going to. So we're gonna keep all the money in the general fund. And at that time, you know, we were kind of wondering out loud, okay.  And we were kind of thinking, okay, how does this dovetail with emergency functions? It's just a money grab. And I thought and I published a piece saying that it was just a money grab and it should be challenged. But did the city and county challenge it? No. Did any other county? They have a corporation council with dozens of lawyers there. It's not like they didn't have a lawyer handy. That's right. To file papers in that case. Dozens of lawyers, dozens, all of whom are paid at market or better. That's right. And it affected the other counties too. And they have departments of corporation council in all of the other counties too. So it's not just Honolulu. There's Maui and Kauai and the Big Island. So why didn't any of them do anything about it? That's my question. You say it's rhetorical, but what is the real reason? Let's advance this conversation into the real reason. I think they were afraid. I think they were afraid that the next time the legislature meets, they would do something to squish the counties flattered in a pancake. The power of the purse. Not only the purse, there are other things that they could do as well. They can make life difficult for the counties as they did with House Bill 862. I mean, let's kind of remind ourselves of what House Bill 862 does. Okay, yeah, it shuts off the transient accommodations tax load of the counties. That's, what, 150 million? It, and what does it replace with? It replaces with a grant of authority. So the counties have to go past their own ordinance to impose a up to a 3% surcharge on the county, on the TAT, okay? But how do they do this in practical terms? How are they gonna enforce it? Do they get to ride upon the coattails of the state like they do for the GET? No. Matter of fact, what I had heard was the counties and the Department of Taxation were negotiating a memorandum of understanding which would have let them do that. They're the same as for the general excise tax in properly in return for getting a cut of some kind. And then the attorney general's office stepped in and put the kibosh on it saying, well, this statute doesn't authorize it. So you can't do that. So each county now has to hire new people, make their own new forms, put their own processes, procedures, enforcement, et cetera in place to collect this transient accommodations tax, which they didn't have before. The economy's the scale that'll reply down. That's right. It's totally upside down. Well, I wanna add a story to my own. Sure. In the practice, I told you about this before the show. We represented a landlord who entered into the long-term lease with the state. The state was a very hard negotiator, by the way. They require all kinds of improvements and expenditures by the landlord at the beginning of the lease. You know, improve the space for the state. And it wasn't a year into the lease when the state wrote a one-liner saying, we're leaving, we're leaving the space. We're breaking the lease. And the landlord was hoping for a cash flow for some time. This was, you know, otherwise, I guess to have the state know, you're not gonna have a default on your hands, but instead you had a cancellation on your hands. And the lease was an escape provision that probably still exists in all state leases today. Yeah, and federal ones also. I mean, it's a clause called termination for convenience of the government. Yeah, it was something like that. Convenience of the government. If some administrator determines that it's in the best interest of the state to walk away from this lease and leave the landlord hanging, you know. The implication was that the state didn't need the space anymore. I think that's the way it was conveyed. The state didn't need the space anymore. Well, a few months later, the landlord found that the state had taken exactly the same amount of square footage in a building down the block and got a better deal. So what happened is the state found they could get a better deal down the block. And they said to the landlord, take a hike, you could eat the start of expenses you put in and we're walking on the lease. That had been a private citizen, a private company that would have been a big lawsuit. But the state felt that they could screw this landlord without so much as a fairly well. Now you can say it falls within the bounds of this provision about the convenience of the government or whatever. But in fact, it was very, very unfair. And I tell you, and it was tremendous loss to the landlord and it was not acting like a civilized player in the community at all. So I'm just, I'm hanging that one out there and I wanna tell you one more thing that I learned in the course of practice and that is this. If you were involved in disputes of some kind, not necessarily involving the state and you wanted state records under the Freedom of Information Act, it was the statute that laid out, the federal FOIA statute laid out how you get them. You write a letter and have so much time and then have to give it to you and you pay the copy and cost, whatever, it's a system. And we used to do that in the practice we would ask for these records, but the state would never provide them. I don't mean sometimes.  And finally, I had a conversation with some guy and I said, well, why? Why is that you never actually comply with the statute? Why do you always make us through you in court? And he said, well, we don't think the statute goes far enough to protect us. We're the state. And so we wanna see an order from a judge. We wanna take you through a contested proceeding in front of a judge, get the lawyers to write papers and make arguments about how you're entitled to these records. And only then are we gonna give them to you, not on the basis of the Freedom of Information Act. I said, that is really awful. Not only was it awful in any one single specific case, but it was a matter of policy, it was worse. And that's what the state was doing. Now, I don't know if they're still doing that, but that's what they were doing then. And I mean, what happened in the beginning of the pandemic was that same law that you're talking about, swish. It was eliminated with the stroke of a pen that was part of the same emergency proclamation. Chapter 92 F is gone. Our organization and a number of others that advocate for transparency in government, we had a talk with the attorney general or at least our spokesperson did, and we got them to roll that back a little bit. But under the elimination of chapter 92 F, the state didn't really even, they didn't even have to respond to a request for records. They could just throw it at the trash. Well, that's what happened. And in my experience, that's what happened. You didn't get a letter saying too bad for you. You got nothing. And when you asked them, ostensibly a friendly conversation with the attorney general, that's when you found out that they blew this all up completely as if you had no right at all. So you got other examples of overreach because I really wanna get to the core of why this is happening, how it started as a culture point in Hawaii. Well, I do agree with you that it is a culture point in Hawaii. And I think that's the cause of the problem. We have this culture of, ah, let's get along, you know, we don't wanna fight and we don't wanna cause trouble. And by the way, if we do, there will be retaliation. There will be consequences. I mean, we found that out, the foundation found that out. Because we had somebody talk to lawmakers after we filed our rail suit. And, you know, the particular consultant we had was interested in seeing whether, you know, because we perform a public service, we could get a grant in aid or similar funding from the state. And the response we got back from a very highly placed legislator, you know, who was at that time a vice chair of one of the money committees, okay, was, look, these bozos sued the state, they're not getting a penny. End of story. I have one for you along the same lines. My neighborhood was very concerned about the circumstances of the subdivision approval. They thought it was improperly granted, PPP. And so they sued the city for that. At the same time, another person in my neighborhood went to the city council through Rod Tam, as I recall, who he's gone now, and tried to get a bill introduced that would resolve this. And the answer from the city, that request was remarkable. And this came from the corporation council. Since people in your neighborhood, not necessarily the same people, by the way, since people in your neighborhood filed a suit against the city about this particular subdivision application, we are not going to entertain any bill from anybody in your neighborhood about that subject. You have disqualified yourself by filing a suit. It had not been resolved, it was just pending. But the whole neighborhood was disqualified from taking their right to submit legislation bill to the city council. Everybody was disqualified. I find that was something out of the year, 1215. Quite remarkable, and what are you going to do? You're going to sue them again. It's exactly, it's the civil rights issue, but worse than that, it's a misunderstanding, misunderstands a broad word in this context of the way our system of government works. But then you have it, it's the same thing, Tom. Well, let me react to that. Okay, whatever happened to land of the free and home of the brave? Battles are fought all the time to keep freedom alive. The battles of today, you're not using muskets and sabers. Some of those are in the courtroom, they're reserved in the court of public opinion. I win sometimes when I hear about the activities of some of the activist groups, but at least I got to give them credit for getting off their duffs and doing something. We need gladiators. We need people who are willing to step into the ring, whatever form it is, and make the case for, let's be a government of laws and not of men. Let's not carry forth these petty grievances that really don't have anything to do with anything. But we're all in this to keep our society alive and vibrant. Now, not all of us were meant to be gladiators. I understand that. And some of those can't stand the possibility of consequences. Yeah, not everybody wants to shed blood, but there are other ways to show bravery. You can complain about government oppression or overreach to a legislator. You can come to an organization like us or somebody else who does gladiator work, there are plenty of them. Tell them you appreciate them or maybe even send a few bucks their way. But the worst thing that you can do, I think, is just to do nothing and let yourself be stomped on because that's what's going to happen. Now, let's... Why do people in government want this to happen? And by the way, I think we have to distinguish, there are three branches of government. And in fact, I would divide the executive branch up into the governor and the various departments under the governor. And where is the fault here? Or is it everywhere? I mean, you have the courts, let's put them aside for now. They're not really directly relevant to this, although maybe they should be. You have the administration, you have all those departments, you have the legislature, you have the county councils. Where is the fault? Well, I think primarily you need to look at the legislative, not legislative, the executive departments and not the people who are on top, people who are in the middle, because a lot of times they have processes, procedures, understandings and so forth that nobody knows about. Only they know about it. Like this city council, oh, we're going to ban everybody in your neighborhood from coming up to the city and doing anything. That's not written down anywhere, but it's an understanding among people and probably middle management. And they survive when administrations change. They're the civil service people. They're gonna stay, even if the department head or the deputy director of wherever it is changes. The civil service people are still there. And they come up with these understandings and ideas and processes and procedures. Whether they are consistent with the law and the books, they don't care because- Well, I'd like to offer this to your comment. And that is, it seems to me that it's an us and them mentality. In my time here in Hawaii, it's always been effectively that. It's the government and the consumer, the little guy. And the government always has the heavier hand.  But it doesn't work that way. Somewhere along the line, it got to be us and them. The government is trying to maintain distance from the consumers, keep them at bay. And the consumers are all who, who at the government. And they treat them either with disrespect or with what do you want to call it? Genuflecting total, complete, over-respect, in order to get what they want. And I think about why this has happened. This is dynamic, I can't say it was always like this. It just became more and more like this. And in order to try to understand it, I want to tell you one last story. I'm in a meeting in the governor's office. This is governors ago. And we were seeking some kind of thing on behalf of our client and we lined up a bunch of department people and they were all pretty much game with it. And the chief of staff of the government, of the governor was there. And it all seemed like it was gonna work. And then somebody said, but you know that one of these activist organizations is opposing this. And if you do this, that activist organization is gonna make a sting. And at that point, the guy running the meeting said, oh, oh no, we can't, we can't deal with that. We can't have that. We have to fade on this. We can't do the deal because some activist organization is going to oppose it. I said to myself, wait a minute, you know, it's just the specter, the possibility of opposition by an activist organization gonna quash this whole discussion. You know, it's like 10 people involved in the meeting and it was fine until he said that, somebody said that. So what I conclude out of this is that somewhere along the line, so many people making such demands and a lot of them are activist demands that the government has got skittish, that the government has started to think, did start to think of it's us and them. We have to be so careful because we could be criticized. If we could be criticized, everything is a matter of shaping the public relations and avoiding any accountability. Just, I think if there were more activist organizations including the ones that advocate for good government and whatever, the dynamic would be changed to, okay, whatever we decide somebody is going to criticize it, but that's okay, we have to do the right thing. I don't think we have that. That's where we need to get to, I think. We have a CYA kind of mentality, CYA and us and them. And that leads to, now a bad solution process and it also leads to a lack of interest and caring about what's good for the state, good public policy because it's all about covering your own old calling. And I think that's what's happened in my career, my observation of this. And I don't know how you fix that. You can say, well, we want more organizations to step up and demand good government and it's a countervailing power, isn't it? So the ones that demand me only, right? My silo ahead of your silo, we have to have countervailing organizations that argue with that. I don't think we do. Yeah, so we need, I think, more of the gladiators. We need more of the countervailing forces so that the so-called fringe forces won't exercise untoward power that they shouldn't have in the first place. And of course, you were going to talk about leadership in this context. Leadership factors in quite well, of course. It's easier to stick to a position when there is a clear vision behind it that's integrated with other things that the Department of the whole state is doing. If you have that kind of leadership, it's tougher to rock the boat or have the boat rocked. If you have a ship that's sailing to point B and you don't really know how it's gonna get to point B but you're kind of going that way in a general direction.  Right? But if you have a clear plan and a direction, the ship can always return to that. And if you follow the rule of law. And you need to follow the rule of law. And you're gonna be able to. That's what our nation was founded upon. People shed blood for this. Okay? We need to kind of go back to how that laid out. And of course, this whole discussion is with due regard for what's happening on the mainland. But, you know, we're focusing today on Hawaii and we'll continue to do that in the future. I sure appreciate your thoughts on this comment and the role you play in all of this process. And of course, I appreciate you coming on the show to discuss it. Thank you so much. Tom Yamachika, President and Tax Foundation of Hawaii.


All right, we're time to ask questions. Let's see what we've got here. All right, Marta, let's see. Question, I found my guy a month ago and I'm surprised how many triggers are coming to the surface. Are you experiencing that in your new relationship? Actually, I had an interesting trigger today. What happened? God, what happened? There was something when I was getting out of the car. It was a simple thing. I can't remember what it was. So I'm gonna say to you, I'm gonna answer the question this way. I don't think I've ever felt connection like this before. I really, I know for a fact I've never felt connection like this before. I've never experienced a relationship where I really just, I just dig this person. I mean, I just wanna pour my heart out in this person. And more importantly is I can feel it from her. And I will say recently, I got scared. Cause my, so there's a picture of my mom and dad. And my mom did her best to be a good mom and she was a very loving mom. And at the same time, she had a capacity to give love and pull it away and give love and pull it away and give love and pull it away.  And after a while, I didn't realize I couldn't trust love.  It's just her presence and her words, but there's just this energetic presence and it freaked me out. Cause for a moment, I was afraid she'll pull it away just like my mom did. And I shared that with her. And those are uncomfortable things to share. And I'm not suggesting it was a trigger per se. It was a trigger in the sense of, we often, many of us have experienced the same thing. And what I appreciate most is we've already began a relationship of radical honesty. We began a relationship of laying our cards on the table. That's one of the benefits of long distance relationship. Now, in our particular case, we are spending a significant amount of time together because we're blessed. We have a flexible lifestyle with one another. Our dynamic fits really well together. But coming back to your question about trigger. Yeah, I've had multiple triggers. And you know what? I've shared it with her. So here's what I invite you to do. When you get triggered with a man, share the trigger with your guy. Share what's coming up for you. Now, more importantly, it's best if you know where the trigger began.  I mean, listen, if you haven't done the Hoffman process, check out the book, The Hoffman Process.  And I've spent a lot of hours finding out where all my triggers began. And so when I could share it with her, it wasn't pointing the finger at her. Not that there was anything to point, by the way. Or just sharing what came up. So here's an opportunity when you share from a heart-centered place with a man, it's actually an invitation for deeper intimacy. What is intimacy?  And if you want that deeper connection, it's gonna require opening up. And men aren't really good at this.  Okay? I'm a unicorn in that way. And there are plenty of men who are absolutely capable of leaning into their emotions and their feelings. I mean this sincerely. Most men are good guys. They just need a little help along the way. Now is it gonna work on every man? No. But you certainly start with somebody. That's my invitation for you. Thank you so much for that question. I really appreciate it right now. Cecilia says, this is a great video, Jonathan. I'm adding it to my playlist. Thank you so much. I'm hoping I've inspired you to shift the narrative. Because most guys, they deeply want to open up to emotional intimacy. They want their little kid loved. It's hard for us to do it on our own. And that's why I invite you to read these books, to do the work, try some of the examples I shared here in the beginning of this video. Because you might be surprised. You might have a diamond in the rough right now. And all it takes is a little bit of squeezing, if you will. That's how a diamond is made. And who knows? You might find that you have a great guy with you right now. Or you can be prepared now for when you do meet a great guy to actually live a more empowered, joyful, happy relationship with someone. And that's my invitation for everyone. All right, folks. I think this would be a great place to wrap up this video. Again, don't forget to purchase a super sticker, super chat, or super thanks if you appreciate this video. And I've had value for you. Don't forget that's for the Connor Asley Scholarship Fund. And I'm gonna wrap up this video as I always do.  I'm gonna reach into the camera. Oh my God, you saw my pit stains. Reach into the camera and give you a big gigantic hug of love if that's okay. I'm asking to turn to someone, a pet, a teddy bear or pillow, and give Iter them a hug of love because hugs are a great source of love. And let's face it, we could all use more love in our lives. I wanna thank Roller Girl.