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Some of the crude rhetoric at Donald Trump rallies, and use of coarse language, according to the NYT. Working class and older Americans show their anger at a system that appears to have left them behind with slogans, stickers, T-Shirts. The idea of the wall figures in much of this and shows that the wall has become not jut about Mexico but a metaphor that captures this anger, that reflects this anger. Another aspect of the 2016 campaign is that those most vulnerable and most in need of help have not sought the comfort of knowing about programs to improve middle class and working class wages, incomes, to build infrastructure, create jobs, stop companies from shifting jobs overseas, plans for improving accesss to health care and education, to ask for specifics and delivery. This is the supreme irony of the 2016 election campaign that not enough attention is going to what will be done for the middle and working class, and what specifics will be delivered, in what time frame- which is essential for restoring the condition of the American middle and working class to where it was in the 2 decades after the Second World War. ...

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WSJ reports that the former president's supporters will rally to his side but swing voters might be repelled by this latest legal controversy including the context in which it happened that of a sordid affair. Mr. Trump built his support base out of two mistakes of president Obama, his neglect of rural America, and neglect of American manufacturing. And of the mistake of president Bush in pushing America into two wars in Afghanistan and Iraq that put money into wars with no productive purpose that needed to be put in rebuilding America's infrastructure. Others could have done this, Mr. Trump aggressively pushed ahead and found himself first. President Biden has closed the chapter on the wars by ending them, he has also closed the chapters of neglect of American manufacturing and put working families and America at the top of his agenda at every point. And as he did at the State of the Union address in 2023, made it personal by reciting what his father has told young Joe about standing up for working families. Biden's abilities rival that of president Lyndon Baines Johnson, who had as much experience in the US Congress as Biden, and delivered the passage of Medicare and Social Security for all Americans. Biden has done something that ranks similar with trillions of dollars for the Inflation Reduction Act, CHIPS and Science Act and pandemic assistance, and has the conviction that there is much more to be done. ...

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Lipton, Austin and LaFraniere of the NYT tell the story of how the serious differences between the prime contractor for the federal healthcare website, CGI Federal, and the Obama administration officials handling the website, evolved into conflicts that could not be resolved. This led to the flawed website being rolled out on schedule ignoring serious problems with the website. The detailed report comes after interviews with Obama administration officials and specialists who worked on the project and looking into government and contractor documents. A month ago in October 2013 the healthcare website for the Obama healthcare law was up only 42% of the time with 10 hour failures happening frequently. Basic steps for the functioning of website backup systems in case there is a failure, testing to ensure negligible or no outages, were not secured. The government officials responsible for the rollout did not have the capabilities to handle such a project. Henry Chao, who worked in the Medicare agency for 19 years was left to oversee day to day questions for the website HealthCare.gov, but lacked a formal background in software engineering and no authority to make the decisions needed. The $630 million project was setup inside the Medicare Agency, instead of a separate agency specially setup for this project and staffed with the appropriate skills as originally proposed. Five different lower level government officials made decisions without the authority needed and no one person with the necessary skills was given overall responsibility and decisionmaking. A series of missteps were allowed to take place- settting many added requirements that made it difficult for contractors to focus on basic steps and get them right, use of the MarkLogic database system instead of systems from IBM or Oracle against the advice of contractors, multiple contractors without a way to control the overall project, shifting requirements from the government and bureaucratic delays for resolving basic issues such as use of social security numbers, all worked to create delays. With the delays came a deterioration of relations between Obama administration officials and the contractors. The government officials response was to stick to the deadline of Oct. 1 rollout, with Michelle Snyder, chief operating officer of Medicare agency telling people she would fire the contractor if possible. In the end no one took responsibility for a safe reliable rollout, even though the system failed a test of 500 users in late September and was down half the time in mid-October. President Obama or his advisors were either not kept fully informed, or did not grasp the significance of the collapse in relations between contractors and the government and a project out of control. His aloof distanced approach was not an asset in such matters- saying about the rollout and use of the website: "this is real simple" like using the Kayak website for travel bookings- and he saw no need to take action leading to the major failure for the administration that followed....

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The influence of the AMA convened Relative Value Scale Update Committee (RUC) on how the Medicare payments to doctors is shared, and on the growth of the Medicare budget. Concern that the interested party is driving the decision making process. Medicare costs went up by 9% in 2009. Fears that doctors have too much control over the dollars in the $500 billion Medicare program. The tendency to focus on more expensive procedures and short change preventive and less costly care. Medicare spends $60 billion on doctors fees. The older codes remain in place even when costs are reduced, leading to higher costs for the Medicare budget each year. And there is little incentive for doctors in RUC to revise overvalued codes.

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David Wessel points to some problems with the Paul Ryan budget proposal. Ryan's plan does not balance the budget till after 2030, and Congress would have to raise the debt ceiling each year till then. The changes to Medicare Ryan proposes would limit how much the government spends, but the savings from this do not come for a decade, as people expected to retire in the next 10 years will still have Medicare. Ryan's proposal shows how deep the cuts will have to be if deficit reduction is done without raising taxes. Pete Domenici and Alice Rivlin who developed a deficit reduction plan, said they were disappointed that the Ryan plan "fails to address the need for new revenue," which they consider crucial for truly tackling deficit reduction. The Obama budget failed to offer a comprehensive deficit reduction plan, leading to openness for new ideas. The health care delivery system in the U.S. needs to be efficient and costs need to come down. Ryan's proposal gives no idea where the efficiencies will come from. Would they come from competition between private insurers? How will escalating healthcare costs be controlled. Another consideration is that even with its problems Medicare is less costly to administer than private insurance. Everything depends on seniors shopping vigorously for the best premiums because risks and costs are borne by seniors, with the idea that this will somehow control escalating medical costs....

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Susan Jaccoby brings up a major issue facing healthcare in America from personal experience. A third of the Medicare budget, she says, goes to the last year of life, and a third of this goes to the care in the last month. At the same time public opinion polls show Americans see the problem being too much medical intervention rather than too little. Especially when there is no hope except to prolong life for the patient with an highly deteriorated qulaity of life for a few months or a year, doing no service to the patient or future generations who may see their basic services cut when they most need it as a result of the unaffordable spiralling cost of Medicare. A Pew Research Center poll in 2006, shows 22 percent say a doctor should not always make efforts to save a sick person's life, and 70 percent believe that patients should be allowed to die in some situations, when it only prolongs life for a few months for instance and patients live in pain. The problem only gets worse in future years as an estimated 8.5 million Americans are expected to be over 85 years in 2030 with these same choices facing patients, their families, Medicare and the country....

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The rapidly changing demographics as the U.S. becomes more of a multicultural society. For the first time minority babies formed a majority in 2011 with 50.4% of new babies, according to the Census Bureau. The median age of the non-Hispanic White population is 42 compared to 28 for Hispanics. Hispanics are right at the child bearing age. This also raises the issue of how the U.S. will educate the minority population. Today 13% of Hispanics have college degrees, 18% of Blacks and 31% of Whites. High school graduation rates in places like New York City for Hispanics are lagging far behind other groups. The economic downturn after the 2008 financial crisis has worsened the educational prospects for Hispanics and other minorities. The education of minority children is essential to improve the competitiveness of the U.S. in a global economy, as the educational levels in emerging markets accelerates with more opportunities.

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In a program of gradual change the new leadership under premier Li Keqiang steers China's economy in the new direction set by the DRC Report: China 2030 and the Third Plenum in Nov. 2013. New priorities listed under major Tasks in the annual work report by Li Keqiang place setting up deposit insurance at the top of the list. Policy changes include allowing cities to issue bonds directly to increase transparency in construction spending and control burgeoning debt.

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Joe Nocera describes his personal situation which also reflects the situation of the average investor in his 401(K) for retirement - inexperience in handling the boom-bust cycles in the market and loss of savings, especially in the last two decades with sharp swings in the market. The Employee Benefit Research Institute statistics on savings of the average American are striking, dismal is the right word- only 22% of workers 55 or older have more than $250,000 set aside for retirement, and 60% have less than $100,000 in a retirement account. The average savings of an American near retirement are $100,000.

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Katrina Vanden Heuvel describes the problems with media coverage in the 2016 U.S. presidential campaign, where what dominated she says was fake news, fake coverage, and misinformation, failure to adhere to the American values that would censure any denigration of women, and failure to cover the critical issues of how the election would affect the economy, the middle and working class.  She points out that the election of a first female president was not treated with the same respect that the election of a first black person as president was. 

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The May 6 episode of the stock market plunge of 900 points in the U.S. and then recovering had the effect of rattling investors nerves especially retirees. The impact of this episode is recorded in the experience of one Charles Schwab broker office in Englewood, Colorado. By the end of that day this broker had 50 calls on his answering machine from a fifth of his clients, all seeking to know what happened. Charles Schwab, who helped launch a period of individual investing in the U.S. after 1982 by cutting fees and going after the average investor, (along with others like Jack Bogle of Vanguard Funds), is also on edge. He says he has not seen anything like this since his early days. Schwab confirms Yale Prof. Shiller who says (see link) that his index for markets shows a lot of nervousness. Saying that 98% of people are still very concerned, coming after the May 6 incident, and the Greece and eurozone crisis that impacted US stock markets. One other factor he points out is the constant flow of headlines that suggest certain business people engaged in fradulent practices, something that fuels a lack of trust. Charles Schwab ponders from his office across the San Francisco Bay Bridge, whether words like safety and soundness mean anything anymore. Another factor of concern, Bogle points out, is that institutional investors now own 70% of American corporations, up from 35% in 1975. And the advantage has veered sharply in their direction as institutions, hedge funds, and investment banks trade on their own account, with wealth moving in that direction. This leaves the individual investor and especially the retiree or those about to retire in a severe predicament....

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The response of Ronald Reagan and George Bush in a Republican presidential primary debate to the question: Do you think the children of illegal aliens be allowed should be able to attend Texas public schools free, or do you think that their parents should pay for their education? Bush's response: "I would reluctantly say I think they would get whatever it is that society is giving to their neighbors... If they're living here I don't want to see a whole thing of 6-8- year old kids being made totally uneducated and made to feel they're living outside the law. Lets address ourselves to the fundamentals. These are good people, strong people. Part of my family is Mexican." Ronald Reagan's response was: "Rather than talk about putting a fence, why don't we work out some recognition of our mutual problems with Mexico? Make it possible for them to come here legally and with a work permit- and then while working and earning here, they pay taxes here. And when they want to go back, they can go back. And open the border both ways by understanding their problems."...

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George Will lists the shortcomings of Romney and Gingrich, as U.S. Republican presidential candidates in 2012. Gingrich is the worse candidate, says Will. Gingrich was paid $1.6 million by Freddie Mac, for services as "a historian." His response was to say "If you put people in jail," look at "the politicians who profited from" Washington's environment. He criticized government housing agency Freddie Mac for its role in the housing crisis, and at the same time profited as a lobbyist for Freddie. This shows his personal record and lack of conviction about the need for integrity in government officials. Conservatism, says Will, is about understanding that man does not fully understand the complexities of the world around him. It stands in opposition to man saying that he has grasped these complexities and assuming a hubrisitic attitude. Gingrich with his fervor for the latest idea, is the opposite of what conservatism stands for, says Will. Will sees Rick Perry and Jon Huntsman as better candidates than Romney or Gingrich. Presidential debates don't test what is needed to perform presidential duties and have become ridiculously important. Rick Perry's Texas record as two term governor, and his skepticism and distaste for Washington and Wall Street, give him assets that could prove to be vital for the job of president. Huntsman's positions on issues are closer to the conservative approach to government than Romney's. Will says it is important that Republicans don't give an Obama running as a Harry Truman did in 1948, against Congress, the one thing needed to win - someone who voters have a distaste for....