American Healthcare Disruption

The US health system is completely broken and its time for a complete overhaul. A combination of government health care for all and a robust private system living side by side work in many countries and should be amenable to both Republicans and Democrats. The previous entry was for the quick fix. This is for the permanent fix.

1. Government sponsored healthcare for all US citizens. Essentially, medicare for all. Private company(ies) with the aid of AI to monitor usage and detect fraud and abuse by patients, providers, health care companies and hospitals. 

2. Managed care companies to compete with the government plan for patients as it does currently with medicare part c. Through competition of government and private insurance plans quality will improve at a lower cost. 

3. Optional supplemental private insurance to see providers and visit hospitals outside the medicare system.

4. Patients can choose to use either their medicare or go private or hybrid if available.

5. Doctors can choose to participate in medicare but also can have separate private hours to encounter patients privately with clearly laid out fees. (currently this is against medicare rules).

6. Value based care with risk adjustment. Essentially, providers are rewarded for better outcomes corrected for risk inherent in treating sicker patients. 

7. Medical school is substantially subsidized by the government. The tuition is more than earned by their labor during internship and residency.

8. Primary care to be delivered by PAs and NPs. All MDs encouraged to have some specialty.

9. No more employer sponsored health insurance but employers will be charged a per employee tax to the federal government to support government sponsored healthcare.

10. Malpractice reform to include caps on pain and suffering, caps on lawyer's fees, loser pays, etc.

11. Medicaid to continue but at a level, lesser than for those on medicare for all in terms of availability and options. All poor and/or not covered by the employer tax are covered by medicaid.

12. All children through 25 years old are insured through their parents coverage whether government based or private.

13. Hospitals streamline and compete with each other for patients. They continue to compete with cheaper options like urgent care centers and outpatient surgery centers. Poorly functioning, unprofitable, redundant and unnecessary hospitals to close. Hospitals to specialize in certain fields which will improve outcomes.

14. Drugs are to be priced globally at a level that is fair to Americans so they do not subsidize the rest of the world. Yet, priced to incentivize the pharmaceutical companies to continue to innovate.

Obviously, this is an outline with each point representing a tome of rules and regulations. The time has come for a disruption of the American healthcare system.

It is Finally Time to Expand Medicare.

The current health care system is broken for millions of Americans. The vast majority of Americans are happy with their coverage through employer sponsored health care or within the Medicare system. These in combination with the millions of Americans on Medicaid cover most Americans. These programs should not be changed as they are functioning well for the most part. 

The part that is broken and currently the point of contention causing government to shut down is the approximately 25 million people who get insurance through the exchange/ ACA marketplace. Premiums have soared, primarily because they are subsidized by government which functions as a blank check for the insurance companies. Customers going to the exchange are faced with premiums costing over $30,000 per year for a plan with large deductibles ($10,000 before their insurance begins to pay). No surprise that subsidies are needed as this is unaffordable for most people. Available insurance that few can afford is a broken system.

The fastest and easiest solution to this debacle is to add to the exchanges the option to buy into Medicare and let the private companies compete with the Medicare program.  Currently, for those over 65, this private vs government competition functions well with the Medicare system (government) competing against Medicare Advantage plans (private). They exist in equilibrium by competing over quality and price, ultimately driving down costs. For those under 65, Medicare should be offered at a cost that is not subsidized and reflects the age adjusted risk and be actuarily sound.

The Medicare system already exists, functions well and has high satisfaction. It can easily be adapted, quickly implemented to those under 65, and priced at an actuarily sound level. Democrats should be happy with this as it a step towards a one payer system, their utopia. Republicans would hopefully support this as it increases competition even though that competition is coming from government. Perhaps throwing in an expansion of HSA will sway republican votes.

Early retirees are facing huge increases in their premiums and some pre-retirees are postponing retirement due to the fear of rising premiums which they will have to pay until they reach 65. Offering them to buy into medicare will spur retirement and free up many job opportunities for the younger generation at a time when job losses are mounting due to AI, corporate downsizing, etc.

Younger people are reluctant to be self employed or start a business but rather prefer getting a corporate job due to the security of employer sponsored health insurance. This stunts creativity and the entrepreneurial spirit so vital for the growth of the economy. We should be incentivizing creativity, not creating barriers.

Generally, solving problems by promoting competition in the the private sector is preferred over government solutions. But, evidently, the private solution with creation of health care exchanges is failing and has not resulted in a decrease in premiums as promised by the Obama administration. The idea of having private insurance companies compete with each other on the exchange to control prices has failed. Quite the contrary, premiums have tripled and have outpaced employer sponsored plans. Perhaps, the competition between private and government plans is the key to reduce costs.

The Republicans have no real solutions except HSA accounts which do not fix the problem of soaring premiums. Trump's idea of giving money directly to consumers will not work as this does not drive down costs and buying a health insurance policy as an individual will be prohibitive. The Democrats just want to throw more money at the problem through subsidies without admitting that their creation of Obamacare has failed and needs an overhaul.

A change is needed for the millions of Americans who get their health insurance on the ACA marketplace. It is failing too many Americans. The time has come to expand Medicare to those under 65 at actuarily sound unsubsidized premiums. Introducing this option will provide the necessary competition to drive down costs quickly.

Omer Neutra

Omer Neutra was a 21 year old young man who grew up in Plainview, New York and was a typical Jewish American who loved sports, spent his summers at Jewish camps, and planned on attending Binghamton University. He deferred his enrollment and opted to spend a gap year enlisting in the Israeli army. Two years ago he was murdered by Hamas terrorists while working as a commander of a tank division. Last week, his remains were returned to Israel and was laid to rest. He prioritized his desire to defend a land that he did not grow up in but felt obligated to defend. Ultimately, at the cost of his life.

What is the average American supposed to think about this young man who enlisted in a foreign army and sacrificed his life defending a foreign land. Although inexact, there are thousands of Americans currently serving in the IDF. Are there any other countries where Americans enlist in foreign armies at such numbers or is it just a Jewish/Israel phenomenon? To some, this only confirms the notion that Jews have dual loyalty and prioritize risking their lives for Israel over enlisting in the US army and defending their actual homeland. And furthermore, if their loyalty is primarily to a foreign country, should their citizenship in the US be rescinded and shouldn't they be forced to move to Israel if they're connection is so deep even to the risk of their lives?

This is the naturalization oath of allegiance to the US that prospective citizens must declare:

"I hereby declare, on oath, that I absolutely and entirely renounce and abjure all allegiance and fidelity to any foreign prince, potentate, state, or sovereignty, of whom or which I have heretofore been a subject or citizen; that I will support and defend the Constitution and laws of the United States of America against all enemies, foreign and domestic; that I will bear true faith and allegiance to the same; that I will bear arms on behalf of the United States when required by the law;

It certainly seems that those who claim that Jews have dual loyalty have a point and that if their allegiance is primarily to Israel then they should just move there. 

However, it all depends on your perspective and the answer to a fundamental question. And furthermore, the answer to this question explains the anti-Israel sentiment that is spreading throughout both political parties. The ultimate defining question is whether the battle between Israel and its Arab/Persian neighbors is a local/regional war or is it the front of the battle between the West and the forces looking to destroy Western civilization. If it is the latter, then these American boys enlisting in the Israeli army are at the front of the West's existential battle against a fascistic ideology determined to topple Western civilization. They should be exalted by America and should receive all the benefits of an American veteran. They should be viewed by their American compatriots as tremendously brave heroes who volunteered to take it to America's enemies, fighting America's war preemptively by putting on a different uniform.

If there is any doubt whether this is a local/regional war or a civilizational war, just listen to the words of the enemy. "America is the great satan".

Similarly, Israel is spearheading the fight against the enemy of the West and should receive full support. Certainly, not the criticism and charges of genocide it has received by the woke progressives and the America first crowd. Yes, many Jews have dual loyalty, but their loyalty to Israel is not at the cost of diminishing their loyalty to the US, but rather accretive to it.

Omer Neutra is an American hero and his parents should be extremely proud of their son and his memory should always be a blessing. May he finally rest in peace.

  

JINO

The election of Mamdani as mayor of New York under a socialist label in the center of capitalism for the country and perhaps the world is astounding and scary. But even more shocking is that he was elected in a district that has the second largest jewish population in the world, Israel being the first. An individual, who chants to globalize the intafada, fails to denounce the terrorist Hamas, and happily sits with antizionists and avowed antisemites. He was elected with the help of the Jewish vote which in polls support him with 30%+ of their votes.

How can it be explained that a third of Jewish voters support Mamdani? It makes sense if you understand certain facts. A large group of Jews are Jews in name only, JINOs. They are, in reality, woke progressives masquerading as Jews. They have either co-opted the religion by using a veneer of Judaism while their true intention is political progressivism, or actually believe in their Jewish identity but have misinterpreted Judaism as a mandate for repairing the world through social justice, what they term tikkun olam. Either way, the end result is political progressivism.

Most JINOs are minimally observant, if at all, equating their Jewish identity with woke progressivism exclusively. Their religion is, in fact and in reality, woke progressivism and this trumps any desire to improve themselves as Jews, or for the betterment of the Jewish people as a whole, or the Jewish nation, Israel.  Instead of taking on the demands of the Jewish religion which ultimately leads to the betterment of the individual, they cede their responsibility to government and proclaim that by supporting the political party that supports social justice, they are "good Jews".

Thus, it becomes understandable how Mamdani received a third of the Jewish votes. The JINOs believe that woke progressivism is their utopia, their ultimate desire and everything else is secondary to it. The safety and security of the Jewish people in New York City is of secondary importance. The State of Israel is seen as a force contrary to social justice. The Torah is irrelevant to them. Woke progressivism is their religion, not Judaism, and Mamdani is the beneficiary of this mental disorder. They are Jews in name only, JINOs.

A Marxist, Antisemitic, New York Mayor and the Jewish Vote

The race for the next mayor of New York is shaping up to be a major inflection point in the ongoing infiltration of socialist/woke/Marxist ideology into the fabric of the United States. The success of Zohran Mamdani is very concerning for the future of NYC, the most important and consequential city in the US. If he becomes the mayor, the deleterious effects will be immediately and permanently consequential. The seat of capitalism for the entire world will be led by a socialist, anti-capitalist. To boot, the most Jewish city outside of Israel will be run by an avowed antizionist, pro-Hamas, antisemite. 

It is a complete failure that a better candidate wasn't recruited to run for mayor. It is critical for the financial industry centered in New York to have a moderate mayor and the blame and consequence will be directed at them. Where are the finance leaders like Jamie Dimon that invest billions into NYC? Where are the NY real estate moguls that have so much to lose if Mamdani wins. There should have been a candidate for mayor from the business world. Instead we had the choice of a Marxist, a washed out disgraced politician in Andrew Cuomo, and an ineffective incumbent in Adams. But it is too late.

It is inconceivable that the majority of New Yorkers desire Mamdani to lead their city, but he can win for several reasons. The small but vocal woke minority will be sure to get a high percentage of its adherents to get out and vote, while the complacent moderates will have a lower turnout. Futhermore, it is appearing  that the  anybody but Mamdani vote will be split amongst more than one competitor. This anybody but Mamdani vote has to consolidate behind one candidate for their to be a chance.

Most importantly, the Jewish vote has to be motivated and mobilized to vote. There is every reason for every Jew in NY to vote against this antisemitic, anti-Zionist. The Jewish vote can sway the election holding 12% of the electorate with the potential for an even greater relative percentage by pumping up turnout. Every Rabbi should begin immediately sermonizing to their congregations about the importance of coming out to vote in November. Every Jewish organization should be pounding its NY members to vote.  

We cannot sit idly by and watch an anti-capitalist lead the center of capitalism and we cannot allow an anti-semite lead the center of Jewish life in the diaspora.

If you are horrified by the events of October 7 and the public's pro-Hamas response it is incumbent on you to vote. If you are Jewish or supporter of Israel, please make it your business to vote on November 4 . 

NO EXCUSES.

for early voting by mail or in person:

https://vote.nyc/RequestBallot

Private Equity Scam

 I recently had a very honest sprinkler mechanic come by my house to fix some issues and I was enlightened by his description of the sprinkler business. Basically, the sprinkler companies pump up their earnings by requiring their technicians to upsell questionable services and repairs. After achieving a certain level of revenue they sell the business to a private equity firm for a multiple of the revenue. The private equity firm consolidates several of the sprinkler acquisitions into one company which it then sells for a profit. Is this good for the consumer?

This model seems to be effecting many business, including the medical business, where private equity  gobbles up profitable, autonomous, doctors practices then employs doctors at a set rate. The doctor becomes an employee and earns a salary based on productivity and doesn't gain from the profit of the business. The PE firm tries to maximize its profit by increasing the revenue and minimizing expenses. Basically, the business goes from a doctor run enterprise to a doctor employee model. Does anybody think that the employed doctor would be as motivated as the doctor owner? Does anybody think the PE firm cares about the best interest of the patient's health?

We are experiencing the corporatization of many businesses that were traditionally run as Mom and Pop endeavors and are being consolidated into larger entities by private equity and this is not in the interest of the consumer. Pre-sale, it creates negative incentives for small business owners and results in unscrupulous business practices.  Post-sale, the corporatized employees that ultimate deliver the services have little incentive to generate satisfied, recurring customers but only to generate a cash flow for their bosses to pay off the debt incurred by the acquisition. Furthermore, the corporatized business will attempt to drive down expenses, including salaries, in an attempt to reach projected targets. The greater the profit minus debt service, the greater the value of the enterprise and hence, valuation to the next buyer. Until it all comes crumbling down.

I believe that many of these consolidated business entities will fail as they will have overpaid for the underlying businesses, projected unrealistic goals, and cannot generate the cash flow required to support the debt. Additionally, the services provided by these large businesses will be of poor quality in comparison to the small business providers, further decreasing their profits leading to their demise. 

Private equity is creating short term profit at the expense of reliable, honest, quality services. Their goal is only to increase the value of the business to sell to the next buyer at higher valuation. Ultimately this model will not succeed. But as with everything, opportunities arise when other things fail. The appeal of a committed local small service provider and the relationship between a local provider and his/her customer will be preferred. Personally, I always search out for the individual plumber, HVAC technician, or sprinkler mechanic.

Lessons from the First Israel Iran War

There are two lessons that can be learned from the ongoing Israel Iran war started on October 7, 2023, its mission, to eradicate the State of Israel and the Jews. The first is that Israel is most vulnerable when they have been lulled into a sense of security and complacency as was the case prior to October 7, 2023. The second lesson is that the enemy has only 12-24 hours to achieve enough of their goals before Israel has the time and ability to mobilize. And this is an obvious weakness of the Israeli military since it relies heavily on its reserve forces to compensate for its smaller population and hence smaller standing army. Time is required to mobilize this reserve force as most are going about their normal lives.

As in the case in the 1973 Yom Kippur war, Israeli intelligence failed to recognize the impending attack which resulted in the enemy forces making significant progress against Israel in the beginning of the war. They failed to capitalize on these gains and allowed Israel time to mobilize which eventually led to their defeat. Had the enemy been able to disrupt the mobilization of Israeli forces, the outcome may not have been favorable for the Jewish state.

If there is another existential war against Israel, the enemy will have probably learned their lesson and after a surprise initial attack would plan a secondary mission to prevent mobilization of Israeli reserve forces. This may take the form of disrupting communications via electromagnetic pulse or a biological or chemical attack.

Israel must prepare for such a scenario. Their best preparation is to capitalize on their strengths which include their intelligence and their technology advantage. In addition, it is clear that preemptive attacks by Israel results in its best outcomes and this was proven by the 67 war, the destruction of the nuclear reactors in Iraq and Syria, and the recent attack against Iran. Intelligence will lead to necessary preemptive attacks preventing full scale existential strikes against it as well as secondary strikes.

Israel's demographic disadvantage can be offset by their technological advantage. They require a force to withstand the initial attack to give it time for its reserve forces to mobilize. This may take the form of a drone/robotic force led by artificial intelligence that requires minimal front line personnel. Imagine a force of remote controlled tanks, remote controlled drones, remote controlled surface to surface missile banks along with a defensive shield. This can all be controlled by a small remotely located technology group assisted by AI, allowing time for reserve forces to mobilize.

We are living during the first Israel Iran war which started on October 7, 2023 led by the proxies of Iran. Israel is winning the war on multiple fronts but lessons are learned by both sides and both will make changes as a result. Israel has to invest in its natural advantages to overcome its demographic disadvantage. Although hopefully there wont be another, the second Israel Iran war will look very different from the current one.

Hardening of the Heart

In the story of the Exodus, it took 10 plagues for Pharaoh to allow the Jewish people to leave Egypt. And even then, he chased after them. You would think he would have seen the writing on the walls way earlier, preventing all the death and suffering experienced by the Egyptians. It is written that Pharaoh's heart was hardened and this prevented him from conceding defeat and he continued to pursue the enslavement of the Jewish people. Ultimately the Jewish people escaped and became a nation.

In the 1967 Six Day War, the king of Jordan was warned by Israel not to join with the other Arab countries to go to war against it. If they had stayed neutral, their borders would not have changed. Jordan's King Hussein decided to throw in with the Egyptians and went to war against Israel, resulting in the rapid defeat of the Jordanian army. This terrible decision by King Hussein led to Israel's capture of all of Jerusalem, including the temple mount. Was his heart hardened?

The Ayatollah in Iran is experiencing a similar scenario. Hamas and Hezbollah were defeated. Syria and the Assad regime have fallen and allow the Israelis to use their air space to attack Iran. Iran's nuclear facilities have been destroyed and the IRGC are being gradually eliminated. Israel flies freely over Iranian air space, bombing military installations, assassinating enemies at will. Yet, the Ayatollah doesn't concede defeat, obvious to anyone looking from the outside.

Why will the Ayatollah not give up? Is his heart being hardened?  Perhaps, there is a larger plan in place that is yet to be played out. In the above two examples, the hardening of the leader's hearts led to the Jewish people becoming a nation and to the reunification of Jerusalem under Israel. What will be the result of this obstinance by the Iranian leader?

We are living through historic times. These weeks that we are experiencing now will be remembered for centuries if not longer. It is clear, the orchestrator is moving pieces around and we are at an inflection point in his plan. Hardening of leader's hearts is just one tool He uses to achieve his goals.

Am Yisroel Chai!

Caitlin Clark

 Caitlin Clark's popularity and rise to fame has generated a lot of racial controversy within the WNBA in particular, but also within the sports world generally, and the country as a whole. An organization with predominantly black players, the WNBA has seen it popularity explode with the entrance of Caitlin to it's league. This has generated blatant resentment toward Caitlin by the other, mostly black players, who have subjected her to flagrant fouls and verbal attacks. To her credit, Caitlin has been the ultimate professional throughout, disregarding the attacks and never complaining about her undeserved treatment. She maintains her composure on and off the court and plays with admirable sportsmanship. 

Beginning last year with Caitlin's introduction, attendance to WNBA games has soared, salaries have improved for all players and the teams travel more comfortably. But even with that, it is understandable why the black players should feel resentment. They make up 70-80% of the players, are very talented, but who had received little to no attention prior to Caitlin. Then, here comes this white girl and the sport explodes in popularity. 

It is absolutely clear that it is the fact that she is a white girl successfully competing in a predominantly black sport that has generated this giant leap in popularity and attention to women's professional basketball. This is undeniable and rightly causes resentment amongst some black players who worked so hard for many years, devoting their lives to the sport but generating little interest.

From the viewpoint of the sports fan, seeing a white woman play at such a high level is compelling and draws viewers and attendees. Yes, this is based on her race since if Caitlin were black, she would be just another ordinary but excellent basketball player in the WNBA rolls. The white sports fan sees the anomaly of a white woman competing in a black space and feels intrigued and proud.

But is this any different than a Tiger Woods who shattered the mostly white golf world or a Serena Williams who dominated in tennis. Are Tiger Woods achievements a source of pride for black people? Do black people see Serena Williams as one of their own dominating in a mostly white sport? And for that matter, did black people feel proud when a black man was elected president, twice. I believe the answers to these questions are yeses and black people should be proud of their achievements. So then why cant white people be proud of other white people when they excel in arenas dominated by other races.

Apparently, when white people are proud its considered racist but black pride is acceptable. 

Caitlin Clark's and the WNBA's exploding popularity are being triggered by her white skin. This is difficult to say out loud in our race obsessed culture but it's the truth. 

Some People are Just Very Lucky in Life

Some people are just very lucky in life. Things have a tendency to go their way for whatever reason, regardless of their intelligence or any inherent advantage. It is as if they have an external force that works in the background making sure that they succeed in whatever endeavor they pursue. And when things tend to go awry, they suffer little setback. One such person is Donald Trump.

If you look at his history, it is amazing what he has been able to achieve even though he is not exceptional in any way. He doesn't have great intelligence, great looks, great communication ability. But, he has managed to be a successful real estate developer, successful tv personality and successful politician. Furthermore, he survived two assassination attempts, one by millimeters. Their must be a force acting on his behalf, it cant all be attributed to luck.

I believe this partly contributes to what triggers TDS (Trump Derangement Syndrome). His detractors cannot accept the enormity of success achieved by such an average man. And even more to a man they see as unintelligent, coarse and a blowhard. It drives them crazy as the more they try to bring him down, the more victories he wraps up. 

Even losing the 2020 election turned out to be a big win for him as it is allowing him to be a much more effective leader as a discontinuous president with a gap in between. And losing to Biden ,allows him to be compared to a president with dementia. Very easy comps.

Because of this unexplainable success, I think it would be a mistake to bet against Donald Trump. I think both domestically and internationally, he will continue to succeed. Yes, the administration is somewhat chaotic, in terms of the economy, tariffs, taxes, etc. but my bet is with the perpetual winner. To try and counter this trend is a foolish endeavor.

It is unexplainable why some seemingly undeserving people succeed endlessly. And why good things happen to bad people, and bad things happen to good people. Is it just luck and randomness or is there an entity moving around the chess pieces. It reminds me of the movie Amadeus, in which Salieri questions how such incredible talent could have beed endowed into such a boorish character as Mozart. In any case, it is a good lesson in life to recognize the winners in society, pay attention to them, latch onto their coattails and ride alongside them. 

Juneteenth, MLK Day, and Passover

 As a white Jewish American, I struggle to understand the need for an additional day off that has recently entered our calendar, Juneteenth. It seems that MLK day already achieves the purpose of highlighting the freedom achieved by Black Americans and the entire nation should rightly remember and celebrate this. Having two days confuses and dilutes the issue and many non-Black Americans view Juneteenth mockingly.

Alternatively, one can suggest that there is a difference between MLK day and Juneteenth. The message of MLK day is a universal truth that one should be judged not by the color of his skin (or sex, religion, race, etc) but by the content of their character. A lesson all Americans need to hear regularly and reminded of frequently, especially in such a diverse society as ours. 

In contrast, Juneteenth recognizes specifically, the freedom from slavery achieved by Black Americans, a uniquely Black American experience and rightly celebrated by Black Americans. But I question whether the entire nation should celebrate Juneteenth and further, whether making Juneteenth a national holiday actually dilutes its meaningfulness to Black Americans and the nation as a whole. 

Passover, similar to Juneteenth, celebrates the transition of a people, the Nation of Israel from slavery to freedom. We remember, retell, and actually relive our historical path some 3500 years ago on Seder night. This highly choreographed service achieves several important cultural goals, one of the primary being for the children to be active participants by asking questions. We perform strange rituals on that night specifically to prompt the children to be intrigued and inquire. This accomplishes the goal of teaching the children who they are and where they came from and perpetuates the tradition through the generations. We acknowledge the slavery and suffering at the beginning but end with and stress the celebration of freedom. 

Passover is celebrated by the Jewish people as it is our unique historical experience. It is a celebration of our freedom, not a condemnation of past grievances. It allows us to continue to pass our tradition through the generations and to warn of future threats (uniquely needed by the Jewish people). It is meant to be a fun, instructive, positive, encouraging experience. To remember and be forewarned but not to dwell. To ultimately provide pride and hope.

We wouldn't expect the current day Egyptians to mark this achievement and certainly not any other non-Jewish nations. It is our journey and only we own it. It is not intended to provide universal national or international lessons. It shapes our culture. 

Juneteenth can be a similar experience and can be choreographed to be an important tool to instruct Black American children and shape their culture. Of course, they will start by learning that their ancestors suffered as slaves but will then transition to attaining freedom and conclude with the remarkable achievements by Black Americans, overcoming immense challenges. This will have the consequence of the children learning where they came from and more importantly, instill pride in their historical path and provide hope for their futures. It should minimize the grievances but concentrate on the achievements and the future. 

Juneteenth should be a holiday celebrated by Black Americans commemorating their unique journey. It is their history, their suffering and their achievements and they should own it exclusively. Not to be diluted and mocked by others, but to be admired and to be used as a tool to advance their own culture and provide pride and hope to their children.  How much more powerful would it be for the entire nation to observe Black Americans take the day off in commemoration of their journey while the rest of us work. 

Juneteenth should be a holiday for Black Americans exclusively similar to Passover for the Jews.  If planned properly, it would be more meaningful to both Black Americans and for the nation as a whole. Yet most importantly, provide the pride and the hope Black American children truly deserve and need.

Global Chess

What does Iran have up their sleeve? They are not acting as one would expect based on media reports of their diminished military capabilities, their population's hatred towards the government and their economy being in the toilet. One would expect them to be more receptive towards the West and less instigative as they seem more isolated but act emboldened. 

It is possible that this attitude represents religious fanaticism which in their minds ensures their ultimate victory over the West despite prevailing conditions. But perhaps they have a well thought out plan as they are very smart and experienced strategists. Perhaps their plan is currently underway and began on October 7 with the Israeli and US response fully anticipated and going according to their plan that they keep under wraps. Maybe it started with the invasion of Ukraine.

Perhaps they have a secret plan known to China and Russia to thwart the US and its allies. It seems that Iran is intentionally provoking the West into military action in order to justify a retaliation which is their ultimate plan. That retaliatory strike would likely target the United States directly as the US with its open borders in the last 4 years could easily have admitted a sleeper cell planning a major terror incident. The US has many soft targets and this can easily be exploited. It may make 9/11 seem small in comparison. 

Iran would put all the blame on Israel and the US' support of Israel for the attack in order to sway US public opinion against Israel, attempting to drive a wedge between the US and Israel. The ultimate goal being to cut off Israel's main benefactor and then try to eliminate Israel.

The West has to be smart with its aggression towards Iran and should use the Iranian population's hatred towards their government to their advantage. The US should not attack Iran directly as this may turn the Iranian public opinion against the West, and should be left to the IDF which has justification. The west should instead help the Iranian people overcome their government themselves. Hopefully, there exists connections within Iran to instigate a revolution against their tyrannical leaders enjoining the military to turn against the current government with the support of the masses.

Lets hope and pray we are one step ahead of Iran and not the other way around.

A Big Deal

 The Democratic party approval ratings are in the toilet and rightly so. They have shown themselves to be liars and as I have written previously, demonstrate a lack of concern for the needs and desires of the American people. They care only of their own power regardless of whats good for the country and its citizens. They desperately need a fresh approach and need to realize that being an obstructionist party is a losing strategy that will only entrench the GOP's control. 

With all due respect to Chuck Schumer, he is a horrible leader for the democratic party and will only lead to more democratic losses. He is a reminder of the horrible Biden years. He perpetuated lies from the Senate floor. He is too old looking with the reading glasses on the tip of his nose. He is seen as an obstructionist and not as a constructive leader with a forward vision for America. A new face is needed to lead the party. 

The Democratic party has to start making deals with the right, advancing some of their policies in exchange for allowing some right leaning policies. They need some wins, even if it entails some right wing victories. The Dems need to demonstrate their value to their base and to try and recover a portion of the working class. They only need seven senate votes to overcome the filibuster and enact legislation. A coalition of seven moderate, young, fresh democratic senators should lead the party in this endeavor and into the future. 

A bold deal can be made between the dems and the GOP. Here's what it may look like. The GOP would get a halting of birthright citizenship and a change to the asylum laws which have been greatly abused and gamed. In addition. immigration will be revised and enforced, and illegal immigrants will be deported. Revocable residency visas will be granted but will not lead to citizenship or come with benefits.

To the dems in exchange, the broken health care system of the US will be dramatically changed. Healthcare will be guaranteed to all citizens and every citizen will be insured. There will be a public healthcare system that would NOT be managed by government but by private companies such as United Healthcare, etc. Medicare and medicaid would be abolished as everyone would be included in the public system.

A payroll tax will be instituted and paid by employers, but the employers would save the premiums they are currently paying to insure their employees. A work requirement is implemented for all citizens.

In addition, there would be a private system where people can upgrade their insurance or buy a supplemental policy which covers providers in a private arrangement. Providers can work both in the public system and in the private system depending on their desires and schedules. 

Plus, as long as the main health related mandatory spending burdens on the budget are controlled, the sole remaining factor, social security will finally be reformed. Now is the time to strengthen this system to ensure its longevity and doing it concurrently while both parties are compromising makes a lot of sense. This is the easiest piece and many solutions abound, but requires bipartisan unanimity because it is deemed to be a political loser. It doesn't have to be, since everybody ?50+ would be grandfathered to the current system.

Of course, this deal as described is a concise outline and there are many details to work out. But it would show that government CAN work. This bold deal would be good for a new face of democrats looking to advance their agenda and demonstrate a constructive vision of America. It would be good for the GOP, finally achieving a long desired outcome. And most importantly, it will be good for the citizens of the USA.

Buy, Buy, Buy

 Capital markets are declining big time after an initial uptick following Trump's election. Market indices are in or heading to correction territories. The cause is based on the narrative that we are heading towards recession due to tariffs leading to higher prices and reduced consumption. A loss of mostly government related jobs due to overhiring in the Biden administration, raising unemployment. Less government spending, due to DOGE, which was pumping up the economy up by recklessly spending and borrowing. 

These Trump initiatives are necessary steps to put the economy on a better footing and create long term stability and healthy growth. They are short term hits to the economy in the anticipation of long term benefits. A responsible government is finally in place to reverse the irresponsible actions of previous administrations (including Trump 1.0) and sometimes it comes with some bitter medicine. But, there are other factors which can mitigate the negatives which are being overlooked.

If it appears that the economy is slowing, interest rates will fall and this will be very bullish for America and what Trump is attempting to engineer. As a real estate guy, he knows the power of lower interest rates. Lower interest rates will allow homeowners, businesses, and government to initiate and refinance their debt allowing for spending, expansion and reducing debt payments. All boosting economic activity.

Lowering of oil prices and gasoline reverberates throughout the economy and improves balance sheets of families and businesses. Manufacturers benefit from a reduction in their input prices. Oil has fallen from over $80 per barrel to under $70 per barrel under Trump and is expected to go under $60 per barrel as supply increases. 

The reduction of regulations is likely proceeding under the radar screen as government cuts by Elon Musk and DOGE are taking up most of the oxygen in the room. The regulatory bureaucracy puts a major weight on the shoulders of businesses and by reducing and eliminating them, businesses are empowered, boosting the overall economy.

Yes, there will be some negative policies intentionally placed on the economy but these are much needed corrections of previous irresponsibility. They will be sufficiently offset by other actions and trends. This market downturn is a great buying opportunity and I hope it goes down further to enable the purchase of additional assets on sale.

Plan B

Now that Trump is back in the white house, there is a 4 year window for people to make contingency plans in case the US spirals towards a more extremist government after Trump. The dems want to label the current government as extreme which is their usual claim towards any republican administration (see Mccain, Romney). But their claims now fall on deaf ears as they have cried wolf once too often. 

As the pendulum of party control goes back and forth, the arc becomes more extreme in either direction. It is only a matter of time until a real extremist is elected. One can argue if this will be from the left or right but the democratic party has a much larger progressive wing than its republican extreme counterpart. The left has certainly shown its fascist tendencies with limitation of freedom of speech and freedom of the press, limiting citizen's gun possession and manipulation of elections through cheating.

We all need a plan B, so now is the time to make plans for an escape to another country just in case things really go sour. A lot of paperwork is required which takes time, plus imagine if everybody looks to leave at the same time, overwhelming government agencies. A second passport is a critical safety valve that can save your life and now is the time to pursue one. If you wait until things turn bad, it will be too late. 

The first path to consider is citizenship by descent. Where were your parents and grandparents from? Where were your spouses parents and grandparents from? It is possible to obtain citizenship if they immigrated from another country, particularly if they were forced out. It takes quite a bit of time to obtain but it can be the cheapest option.

Another option is to purchase citizenship. Some Caribbean countries will sell you citizenship and this can be done rather quickly but at a cost minimally in the low six figures. 

Some countries will issue you a residence permit and passport which allows you to live in their country as long as you can prove that you can support yourself. But a residence permit is not as binding as citizenship. 

Lastly, consider the option of citizenship by investment. In this case, one makes an investment in a country in exchange for residency or citizenship. For example, the purchase of real estate in a country above a certain value, comes with citizenship or residency. The value of this method is it allows you to obtain a second passport, have a piece of real estate to escape to, and most importantly, moves part of your assets outside the US.

These options are especially timely for my fellow Jewish Americans who often have their heads in the sand but who should be the most aware due to their historical expulsions and persecutions. Plus, most have historical roots in other countries which can be exploited. If you're depending on Israel to be your escape valve, well that may be an option but squeezing hundreds of thousands of people into tiny Israel in a short time would be overwhelming for years until the country could catch up. Make Israel your plan C.

This post may be considered radical by some but things always appear calm before the storm. Things can change and change fast. It's always good to have options, even if they are never needed. Everyone should seek a plan B for themselves and their family, what's the harm? Get a second passport

Impressions of Dubai

 I am sitting by a pool in Dubai and I am fascinated by the success of the UAE. A moderate Muslim country that is growing its population and skyline and is tolerant of all religions and nationalities. It welcomes migrants to work legally and earn more than they would in their home country. It attracts foreigners with their tax free policy allowing migrants to escape high taxed as well as war torned countries. It is an oasis from governments that tax away your money in the belief that they can spend and redistribute it better than you can. Seems ideal.

What's the catch? You have to obey the law or you will be deported. There is no option for citizenship, only a residence permit which can be withdrawn. There are no government service, specifically, no government supplied health care or retirement benefit. Of course, you can purchase insurance or pay for health care as needed. There is no safety net, so you either have to work or be able to pay your own way. Essentially, you are there voluntarily at the benevolence of the crown prince. Both the migrant and the UAE benefit.

It is a very international crowd with a heavy proportion of Indians and Pakistanis who make up a large proportion of the work force. You hear a lot of Russian being spoken which is no surprise as wealthy Russians escape the current war and also escape taxation. Many Brits as well have immigrated to the UAE to escape their declining standard of living in the UK. 

It is ironic that Muslim immigrants to European nations have influenced their new countries toward a downward trajectory and a decreasing standard of life. Yet, the native populations in Europe escape to a Muslim country for a better life. 

The UAE demonstrates what a moderate Muslim country can accomplish and contrasts with other Muslim countries that focus on hating non-Muslims. The quality of life rises dramatically once hatred of others abates. This must be so obvious to those visiting the UAE, yet the hatred is so deep that it trumps a better life for themselves and their children. I'm not sure if it is a different interpretation of the religion or repressive tactics by the rulers to focus on hate. Hard to figure but the UAE does so many things right.

The UAE is going to continue to attract worldwide wealth and to grow its population. As the West declines, the UAE will benefit by attracting the upper tiers from around the world. This includes successful businesses, innovators, scientists etc. Is the UAE the new land of opportunity?

 Investing in the UAE seems to be good bet.

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.