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This article is a must read for everyone to know where our plastic and other paper waste is ending up. With China's ban on importing plastic waste the stuff is being shipped to India, Malaysia, Philippines and Vietnam. Now these countries are turning it back. Who needs sometimes contaminated waste. In the U.S. it ends up mostly on landfills. It is a health hazard as one recent story of waste shipped out to a part of Chile shows- with health problems for people in the vicinity. The WSJ has done an excellent story with diagrams and pictures in this exceptionally good story we recommend for our readers to know what is happening worldwide with plastic waste.  There is increasing education of the harmful effects of plastic and there is a government campaign in India supported by the prime minister Modi to reduce use of plastic bags and find ways to dispose off local plastic waste. In the light of this why would India or Malaysia or any other Asian or Latin American or African country want any other country's plastic waste, particularly when it is a health hazard. In fact China for so long allowing importing of plastic waste till recently so it could be processed with low cost labour and reused for plastics production is incomprehensible, considering the health risks involved. ...

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The World Vaccine Summit raises about $7 billion to immunize about 300 million children for polio, diphtheria and measles, over 5 years. Prime minister Boris Johnson who opened the summit called it "the greatest shared endeavour of our times." Bill Gates donated $1.6 billion and Britain pledged 1.65 billion pounds over 5 years, making Britain the largest donor. Mr. Trump also addressed the summit in virtual manner- "we will work hard, we will work strong... good luck, let's get the answer." Mr. Johnson called for renewing "the collective resolve."  Specifically he stated: " Just as we have great military alliances like NATO.... where countries collaborate on building their collective military defence, so we now need that sam spirit of collaboration and collective defense agains the common enemy of disease." Referring to failure of early warning systems for coronavirus with crucial weeks between Jan 6 to Feb 16 lost for the West with lack of international cooperation- "It will require a new international effort to cooperate on the surveillance and sharing of information- data is king- that can underpin a global alert system, so we can rapidly identify any future outbreak. And that will mean a rapid scale-up of our global capacity to respond."  ...

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Former Rep. Mike Gallagher of Wisconsin on Harvard, Columbia and other US universities dependent on full tution of foreign students to where they make up 30-40% of students, highly disproportionate to the American student population, which the author says funds the universities expanding buildings and bureaucracy. It means fewer opportunities for the American student population at the Nation's universities. An hidden aspect of this is that at the upper tier and upper middle tier of universities in the US this helps support rapid increase in the tution fees to levels not seen in two generations, making even upper middle class families with incomes over $200,000 a year find it hard to save for several children at such schools. It imposes an unnecessary and stiff burden on parents in the upper middle class. At the middle level of middle class incomes of $100,000-$150,000 the general inflationary trend for college tution puts these universities also in the range where the middle class can barely access them- cost of $30,000 a year over 4 years adding upto $120,000 and total of $360,000 for 3 children households. Basically universities have become an entrenched system operating in the interests of their own operations now in conflict with what is good for the Nation. ...

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Utah governor Spencer Cox and call for introspection on open debate and discussions without rancor and strife. Cox launched a “Disagree Better” campaign in 2023 with Democratic Colorado Gov. Jared Polis in an effort to restore civility and respect in open debate between differing viewpoints. After all there have been strident difference of opinion since the founding of the Nation and the many crises it has faced. The years leading to the Declaration of Independence to the War with Mexico, the Civil War, the peace movement before World War II, the McCarthy years, Nixon years, and the strife over DJT rhetoric and style of politics. Cox says- “It’s important to understand that in our political system today all of the incentives are lined up against this concept of dignity and respect,” he added. “We made a decision that we would only run for this position if we could do it in a different way and it had to be a positive vision.”  “Social media is a cancer in our society right now, and I would encourage people to log off, turn off, touch grass, go hug a family member, go out and do good in the community."   ...

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Obama vists Acrra, Ghana, July 11, 2009. It is an emotional moment for Obama, and for Ghana and the African continent as a whole. It seems the whole nation was out on the streets,on crowded rooftops, packing balconies, leaning out of windows, to get a glimpse of Obama. Particularly emotional is the moment when he stood at the Door of No Return at Cape Coast Castle, a notorious slave port perched on the ocean. He spoke about the existence of "evil" that he had seen at Buchenwald, and here again. He spoke up against the poverty of Africa that is compounded by the greed, corruption and the lack of responsibility of the elites in African countries. Obama said "Africa doesn't need strong men, it needs strong institutions." He talked about his personal experience: "I have the blood of Africa within me, and my family's story encompasses both the tragedies and triumphs of the larger African story. Some of you know my grandfather was a cook for the British in Kenya, and though he was a respected elder in his village, his employers called him boy for much of his life." See the related story on Nigeria, which was avoided by the President on his visit. And where because of the corruption and lack of responsible government, influential Nigerian voices themselves feel this was the right thing to do. This is one area in which Obama picks up from a strong effort by President Bush. Bush tried to frame policy by rewarding good government and building institutions through programs like the Millenium CHallenge Corporation, an antipoverty effort that gave Ghana $547 million in 2006. Both Bush and Clinton visited here....

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Is the jobless rate in Liverpool, in the one time industrial heartland of Britain about 6% or counting the hidden jobless close to 13%. Is the unemployment rate much higher than the 3% in official statistics for Britain because official statistics do not include the hidden jobless. Learn more about this astonishing quirk in the statistics that distorts reality about social conditions. None less than the OECD, the Organization of Economic Cooperation and Development and the Center for cities thinkt tank is of the view that 3 million people are missing from the official jobless figures. The OECD report says that when these 3 million people are counted the UK's unemployment or jobless rate is about 13.2% or abut 4.3 million people. This report shows that the austerity policies of the last ten years in Britain have bit by bit hurt people's chances of finding work.  The OECD/Centre for Cities study shows something else that is striking- it says Liverpool has the highest rate of hidden jobless in its study, with about 20% of working age adults out of work compared to an official rate of 5.8%. The mayor of the Liverpool region, Steve Rotheram, sitting in his office overlooking the Albert Dock on the banks of the Mersey river, where Britain's mighty shipbuilding industry once dominated and now in decay, says sanctioning people does not work,  a decade of cuts have done damage, and that his authority runs Households into Work, in an attempt to treat people as human beings first to get a better response. The government job centres tend to focus on people 25-35, says food bank and job support charity at the Anglican Cathedral on a ridge overlooking the Mersey. That means a lot of people in their forties and fifties are left out. ...

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The poor kid from Sao Jose Dos Campos 150 miles northeast of Sao Paulo makes it against all odds to play soccer in Sao Paulo. Steve Lowe of the Guardian does this wonderful interview for soccer fans with Casemiro the defensive midfielder for Real Madrid.  Casemiro is all humility, hard work down to the kind of details soccer coach Jurgen Klopp loves to pay attention to in practice, and never forgets the values his mom taught him about not being too loud. And to remember where he came from, to always look for ways to help other kids like him aspiring for a better life. Casemiro says he plays strong and even aggressive, but it is always about using your head in the game, the key was thinking ahead, being better positioned, seeing the move before it takes place. It cost 3 euros per week to practice at a club 6 mile walk away which he could not afford once he came to Sao Paulo. Mr. Moreira who ran the club paid for his boots, food and the fees. When he says he gives 200% Casemiro is speaking with authenticity because it was hard in Brazil for kids from poor families aspiring to make it in club football. He loves to learn, listens well, and he says he watches the errors, thinks like a coach, always trying to read the game, the other team's mind, their coach, what they were trying to get get done. He sees it as his work and does this in a disciplined manner. Casemiro may now be the top player in world soccer today as Real Madrid head to Manchester City under coach Zinedin Zidane. Zidane meant a lot to Casemiro as inspiration in the early days he played in Brazil.   ...

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Su Liping, professor at Tsinghua Unversity, says there were 180,000 protests, riots and other incidents, protesting economic injustice in 2010. Most of the incidents were against land grabs, corruption and abuses by local officials, and unpaid wages. Inflation has hit the poor, migrant workers and people with low incomes hardest. Food prices were up 13.4% in August over the same month prior year. Pork prices were up 52.3%. Other problems are now meshed in with inflation. Local government debt in China, according to the National Audit Office, was 10.7 trillion yuan in June 2011. The National Audit Office estimates 23% of this, or 2.5 trillion yuan, depends on land for repayment. Analysts say China's local government made repayment in 2010 using the 2.9 trillion yuan in revenue from land sales. The same amount of land has to be sold in 2010 to make repayment. At lower prices even more land may have to be sold. The danger say Orlik and Jie, is that inflation and the pressure to acquire more land- and consequently more land grabs- will pose severe risks to the social contract in China....

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Republicans hold a lead over Democrats on foreign policy and managing the economy. An anti-incumbency mood favors Republicans with more Democrats up for re-election. Healthcare is not a major issue in the election. Women voters continue to provide significant support to Democrats.

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Aizenman in this must-read describes the National Soda Summit and the presentation of one man Todd Putnam, a former executive from Coca-Cola that throws light on one of the truly important things that happened in the lives of Americans in the postwar period of development and growing prosperity. This is the development of marketing and advertising and its singular application in the case of Coca Cola to promoting sugary drinks. It is also related to what even business people describe as the single biggest problem in America. And it is happening at a time when the story is being repeated in developing countries such as China and India. Putnam describes the exhilaration, he and other Coca-Cola managers felt when the graphs at internal presentations showed Coke passing milk in consumption per capita in America. Several other facts stand out in Putnam's description of his experience- the ignorance on health issues among his marketing peers, the huge marketing prowess and dollars brought to bear once a goal such as increasing per capita consumption of sugary drinks was set- he was hired out of Purdue by P&G and worked at Disney before joining Coca-Cola- and the focus on the 12-24 demographic with 90% of all soft drink marketing targeted at this segment. What he regrets most is the focus on minorities who suffer some of the highest levels of obesity in America. No mention is made of the efforts underway in developing coutnries such as China and India which are seeing a surge in obesity rates and diseases such as diabetes. Coca-Cola says 41% of its sugary drinks are low calorie, but compared to milk, fruit juice and other healthier alternatives where does this rank? The cost to the nation's health care system alone would show that the performance of Coca-Cola's stock price over the postwar period came with a price tag that was never even thought about, when healthier alternatives as health drinks companies have found sell well when well marketed and formulated for different groups....

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Somini Sengupta reports on the Green Revolution and its aftemath from Jalandhar (Jullundur in Hindi) in the Indian Punjab wheat belt. Problems facing farmers here are the shrinking water supplies as more of the table water is exhausted through pumping from tube wells, lack of government investment in agriculture, the low grain prices paid to farmers by the government, and poor storage and transportation to market. Also affecting the suuply of grain and lentils and agricultural produce is the progress of industrialization as more farmers either grow crops that are in demand in the cities like baby corn instead of wheat, and the farmers who sell of land for industry or commercial use. Only 40% of the land is irrigated so too much depends on the monsoon and other rainfall, which is why India's large agricultural component in the economy affects the growth rates depending on the monsoon rains. What happens here affects food supplies worldwide and prices. When India is self sufficient or able to export there is less pressure on prices. Two years ago the situation deteriorated and India imported about 7 million tons for its grain stockpile. Since then the government raised prices for grains the situation has improved, farmers planted more wheat and sold more supplies to the government for building up buffer stocks of grain. Now the emphasis shifting to USA-India cooperation in the field of agriculture for a second Green Revolution. Agreements for the agricultural improvements were signed as part of the agreements signed for cooperation during President Bush's vist to India. The government of Manmohan Singh was elected for another 4 year term and is committed to helpiong Indian farmers. A more organized funded effort is needed especially with the economic crisis. The rural areas are the fastest growing part of the Indian economy. See link. ...

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In 1980 Jeb Bush 27, was looking for a place where he could make a fresh start away from the Bush name in Washington and Texas. His father was making a run for president that year. Miami with its bustling Cuban American community seemed a perfect place for Bush with his fluency in Spanish and his Mexican born wife Columba. The co-chairman of the Bush campaign in Florida was a Cuban American, Armando Codina. He set up Bush Realty, making Jeb Bush a partner with a 40% stake in the firm. In this period 1980-1992, Bush's gross income averaged 107,000 for the 6 years before the elder Bush was elected president to $1.6 million in 1990 half way during the elder Bush's term as president, according to a WSJ analysis of tax returns. This was also a period when Jeb Bush while engaging in business deals, was also running for office- first as Commerce secretary for 2 years in 1987, making a unsuccessful run for governor in 1994, and a successful run in 1998, 2002. He helped boost the Republican party in the Miami area, bringing together Republicans and the Cuban American exile community, during the anti-communist mood of the Reagan period. As Miami-Dade county Republican party chairman he helped boost voter rolls for the party, which had a 2 to 1 Democratic party advantage in earlier years. Stewart and Reinhard document the situations in which the Bush connections at the White House helped Jeb Bush in his real estate business....

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WSJ's Trofimov talks to some of the 2.5 million refugees and displaced people in the sectarian conflict in Iraq in 2015. He finds a mood of despair and resignation to a permanent partition of the country following sectarian conflict between Shiites and Sunnis. The situation is being dictated by the facts on the ground as the refugees see little prospect of returning to their homes, and the different regions controlled by Sunni, Shiite and Kurdish forces with borders.

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Some straight talk from Bethany McLean on why Congress which repealed Glass-Steagall and refused to regulate derivatives. She says the Fed and the SEC which did nothing while all the excesses and risky behaviour were playing out on Wall Street should also join Goldman on the hot seat. The Office of Thrift Supervision and the Comptroller of the Currency, she points out actually used their power not to protect but to prevent predatory lending laws. And the ratings agencies signed off with AA ratings for a lot of junk. McLean tells readers Goldman's idea that what is good for Goldman is good for America is downright scary. She is a former Goldman employee who reminds readers that Goldman's 14 principles had integrity right up on the list, something Tourre and other higherups at Goldman simply lost sight of.

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On the life, achievement, and performance of Hank Paulson in the present financial crises. The skills he brings, the problems he has overcome and the legacy he will leave when he leaves office at Treasury 6 months from now. A detailed account of what makes him click, what he enjoys doing and waht he is good at and various aspects and milestones, and the people in his career. Like Ben Bernanke he is an unpretentious man, who has a good sense of his own bearings, and comes from Barrington, Illinois where he has a house and where he goes back to for renewal. He follows a simpler routine excusing himself at 8,45 at Goldman dinners so he could go to bed, did not drink, and he and his wife are avid bird watchers and he headed Nature Conservancy before Treasury.

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Amy Hood growing up in a small town in Kentucky, then a move to Nashvile, Duke and HBS. She joined Microsoft in 2002 on its investor relations team. She moved into management the same time as Nadella who is CEO. Before the pandemic Microsoft's capital expenditures and investments cost about $16 billion. It is now 4 times that at $64 billion. It is Amy Hood's job as Chief Finanacial Officer to see that all that money is well spent for products with demand. AI services bring in about $10 billion annually.  Yet this may just be deflecting by Wall Street of the real question about the funding needs that are being neglected in education, health care and child care, when huge amounts of capital are being diverted by capital markets in ways reminiscent of the warnings of Franklin Roosevelt at the Democratic Convention of 1932. Warnings that the whole capital markets system was not working right, was only defunding the vital needs of the American people. ...

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America takes the first step to improve relations with Belarus as part of improving relations with Russia. For the British, French and some northern European interests arguing for continuing policy of war in Ukraine, one can only see a long history of opposing Russia from the beginnings of the British and French Empires after defeating the Spanish and the Dutch by 1700 and for the last 325 years. American interests have diverged from the British in the policy of freedom for Asian and African people under FDR that led to decolonization after the war.  America has the greater responsibility to reduce the buildup of nuclear weapons, to ensure that fertilizer and food supplies flow to all countries, build peaceful relations with 3 billion people in China and India, and to reduce international tensions. DJT shows a concern for all loss of life in Ukraine, particularly for the young of all sides who are losing their lives in a senseless war that needs to be respected. ...

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Between 2008 and 2009 September the price of polysilicon for solar energy products dropped from $400 per kilogram to $50 per kilogram. This doomed any chances that Solyndra could succeed, yet in 2010 and into 2011 Solyndra executives maintained that the company was in good shape financially.

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The political mood changes in Cairo as Egyptian voters choose a presidential candidate and Egyptians participate in an open political debate. For a country where open political discussion and honest elections had not taken place for three decades the change can be felt in Cairo streets.

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Two of three obese people live in developing countries. About 29% of the global population is obese in 2013, according to the Institute for Health Metrics and Evaluation at the University of Washington. Between 1980 and 2013, obesity increased by 47% for kids and 27% for adults in the global population. Dr Murray of IHME says no country was the exception. Diet and inactivity are the principal culprits. About 37% of world's men and 38% of women are obese. Obesity increased rapidly first in developed countries, becoming noticeable by 1980 and slowing since 2006, and now is growing fast in developing countries. Germany is a surprise No. 8 on the list. The U.S. No. 1 ranking tells a lot about the misguided priorities of living in the U.S., lack of education on healthy eating and healthy living, and not putting healthy habits at the top of things to do above making more money. An extreme case is South Africa where 42% of women are obese. The most obese countries are by rank - U.S., China, India, Russia, Brazil, Mexico, Egypt, Germany, Pakistan, Indonesia. Middle Eastern and North African countries have high obesity rates for children. The study is funded by the Bill and Melinda Gates Foundation....

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WSJ looks at the changes in the way medicine should be practiced in the light of what we have learned from the pandemic.  Medicine practiced before the pandemic and still today relies mainly on a visit to the doctor or specialist who is short of time. There is a shortage of doctors. Patients have many illnesses as a result of decades of neglect of proper nutrition, and exercize habits. Obesity is at about 40% in the U.S. about 30% in the UK and 17% in France, and high also in other parts of the world. These high rates were unknown throughout history and result in many illnesses and increase by four times the vulnerability to the coronavirus. One authority in medicine calls obesity pouring gasoline on a fire for effects of the virus.  A doctor's appointment with doctors short of time with no coordination around a whole range of factors related to obesity, illnesses, health checkups, mental health, is now seen as a heavily handicapped way to practice medicine or for patient healthcare and wellbeing. The alternative is discussed here as the way forward. A  team will be responsible for a patient's care not just an individual doctor. The team would care for general health after a patient's checkup, cover individual illnesses, weight issues, mental health, exercize nutritional needs and other good healthcare habits. Instead of relying on doctors at a time of shortages of doctors the team would be led by nurse practitioners.  A nurse practitioner is someone with a bachelors degree and a masters degree or doctoral degree in nursing with 1000 hours of clinical training. Studies have shown that they are effective and even more effective than individual doctors. Today particularly with the problem of doctors with limited time compounded by the built up problems of decades of bad habits in nutrition and exercize and poor "cultural" habits getting entrenched, there has never been a greater need for a better way to practice real healthcare for a person's wellbeing. Particularly in rural areas with an even larger shortage of doctors the health practitioner led team will play a big role. Patients will under this setting receive more care virtually and get more followup care by phone and video messaging. The numbers tell the story- there are shortages of doctors in USA, Europe, Africa, Latin America and Asia. In the U.S. shortage of doctors is 55,000 projected to 2033 by Association of American Medical Colleges. There are 290,000 nurse practitioners licensed in the U.S. and 131,0000 physician assistants. The goal will be to get an adequate number of nurse practitioners licensed in this decade to take care of these teams. The pandemic has made virtual visits to doctors and nurse practitioners popular. Medicine reimbursement should and would be practiced on the basis of how well a patient is doing not on a fee for each micro service that is delivered. For this to happen the teams led by the nurse practitioner have to commit to patient education of the benefits from good practices and good habits for nutrition, exercize, caring for oneself. A doctor short of time is hardly the person to carry on this patient education which is where the major opportunities for a new system arise. The virtual care also provides a new medium for patient education and awareness of the risks of getting illnesses, preventive actions to be taken in advance. One approach being tested in California and Texas is for a monthly fee for patients more payments by health plans to doctors or healthcare teams if the patient is healthier. Additional health professionals are added to the team including health coaches, dietitians and medical assistants to increase its effectiveness in counseling and education and monitoring.  The nurse practitioner team approach is already being practiced in parts of the U.S. including the example of New Hampshire shown here, and is predicted to be the approach for primary care in the next decade. ...

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Bret Stephens on the foreign policy debate about supporting or not supporting dictators. On the big one today of Iraq after the large gains with Maliki in Iraq it could be said that its not an easy path either way with each path fraught with dangers, but in the long run if one perseveres and again in the spirit of democracy and with the people in the region themselves and their leaders having good sense and good judgement and putting the interests of the whole region before their personal interests, given this you are always going to do better by your people and the people in the region affected, by respecting democratic ideals and principles. Pakistan is not a good example because its leaders have put their personal interests before the interests of their people but even there things are changing. Zardari's dirtier and clumsier hands are mentioned by Stephens but even here this time the opposition led by Nawas Sharif decided that its more important to respect the electoral process and democratic ideals and let Zardari run Pakistan. Administrations like the Bhuttos and Zardari's have alway been corrupt so there are no high expectations but even here the people of Pakistan will find a way to make the progress they desperately need and find the leadership that can provide it. The military muffling and jailing dissent and not respecting the independent judiciary may not affect the person on the street in Des Moines or Delaware but for people in Pakistan who have suffered under military rule this may be a different story. And in the Middle East things were not that much better with dictators in power either in Palestine and its an area where the conditional part of leadership in the region having good sense and judgement should be considered as well as history. In Iran its not between the Ayatollah and the Shah, before the Shah an elected government in Iran was overthrown when its anti western oil company stance was seen in the light of the cold war. It was the overthrow of that government that brought the Shah in. Had it continued the internal politics of Iran would have been resolved by the people there. In other words western oil interests and lobbies and the cold war distorted the process there. Without the two Iran's politics would not be of much interest to people in the USA and governments there also would have no reason to be especially friendly or especially hostile to the USA. So once one removes the distorting factors and takes out the countries which cannot be used as good example like Palestine and Iran, on the big one Iraq where the people and the leadership in the region did not fail even in very difficult situation and the US persevered, respecting democratic ideals and principles was the best course with the best results. The improved Libyan relations should not be chalked off as a point in favor of dealing with dictators. With better or worse relations with Libya it made little noticeable difference or probably no difference to the people in Des Moines or Delaware. For Iraq it makes a big difference to get it right by both peoples. Libya which had closed itself off from western technology and ideas now opens itself up because this way it can improve life for people in the region, this may be the only thing that has changed. And Stephens puts it another way its more sustainable. But why is it more sustainable to respect democratic ideals and principles given that the leadership of people in the region affected and the people themselves have good sense and judgement? Because in doing so one is respecting oneself one is more true to one's own people's idea of a good and just society and one is respecting other people....

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The startling truth about health "reforms," - they won't control spending, and without that the whole system of health care will rapidly become unaffordable and unsustainable. Obama's Council of Economic Advisors points out in new report that since 1975 annual health spending per person, adjusted for inflation has grown 2.1 percentage points faster than overall economic growth per person. At this rate health spending which was 5% of the GDP in 1960, and is 18% of GDP today, would grow to 40% of GDP in 2040. Medicare and Medicaid would increase from 6% of GDP now to 15% in 2040, or equal to three fourths of federal spending. Employer paid insurance premiums for families which grew 85% in inflation adjusted terms from 1996 to $11,941 in 2006, would increase to $25,200 by 2025 and $45,000 in 2040. This would force employers to reduce take home pay. Samuelson says the uncontrolled health spending is singlehandedly determining national priorities, reducing discretionary income, raising taxes, widening budget deficits and squeezing other government programs, while it is producing large amount of waste in medical spending. See the link to Prof. Tyler Cowen of George Mason University in NYT, 6/14/ 2009, who cites the habit of doctors to write many expensive tests as one of the prime culprits in the wasteful spending. And in the process it delivers higher cost for lower overall quality of health for the American people. This at a time when many European countries provide live examples of doing it in a better way- lower cost, better health. The serious problem with the Obama health reforms says Samuelson is that it talks about restraining spending but may end up increasing spending. Its talk about controlling spending he says is good intentions, but based more on hopeful thinking, public realtions and risks becoming cosmetic reform. Because to really control spending will require coming to grips with its fundamental cause- hospitals and doctors are paid mostly on a fee-for-service basis and reimbursed by insurance, private or governmental. Such a system encourages doctors and hospitals to provide more services, expensive tests, favors heavy use of expensive medical technologies to increase profits, and for patients to expect them. Samuelson puts his finger on the root of the problem - there is no incentive and every disincentive for all the players in this game , doctors, hospitals and patients to seek reform of this system. For doctors and hospitals the hope would be that this cosmetic "reform" would leave the system basically unchanged, and patients to continue with a lifestyle and expectations that do not not acknowledge the fact that a lot of healthcare does not come from spending but from preventative care, education, good eating and exercize habits, and healthy lifestyles. And the uninsured are no exception, they would simply start consuming the expensive care for lower quality of overall health like everyone else. With this kind of situation confronting us, the views of Samuelson, and Professor Tyler Cowen of George Mason University, as welll as a growing chorus of informed public opinion on this subject, is that insuring the uninsured is a good idea, but doing it within the bounds of the present system, can only increase the costs. And too much is at risk, to rely on what Samuelson calls a scattershot of measures to control costs made up by Congress such as "evidence -based guidelines," "electronic record-keeping," "bundled payments to hospitals, to give the illusion of progress that won't make a serious difference. A sweeping restructuring of health care is needed, that would overhaul "fee-for-service" payment and reduce the fragmentation of care. It will also need what has not even be touched on adequately in the debate. This is the massive need for education in the schools about nutrition, eating, exercize, healthy lifestyles. It would also require opinion leaders in each field from sports and other fields to lead by example and with constant public presence, the media, and companies to form a partnership with private institutions to change existing eating habits and lifestyles that encourage obesity, smoking, fast food eating habits, large portions in restaurants....