Mr.. President, Look Here! Low Hanging Fruit

 The implementation of tariffs by the Trump administration is a complicated manner as it is being used for several purposes. Certainly, they are being implemented as a negotiating tool to demand changes by other governments such as immigration policies and illegal drug importation. They are also being used to counteract unfair trading practices that have been allowed to go on for way too long. For example, allowing free automobile importation into the US yet American automobiles are nowhere to be found in the streets outside the US. 

But, there is one industry that is effected by unfair trade practices that are egregious and that is the pharmaceutical industry. In order to export drugs into foreign countries, they are mandated to lower their prices, in what is characterized as price controls. Essentially, an American dominated industry is being forced to lower its prices in exchange for opening the market to them. This has the same effect to the manufacturer as a tariff placed as it results in less revenue per sale. This is not only unfair to the pharmaceutical industry who are singled out to operate under these foreign government imposed controls, but also to Americans who end up paying higher price for prescription drugs. The drugs were developed here in the US and the companies reside in the US. By Americans paying higher prices for drugs, we are subsidizing those drugs to the rest of the world. Its time for this to stop.

All drugs being imported into the US by foreign pharmaceutical companies should be subjected to reciprocal price controls. Countries that implement price controls but do not export pharmaceuticals to the US should have offsetting tariffs placed on their non-pharmaceutical exports into the US. 

The pharmaceutical business is a jewel of American industry. It reflects our ingenuity, our commitment to science, and our culture which allows for many failures to produce one blockbuster. It produces drugs that improve and extend our lives at the costs of billions of dollars in research and development. We shouldn't be selling them on the cheap to other countries. If anything, they should pay more.

This is low hanging fruit for the Trump administration and I implore President Trump to investigate the great rip-off of the American pharmaceutical industry by foreign nations.

The Democrats

There are two conclusion that can be reached when evaluating the actions of the Democratic party. Firstly, they are a completely and absolutely a corrupt operation. Their one and only formula is to spend tax payer dollars for the sole purpose of ensuring votes to maintain their power. This spending is regardless of the impact on the country's safety, the expanding national debt, and the needs of its citizens. Their only motivation is to their own power. 

Secondly, they could care less about the United States of America. They care nothing about its citizens, its history, its future, its culture, it's borders/safety and its future financial well being. They demonstrate no love for their country. They have no allegiance to anyone or anything, but only feign to care about certain groups in order to obtain their votes. The groups include LGBTQ, blacks, Jews, climate fanatics, the woke, the poor, amongst others.

They work by deliberately dividing the country and encourage more people to define themselves in more narrow terms such as sexual preference, skin color, and such which creates a greater perception of victimhood. These more numerous and more narrow "minority" groups/"victims" promote a search for advocacy which feeds votes to the Democrats. Conversely, by defining oneself more broadly, primarily as an American promotes the desire for the country as a whole to excel. This patriotic identity feeds the Republicans. The Democrats thrive by dividing, victimization and perceived oppression. The Republicans thrive by unity and patriotism.

The DOGE audit has exposed many examples which lead to these conclusions. It is clear that the Democrats hired a huge surplus of people to work for the federal government. At an average of 100k per employee this amounts to one hundred billion dollars to hire one million people. This chicanery is done with the sole purpose to buy their votes and effect elections on the dime of the American people. It is not for the actual needs of government and puts the nation in a worse financial deficit. 

What other explanation can you attribute to the opening of the border to millions of illegal aliens? It harms so many American citizens. It suppresses the wages of citizens. It overwhelms government services to the detriment of the citizens. It leads to more crime against citizens. It allows more lethal fentanyl to enter the country killing more Americans. All in the hope of garnering additional Democratic voters, regardless of the deleterious effects on the American citizen.

The promise to forgive student loans to the tune of billions of dollars is a direct payment from the government in exchange for a vote. This was a deliberate plan by the Democrats when Obama took over the lending program from the banks in 2010 and culminated in the unfair, unaffordable, unconstitutional forgiveness program of the Biden administration. Screw the country as long as votes and power are attained.

The payoff of unions and its members through bureaucratic departments such as the the DOE amount to billions of taxpayer dollars in exchange for political support.

The examples are endless. You, useful idiots who vote for the Democrats because you think they represent you against oppression, look deeper. They care not a bit about you, only your vote, and will lie to you to secure it along with their media conspirators. It's time for Americans to see the Democratic party for what it is, CORRUPT.

I Am Somebody? I Must be Respected?

This past weekend's superbowl did not live up to its buildup. It was a boring, noncompetitive game that was massively hyped up and could have been turned off before halftime. The odds going into the game had the teams within a point. But of course, no one knows in advance the quality of the game and as with any sports game, the outcome can never be predicted with certainty. The experience can range from overwhelming excitement to a total bore. Victory and defeat can be determined only once the two opponents actually face each other and I suppose this unpredictability is what makes sports so much fun to follow. But, the game is not what I wanted to write about.

There was a commercial that struck me (to watch, google "I am Somebody" superbowl ad). It showed a series of pictures with an adult and 10-20 children. The adult would say "I am somebody" and the kids would repeat the line. I suppose the message is to give each child, regardless of looks, race, ability, sex, the notion that they are individually special and he/she should feel self-worth/pride regardless of  their external characteristics. A valuable message.

But intermingled with the "I am Somebody" segments there was a part which proclaimed "I Must be Respected" and all the kids responded as such. This seemed troubling to me as there is a significant difference between the "somebody" message and the "respected" message. The "somebody" message is one that can be felt internally and it represents how one learns to feel about themselves, to define and be proud of oneself. It is not dependent on others bestowing upon me. 

OTOH, the "respected" message is completely dependent on someone else's feelings towards me. This is a terrible message as respect is completely beyond my control to influence. It relies on someone else's feelings, biases, and notions. Of course, everyone deserves a certain level of respect. But, the ad suggests equivalence of "I am Somebody" to "I Must be Respected". The message, that my identity is defined by someone else's opinion/respect towards me, is dangerous.  Does not being respected mean I am lacking in some way? If I am not respected then what is my recourse? How do i get someone else to respect me? Can I retaliate against them since they harmed me by not respecting me? Does it justify becoming physical? 

Respect is synonymous with honor as it relies on someone else's bestowing it upon me. I cannot honor/respect myself. Honor/respect is bestowed by others, while conversely, pride is how I feel about myself and exists regardless of others opinions. The "Somebody" message is about pride while the "Respected" message is about honor. I can effect pride, but I cannot effect honor if its reliant on an external force.

Honor's counterpart is shame, while pride's counterpart is guilt. Honor/shame are externally generated and can only be effected by changing others actions and beliefs. Conversely. pride/guilt are self-generated and can be generated and dealt within oneself. I will have more to say about people and societies that are honor/shame based vs ones that are pride/guilt based. It explains many of todays ills. 

Ultimately the message we need to send to both children and adults is one that teaches them to define themselves based on their own self-image rather than to depend on others image of them to achieve their self worth. "I am somebody" is the right way. "I must be respected" is destructive.

(refer to Rabbi Jonathan Sacks, "The Difference between Shame and Guilt Cultures" November 4, 2014)

Doctor, Heal Thyself. If I Only Could.

Its been 14 years since my last post and a lot has transpired in that time, both personally and externally. My son recently surprised me and sent me a couple of my old posts which led me to review some of my other old posts and I began to think about resuming. Looking retrospectively, with humility, I was somewhat prescient about certain things and way off about others. It's revealing and interesting to be able to review what my thoughts were 14 years ago and if nothing else, that was the value of having written back then. Perhaps, by restarting my blogging, I will be doing a favor to my future self. 

I retired from my profession as a doctor/surgeon at the age of 57, 3 years ago, so now I have time to devote to writing. The stress of the job after 25+ years finally got to me and I was completely burned out. For the final couple of years, my thoughts always drifted towards finding an exit plan. This was a definite clue that my time in that job was nearing an end and although there were parts of the job that i enjoyed, the parts that i dreaded overwhelmed the good parts. Performing surgery was the most rewarding part but as the practice evolved, I was doing less surgery. Its probably wise for a surgeon to consider retiring after 55 since without a doubt surgical skills are on the decline.

Burnout is major problem for physicians and studies confirm the burnout rate to be surprisingly high amongst physicians and especially surgeons. Now, when I go to the doctor and I tell them that I retired due to burnout, they all look at me with envy and wish they could stop as well. Even, younger doctors. 

The people who study this condition blame excess paperwork, poor work-life balance, demands of the job beyond patient care. But, beyond these, I felt the main factors were related to patient care. The need to see many patients to cover costs, the demands of the hospital regarding being on call, the inevitable difficult patient (both medically and psychologically), the stress of the patient care itself. There are always cases where things may not go exactly as planned and the stress of dealing with it takes an enormous toll. It is by nature an emotionally draining job.

Now that the vast majority of doctors work for hospital systems and large corporations, there needs to be a mechanism to ensure the health and longevity of the physician. I propose a version of a sabbatical. It shouldn't necessarily be a full year as this may impact a physicians quality upon return. But consider a system that for every year of work, the doctor earns a one month extended time off beyond the normal week vacations taken during the year. This can accumulate and after three years the doctor earns a 3 month paid extended time off. This will allow him/her time to refresh and come back renewed. I believe this system would lead to better, more compassionate physicians and would enable them to extend their careers. 

As a society we need to take care of one of the most important segments of our population that eventually, we will all put our lives into their hands, our physicians.