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The health care system is designed to encourage procedure based specialist practices and discourages the patient understanding education and monitoring that occurs with a well designed preventive family physician practice. As a result a patient only spends 30 minutes ayear on average with family physician compared to one hour in other developed nations. In the USA there has been a steady decline in the level and quality and extent of family care and the close one on one rapport with well trained family physicians who enjoyed their work and understood their patients and kept up with their health conditions and provided good and regular advice on these conditions. There is no money in this care as a result first you provide an environment where a whole range of medical conditions can flourish and expand, and then you hit them with a whole series of tests to rule out specific medical conditions. It is a perfect way to expand the testing and let testing flourish, so it would appear that if someone had wanted to start with a goal of letting testing proliferate unhindered then this would be the perfect way to design it. ...

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The comparison by Goldsmith and Moyn has picked the wrong Roosevelt. Only Washington in the war of independence, Lincoln in the Civil War over slavery, and FDR Franklin Delano Roosevelt in the Great Depression and economic collapse, fall in that category and there is no one and nothing to compare with both the struggles they fought and the challenge to the survival of the US. On the next scale comes TR Teddy Roosevelt, and this is the Roosevelt to compare DJT with. TR was unconventional, TR spoke a different language and could be frank and outspoken. TR actions matched his words, as his days on the Indian frontier and with the Rough Riders. TR also had one term plus completing McKinley's term after his assasination. And TR like DJT did not like his successor and did everything to make the comeback denouncing the policies of his successor William Howard Taft in the 1912 election, which TR lost to Democrat Woodrow Wilson. All this is true for DJT in 2026. TR denounced the shift away from his "progressive policies" and the shift to corporate interests of Republican Taft. In this sense also DJT is similar as he denounced the shift to corporate interests of the Bush/Clinton/Bush/Obama years. TR was no country club Republican and was willing to confront opponents in the politics to fight for the benefit of the working man, splitting the Republican party in the process. This is true of DJT. TR launched the rebuilding of the Navy, and announced he would reassert the Monroe Doctrine. DJT is doing the same and is reasserting the Monroe Doctrine. One could say that DJT feels the hidden TR in him and like Teddy Roosevelt is putting America in the place it once was. For TR the industrial revolution had distorted a country founded on the backs of settlers owning the land independent and rugged, as industry turned the country into corporate interests and workers in factories with few rights, and poor working conditions and wages. This TR even as a Republican fought to reverse. In DJT there is the Republican also of a different mould who fights to reverse the situation created by Bush/Clinton/Bush/ Obama over three decades since the 1990's when America has fallen to new lows when drug trafficking gangs in Mexico and Venezuela are able to run rampant over the western hemisphere, when elites in Canada and the US act impotent in the face of this, or living in their own world away from the streets and neighborhoods of America devastated by drug trafficking, towns and neighborhoods from Janesville to Flint economically deprived as elites shifted manufacturing overseas to China in complete indifference to the American worker and his family, and carried out wars in remote parts of the world such as hills of Afghanistan and deserts of Iraq no worker or farmer in America had even heard of or cared about since the American continent was settled in 1600. If there is a Woodrow Wilson around the corner who won in 1912, for the 2028 election, then it is someone who like Wilson will take policies to benefit the American worker and farmer and his family, and America as a Nation to a better place over the next decade. A passage from Teddy Roosevelt from his Autobiography about who TR was struggling against illustrates this point- "They favored Civil Service Reform; they favored copyright laws, and the removal of tariffs on works of art; they favored all the proper (and even more strongly the improper ) movements for international peace and arbitration; in short, they favored all good and many goody-goody, measures so long as they did not cut deep into social wrong or make demands on National and individual virility. They opposed, or were lukewarm, about efforts to build up the army and the navy, for they were not sensitive regarding National honor, and above all they opposed every non-milk-and-water effort, however sane to change our social and economic system in such a fashion as to substitute the ideal of justice towards all for the ideal of kindly charity from the favored few to the possibly grateful many." (Theodore Roosevelt, Autobiography, Chapter 5 title: Applied Idealism, 1913) ...

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This analysis in the BBC says women carry an invisible load. The BBC calls it cognitive labour, emotional labour and the intersection of the two, which puts a major burden on women. The cognitive labour is thinking about all the practical elements of household responsibilities. Emotional labour is maintaining the family's emotions, calming things down if the kids are acting up. The intersection of the two is preparing, organizing, and anticipating everything to make life flow.

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AARP shows 29 million Americans working and taking care of older parents. Many work 40 hours a week and work an additional 20 hours helping elderly parents. About six out of ten people of this 29 million work full time. In 2024 a lot more people are living longer and older people prefer staying in their own homes and need help from family members. A simple fall or a cancer diagnosis can lead to long hospital stay, months of treatment, and worrying for family members. Company benefits in 2024 do not include senior or eldercare support or even accomodating employees caring for their parents. In America today federal and state laws do not protect people caring for elderly parents from discrimination in the workplace. Consider how this is affecting companies, as about one third who are caregivers say they are going to leave, and half of the employees leaving are senior manager and executives with much experience. This comes to about 5 million senior managers and executives that American industry can ill afford to lose as it competes with China, India and Europe. About half of all companies are making this a priority in 2024, according to Care.com. Citigroup added 2 weeks of paid leave to care for immediate family member. Companies allow employees to add older parents on their health insurance. These benefits are being added to maternity and paternity leave. The fact that Congress and state legislatures have failed to enact laws protecting caregivers is one more reason for the discontent and unrest in the US after the pandemic. ...

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A report on a program in the U.S. called Thread that has taken 415 underperforming students in Baltimore, Maryland schools and created an extended family that supports them using 1000 volunteers. 

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Germany is once again seeing new cases of coronavirus at levels seen in May, with 1226 new cases August 11. Health minister Jens Spahn says it is because of family gatherings and partying, and also travelers from summer holidays overseas. Germany now has 218,000 cases and over 9200 deaths. Russia has 900,000 cases and is testing a new vaccine.

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A wonderful video on how Ukrainian refugees in Berlin are going back home some for a short time to see friends and their homes. Six buses go back and forth taking people in both directions every day says the bus driver for this bus company for Bonn to Kviv bus. There are 800,000 refugees from Ukraine in Germany. Some young women have family who are soldiers in hospitals who they will see. Most have not seen their homes for 3 months.

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Charles does a walkabout at St George's Chapel on Easter Day 2024, after a traditional Easter Service. He greets wellwishers who say they have the royal back. Charles and the Princess of Wales have boosted the spirits of many with their sharing of their own stories dealing with cancer. On Easter Day Britain comes together with the royal family in spirit just as it did when Queen Elizabeth gave her message to people in the early days of the pandemic.

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The spending on services like cable, television, internet connectivity, video games according to the Census Bureau for 2004 was $771 per year In 2008 this was $903, in 2010 $997 And add anothe $1000 for cellphone service and the average family in the USA spends as much on this as it does on dining or buying gasoline. Add extra for iTunes, texting services, music. Now buyers of Apple iPad can buy unlimited data access from AT&T for $30 a month. Are these expenses discretionary? Some experts think that it is part of the need for connectedness in today's society, and part of being functional in today's society.

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Shiller says policy is captured and communicated by metaphors, the most effective being belt tightening for a family. However what works for a family does not work for a country in the same way, especially if not accompanied by other measures and implemented in a strict manner without looking at the real situation. Better suggests Shiller, and more real is the metaphor of "winter on the family farm," where people work to do other chores than planting and harvesting, because a lot of other things need to be done and this is a good time to do it. This would include cleaning up the place, fixing the farm and the barn, fixing machinery, building fences. The farm's members pay a tax in terms of donated labor which goes to do all the work needed and helps the farm's productiveness as the weather changes. Similiarly the Salant-Paul Samuelson balanced budget theorem from the FDR days shows an increase in national output by the amount of a tax, such as the one proposed in France by president Hollande; that would then be invested in hiring more teachers (the labor) and investing in education infrastructure....

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London as one of the largest megacities, but a fifth of the land area covered by treesmaking it one of the greenest cities.  And areas like Regents Park where this family moved from Kent, England.

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The Irish prime minister Varadkar says it is time to move on. When he assumed office he was the first from an ethnic minority background to lead Ireland, the son of an Irish mother and an Indian immigrant father. He took Ireland through the crises of coronavirus pandemic, Brexit, and improved unemployment and budget shortfalls. Recently he accepted defeat on a referendum intended to remove language in the Irish Constitution on a clause about "a woman's life within the home." Disagreements over the language of the referendum led to its not getting approved on International Women's Day by about 70% of the vote with 44% of people voting. It suggest there was no enthusiasm and its relevance at this time was not understood. It is not clear why there was a need for this referendum in the first place to remove one text of the constitution that respects the role of family and mother's contributions in the home. During the pandemic for instance women played a major role, and sometimes took on a greater share of the burden. Efforts to have women's participation as shown in Japan and India does not require constitutional wording to be changed. Japan has done remarkably well and India is about to do this. And removing the wording about women's role at home, instead of encouraging or adding wording about women actively participating in the workforce and actions to make that possible, accomplishes little. Coupling this with a wording that includes gay families in the definition of family while removing the role of women in the family language seemed to be making changes that had little to do with each other. ...

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Christine Armstong gives this excellent story in The Times on how difficult it is for women to maintain work-life balance in today's work and business environment that gives little allowance for things like raising a family and children. In interviews with many women she describes each situation with insights and what it means for working women and for dads.

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New fixed rate 30 year US mortgages have interest rates of 7% in September 2023. Interest rates on car loans also have become much higher. The American Association of Realtors says the typical American family cannot afford to buy a median priced home. The typical American household would need 42 weeks of income to buy a new car up from 33 weeks in 2020. Car buying is unaffordable for buyers now because of high car prices and high interest rates on car loans, says the chief of Moody's Analytics.

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Loneliness and isolation increases the risk of disease with higher bodily inflammation, and risk of dying. Monthly visits of family and friends can make a big difference. More frequent than that does not give added benefit. The quality of social connectedness is also important - having someone who cares and one trusts. A Gallup poll in 2023 shows 17% of Americans are lonely and one third of people under 30 years 18-30 years are lonely. Surgeon General Vivek Murthy himself talked about how it feels with lack of social connectedness.

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This special series in the Guardian called Mother Load looks at the situation of mothers in the U.S. who lack the social protections that are taken for granted in England and other European countries. One mother calls it an ever present mental and emotional stress from the lack of social support such as maternity leave and family leave. The constant stress of parenting and motherhood in America is described here in the first person with the stories of many mothers in different parts of the U.S.

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This report in The Times remembers Alex Ferguson, manager of soccer team Manchester United for the wonderful way he motivated his players, by appealing to players hearts. One player who went through that period under Alex remembers Sir Alex talk about the work ethic of shipyard workers and miners, the culture of Manchester United, the importance of making your family proud, and not "letting yourself down."

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PM makes a point at G7- should not the 1.4 billion people of India most of whom are poor have the same access to energy as the people in the rich countries of the G7? It is to ensure this access to energy for the over 1 billion people in India that India has sourced oil from all countries when geopolitical tensions have made the price of oil to jump to new highs. Modi told a session at the G7 meetings- "All of you will also agree with this that energy access should not be the right of the rich only- a poor family also has the same right to energy. And today when energy prices are sky high due to geopolitical tensions, it is more important to remember this thing." Modi said that it was by "taking inspiration from this principle" that "we delivered LED bulbs and cooking gas door to door in India and showed that millions of tons of carbon emissions can be saved while ensuring energy for the poor." Never before in history has this been done on this scale as hundreds of millions of women have benefitted in poor areas where cooking was done by burning wood, and electricity did not exist. Water by tap water in every home, cooking gas, and electricity are now within the reach of every family in India.  Has G7 even thought of these things? And of the scale of the challenge that is being met and the future challenges for climate, technology and health that are being tackled on an unprecedented scale? ...

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This very exceptional report from the city of Recife in Brazil's northeastern state of Pernambuco, comes from WSJ reporters Johnson and Jelmayer. It is about the physicians Vanessa van der Linden Mota, and Ana van der Linden Mota, her mother, who first alerted health authorites in Pernambuco about the cases of encephaly and the links to the mosquito Zika Virus in Recife, Brazil. From 147 recorded encephaly cases, and babies born with shrunken skulls or calcified brain structure in 2014 in Brazil, the cases reported jumped to 4,180 suspected cases. Estimates of cases by 2020 for such cases run up to 50,000 to 100,000 if the problem is not tackled. The family of the van der lindens come from Dutch-German immigrants settled in northeastern Brazil, a less developed region of the country. The family is unique with five doctors including neuro pediatricians Ana and Vanessa working in public hospitals in Recife , and father Helio a neuro surgeon. The entire state of Pernambuco has a total of 15 neuropediatricians, according to this report. The Ebola Virus emerged in countries such as Sierra Leone and Liberia which suffered from war and neglect of health infrastructure. Here in Pernambuco state, as reporters Johnson and Jelmayer point out, the problem stems from neglect in public health infrastructure, especially sanitation and drinking water for shantytown dwellers and vast majority of poor residents in a city of 3.5 million, typical of developing countries in Latin America and South Asia, where development in some parts of the country have lagged far behind, and where needed public health infrastructure investments have not been made. Lack of dependable drinking water means collecting water in containers that are susceptible to breeding mosquitoes, such as the mosquitoes carrying the Zika Virus. A public debate on the lack of attention by socialist and worker's party led governments to this type of infrastructure and transportation services was already underway in Brazil leading to widespread protests in 2013. A $226 million investment in a soccer stadium in Recife, and similar investments in other smaller cities in the northeast were made under the Worker's Party government. Large investments for the Olympics now come as the economy contracted in 2015, and Brazil is hurt by another boom-bust cycle with the slowdown in China- with fiscal austerity policies, a loss of a third in the value of its currency, and the popularity rating of the newly elected government from the Worker's Party in single digits....

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A farming family at Misty Brook Farms in Albion, Maine realizes how suddenly you find contamination from forever chemicals in the soil. You can't see this, can't feel or taste it, say farmers in Maine. Some time in the past sludge from waste water treatment plants in Maine was used as fertilizer for the soil without realizing the danger of toxic chemicals such as PFAS, called forever chemicals. This story in the WSJ shows the damage it is doing to agriculture in Maine and other parts of the US.