Author, Doctor, Speaker, Joseph Bentivegna

Doctor Bentivegna is an ophthalmologist living in Connecticut. He has written numerous op-ed pieces for The Hartford Courant and The New York Times regarding health care, tort reform, and the political situation in Haiti.

Archives for February 2017

    Donald Trump Should Replace Obamacare with a Universal Health Safety Net

 

 

November 27, 2016

 

President-elect Trump has promised to repeal Obamacare but thus far has been vague about alternatives. Rather than tinker with the system, Mr. Trump should boldly propose that all Americans have a Universal Health Safety Net that protects individuals and families from huge health care bills while lowering premiums for the middle class and working poor. The most straight-forward solution is to provide every American with government-backed catastrophic health insurance.

Because of technological advances, bureaucratic mandates and an out-of-control legal system, the average annual health care costs according to the actuarial firm Milliman, Inc. is $24,671 a year for a family of four. Those who are not self-employed pay $10,473 out-of-pocket while the employee pays the balance. Middle class wages have been stagnant for over two decades and now average $53,657 a year.  When the employee contribution is included, many workers are paying almost 30% of their wages for health care.

Providing a Universal Safety Net does not require a new government program. It already exists. It is called Medicare – a plan that protects our elderly and disabled from large health care bills. All that is necessary is to extend Medicare to all Americans for medical bills that exceed $75,000 a year. Purchasing insurance to cover this first $75,000 would be inexpensive.  This would be financed by increasing the Medicare tax (presently 2.9%).  The vast majority of citizens would see their health care bills plummet to around $4,000 a year.

Further cost containment could be realized by classifying diseases and treatments according to efficacy and level of seriousness. It is well known that removing lung tumors before they have spread or treating hypertension and glaucoma saves and improves patients’ lives. Other treatments – back surgery without a herniated disc, prostate cancer and colon cancer chemotherapy in those over eighty years old – are controversial. These treatments could be partially covered and patients could decide if they wanted to pay out-of-pocket for them or else purchase extra coverage.

Furthermore, bureaucratic mandates are requiring doctors to waste endless time inputting useless data for the government to peruse while the complaints of patients are being ignored. Doctors are literally dealing with an Kafkaesque maze of acronyms – HIIPA, MIPS, QPP, APM, CEHRT, MACRA, PQRS (don’t ask) – that do nothing more than waste time.

Tort reform is crucial too. Forcing doctors to perform unnecessary tests adds 15 percent to medical costs. Doctors are also afraid to use modern technology such as e-mail, Twitter, Skype and Facebook to service their patients. Indemnifying doctors for these modalities would enable elderly patient and disabled patients to be consulted without leaving their homes and decrease the need for family members to take time off work, saving billions of dollars in worker productivity.

This plan would also have several political benefits. First of all, it would attract bipartisan support. Many Democrats would see this as a reasonable compromise to the socialistic plan proposed by Bernie Sanders during his presidential campaign. Secondly, it would allow President Trump to negotiate better trade deals as the health care costs for corporations would decrease. Finally, it would decrease resentment towards illegal immigrants who receive free health care while those who are citizens of the country and forced not only to pay outrageous premiums, but taxes to support the  emergency rooms that give the illegals free care. Lowering health care costs would make many more receptive to a reasonable plan to allow more immigrants.

The rise and fall of the Trump presidency will be determined by the upward mobility he can create for the working class who has been left behind by globalization – the so-called deplorables that Hillary Clinton and the liberal media enjoyed ridiculing.  If President Trump and the Republicans extend coverage to all Americans for catastrophic coverage, not only will they be doing the country a great service; but they will enable small businesses and corporations to thrive.

  President Trump versus the Imperial Judiciary

    February 10, 2017

        America’s Ruling Class is determined to negate the results of a democratic election in which a reality-star billionaire outsmarted the so-called best and the brightest. Donald Trump was opposed by the entire Ruling Class: politicians of both parties, Hollywood, the media, the academic community, obscenely-wealthy nighttime comedians, Wall Street and corporate chieftains. Even the Pope practically endorsed Hillary Clinton. His campaign basically consisted of himself – no focus groups, no significant ground game, no early voting campaign, no surrogates, minimal polling, internet fundraising and interviews with anyone who would put a camera or microphone in front of him. He made statements that insulted the majority of the population. He barely prepared for his debates with Hillary Clinton and according to most objective analysts, lost all three. For this man to win, the general population had to be truly outraged.

Yet in the biggest political upset in American history, he won fair and square, destroying two political dynasties in the process. America’s Ruling Class is livid and refuses to accept his legitimacy. But protests by upper middle class women, Hollywood ridicule, boycotts by snooty clothing lines and vicious op-eds in our leading newspapers have done little to stop him. Under his leadership, the Republican Party has finally grown a spine and is slowly but surely confirming cabinet appointees that are so conservative that they would make Ted Cruz blush. But President Trump is now encountering a foe that will test all his abilities: the Imperial Judiciary.

The opening salvo occurred when the President restricted immigration from seven predominantly Muslim countries, a policy he advocated very clearly during his campaign. An obscure Washington-state judge ruled that not only could the President not control immigration into the state of Washington, but he could not restrict immigration into the entire United States! A trio of liberal judges in the Ninth Circuit Court of Appeals rubber stamped this ruling.

This ruling has nothing to do with Rule of Law and everything to do with politics. In spite of what the talking heads are saying, no matter how the President crafted his immigration order, our Imperial Judiciary would have heaved it.

Our law always gave the president, the Commander in Chief, the right to control entry into our country for security reasons. Presidents Carter, both Bushes and Obama issued similar restrictions. If fact, the seven countries the President choose in his order were recommended by the Obama administration. When President Clinton rejected Elian Gonzalez’s asylum application (costing Al Gore the presidential election), our courts sent him back to Cuba. When President Obama refused to enforce immigration law, Arizona tried to do so. The courts ruled that President Obama, as the chief executive, had authority over the states.

But now that Donald Trump is president, judicial philosophy has rotated 180 degrees. The real purpose of this ruling is to put President Trump in his place and warn him that the Imperial Judiciary will protect the interests and world view of the Ruling Class. The Imperial Judiciary plans to stop President Trump from building a wall on our border, enforcing our immigration laws, defunding Planned Parenthood, defunding sanctuary cities, eliminating Obamacare, opening coal mines, negating carbon emission restrictions, building the Keystone Pipeline, allowing those in poor neighborhoods to have school vouchers, preventing voter fraud by requiring photo identification and on and on. And if a financial crisis hits, our Imperial Judiciary will see to it that the Wall Street Welfare State is bailed out and the inflated real estate values of our Ruling Class in Nantucket, Manhattan and coastal California are protected, whether President Trump likes it or not.

How this will end is anybody’s guess. This is the first time in recent memory that the Ruling Class despises the President. There is even talk of canceling the White House Correspondents’ Dinner. Even President Nixon didn’t engender such opprobrium. But unless President Trump has a brain transplant, he will fight tooth and nail. He is acutely aware that the Ruling Class views him and his hard core supporters with utter contempt. He and his family are being ridiculed and ostracized by the media and corporate America like no other presidential family has been in modern history.

When Andrew Jackson disapproved of a ruling by Justice John Marshall, he responded, “John Marshall has made his decision, now let him enforce it.” Whose picture did President Trump choose to hang in the Oval Office? Andrew Jackson’s. As the Chinese say, “May you live in interesting times.” We certainly are.