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Arguments that are expected to be used by both sides before the U.S. Supreme Court on the health care law. At the heart of this is the 1942 decision, Wickard v. Filburn, on the limits of federal power. Mr. Filburn, was an Ohio farmer who questioned a 1938 federal law that imposed a penalty on every extra bushel of wheat on his farm beyond the stipulated amount. The decision was unanimous and went against Filburn. At issue is whether the federal government can impose a penalty on individuals for not buying health insurance. Justice Robert Jackson wrote in that case: "Even if appellee's activity be local, and though it may not be regarded as commerce, it may still, whatever its nature, be reached by Congress, if it exerts a substantial economic effect on commerce." The Obama administration's argument in its brief is that the decision of individuals not to buy insurance, like that of Filburn to plant that extra bushel, has larger effects beyond the local one and serious consequences for the whole country- it raises insurance rates of people in states across the country and makes hospitals bear the burden of caring for these uninsured people. For over 50 years the Supreme Court has largely supported the idea behind the Filburn decision, except in 1995 and 2000- these two decision invalidated laws made about guns near schools and violence against women. The Court ruled that the activities were local and noncommercial and beyond the federal power to regulate interstate commerce....

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House Democrats in the U.S. see the Republican health care plan making the same mistakes in 2017 that the Democrats made in 2008. With the passage of the bill in the House of Representatives with a vote margin on May 4, 2017, rushed through in the way the Obama bill was also rushed through, the nation remains as divided as ever on the issue of health care. The Republicans favoring limiting subsidies and cutting Medicaid, and using some of the savings for a tax cut. The Democrats favoring mandated coverage for all and large subsidies to reduce the number of uninsured Americans, with expansion of Medicaid for very low incomes. Democrats in the House say the Republican House bill will result in Republicans losing seats in the House in midterm elections.

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Peter Orszag's role in the healthcare debate and the formulation of health care policy proposals. One proposal of Orszag, who heads the Congressional Budget Office, is to set up a new agency with powers to cut spending and implement changes in Medicare. Says Orszag, "one of the reasons we have such disjointed and skewed incentives is that we have an excessively political process." At a recent meeting with House Democrats, one Congresswoman said her top priority is winning higher payments for oxygen suppliers, and Orszag was taken aback. For years officials have been trying to cut payments to oxygen and medical equipment suppliers, which are said to be inflated. When a new competitive bidding process was set to take effect last year, industry supporters in Congress were able to delay the plan, and these supporters are still fighting to block changes says the WSJ. Here is a 40 year old Orszag, with degrees from Princeton and London School of Economics, who got his early experience in the Clinton adminstration at age 24. He then followed this with a number of policy oriented jobs, ending with appointment to head CBO in 2007. And he faces the whole system of Congressmen from both parties beholden to interests in the healthcare industry, who provide the donations for them to finance their election campaigns. Dan Eggen describes this in the Washington Post, 7/21/2009. Max Baucus of Montana, and to some extent Grassley of Iowa, are senators from both parties who Eggen points out are beholden to the healthcare industry because of large donations they receive from the interests in the healthcare industry. These interests want to see their payments system protected. The further escalation in health care costs, which would make the whole healthcare system unaffordable even as it delivers poor results, can only be prevented by making cost control an exercize that is not influenced by healthcare industry donations. Jackie Calmes describes the huge hurdles in achieving a deficit neutral move to universal health care in the U.S. in the NYT 6/26/2009. See the link. The exchange between Grassley and Orszag on the issue of the $177 billion in savings needed from the payments to health insurers under the Medicare managed care plans- which allow seniors to obtain Medicare coverage outside the government run program -went as follows. These are dubbed overpayments by outside experts and efforts have been made to cut them in Congress. When Mr Grassley raised concerns about the impact of such cuts in a hearing, -and Grassley has opposed the cut for this overpayment to insurers- Orszag responded saying: "I very firmly believe that capitalism is not founded on excessively high subsidies to private firms. This is what this system delivers right now." ...

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The mysterious activities and losses of a South Korean/Japanese venture capital company Softbank which has been part of the massive misallocation of capital away from infrastructure and health care services during the decades before the pandemic. It has emerged recently as the mystery investor in options on tech shares that led to shares losses of 7 billion pounds for Softbank.

It lost half of its value in an earlier dotcom crash. A few investments in China during the early period of its development based on gut feel of the founder, including Alibaba an e-commerce company based on Amazon's success in the U.S. and other investments in China, is the basis of its business model. This model puts huge amounts of U.S. and foreign capital with estimated pool of capital at $100 billion into ventures that set the wrong priorities for investment- leading to misallocation of capital at this time of the pandemic. 

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The U.S. under president Trump ends the 18 year long war with an agreement signed in Qatar between the U.S. and the Taliban. The Taliban are required to fight all forms of terrorism in Afghanistan as part of the agreement. In the first phase of the withdrawal of American troops, a third of the 12,000 American troops will be withdrawn with a similar reduction of NATO forces. This ends a costly war that cost about 1 trillion dollars and acted as a distraction from major problems in America such as aging infrastructure, and problems related to health, education and other services. President Trump was clear about his perception of America's role during a New Delhi news conference. America could not act in a police role for other states and regions, he said.

President Trump has secured support of Pakistan, Saudi Arabia, and India for the agreement to bring peace to the region.

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Stock funds in the US which suffered decline of 18% in 2022 staged a recovery of 7.8% in January 2023. The Fed's ability to bring down inflation and the health of the economy, improving economic conditions in Europe, China, and India, provided supportive conditions.

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RFK Jr. nomination heads to the full Senate for confirmation as Health Secretary to bring new ideas and solutions to tackle obesity and disease in the US. He called the US health condition dismal as it is, not just for what is spent. RFK Jr called the US a sinking ship when it comes to the health of its people as he answered questions from Senators at Senate hearings. Ron Johnson, Senator from Wisconsin, said RFK Jr. was an answer to his prayers for someone who could help tackle this crisis. RFK Jr. said he was pro-vaccine and his opposition was only to some aspects of vaccines in certain situations. He also said that his father Robert Kennedy who died in 1968 when RFK Jr. was only 14 years old had told him when he was just 13 that it was important to have a fierce skepticism.  The magnitude of the crisis is so large and the budget is so large that only someone with the experience and one who has fought hard won battles against coal and for the environment for decades, and with the tenacity of RFK, is capable of taking the action needed today. Many senators applauded Make America Healthy Again, even as others asked RFK Jr. to support all vaccines at a time of public skepticism of the government. ...

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At a critical juncture in the global fight against the pandemic eight in ten U.S. counties are in lockdown. About 29% of the U.S. economy is offline on April 5, 2020, according to Moody's Analytics. U.S. daily output has fallen by 29% compared to March 2019. Moody's Analytics predicts a 30% annualized decline in the second quarter GDP as businesses gradually reopen in the summer. Higher unemployment and loss of household wealth are likely to cause demand side drops making the recovery very gradual in this scenario. It all depends on how long this lasts and how effective the fight against the pandemic is including the steps taken to cut the spread of the virus, the action taken for rapid testing and isolating of clusters as happened in South Korea and Taiwan, which remain models for effective action. 

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The Centres for Disease Control agency in the U.S. was unprepared for this pandemic in the early period from January to March. This report in the NYT shows how the agency failed to respond effectively in the early days leading to the loss of lives now past 100,000. When travelers arrived at U.S. airports in February from China carrying the virus with them these flights were diverted to selected airports with CDC conducted screening but the screening proved to be defective. Health officils desperate to set up isolation and quarantine could not act because the information provided was not accurate and missed many details resulting in the inability to quarantine early and isolate clusters as other countries Germany and South Korea have done.

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Feldstein points out that Obama economic plans missed the real target, which was on the home front where it came down to addressing the problems of 15 million homeowners under water- with mortgages exceeding the value of their homes- and lack of solutions to deal with the $1.5 trillion in troubled commercial real estate loans. Administration plans really did not help more than a couple of hundred thousand homeowners to reduce their monthly mortgage payments. Getting banks to start lending again by selling impaired loans to nonbank investors, also failed to work, as banks were reluctant to do so and reduce their accounting capital. Health care legislation simply distracted attention from the real problems. See the links to Feldstein's repeated insistence that the new administration (and even during the late stages of the Bush administration) focus on these problems. Health care legislation that passed simply would not control the increase in health care spending, that the public correctly perceived as the real problem if the other health care issues were to be resolved. Instead Obama's health care legislation offered to increase the deficit to unsustainable levels, with no solutions to more pressing home front problems in sight. Feldstein, is one of the most eminent US economists....

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Leonhardt argues that rationing is rational allocation of limited resources, health care budgets are limited resources even in rich countries like the USA, and if you overpay here you cut somewhere else. Now the cuts that are not noticed he says are in take home pay as employers face increased premiums from insurers. Rationing is taking place all the time with poor health outcomes relative to the cost for poor allocation of resources as survival rate for many diseases are not that much better than other countries. Rationing takes place everyday when patients see doctors only for a few minutes as doctors race to see more patients, and when diseases are not caught early on in the process as doctors do not know their patients well enough. And rationing is taking place as patients simply delay or forego treatments based on the extra cost, or as uninsured get no care. There are so many buzzwords like this thrown around, with doctors, hospitals and insurers and other groups trying to preserve the status quo, even as it is becoming rapidly unaffordable fort the US to be spending so much on health care....

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Leonhardt points out that public workers receive lower salaries and higher benefits than private workers. They are being paid in the wrong ways. For example with health insurance coverage that require little or no co-payment, which lead to overuse of healthcare services that don't necessarily improve health. Politicians and unions appear to have accepted this practice over the years. Public sector unions have blocked efforts to improve efficiency and find better ways of doing things from the classroom to work in government offices. Reforms in states such as Indiana have produced some results. But even these improvements do not address the magnitude of the problems facing the U.S. which stem from the public's desire to have it all- from large defense spending, public services, low taxes and no changes to Social Security and Medicare. Polls show Americans want to reduce deficit spending, but the same polls show Americans unwilling to make some difficult choices.

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President Trump says the U.S. could permanently cut off funding to the WHO and revoke U.S. membership if the group does not make changes in the way it operates showing a lack of transparency in its operations and dependence on China. Mr. Trump says the WHO has shown "alarming lack of independence" from Beijing. In a direct letter to the Director-General Tedros Ghebreyesus -"it is clear the missteps by you and your organization in responding to the pandemic have been extremely costly to the world." Mr. Trump gave the WHO 30 days to make "major substantive improvements" or he would cut funding and reevaluate U.S. membership. Mr. Trump said in the letter that the WHO ignored early reports of the virus spreading in Wuhan, failed to share information with other countries. The U.S. which has the largest contribution by far to the WHO was unable to influence the organization. The U.S. has influence in finance at the IMF, the World Bank, and in the tech world, yet this did not extend to important matters of public health. It could be that public health had become an afterthought in the rush to prominence in tech and finance. The contributions of the U.S. exceed anything any other country has made. During the 2 years 2018 and 2019 the U.S. contributed $893 million, according to WHO records, cited in the WSJ. During this period the contribution of China was $86 million with an additional $50 million added recently. The $2 billion Mr. Xi said China will contribute is incorrectly reported as for the WHO, it is what China says it will use to support Africa and other countries in the world to fight the pandemic. ...

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42 year old Jason Smith of Missouri will head the powerful House Ways and Means Committee in the US Congress. He is an ally of Speaker Kevin McCarthy and one of the youngest  persons in this position. He will help form new trade, tax and health policies for Republicans.

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The University of Washington Institute of Health Metrics and Evaluation has doubled its forecast of coronavirus deaths in the U.S. to 135,000, about twice what it is today at 69,000, by early August 2020. This is based on the assumption that with reopening the economy and return to actively operating in offices and shops, in construction and factories, the social distancing will be relaxed. Factors such as rising temperatures are not seen as offsetting the increased mobility in reopening. Dr. Fauci, top U.S. infectious disease official said on My 4, that the relaxing of social distancing could get a rebound started considering the coronavirus "phenomenal capabilities of spreading like wildfire." There is concern that the cases may be much higher in Brazil where there is not much testing, even higher than in the U.S. according to one university study. Argentina is a contrast having imposed a lockdown much earlier and has only 246 coronavirus deaths. ...

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Mr Biden's bold vision for the US in infrastructure, in health and education, in competing in the world is outlined in this video in the NYT of his address to the joint session of the US Congress in April 2021. Biden is determined to move quickly and this comes across in the first 100 days. He says he "has never been more optimistic and confident about America."

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What the French take for granted today- 99% of the French people are covered by national health care- started when Charles De Gaulle faced rising scial discontent in the postwar period, and accepted a demand for worker protections. During the postwar period Frenchmen are paying higher taxes, but in the first 30 years because French salaries were growing fast this was not noticeable. With slow growth and rising healthcare costs its getting harder to increase these tax deductions for overall social security, which have reached one third of apaycheck at the low end, say for ataxi driver in Marseilles. So you have the government running deficits of $15 billion in 2004, even after increasing co-payments for routine care and doctors visits. Experts say this could reach $40 billion in 2010 and $90 billion in 2020. In 2007 health care cost the government $300 billion, or 11 % of GDP, (OECD numbers) and the bureaucracy and rules are getting more complicated. This 11% is well below what Americans pay for asystem that leaves out about 50 million people. France ranked 8th on the OECD list in cost per capita, the US at the top. And the French life expectancy is higher at 80.98 vs. 78.11 for the USA, higher by about 3 years. For this cost the system is cost effective according to the OECD. And the French find the American debate abouthealthcare public option "altogether surreal", as the newspaper Le Monde put it. To keep the system in viable form the government is increasing copayments, such as the decrease in reimbursements from 80% to 65% for routine care and doctors visits in 2004. As aresult the deficit dropped to $6 billion in 2008. ut the global economic crisis and rising unemployment has made this grow to estimated $13 billion for 2009. Measures under consideration: increasing hospitalization copayments to $28 a day from $22. To fill this substantial gap for routine care and other costs the French system has private insurance companies called mutuals that offer different policies. Which is where the Fench notion for equal treatment in health care gets distorted because different people can have different coverage. The French though compare their system to the British system and say theirs is not as nationalized as it appears and the Brisih one is much more so. The French system though supervised by the government is different from government run health care as in Britain. French people are free to choose their own doctor who is often a private practitioner. ...

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This NYT report shows the extent of frustration with delay, dispute and denial as a practice in the US health insurance industry. Much of the comment in social media focused on this frustration. Between 2020-22 the number of denials doubled to 25% for UnitedHealthcare in its handling of claims by patients.

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John Cochrane, professor at the Booth School of Business, University of Chicago points to the simple truths about U.S. healthcare- out of control pricing because of the pathologies created by previous laws and regulations. He points out that costs are high in healthcare because regulations keep them high. Supply of new doctors is controlled because Congress and the AMA made it that way with a cap on residency programs and AMA opposing the expansion of medical schools. In a system of open competition new hospitals and health care businesses would challenge old ones which is not happening in a regulated market with regulations working to limit competition for the firms already in the business and with the influence to limit competition. Insurance costs for major expenses in an open and deregulated competitive market without the regulations would be so much lower than todays costs that its likely we would not even need a mandate such as the one the Obama healthcare law imposes.

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Meditation HRV and the parasympathetic nervous system. Meditation helps calm the system and build resilience. Health conditions, fatigue, worry, illness, exercise, travel, and also cold, political disruption, deadlines, perception of loss of some sort, annoyances, disruptions,  accidents, other events cause the heart rate variations and the two systems to react in different ways, the sympathetic nervous system and parasympathetic nervous system. The parasympathetic system calms us down and meditation is one of the effective ways to get this process to work smoothly.

 

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500 million tons of plastics are produced today compared to 250 million tons in 2004. Califonria sued Exxon Mobil in Sept 2024 for overhyping the promise of recycling. In reality says NYT's Hiroko Tabuchi only some of it gets recycled- an astounding low rate of 30% getting recycled- and the rest 70% of 500 million tons or 350 million tons ending up incinerated or in landfills or ending up in the environment on coastlines. The NAPCOR is association for PET resources, PET standing for single use plastic the kind you have in water or soda bottles. It is presenting the promise of recycling and the importance of these bottles for hydrating, without stating that there are alternatives.  All the time this is going on the threat to public health for the people, for us all, gets larger. Note that even developing nations such as India have the prime minister himself take up the campaign against microplastics, plastics bags and bottles, as Mr. Narendra Modi has done in India. A conference in Busan South Korea is discussing a global plastics treaty to end this plastics threat to health and the land we live in. It shows how regulation is needed in a capital-ist economy because companies and jobs at companies of 70 plastics and recycling companies are at stake and so is the public health, our health and our land, its coastlines and waters. ...

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The U.S. bans travel from most of  Europe and India imposes quarantine on visitors and overseas citizens entering the country for 14 days. Countries around the world reacted quickly to the situation in Italy, France and Germany. The strict measures taken by China are gradually being adopted by other countries. Quarantine done early has worked limiting the spread of the coronavirus. Countries with strong public health systems are better positioned to weather the health crisis. Where strong action is taken early and in anticipation, with a strong public health response, there is better control over the spread. This comes with some economic cost as it has hit the Chinese economy, yet the rebound is likely to be that much quicker and done with more confidence. For instance air travel in China declined by 85% in February from a year earlier to 8.3 million journeys according to Chinese aviation officials. Moves to keep social interactions to a minimum have yielded results. Only food stores and pharmacies remain open in China till March 25.  ...

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Millenials are promoting healthy eating habits in the U.S. as awareness among young people grows about faulty eating habits that have become commonplace in the U.S.  Words such as naturally grown, organic, sustainable, locally sourced are important in the way millennials demand their food, and grocery stores are listening. Millennials are also trying vegan and vegetarian options. Packaging has to be resealable, easy to open and portable. And when it comes to baby food millennials have definite preferences. 

The result is that variety and quality is improving on grocery market shelves.

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The Even Hotels brand of IHG which operates Holiday Inns will focus on frequent travellers in the U.S. who want to keep their exercize routines. It will have fitness centers 3-4 times larger than existing ones, located right near the lobby, benches that can serve as exercize benches, a mat for exercize, bathrooms that let in natural light, cafe with healthy items on the menu. This segment is also being served by Courtyard Marriott, and Hilton Garden Inn. IHG will convert existing hotels and rooms with 100 hotels planned by 2015, the first opening in 2013.

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Hospitals in Europe are filling up quickly in the second wave of coronavirus. Coronavirus patients had to be transferred by helicopter to Germany from the Netherlands because of overburdened Dutch intensive care units. National Guard troops were flown in from the U.S. to the Czech Republic to help. In France as cases approach cumulative 1 million about 2000 patients are admitted to hospital for coronavirus every day on October 29. At some point French hospitals could be overwhelmed this winter, and doctors having to choose which patients to save, says president Macron. In the Czech Republic a collapse of the health system is expected by mid-November says the prime minister. No one expected this to be this severe, he says.  About 40,000 patients are hospitalized for coronavirus in the U.S. During the last week the case are increasing by over 40% in the U.S. and increase in hospitalizations are expected. Recovery rate is improving from the first wave. At NYU Langone hospital system in New York with 5000 coronavirus patients hospitalized recovery rate is improving from 25% in March to 7% in October. Better handling of cases and knowledge gained by doctors is a big part of this. ...