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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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The basic outlines of new health care legislation takes shape as Senators Dodd and Kenedy come up with a plan that scales down subsidies to low-income people to buy insurance. Attached to their revised outline is a budget office analysis thatprojects the plan costing $611 billion over 10 years and with expected changes from the Senate Finance Committee would cover 97 percent of all Americans. And earlier plan received much criticism because the Congressional Budget Office estimated its cost at $1 trillion over 10 years and left 37 million Americans uninsured. In addition there is the revised Medicaid expansions for aid to the poor that would add a couple of humndred billion dollars to the total tab. The administration's goal is to keep the cost down to $1 trillion over 10 years. The legislation as it stands includes the public option which is designed to control insurance costs. Mr. Obama said this week that "the public option would keep insurance companies honest." Employer mandated insurance is part of the Kennedy-Dodd legislation proposal. Employers with 25 or more workerswould have to provide coverage or pay the government an annual fee of $750 for each full-time worker and $375 for each part-time worker. The government pays the startup costs for the public insurance option as a loan to be repaid, and premiums would make the option self-sufficient....

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A WSJ study showing the plans offered under the new U.S. Health Care Law in the state of Oregon. For young people ages 18-34 earning about $17,000 and uninsured the law offers a bargain with insurance premiums monthly at about $52 and deductibles as low as $100, because of higher subsidies. The situation changes at incomes of $29,000 when the deductibles are about $6300 and the premiums per month at about $147 a month, because subsidies are much smaller, or deductibles dropping to $2500 at $172 in monthly premium. The federal subsidies disappear for single people under age 30 earning much more than $26,000 because of the way the law places them to specific plans on each state's exchange. According to the U.S. Department of Health and Human Services, there are 11.6 million people in the U.S. ages 18-34 who are uninsured. The federal government has to get as many of these people to get insurance so that the cost of medical care for the elderly can be supported.

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The costs of fraud in medical care from spurious Medicare claims to kickbacks for unecessary services is estimated at $125 to 175 billion. Costs of unnecessary care from overuse to unnecessary lab tests are between $250-325 billion. The amount wasted for on treatment for preventable conditions such as heart disease and diabetes. is $25-50 billion. This number is much higher when all the complications from obesity are figured in. These amounts alone add up to $500 billion. Add to it the problems and the costs of medical errors leading to bad drug reactions or other misdiagnosed procedures which cost an estimated $75-100 billion and the the total is upto $600 billion. These amounts are not going to be tackled by computerization of medical records. The whole manner and ways in which medicine is practiced today and the manner in which the public takes care of its health would have to change for an impact to be made in these numbers.

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 Frustration has grown with the poor early management response from U.S. Health and Human Services Secretary Alex Azar, says WSJ.  The president responded at one point with a tweet that "he told me nothing until later." The WSJ looked into Mr. Azar's missteps in a report recently. The president is considering replacing Mr. Azar says WSJ. Ms. Verma the head of Medicaid and Medicare Services is being considered. She has worked closely with vice president Mike Pence throughout this crisis. Mr. Azar served as HHS general counsel and later deputy secretary under president George W. Bush. He then worked as lobbyist for Eli Lilly.  This WSJ report says Mr. Trump called Mr. Azar on his flight from India to Washington, and the next day replaced Mr. Azar as head of the White House coronavirus task force with Mr. Pence. The president says repeatedly that vice president Mike Pence, as head of the White House task force has worked night and day round the clock to guide the effort- including talking to 51 state governors, coordinating the entire effort, and providing the president with reliable advice. In the depths of this crisis never has so much depended on so few- on vice president Pence, a former governor of Indiana, Admiral Polowczyk, Dr. Birx, Dr. Fauci, and the governors of states worst affected by the coronavirus. ...

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Comments on the health care system in Holland, article frontpage Sept 6, 2007, wsj. See also Mayo Clinic's recommendations.

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President Obama has 63% job approval rating in a New York Times/CBS News poll. His backing is among Democrats and independents alike which is very useful for Obama.But the poll shows more American having faith in the President than in the handling of specific issues. He gets good approval on foreign policy initiatives at 59%, but in the handling of the Auto bankruptcy, or of health care his ratings are below his personal ratings as President. A majority of those polled were concerned about the rising budget deficits. BUt his ratings among Republicans has fallen from 44% in February to 23%. Republicans were viewed favorably by only 285 of those polled, the lowest ever.

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Healthcare coverage of illegal migrants is at the center of the fight between Democrats and Republicans leading to the government shutdown on October 1, 2025. A slight majority of Americans favor deportation of illegal migrants is shown in a recent NYT poll. Even higher numbers are likely to see higher priorities in the Nation than funding of housing and healthcare for illegal migrants when most families in the US are living from paycheck to paycheck and government subsidies and assistance are being cut after Covid.

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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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Walmart comes out in favor of requiring employers to provide health insurance to all workers, a central feature of President Obama's effort to provide near universal coverage in the USA. As the country's largest private employer, employing 1.4 million Americans, this change is significant. In a letter to the President, Walmart CEO Mike Duke, joined by Andrew Stern of the Service Employees International Union, and John Podesta of the Center for American Progress, who also signed the letter, say they are for an employer mandate which is fair and broad in its coverage. Walmart had a couple of reasons for doing this. For one Walmart needed to join the negotiations, as the Senate Finance Committee is considering other proposals that are less favorable to Walmart than employer mandate. Already Walmart is covering 52% of its employees, and has improved health benefits in recent years in response to criticism of the company. The industry average is 45%, according to a 2008 Kaiser Foundation study, and some companies do not provide the health benefits that Walmart does, so this helps level the playing field by requiring all large companies to share the burden. Walmart wants to see effective cost controls to keep costs down, and Rahm Emmanuel, the President's chief of staff, assured Walmart that "cost control and employer mandate are heads and tails of the same coin." Under the plans considered by the Senate Finance Committee under Max Baucus, small businesses are exempted from the employer mandate. Republicans have opposed employer mandate. And the U.S. Chamber of Commerce has opposed it saying it would make companies lower wages and cut jobs. Walmart's shift has been gradual. From a company used to providing skimpy benefits, it has evolved as it improved benefits, and two years ago it joined the SEIU union to call for affordable health care for all Americans by 2012. It has Mr Dach as its governmental affairs vice president, and this is significant, as Dach is an advisor to Democratic party politicians....

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How the pandemic changed how a new generation sees work success and health priorities in life. Young people in their thirties describe their experiences in life before and after the pandemic and the challenges at work in careers that made them think about the importance of health and mental health in the twenties and and thirties, so that by middle age 40-60 years the do not face health problems. A deterioration in health that they see in the population of older people makes young people ask questions how to incorporate healthy living as a top priority in their choices.

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Samuelson points to the risks to the American economic growth from excessive health care costs. This is hurting take home pay and shows up in consumer spending. It is hurting government spending in other areas such as needed infrastructure spending and efforts to reduce the deficit. This hurts private capital investment to create jobs because of lower demand from constricted consumer spending. The U.S. budget has as its largest single expense 27% on health care compared to 20% on defense the next largest expense, with growth in health care spending taking this to one third of the budget in coming years. Without addressing health care, says Samuelson, the Supercommitte in Congress even if successful at deficit reduction will basically have failed to do its job, and it did not have the time, resources or conviction to do this. According to a new study from the Organization for Economic Cooperation and Development (OECD), U.S. healthcare spending per person is $7,960 per person in 2009. This compares with Norway $5,352, Britain $3,487, France $3, 978, an OECD average of $3,233. Life expectancy in the U.S. is 78.2 years, compared to Japan 83 years, OECD average of 79.5 years. Chile and the Czech Republic have life expectancy equal to the U.S. Except for cancer care where the five year survival rate is 89.3% in the U.S. and the OECD average is 83.5%, the U.S. lags far behind in much needed critical areas such as diabetes and asthma. Rates of emergency hospitalization for asthma are 3 times that in France and 6 times that in Germany and Italy. The U.S. has fewer doctors per thousand population and higher cost per medical procedure- with more frequent use of the costliest procedures- creating a supply shortage that induces higher prices, and less preventive and early action care through physician visits. The number of practicing U.S. doctors is 2.4 per thousand population in the U.S. compared to 3.1 per thousand for the OECD average; and number of annual doctor consultations 3.9 per capita in the U.S. versus 6.5 for the OECD average. Appendectomy cost $7,962 in the U.S., $5,004 in Canada and $2,943 in Germany. Coronary angioplasty cost $14,378 in the U.S., compared to $9,296 in Sweden, and $7,027 in France. Knee replacement cost $14,946 in the U.S., $12,424 in France, and $9,910 in Canada. Knee replacements, angioplasties and MRI exams are twice as common in the U.S. compared to the OECD countries. ...