A Year and a Presidential Era in Review

Reflections, Insight, Guidance and Recommendations for a New Year

Photo by Stephanie McCabe on Unsplash

2024 was a very strange year. The year ended with our country, our world and the medical profession in a very dangerous place.

There are signs of hope in our country more meaningful change is needed. American Pride must be restored in our constitutional republic. An end must come to the powers at be that rule with their money, power and the media mob that they use for their own personal, political and pecuniary benefit (on both sides of the political aisle).

What Does a Congressional Campaign Reveal about our Electorate?

During my Congressional campaign, I found that many people are totally unaware of what is happening. Our best defense is an educated electorate and that is hard to come by. Most people wake up in the morning, send their kids off to school, go to work, come home, eat dinner, watch some tv and go to bed for another day of rinse and repeat. I still meet people who did not know I was running but voted for me because they voted across the line.

As for the average American, if their life is ok, and there is something leftover in their pockets after the bills are paid, then they are totally indifferent as to what is happening in this country or the world. There is a minority of Americans that either care to take the time to be informed or even exercise their vote at the polls. The strangest phenomenon with Connecticut is that almost half of gun owners are not registered to vote. So, even single issue Americans do not participate in the political process in CT.

Lackluster Participation Allows for Coercive and Devise Measures to Take Hold

As a result of a fragmented and disenfranchised electorate, those groups that are organized for any purpose, profit, ideology or disruption, combined with biased rhetoric disguised as news have created an opportunity to advance their agenda. The media “cycle” is 24-hours and the majority of air-time is devoted to segments with opinions under the guise of news rather than simply reporting the actual news. Despite tons of availability of airtime, those with opposing views face an uphill climb to get their views in front of the American public and electorate. Even “left” or “right” media will not give outside or longshot candidates a chance at reaching the voter unless they buy ad time or do something controversial. I personally struggled to get interviews and when I was interviewed for 30 minutes or more, the end result was a two or three minute soundbite. Walter Cronkite who sat and reported facts would be rolling over in his grave.

Our Government Has Some Very Misguided Policies

Over the past 4 years, our government sided with criminals who they regard as victims while the true victims suffer. These are victims that are are physically injured or killed without justice. It is nearly impossible for a victim to get through these trials and court appearances that require an additional sacrifice of time, energy and resources (at their own expense) to see the perpetrators get their day in court. This can be sustained only when these cases rise to national attention.

De-criminalizing Shoplifting

2020 began the era of decriminalizing shoplifting which created mass stealing. It resulted in rings of shoplifters putting stores (especially independent retailers) out of business while destroying jobs and the hard work that business owners put into building and running their own businesses. The result has destroyed the American Dream and the crime was portrayed by the AOC-Left Wing fantasy that these criminals are' desperate' people are 'stealing bread to feed their children'. The crimes they committed were thefts from designer retailers.

Shoplifting, Covid, and the fear of unsafe shopping created the opportunity for online shopping to grow and the promotion of isolationism over social interaction in any form. Why participate in life when you can zoom into it? The real victims were children and those that thrive in a public setting. The result is a mental-health crisis from social media bullying, PTSD from isolation, and a generation that cannot communicate without a cell phone.

Open-Borders

Joe Biden transformed the immigration landscape with an unnecessary executive order and federal challenges to states like Texas. This inappropriate lax border not only enabled millions of economic migrants to enter our country to take refuge at fine hotels in our cities, but also allowed criminals, drug dealers, gangs, terrorists and military age men from countries that are our adversaries to enter the country. Who would ever think that Tren de Aragua would become a term known by most Americans. In addition, it resulted in at least 300,000 unaccompanied children that have been lost been "lost" by DHS, and that number could be higher than 500,000. These are children who cannot fend for themselves and are likely have become victims of trafficking.

The Real Costs of Immigration - NY As a Real Example

New York has maintained some of the best data on the real costs of immigration. According to a recent report of NY Comptroller DiNapoli, NYC and NYS combined are spending $1.5 billion dollars per month on illegals (as of September 2024). That is over 5% of the state and city budgets and has resulted in cuts to other critical services. It has also increased the volume in HHC hospitals at the expense of our urban poor who depend on these institutions as their only form of medical care.

Where is the Legal Immigration Process that Built this Nation?

We are a nation of legal immigrants and their descendants. It is no surprise that legal immigration creates stricter hurdles and responsibilities than illegal immigration. Those willing to follow the legal process must be vetted, have a sponsor and demonstrate an ability to support themselves and can contribute to our society. The modern illegal immigrant only cares to take and rely on government support at a great cost to our veterans and our poor.

Education

Our education system, the key to creating productive citizens, has been hijacked by woke ideology, which takes precedent over teaching the skills necessary to support democracy and work in a 21^st century economy. Students in poorer communities are deprived of an education due to dysfunctional schools that cost the taxpayers dearly while having no accountability to the voters.

Possible solutions include charter schools and vouchers that would provide other options and result in competition. The opposition is intense as the teachers union is one of the most powerful political forces. It is time students come first and teachers are held accountable as their failures have robbed our youth of the hope and opportunity. The result is generational dependents on the government because they are being deprived of the skills necessary to become our future workforce. Their lack of training results in the expansion of the controversial H1-B visa program that also applies to less technical jobs.

Why do the victims of bad policy continue to vote for the same result?

On the campaign trail, and especially at the polls on election day, it is nearly impossible to inform and educate a voter about a platform that will improve their lives and the opportunities for their children. Fear of losing their insufficient benefits for a better future is enough to intimidated a voter to pick up a palm card and continue to support the politicians who have taken away their future.

College Education is a Privilege

As the cost of secondary education increases with annual private college tuition at $43,505 and public in-state tuition at $11,011 (Source US News & World Report), the education our children need has to be able to service student-loan debt. According to the according to the National Association of Colleges and Employers (NACE), the average income with a college degree is currently at with the average tuition at $68,516. There are not enough careers that our college children can obtain with certain college degrees.

We must wake up parents and students and show them that there is a better way. We need leaders in these communities who will fight for them rather than themselves. These parents must be informed of opportunities and our teachers and guidance counselors should be the first line to identify students that could benefit from alternate education (including technical schools) where those students will graduate with a meaningful career in a field with a labor shortage. This is where government is needed and our Connecticut voters must realize that a one-party system with no accountability is not democracy and it has failed. It is hard to blame others when one party controls the entire state.

We have everything necessary for Connecticut to become a booming state that attracts businesses and jobs except for one thing, bad government. That needs to change and the state that manufactured technical machinery of parts and technology to put the man on the moon can rise once again and not just as a defense contractor like Electric Boat or Sikorsky.

World Turmoil and Rising Dangers

China

Our world is becoming increasingly dangerous. We have wars in Europe and the Middle East and China is unchecked on Taiwan due to a current lack of big-stick diplomacy. China is also following the playbook of pre-WWII Japan by expanding its sphere of influence throughout the third-world and creating a network of military bases that is growing. Yet, our government has done nothing to counteract any of this activity. The US was asleep for Japan and that lead to the attack on Pearl Harbor and the involvement of the US in WWII with some of the largest casualties to American soldiers in the Pacific. I think it could have been prevented. Yet, here we are again and history is repeating itself and once again we are asleep. Communication lines and pipelines are destroyed by Chinese ships that drag anchors across the ocean floor and no one even knows it.

It is time to wake up before it is too late. China has a lot of weaknesses: an economy in trouble, high unemployment, an aging population and many Asian adversaries that can work together to corral and control China. We need to provide alternatives to these Chinese controlled bases, ports and manufacturing zones throughout the world by competition. Tariffs are the first lever to pull while long-term sustainable plans are implemented. The Chinese have even taken over the ports necessary to the passage of ships through the Panama Canal.

Middle East

The Middle East needs a strong Israel and moderate Arab states to act as the proxies for the United State to render Iran powerless and destabilize the radical Islamic Republic. These toxic regimes have oppressed their citizens that are old enough to know that there were more western governments in the Middle East that can be restored by the destruction of their current fundamentalist governments.

Ukraine

We must end the war in Ukraine. While it is really a no win situation for Russia, it is a yearning for a past that cannot be revived. This conflict has cost them, men, money, and geopolitical harm. The Ukrainians have suffered tremendously and need to rebuild their country. This is the first invasion of a European country since WWII and it should be the last one. The US has to stop writing checks with no end in site.

Healthcare

I entered politics on a single issue - Healthcare. Once I looked under the hood, I realized healthcare was like all problems in our government: Overly regulated, administrative laden with meaningless policies and employment positions and a sector with a continued decline in performance with rising costs.

Our healthcare system is headed in the wrong direction. Medical care should be about what it has always been about, patients with an illness undergoing treatment or surgery to save or improve their quality of life, preventive care to stop chronic illnesses from progressing, early detection and treatment of cancer and other debilitating diseases to save lives and improve patient outcomes. Yet, that is not what healthcare is about today. There is an entire healthcare bureaucracy totally dedicated to expansion and its’ effect is crippling care while raising costs and decreasing the quality of our healthcare system. We are supposed to have improved healthcare as technology and innovation increase and that is not the case.

Anti-trust laws which were supposedly designed to stimulate competition, have had the opposite effect. The solo and small family practices, that were the most cost-effective mode of primary care, went out of business or were swallowed by the hospital networks. Hospital groups became the largest private employers in the State of Connecticut and the consolidation has resulted in stronger bargaining power for the hospitals with increased reimbursement rates at the expense to the healthcare consumer and insurance company. These hospital networks have not benefitted from economies of scale as administrative costs have risen.

Most markets have single healthcare insurance companies that dominate the market. This is the most profitable model because less competition leads to higher premiums and lower payments to hospitals and other providers. This also leads to shortages. For example, there are cities throughout the country, and counties in New York where there are shortages or lack of obstetric care.

Medicare for All Is Not the Solution

Many have argued that a Medicare for All takeover of healthcare is the answer. I believe that government is the problem as it has resulted in a healthcare bureaucracy where healthcare dollars are diverted from care to regulatory compliance. Thee average physician spends 20 hours per week doing the computer data entry required by the bureaucracy rather than treating patients. The antiquated anti-trust laws of the 19th and early 20^th century are obsolete and destroyed competition in healthcare. The result is monopsonies and markets controlled by few. Such regulation has transformed Medical care to an assembly line industry moving patients along the line in the order in which they are received. Regulation misses the point of the needs of patients to be treated and not processed through a system where the data in the system is more important than the active listening skills needed to diagnose, treat and heal patients.

Neither the patients nor the physicians and other healthcare providers are happy with the current system. As a result, healthcare has some of the highest worker burnout at all levels and will only get worse.

This anticompetitive, bureaucratic healthcare system has led to skyrocketing healthcare premiums that are unaffordable. The system needs to be fixed so that people and businesses can afford healthcare.

Healthcare Solutions

Pilot programs are necessary to create and scale up better models. Large institutions that have the resources to provide the expensive tertiary care, invest in expensive technology and conduct the medical research necessary to advance our healthcare system are essential. However, they are not the best option for providing cost effective primary care.

Final Thoughts

It is my hope for the New Year that our country, under new leadership of President Trump, will reverse the problems that have been created by prior administrations. Our country needs to return to its core values, our citizens need to be informed and engaged and a lawful society must returns. Our enemies need to know that we have woken up, our allies need to know that they can depend on us once again, new alliances will need to formed and deterrence must be meaningful to convince our enemies that war is not the answer.

Our healthcare system needs massive overhauling. Competition and choice need to replace bureaucracy. Care must be provided in a setting where physicians and other healthcare providers need to be able to focus on their primary goal of providing patient care. Patients need to know that healthcare is for them and not for the benefit of other third parties. Health insurance and government expenditures on healthcare need to be affordable. We can make this happen.

Thank you for your continued support. Please subscribe and spread the word.

Dr. Michael Goldstein

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