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Almost all countries have lower commissions for real estate sales. In the US about 3-4 houses are sold over a lifetime. At 6% commission this amounts to a cost of 25% of the sale price of these homes. This adds to the cost of living for American people and reduces their savings for investment in quality of food, education, health and leisure activities. By comparison in the UK it is 1.3%, in Netherlands 2%, in China 2.5%. In most countries only 33% of sales are done by buyer agents in the US 89%, in the UK less than 5%.

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This editorial in the WSJ describes the sharp increase in premiums under the Affordable Care Act of president Obama. The average premium increase is about 24.2% according to a Barclay's analysis, and as high as 43.9% in states such as Illinois. Bill Clinton calls it the craziest thing with small business affected, and some premiums doubling. Of the 17 million people in the individual market eight million buy without subsidies. One in five enrollees cannot qualify for subsidies. Democrats say subsidies are too small. Hillary Clinton has proposed to have a Medicare "buy-in" for people ages 55-65, and a "public option" government run plan. Republicans want to rewrite the law. But this depends on which party wins the Senate, with the election in Missouri giving Democrats an opportunity to maintain a Senate majority.

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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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This analysis in The Guardian says US president Biden is reversing 3 decades of policy since president Reagan that looked with skepticism at government intervention in the economy. The $1.9 trillion aid package Biden has pushed through Congress is a big game changer in the way government operates to help rebuild America after the pandemic. The 2009 response by the government under president Obama was done without conviction that the government response was the best way to help the economy. By 2016 voters turned to a Republican, Mr. Trump, to help working class voters with a USA first policy, after decades of presidents from both parties Republican and Democrat failed to protect American interests in manufacturing, jobs and incomes.  US president Biden is continuing Trump's policies to protect working class Americans. And bringing new conviction that government not only has a positive role, but has an essential and vital role to play in protecting workers and households struggling to make ends meet. President Reagan had introduced such a deep skepticism of government, that it took so long for people to remember FDR and the role of government before the second world war and afterwards under the Truman administration.  What changed? The health care crisis exposed the weak areas in the governance and policy mindset in America. China had advanced mainly through strong government role of the Communist Party  in steering the economy and business to gain competitive advantage. The health crisis from the pandemic further devastated America's lower middle and working class following the banking and financial sector mismanagement by 2009. The pharmaceutical and health care sector similar to other sectors had shipped manufacturing overseas. In 2021 there is a deep sense that theories don't work, one has to act based on the needs and the situation the country is facing. The way competitor nations such as China are building new infrastructure, gaining manufacturing advantage, dominating key sectors and industries, and creating jobs, requires America to respond. In this situation posing the threat America faces as well as the social dislocation of decades of misguided policies, the US government is the only one capable and having the resources and capacity to respond.  ...

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How transgender issues played out in the 2024 election. Pamela Paul looks at the effects across Europe of the Cass Commission's 4 year research for Britain's National Health Service concluding that gender affirming approach is mistaken. The American Medical Association, the American Academy of Pediatrics and the Department of Health and Human Services, are not a taking a science based approach to this important issue for parents of children, and the serious unease this is causing across the Nation in 2024, is shown in this report in the NYT. This type of unease added to the anxieties about efforts to change the cultural identity of the US based on its history of European settlers, first from Spain and later from France and Britain, over the eighteenth, nineteenth and twentieth century putting politics before history. Not being alarmed enough about a general price increase of 30 percent over 3 years in groceries and housing costs created a general sense of unease in the Nation. ...

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Chile's new constitution was drafted after a vote on a constitutional convention in which many people not involved before and on the fringes of society including indigenous groups were elected. More than half are independents and from different groups of society not well represented before. As a result of this the lack of experience has led to enshrining every single right that one could think of instead of focusing on what the protests were about about - the pension system, unfairness in access to health housing and education in the way funds are allocated from the budget, and promoting fairness in government.  At this time there is no certainty that it will be passed. A 36 year old student protest leader Gabriel Boric is the president elected after two years of protests about the unfairness of the system that took shape under a constitution written by a military dictator Pinochet who ran the country from 1973 to 1990. Pinochet came to power in a coup that is common in the history of South American Republics such as Brazil, Argentina, Chile and other countries. During the period of the government of Marxist president Salvador Allende the country was polarized resulting in the military taking over.  If the constitution is rejected a new convention will be formed to write a new constitution. In following the Structure of the US, Canadian, or British constitution, or the Indian it is important to look at the document so that it will stand the test of time rather than simply enumerating the rights of man. It is also important to focus on how to make the basic rights such as food, housing and education be well funded and society to be run along lines of basic fairness in incomes, while protecting enterprise and industry that can create new wealth for the country. The large South American economies are mainly dependent on commodities for export and there is a need to fund new business sectors which are not in commodity products- copper in the case of Chile- so that the economy can develop in a way that funds progress in incomes. ...

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How artists, musicians are doing in Germany vs. the USA is shown here. In Germany funding for arts continues and a musician shown here continues as before with the same income and benefits. In the U.S. a musician with the same background has no work and has no health insurance for years. The contrast between two societies and cultures, between European concern for social cohesion and sense of sharing vs. a culture in America that helps some in society, and leaves out others. Where government of the people, by the people misses something called for all the people.

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Working part-time during retirement years is important for health- staying active, using ones mind and brain, social engagement, and getting satisfaction in the workplace. A Study in 2017 by the Rand Corporation finds about 40% of workers over 65 who had previously retired back to the workplace. People are lengthening careers, and returning to work not just for financial reasons. Many of these people are looking for ways to remain active after realizing that staying active was important and if this could be combined with having extra time off in part time jobs for other hobbies and interests- this would better fit today's lifestyle and choices with people living longer and having more productive lives than ever before. A recent Pew Research analysis of data from the U.S. Bureau of Labor Statistics shows the proportion of people over age 65 who are employed part time or full time has gone up in 2016 from about 13% to 19% with about half these people working full time. This trend to work following retirement has a word for it- people call it "unretirement." Where work is less taxing as for graduates and people with higher education this is happening more.  From a health perspective this can be important, as people can become more reclusive and more internal looking, less socially engaged as they retire without even realizing it. Some level of social engagement is planned by people retiring, and many retirees do volunteer work, yet this may not be enough. For those people who retired early because of burnout in the workplace, strains with other workers, poor culture in the workplace, the retirement for a few years after 60 can serve as a way to replenish one's resources, recover and resume working again in a place that is better suited for them. The restorative break can then serve as a way to get back to the workplace in a positive way. Work that is meaningful, offering opportunities for contributing one's skills, adds a new dimension to people's lives, and is also a contributor to living healthy lives, at a time when people live longer. Retirement at 65 may not make sense in this new environment, opportunities for part-time work bring the knowledge and skills of experienced people to the workplace and offer a win-win solution for both. More needs to be done to create these opportunities in a planned and organized way in business and government, in all workplaces. ...

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Sophie Egan has put together this wonderful clarification of what works well in foods and what one should eat by taking apart some myths. Myth No.10 is that stuff on nutrition is always changing. It isn't and she gives Michael Pollan's seven words as an example- "Eat Food. Not too Much. Mostly Plants." A recent book has title Ikigai, on people with healthy bodies and minds well into their nineties. It pulls together information from persons in Okinawa, Japan, who passed one hundred years and they say not eating too much, eating plant foods, and community spirit, a passion for doing something worthwhile that you enjoy doing and do well referred to in Japanese as Ikigai, is a way to keep healthy. Other myth clarification- Sophie Egan offers is that soy based foods are good for us, and that plant protein when consumed in different forms can give complete nutrition. Not all fats are bad olive oil and seeds nuts are good for us, and white potatoes are also healthy eaten with the skin. All this adds up to good common sense without getting tied up into knots by too much attention to studies. ...

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Prime minister Boris Johnson outlines his plans for 2021 in the Queens Speech in May 2021. Johnson pledges to seize the opportunity coming from the "extraordinary spirit" with which the British people had faced the corona virus pandemic. He called it "an historic opportunity to change things for the better, level up opportunities across the whole of the UK and address the whole of the problems that have constrained us far too often before." By this he said  he referred to the deep wells of kindness, ingenuity and resourcefulness that exist in each village, town and city in the UK. The government's task will be to unleash that potential.

Jeremy Hunt, a Tory MP and former Health Secretary said that the government needed to address the problem of social care and the catastrophically high care costs that are hitting one family in ten in the United Kingdom.

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Greens and SPD Social Democrat parties in Germany favor social spending, infrastructure spending, and climate change investments. Free Democrats party holding the Finance ministry supports  a brake on spending. There is no agreement on the budget in this coalition, says DW.com. SPD and FDP are not increasing in popularity and SPD could lose the chancellorship if there is a new election. The Greens and the CDU are increasing in popularity. For this reason the coalition is likely to continue even with this disagreement on spending.  SPD and Greens say higher taxes and elimination of some subsidies is one solution. The common platform has not resolved these differences. In the US president Biden has retained the support of voters in the midterm elections and has gained bipartisan support for building infrastructure and investing in renewable energy, cutting health care costs.

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Moderna has made the initial batches of doses of the vaccine for the variant of coronavirus including South African variant, and shipped these to the National Institutes of Health in the US. If the test results are positive the vaccine for variant could be given authorization by the third quarter of 2021. It is becoming crucial to stay ahead of variants developing from the coronavirus and pharmaceutical companies Pfizer, J&J, Astra Zeneca are working on the technology to tackle this.

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The CEO of the New York Times and the former director general of the BBC, takes a look at the public discourse in the 2016 U.S. presidential election and in the Brexit campaign, and finds some troubling changes. The use of words that can eaily be picked up by Twitter and social media to attack opponents, the complete disregard for facts, and outright attempts to denigrate and destroy using rhetorical tactics, and a section of the public that has turned away from the facts or is disinterested in facts, is deeply troubling for Mark Thompson. When the public discourse fails, then the politics as a whole starts to collapse, says Thompson. We are children of the enlightenment, says Thompson, and were taught to look underneath statements to discern the truth. This is a crisis in public discourse. Worse it is one in which truth telling by people who say they are outsiders and tell it like it is, is not about telling the truth. Which is what makes it so dangerous. Thompson cites the statement by Michael Gove that "people in this country have had enough of experts," as another dangerous sign. He says it is time that experts make themselves understandable and talk in a way the public can understand. The media needs to explain issues in clear ways, and professional policymakers language of discourse needs to be conveyed in better ways that the public can grasp, in which the Brexit Remain campaign failed, says Thompson. Its important to acknowledge the problem, as the health of our democracies depends on finding solutions to what has happened in 2015-2016 to change the public discourse and let it deteriorate to unimaginable levels.  ...

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The drop in IPO capital and venture capital is a sign that there is a new awareness of the importance of capital for public investment in infrastructure, manufacturing, and in health and education with the active participation and direction of the government and support in the US Congress. This is happening as there is a sharp decline in the productivity of capital invested by so called "tech" companies. And science and technology investments directed with government support are needed in new scientific advances for chip manufacturing. Other technological developments such as solar panel manufacturing to tackle climate change also need much capital, and electric car fueling stations for EV's.

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Some startling statistics on U.S. wages and incomes and the increase of part-time workers, by the publisher of U.S. News and World Report, Mortimer Zuckerman. He cites the Pew Research Center reports that show one third of Americans identifying themeselves as lower class or lower middle class compared to one quarter before 2008. This affects social mobility with the increasing gaps in incomes, education and social behaviour acting to reinforce each other and leading to even lower future mobility. Industries that are showing growth are in low wage occupations. The Bureau of Labor Statistics shows growth in future in industries noted for low wage part time work- health care, social assistance and retail, with some jobs lacking minimum wage and overtime protections. Revealing in this respect is that in the last 2 years fully 43% of net employment growth is in the 1.7 million jobs added in low wage work in food service, retail and employment services industries. The number of Americans working full time declined by 5.9 million since Sept 2007, part time workers increased by 2.6 million. The effects of higher part time workers and job recovery predominantly in lower wage industries is likely to affect consumer spending and slow growth....

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Years of poor funding of public health departments in the US, Europe, and other countries have left public health departments lacking basics, lacking staff and resources. Here the WSJ shows how this has affected Alabama in the southern US. Alabama has the slowest vaccination program in the US with 10,000 doses given per 100,000 population. Positivity rate is very high at 29.1% for coronavirus, one of the highest for positive coronavirus tests in US in the past month of  Jan. 2021.

A large portion of the population of Alabama lives in rural areas. These rural areas are some of the worst hit in healthcare in the US. Since 2009 7 hospitals have closed in Alabama resulting from poverty of patient populations and population loss. This is part of the general erosion of rural healthcare infrastructure across the US in the last 20 years. A problem that now faces the Biden and future administrations. to tackle the problems of rural US communities.

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US is shutting down 10% of airport traffic because of government shutdown in November 2025. Democrats are holding up the passing of the new budget till Obama's Affordable Care Act healthcare subsidies for low income Americans are restored. Republicans who control both houses of Congress are unwilling to restore these subsidies saying it will cost $350 billion over 10 years. Editorials in the Washington Post in November see Obama's Affordable Care Act as a bandaid approach for a broken healthcare system in the US. Public opinion in the US supports this assessment. Trade unions and labor have called for an end to the government shutdown. Democrats are acting as though the party is for low income Americans and labor yet this is not the party of FDR who fought hard for labor over vested interests, Democrats today are the vested interests whether from Tech which is taking a disproportionate share of the Nation's wealth and resources and pouring it into projects that do not reduce the cost of living or rebuild crumbling obsolete infrastructure, or from Banks which were not sanctioned for their part in the 2009 financial crisis, or from healthcare interests that oppose restructuring the entire healthcare system for fairness in insurance, pharmaceutical pricing and wellness. Republicans are making an effort to displace Democrats in the role of FDR and Lincoln under newcomer DJT who rejects both the incompetent Bush (Republican) and Obama (Democrat) administrations that wasted money and resources in foreign wars while overlooking America's many challenges and strengthening foreign powers including China, while weakening the US. The US government is cutting airport traffic to relieve unpaid traffic controllers. Also at risk are SNAP benefits which are for the loew income Americans. The US president is asking the Senate to drop the filibuster rule which requires 60 votes in the Senate for the biudget to pass it and pass it by majority vote. The Senate Majority Leader Republican Thune wants to keep the filibuster because it acts as a brake for hasty legislation passed by whichever party is in government. ...

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During question time in the US Congress US Senator Rand Paul stated that the US money was used to fund research at the Wuhan Institute of Virology. A ban on gain of function research on virus was lifted by the US in 2018. Following the lifting of this ban which was strongly opposed by scientists at Cambridge, Massachusetts, research was conducted that many of these scientists considered dangerous and risky. This report in the BBC shows Dr. Anthony Fauci. director of the NIAID, the Institute for Allergy and Infectious Diseases responding to Dr. Rand Paul, Senator from Kentucky. Much of the discussion goes into definition of "gain of function research" and misses the broader implications. Scientists in Cambridge had warned early of the danger of doing research because of earlier mishaps such as the one involving anthrax research from accidents that are always a risk. Epidemiologist Marc Lipsitch of the Harvard Chan School of Public Health warned of just such an "accidental pandemic" in Three Questions, Three Answers in the January 2018 issue of the Harvard Chan School of Public Health journal. He stated that an "accidental pandemic" could result from the lifting of a ban on a risky kind of research favored by some virologist professionals. Most of the medical and scientific community in Cambridge fiercely opposed the lifting of the ban on what they saw as risky research with little benefit in 2018.    ...

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State finances in the US are in strong shape with the federal stimulus and rapid recovery, says this report in the WSJ. US states will hold 136.8 billion in rainy day funds. This is 12.4% of total spending. Healthy reserves make spending cuts and laying off workers for local governments and states unnecessary in an economic downturn. This is a good sign for the US economy.

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Additional funding of $100 billion is proposed for the World Bank to meet the needs of Africa, and other countries in Latin America and Asia. These needs are for climate change investments, renewable energy, and for health and education that has suffered as debt repayments have increased with higher interest rates, putting 52 countries near default on debt. The US with 16% of the shares in World Bank would contribute $3.2 billion for this to happen.

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Efforts to end the use of single use plastics that are a threat to health and the environment, land, rivers and oceans.  The use of plastic water bottles has worsened the crisis. Supermarkets are slow in the US to ban plastic bags showing need for prudent regulation. Talks in Busan, South Korea, in Nov 2024 to find a solution to the plastics proliferation crisis. The plastics industry including plastics makers and recycling companies say things are under control with recycling goals, yet reports show only 30% of plastics is being recycled each year in 2024, and going back to the beginning of plastics 2 decades back only about 10% has been recycled. All the rest ends up on landfills, gets incinerated causing more pollution, or ends up on our coastlines and in the land contaminating it.

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Kerala and Tamilnadu states with declining fertility, migration and ageing society are outliers in India with about half its population under the age of 25. About 600 million people in India are in the 18-35 age group- a clear case of rising aspirations society is happening in India at the very time that the US and European Union are looking at India for the future with shared values of representative democracy, open societies, and building a new supply chain in Asia. This BBC report looks at the state of Kerala where migration is leaving parts of the state only with elderly people. About 10% of the $100 billion in remittances each year from Indians overseas come to the state of Kerala. Life span is about 75 years in Kerala exceeding the national life span of 69 years. However this is looking at it backwards as India remains a vibrantly young country even with the advances in longevity where much of India is close to age 70 years in longevity and advances in medical care and health are taking place at a rapid pace. The problems of Kerala are an outlier for India. ...

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Epic Systems of Verona, Wisconsin, is one of the companies engaged in digitizing health records. It has helped develop records for 40 million patients in hospital systems such as Cedars-Sinai Medical Center in Los Angeles, Kaiser Permanente, the Cleveland Clinic, and John Hopkins Medicine in Baltimore and the Weill Cornell Physicians Organization of New York. Epic provides the software, the IT systems, the training and support. Epic is one of the pioneers in this, having been in the business for 30 years. About 40% of primary care doctors in the U.S. and 25% of hospitals use electronic patient records. The Federal government has provided $2.7 billion in funding from $27 billion of Stimulus funds assigned for the purpose of conversion to electronic medical records. This is likely to speed up the conversion. Other providers are Cerner, Allscripts, Meditech, Siemens Healthcare, G.E. Healthcare, and IBM. Epic Systems is considered the defacto standard in the industry for medical schools and some of the major hospital systems in the country. New contracts are leading to a major expansion of Epic Systems which employs 5100 people. Epic plans to hire an additional 1000 people. Revenue for the privately owned company are estimated at $1.2 billion, a 45% increase over the prior year. Epic is expected to have 127 million patients under medical records by mid 2013. To get the feedback essential for such a large conversion, CEO Faulkner relies on feedback from 250,000 doctors who use the Epic systems software, and on nurses and doctors from Epic who visit customer's sites to see first hand how it works and what needs improvement. Judith Faulkner started Epic more than 30 years ago. A project for the Psychiatry department led to other projects after she graduated in computer science from the University of Wisconsin. Epic continues to attract programmers to Wisconsin by making the Epic campus a fun environment and a great place to work. ...

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Mexican president Nieto's poll numbers are at all time low of 24%, according to Reforma newspaper. He took office in late 2012 and has been hurt by human rights scandal of the murder of 43 students in the state of Guerrero, corruption issues, and failure to improve the economy. The invitation to Trump to visit Mexico left even people close to the president surprised, and was criticized widely inside Mexico. It is not clear what Trump or Nieto gained from the trip. As Trump continued his talk about building a wall on the Mexican border and having Mexico pay for the estimated $23 billion it would cost. He did this in a speech to supporters in Pheonix on the same day he met Nieto, showing the use of teleprompters and prepared script was not his way of campaigning. Just as the message to black people that Democrats take them for granted cannot resonate without the basic message delivered with compassion and understanding- such as done by the presidents Bush and Reagan- so also the message to Hispanic people is suffering from the same lack of empathy. Recent polls show only 3% of blacks support Trump. McCain and Romney gained only 4-6% in the U.S. presidential elections of 2008 and 2012. The message of the wall is also baffling as an election strategy. A Gallup poll in July 2016 shows only 15% of Americans opposing a pathway to citizenship for illegal immigrants, and only 24% of Republicans. There is another problem in the strategy. The rhetoric about walls and mass deportations, and the Trump temperament combined with handling of nuclear weapons is not winning college educated women in the suburbs with polls showing Trump lagging behind Clinton by about 20 points or 4 million voters with this group. It is hard to undo the damage done by this kind of rhetoric used in the primary elections as it gains distrust of voters. It would require a bad economy with illegal immigrants taking local jobs, and handling of immigration seen as weak, for such a message to gain some national traction. Both are absent for the most part with a steadily improving economy since 2012, lower unemployment, a tough enforcement policy on deportatons under Obama that exceeded that under Geoge W. Bush, and the talk of a wall comes with illegal immigration having declined steeply since the 2008 financial crisis. The real culprit appears to be elsewhere, the triple hit taken from hollowing out of the manufacturing economy that hurt the Conservatives in Canada, the insecurity created for older whites from the job losses and hits to net worth from the 2008-2009 financial crisis, and the increasing loss of access to health care and educational opportunities with high  costs. About 62 million households or the bottom half of the distribution in the U.S. have a net worth of about $10,000, a quarter of this group having zero net worth, according to the Federal Reserve's Janet Yellen at an Inequality Conference in Oct 2014. Problems no wall is going to solve, problems that built up over 2 decades, problems that will take a generation to fix.  It shows the tech miracle of the last 2 decades as a mirage for quality of life of the middle and working class. Tech as a tool to a goal, not a goal in itself, is the better way forward. ...

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Young people are the major source of transmission of coronavirus in the US with school sports as a major cause. Michigan, New York, Florida, New Jersey, Pennsylvania, makeup 42% of cases on April 11. Adults ages 20 to 39 are affected the most in Michigan. With cases for children under 19 quadrupling from a month ago. 301 reported school outbreaks in Michigan alone. A big problem is that the spread of the variant B.1.1.7  from the UK started in clusters earlier in February. It now has spread to the general population. India has seen a surge in the past 5 days and public health officials are learning from this experience in Europe and the US. The focus  should be on micro containment zones, prime minister Modi told state chief ministers in a virtual meeting on April 10, with screening, testing, tracking, and that health officials should not let higher numbers affect their persistent effort to screen, test and track as with the unceasing effort the results will come. ...