LyrArc Article Gist
Questions about the true cost of the Obama health care legislation and the assumption that the legislation cuts the deficit by billions of dollars. This WSJ editorial says one has to look at this closely, and not merely look at CBO projections, which may be based in a certain context and not reflect the true costs, especially because many accounting gimmicks and use of numbers to present a particular picture is taking place. The information this editorial cites is that: it uses 10 years of taxes to fund six years of subsidies, Social Security and Medicare revenues are double-counted to the tune of $398 billion, a new program funding long-tem care frontloads taxes but backloads spending, and the assumption of an automatic 25% cut to physician payments that Congress is unwilling to authorize. Rep. Rand Paul has tried to present an alternative view which needs to be studied just as closely, because of the enormous impact of a jump in spending at a time when the public finances are fragile. WSJ also cites the work of Richard Foster, the chief Medicare actuary, as an alternate perspective of how things could turn out, Doug Holtz-Eakin, and Eugene Steuerle. It calls for common sense in evaluating programs, entitlements, defense or other government spending. They not only cost money, but costs escalate over time as history has shown over decades, till they eventually are discovered to be not affordable unless the middle class is willing to dig deeper into its finances to pay for them. Alternate perspectives from a range of informed opinion, Howard Dean, Martin Feldstein, and the head of Harvard's Medical School show that the issue needs to be looked at closely and carefully and cannot be something in which CBO numbers can be trusted to tell the whole story. Especially when common sense, history, and informed opinion across a spectrum of thought advises caution, and fragile public finances also suggest caution. Howard Dean, former Governor of Vermont, says the health care bill is not real reform, and may do more harm than good. He says in a Washington Post article, December 17, 2009, the Obama health care bill does not insert competition into insurance markets, does not significantly reduce costs, and does not improve the delivery and use of health services. It was he says done with a political calculus and crafted for votes not real reform. Jeffrey S. Flier, Dean of the Harvard Medical School, gave the Obama health reform bill an "F" grade, saying in a Nov 18, 2009, WSJ article, that it was disingenuous to call this reform, Congress and the White House were simply deceiving the public. He said the bill will accelerate US health care spending, postpone most of the major health care problems, expecially the ones that drive cost, including the "fee for service" system and delivery of health care. He says in his discussions with economists and other health care leaders the opinion was unanimous that the bill will accelerate health care spending. He cites Massachusetts as an example, where access to care was expanded under the same dysfunctional system, and spending went up, and it doesn't work. Feldstein, who in early 2008 suggested proactive solutions to the mortgage debt crisis which were never adopted, says that the Obama health care law means higher taxes in the long run to pay for the $1 trillion cost of health care for the uninsured group over 10 years. Feldstein says that the Obama plan is to cut Medicare to cut spending, and will reduce the amount of medical services, as reduced spending comes from fewer services, not reducing payments to providers. And he asks if the cost reductions are weighted too heavily towards reduced services and not reduced payments to providers ,would this result in large cuts to services to affect the quality of healthcare for the 85% of the American people who are accustomed to a different pattern of healthcare. ...

LyrArc Article Gist
Connecting the National Health Service in UK (NHS) to Nature would take NHS to a new level by bringing mental health through nature walks to many people who need it during the pandemic. Damian Carrington of The Guardian looks at social prescribing where people are referred to nature projects, a trend that is growing in the UK and adding a highly valuable component of health to NHS. This is called Green Social Prescribing. 

There is significant support for the idea of Nature walks adding to wellbeing. A 2019 study cited here shows weekly 2 hour dose of nature improved health and wellbeing.

LyrArc Article Gist
US president's sweeping powers to use tariffs as a tool for policy when American people's jobs, communities, health, is threatened by fentanyl and concentration of manufacturing jobs in China, unfair trade by EU and Japan, is the issue presented to the US Supreme Court. The US president presented it in this way- tariffs as a foreign policy tool, not a way to impose economic policy in the form of a tax on American importers or buyers which is the power allocated to Congress by the US Constitution. Justices who mentioned these powers called them sweeping powers but would not say the word fentanyl or look back at the recalcitrant behaviour of Asian nations Japan and China when it comes to unfari trading practices, where the US could literally negotiate forever and get no result, or to the enormous concentration of manufacturing power and supply channels in China that not only ships out American jobs but leaves Americans at the mercy of foreign powers for cost of living. Nowhere was this more evident as during covid years and now in rare earths export restrictions from China. The Justices assumed it was just alright to ignore this or leave it unsaid.  The cost to American buyers is small because most of the tariffs are borne by foreign suppliers in China, Japan and Germany, who as in the case of automobiles unfairly benefitted for decades and are now bearing most of the cost of tariffs. The large business in the US have increased their margins so much in the 2020-2024 period that they are now bearing some of the cost of the tariffs, as reported in WSJ. So that inflation in the US is at 3.0 % in the US less than anticipated, when average tariffs are at about 10% overall, not what the headlines say of 15-20% because of the product exceptions made in the tariffs for each nation. Justice Roberts may be right when he says more care should be exercized in the placing of a tariff, but even Roberts and Justices Barrett, Gorsuch, Kavanaugh and others know that the US has used this as a last resort, as a policy tool to protect the American people. Sweeping powers need care and caution as Justice Roberts stated- “power to impose tariffs on any product from any country in any amount for any length of time. It does seem like that’s a major authority."   ...

LyrArc Article Gist
Phased retirement is becoming a popular option for many Americans nearing retirement. An example is a employee taking 25% less income for 13 weeks of additional time off to spend more time with a reitred spouse, for vacation, and for trying out new locations for retirement. It gives working Americans an opportunity to gradually adopt a more relaxed lifestyle, to better understand what it would be like in retirement. This option also has the advantage of using good health to add some working years and improve the retirement portfolio, with less demands of work.

LyrArc Article Gist
Several experts point to a dangerous change in the nature of unemployment in this downturn. Heidi Shierholz of the Economic Policy Institute, says people are more likely to get stuck with unemployment now than at any time in the post war period. Andrew Stettner, deputy Director of the National Employment Law Project, says a larger share of the unemployed are not going to be able to go to the same line of work. They will need new skills, just like an auto worker in a permanently downsized industry would have to find new skills to make a product in the renewable energy field or health care. And the law as it currently stands does not help either. Because if an unmeployed worker looks for training or goes back to school he loses his unemployment benefits, something the Obama administration proposes to change. What this means is that many of the unemployed will end up as permanent job losers. Rob Valetta, an economist at the San Francisco Federal Reserve Bank says that throughout the the last 3 decades including good times, the unemployment pool is shifting towards permanent job losers. Lawrence Katz, a Harvard University economist, points out that once workers exhaust their unemployment benefits and don't get new training, they become disconnected to the labor market, and bascially end up on disability or become permanently unemployed. The statistics bear this out. In April 2009, 47.1% of the people collecting state unemployment insurance exhausted the usual 26 weeks of benefits without finding work, according to the Bureau of Laor Statistics, that is the highest rate on record. In December 2007, there were about 2 unemployed workers for every job opening, according to Labor Department data. In March 2009 there were five unemployed workers for every opening. Mark Beaupre, 49, of Providence, R.I. lost his $8 an hour manufacturing job an year ago, one of many manufacturing jobs he has held since the 1980's. His wife Cathy lost her customer service job a year ago. This couple who together made $50,000 a year, are now behind on their mortgage payments and have applied for food assistance. At a recent job fair in Providence he says three thousand people turned up and he could not even get into the parking lot. ...

LyrArc Article Gist
Metro Detroit has 90% of the 17,000 cases in Michigan as the pandemic reaches its peak there this week.  The large Detroit airport renovated and enlarged is seen as a source of the coronavirus as Detroit is where all 3 auto U.S. auto companies are located. GM, and Ford have large manufacturing operations in China, and  Chrysler has plants in northern Italy, the locations where coronavirus has hit hard, and in the case of China where it originated. Health experts say the busy Detroit international airport connecting the Detroit hub to other auto hubs in northern Italy and China- both virus hotspots- may have contributed to the virus hitting Detroit early. This country to country transmission along some route is how the virus has traveled to over 150 countries. For instance German reports show Bavaria as the source of the early cases in Italy's Lombardy region. It could be that German auto companies located in Bavaria with large operations in China resulted in inadvertent transmission of the virus from China through airport in Munich from flights between Germany and China. A Shenyang municipal bureau report provides information on German  investment in Shenyang, Liaoning province. Munich based BMW makes 1.3 million cars here. There is also the newly built Chinese German Tiexi industrial park in Shenyang with 50 German companies BASF, Siemens, located there.  Once the virus arrives in one location its spread depends on the environment with densely packed areas and the health conditions prevailing in a particular area playing their part. Both in New York and Detroit metro area this helped its faster spread in lower income densely packed areas.   ...

LyrArc Article Gist
In his State of the Union Address president Biden set the tone for the next 2 years of his term, and in preparation for another term to Build Back Better for America. He talked about his efforts to address the needs of America in rebuilding aging infrastructure, restoring its place in manufacturing, chips and science, and addressing climate change with trillions of dollars of investments. No longer would crowding out of government investment happen as it did in the last two decades with neglect of infrastructure, manufacturing, workers and families, and massive misallocation of capital in capital markets. On Jobs, America and Renewal, "on rewarding work, not wealth" "Jobs are coming back. Pride is coming back because of the choices we made in the last two years. This is a blue collar blueprint to rebuild America and make a real difference in your lives." He told Congressman McCarthy-          "I don't want to ruin your reputation but I look forward to working with you." Reminding Republicans-  "The people sent us a clear message. Fighting for the sake of fighting, power for the sake of power, conflict for the sake of conflict gets us nowhere." ...

LyrArc Article Gist
Studies at the University of Padova in Italy and by France's research agency INSERM show higher risks of dementia from retiring early. The INSERM study shows that for every additional year worked we reduce the risk of dementia by 3.2 percent. Retiring at age 50 is considered very, very poor decision, and before 60 very poor decision, as cognitive development, mood, and active engagement with work offering complexity, all relate to good mental health. Countries like U.S. and Denmark where people tend to work for longer than in France and Austria are shown to be doing significantly better in cognitive performance in a 2010 study published in the Journal of Economic Perspectives. The Italian study shows the longer you spend in retirement the higher the risks of cognitive decline.

LyrArc Article Gist
Women feel overwhelmed with housework during the pandemic. About 80% of women feel responsible for house work compared to 28% of men, according to a NYU and U Penn study. On average women do one and half times the house chores compared to men. This difference is wider when looking at households where men do very little of the housework. The author of "Fair Play" a book about dividing housework says women are burned out, stressed and full of rage about the way household chores are handled. The pandemic has seen a further deterioration in the amount of time men spend doing household chores, according to the Bureau of Labor Statistics, creating a situation of tension. As men have worked from home during the pandemic the once invisible labor of women is now in plain sight. For women who have quit their jobs and looking for a way to get back to work there is an additional element of frustration. WSJ looks at ways in which men can make the changes to create a healthier situation at home, and reduce the tension. ...

LyrArc Article Gist
Hospitals in Europe are filling up quickly in the second wave of coronavirus. Coronavirus patients had to be transferred by helicopter to Germany from the Netherlands because of overburdened Dutch intensive care units. National Guard troops were flown in from the U.S. to the Czech Republic to help. In France as cases approach cumulative 1 million about 2000 patients are admitted to hospital for coronavirus every day on October 29. At some point French hospitals could be overwhelmed this winter, and doctors having to choose which patients to save, says president Macron. In the Czech Republic a collapse of the health system is expected by mid-November says the prime minister. No one expected this to be this severe, he says.  About 40,000 patients are hospitalized for coronavirus in the U.S. During the last week the case are increasing by over 40% in the U.S. and increase in hospitalizations are expected. Recovery rate is improving from the first wave. At NYU Langone hospital system in New York with 5000 coronavirus patients hospitalized recovery rate is improving from 25% in March to 7% in October. Better handling of cases and knowledge gained by doctors is a big part of this. ...

LyrArc Article Gist
This report on Danish wind energy company Orsted, looks at the journey of the largest developer of wind energy in the world from a company sending natural gas from North Sea to Europe to a joint developer with Denmark's Vestas of offshore wind farms. Last year Orsted, pronounced Ehrr-sted in Danish for the O and named after a Danish scientist, decided to invest $57 billion in offshore wind farms by 2027. It was not easy and the path required a bold vision and bold action to invest in wind energy for the long term even as debt piled up from losses in natural gas competing with coal, climate change committments were not yet strong, subsidies were required to make wind energy competitive, and debt was piling up. It would take a decade of hard work and technological innovation to produce wind energy that could outcompete coal and natural gas on cost without subsidies. The year is 2009 with the Climate Change Conference in Copenhagen. The predecessor company to Orsted was losing money in natural gas with lower cost coal energy generation in Europe at the time. Yet the mood was changing governments were willing to invest in renewables. In 2012 a new CEO Paulsen did a review of 12 businesses of this Danish energy company and decided wind energy was the only one with long term prospects. The Copenhagen Climate Change Conference created new awareness for the need to come up with a long term solution for energy that has no negative health effects and is renewable. That Conference set a goal of 20% for renewable energy by 2020 in the total mix for Europe up from 14%. Paulsen saw an opportunity in the crisis at the company then called Danish Oil and Natural Gas. The new company was called Orsted and the old divisions in fossil energy were sold to invest in wind farms offshore. The way Paulsen saw the situation was that the company had to take radical action whether it wanted to do so or not. By 2012 Danish pension funds were investing in large offshore wind farms of Orsted, taking a stake of as much as 50% in the Nysted wind farm. The Danish government which owned 80% of Orsted thought its projects were risky. Hard work with Vestas which builds the turbines in Denmark paid off in developing a huge new turbine that would bring costs down 65% comparing 2020 with 2012.  In 2018 the European Union was spending about 92 billion euros or $112 billion on energy subsidies including to wind farms. Britain also heavily subsidized offshore wind farms such as Hornsea 1 at about $198 a megawatt hour for 15 years double the electricity price in recent years. Windy conditions and shallow waters in the North Sea were favorable. Technology was being developed with Vestas which would reduce the cost each year. By 2016 Orsted was listed in Copenhagen. The remaining oil and gas business was then sold for $1 billion. The returns are less in wind than coal and natural gas- about 7-8% a year but the big thing is that there is certainty in this compared to coal and natural gas which are volatile and uncertain. The lesson companies are learning in renewables is that with solar and wind technology can. bring down costs, a lot of hard work and creative work lies ahead, that crisis can be turned into opportunity for companies that can be focussed enough to produce results. ...

LyrArc Article Gist
The Deficit Commission setup by US President Obama recommended changes in the tax codes including elimination of the deduction for mortgage interest. It calls for limiting spending on health care, gradually raising the retirement age, and lowering the tax rate. The commission identified $200 billion in discretionary spending cuts, with half coming from defense spending. The federal gasoline tax rate would increase from 2013, increasing by 15 cents a gallon at that point. It would gradually increase the retirement age to 68 by 2050. And combine a reduction in benefits with an increase in taxes on wealthier senior's benefits. It seeks to slow Medicare growth to control health care spending. Other proposals. A freeze on salaries and bonuses of federal employees for three years, to save $15 billion by 2015. And proposes cutting the federal work force by 10% to save additional $13 billion by 2015.

LyrArc Article Gist
Department of Education invites controversy because of diversity programs and "transgender" as culture ignoring health risks. Established by president Jimmy Carter in 1979. Education in the US is run at the state level by each American state administration compared to UK where it is done at the national government level. It has one of the smallest budgets of any agency at 4%, Transportation is 1.7%, Agriculture 3.0%. Most of its work is overseeing $120 billion of federal grants and programs for public education through high school. It supports districts with low income students with $18 billion aid. Head Start program supporting 883,000 low income pre school children in 2022 gets federal aid from Department of Health and Human Services. National School Lunch Act of 1946 by Harry Truman is not affected as it is run by states,  federal aid comes from Department of Agriculture to 20+ million children. Republicans oppose spending about $1 billion to support Diversity program DEI initiatives and support for "cirtical race theory." There is opposition to "transgender." Britain's NHS had a commission look into transgender and says it poses health risks to children and young people. It also adds to anxiety of parents. Republicans are 53 -47 in majority in Senate- to scrap the agency Republicans need 60 votes in the Senate. The likely option is that they will pass a bill putting many of the functions in other agencies reducing its impact- between HHS, Treasury and Interior agencies. ...

LyrArc Article Gist
Some of the statements on the IMF Blog on Inclusive Growth raises the question-Does the IMF, the International Monetary Fund, as an American institution funding developing countries, and economists, grasp what people find troubling in 2022? One of the lessons of the economic crises for families and workers in the US and other countries is that wisdom, a grasp of the soul of a country and its people through the thinking of its founders, and common sense, should drive managing of economies, with a knowledge of how economies work- not economists. Some of that is already happening. America's central bank is headed by Jerome Powell who has wide experience and has knowledge of how the economy runs, is not an economist. He was chosen by president Trump and continues to have the confidence of president Biden for this very reason. Some of the statements on the IMF economic blog are- "Why jobs are plentiful and workers are scarce" Jan 2022 "In the US and UK recent labor market the puzzle, can be partly explained by mismatch, the pandemic's effect on women and older workers leaving the work force." The Reality Wages for teachers are depressed compared to workers in the financial and economics industries, in a frighteningly disproportionate way. When it comes to logistics, hospitality, leisure and restaurants industries workers were paid poorly for what is hard work and long days. In case the IMF economists, and economists at companies, missed this it was called the Great Resignation, people simply choosing to reject the conditions that were handed down to them by the financial industry and economists who built the economic structures of recent decades. Women leaving the workforce are faced with issues of mental health coping with added responsibilities of children at home for the two years, loss of income and widespread mental health problems. The word mental health may be beyond the grasp of economists and the financial industry, yet it is the one of the biggest problems for people. Another pernicious effect noted on the pages of the WSJ is that young white men are dropping out after school because they cannot afford college in alarming numbers. Leading to the kind of discontent for workers and families that president Biden is struggling to address. On IMF Blog- "IMF Podcasts: The Year in Review" Dec. 2021 "The past year has brought us new challenges even as the old ones persist. If anything, the ongoing pandemic has taught us to think differently abut tackling the challenges and questions when it comes to thinking about big issues such as climate change, gender equality, inflation and economic measurement." The Reality Climate change lumped in with economic measurement and inflation. The floods, fires, river and reservoir water levels affecting access to basic life supporting water, drought, all over the world are of a magnitude that is missed entirely.The response to a challenge of this type requires the kind of leadership that president Biden has provided for the world with his $360 billion climate change bill as just the first step of many, and  comprehensive policies covering all aspects of the climate crisis. ON IMF bog- "How Domestic Violence is a Threat to Economic Development." "Stopping violence against women is not only a moral imperative, new evidence shows it can help the economy." The Reality Domestic violence hurts children growing up in such households. It is not so much a moral imperative as it is bad for men, women and children. So many things are wrong about it and it is made worse in conditions of low wages and poor working conditions in poor neighborhoods lacking education. These neighborhoods are also affected by lack of healthcare and the opioid crisis and mental health issues. Not investing in education and healthcare in these communities is what is simply wrong, and which the founders of America as a nation, particularly Lincoln, would find appalling.   Relationship between Capital (the Financial Industry) and Labor (Workers and Families) On the basic issue of the relationship between capital and labor, the IMF and the financial industry, economists, and the economic structure they built in recent decades, have simply got it wrong. It violates both common sense and wisdom, and violates the spirit of the founders particularly Abraham Lincoln. This is what Abraham Lincoln had to say on Upward Mobility, the ease with which each generation can do better than the one before it, as critical in the fight to save the Union. This is from the Annual Message to Congress Dec. 3, 1861, at the start of the Civil War. That upward mobility has been lost in the US with ideas that "place capital on an equal if not above labor, in the structure of government," for the last three decades in the US after the early post war period of Truman and Eisenhower, Kennedy-Johnson.  And Lincoln says this about a hired laborer being fixed in that condition for life, or of future generations of that hired laborer facing disabilities and burdens, similar to the loss of upward mobility for the people today. "Now there is no such relation between capital and labor as assumed, nor is there any such thing as a free man being fixed for life in the condition of a hired laborer. Both these assumptions are false, and all inferences based on them are groundless." "Labor is prior to, and independent of capital. Capital is only the fruit of labor, and could never have existed, if labor had not first existed. Labor is the superior of capital, and deserves much the higher consideration. Capital has its rights, which are worthy of protection as any other rights." "Again: there is not, of necessity, any such thing as the free hired laborer being fixed to that condition for life. Many independent men everywhere in these states, a few years back in their lives, were hired laborers. The prudent penniless beginner in the world, labors for wages awhile, saves a surplus with which to buy tools or land for himself, then labors on his own account another while, and at length hires another new beginner to help him. This is the just, and generous, and prosperous system, which opens the way to all- gives hope to all, and consequent energy, and progress, and improvement of condition to all." Lincoln even offers this warning- No men living are more worthy to be trusted than those who toil up from poverty- none less inclined to take, or touch, aught which they have not honestly earned. Let them beware of surrendering a political power which they already possess, and which if surrendered, will surely be used to close the door of advancement against such as they, and to fix new disabilities and burdens upon them, till all of liberty shall be lost." US president Biden has these ideas in mind as he struggles with one piece of legislation after another to restore what once was, to open the door of advancement, to remove these disabilities and burdens that Lincoln speaks of, and in so doing restoring liberty.   ...

LyrArc Article Gist
A look at Israel at 70 by the Economist magazine shows a country that has combined early achievements of socialist governments such as free health care system and good education system with the addition of 1 million immigrants from the collapsing Soviet Union, to build a highly trained technically skilled workforce and international companies.  It says the Israeli Arabs are still poor and unable to integrate. With ultra Orthodox Jews they make up 30% of the population, and many of them who do not work. Infrastructure has suffered from lack of investment and public transport is in poor condition. About 4.5 million Palestinians in West Bank and Gaza remain a continuous source of tension with no settlement in sight. The shift of the capital to Jerusalem is recognized by the U.S. Trump administration, a win for Israel, but leaving the divisive politics of Mr. Netanyahu in place. So that with the growing economy, there are social problems and political division which need to be addressed as much as the economy. A problem left for another administration, another leader from possibly a revived Labor party and another day. ...

LyrArc Article Gist
Politico magazine says wealth inequality is a worse situation than a country's income inequality. By this measure the situation has deteriorated badly in the U.S. It cites a study by Thomas Piketty of France with Saez and Zucman, showing that a shocking 75% of household wealth, and 97% of capital income-income generated from dividends, interest and capital gains- is concentrated in the top 10% of households in America. More shocking it says is another study showing that nearly 50% of American households could not come up with $400 in an emergency to meet and unexpected expense, while a tiny fraction controls trillions of dollars in assets. Why is this important? Beyond the obvious short term immediate needs there is the need to build a plan for the future, to be resilient in the face of a job loss or major illness, to seek higher education for job retraining,  to save for a home to retire.  In America the history shows that for most of its history since the founding fathers, in the 1750's the situation was that of a rising tide for all sections of society interrupted by the breakdown during post tech boom failures in the 1890's and 1930's. This is embodied in the Declaration of Independence itself the perception of this as something to be taken for granted- "we hold these truths to be self-evident, that all men were created equal and endowed by their creator with certain inalienable rights ..." One proposal is for a universal income. Others are for employees to have ownership in the business that they work for and contribute their skills. Setting up Permanent Funds that pay dividends to all citizens of a state. Some of these proposals are being considered in Britain by the Labour Party, and Democrats in the U.S. as they forge ways to tackle the rising inequality in Britain after a decade of austerity cuts, and in the U.S. after the tech boom and regional inequality.  ...

LyrArc Article Gist
Adirondack National Park with its 2 million acres of wilderness has St Regis Canoe Area, a canoeing part of the wilderness. Here The Guardian shows Megan Bergman taking up the challenge of going up the Seven Carries route in this wilderness finding peace and mental health in the waters  with her backpack in the canoe. Take this trip up the rivers and ponds in the area and through portages which are carrying of the 15 pound light Kevlar canoes on one's shoulders or arms for the sections of land that connect the ponds and rivers. The American Indian and the early French and British explorers made their way through upstate New York and around the Great lakes in Michigan in this way.  Megan says she wanted that sense of calm, of transcendence, and the fierce delight of putting her backpack into the canoe after the portage. She says she felt content out on the water in the wilderness with a friend. I wanted to feel reverent and at peace with this wilderness which felt safe, she says. ...

LyrArc Article Gist
The title may not reflect the content of this report on Admiral Giroir who heads the U.S. coronavirus testing effort. He is a pediatrician who worked for hospitals in Texas before heading a vaccine project at Texas A&M University.  Internal politics led to his resigning from the effort to build a vaccine development capability with pharmaceutical companies at Texas A&M. Most of the rest of this report shows a physician who is determined to pursue big projects such as the one he is tackling today. President Trump appointed him to lead FDA, and to be the Assistant Secretary of the Department of Health and Human Services. With the missteps of Secretary Azar testing suffered in the early months of the crisis as reported in the WSJ. Adm. Giroir has taken a leading role since  this period. He also heads the U.S. Public Health Service Commissioned Corps of 6200 staff playing a vital role. On March 13 he was asked to lead the effort in testing.  He comes to this role with experience in the field of vaccines realizing that "the challenges are not just biological but engineering." New technology would be needed to make massive amounts of vaccine. His idea is that transformational efforts are needed. His idea for a billion dose per month facility in Texas did not work, yet he worked on it for about 5 years from 2010 to 2015 at Texas A&M University, at one point being the vice chancellor. He was selected by Texas Governor Perry as chairman of the task force in Texas in 2014 to oversee the effort to fight the Ebola virus. He now is in a position to bring all his experience and aspirations to tackle the coronavirus, cutting through much of the red tape and bureaucracy, and pulling together the effort combining science of pharmaceutical companies with the technology of manufacturing billions of vaccine doses in a record time. Today he sees capacity for testing reaching 40-50 million tests a month by September 2020.   ...

LyrArc Article Gist
Though the smoking rate has dropped in the U.S. to 15% of adults smoking, the figures conceal a socioeconomic fact. Many of the smokers are now concentrated in rural areas and among less educated people. The rate for people with only a high school diploma is about 40%, according to the Centers for Disease Control and Prevention. The result is that people in rural areas are diagnosed of lung cancer at rates 18-20 % higher than city residents. These are two worlds says one rural resident who has grandchildren in D.C. suburbs. She is fighting the battle against smoking yet sees this is less of an issue for city residents. Her experience is that the family, health, work and other problems drive people to smoke more in rural areas of Virginia, including her small town of Martinsville, Virgina. An added problem is the marketing by tobacco companies to these areas.

LyrArc Article Gist
The US added 103,000 jobs on net in December 2010, acccording to the Labor Department. The jobs were mainly added in leisure and hospitality (especially the food services and drinking places subsector ) and in health care. Payrolls for other industries show no growth. A different government survey, which is based on how many people are without jobs but are actively looking for work, fell to 9.4% in December 2010 from 9.8% in November. But part of the reason for this is that many people stopped looking for jobs.

LyrArc Article Gist
Using the design-build method under which architects and construction experts work together as a team, Orange Medical Centre, a new 374 bed hospital in Middletown, New Jersey, has reduced the construction costs by one third. Only 9% of the total square footage of hospitals built in the USA used this method according to Modern Healthcare an industry publication, so this is one more area in which health care savings can be found- and there may be many more areas like this- which goes to show that ingenuity, experimenting with new ways and asking questions about old ways of doing things, can generate large savings, especially when it becomes a necessity. As the old proverb says, necessity is the mother of invention. Design-build differs from traditional construction in that the architect and the construction company come from the same company. They understand each other so well that they can finish each other's sentences. This cuts out the waste and back and forth that goes on with changes that are made, as the changes are minimal. This is a big source of the savings. This is similiar to the integration of design and manufacturing experts into one team in the auto and other industries. HBE Corporation of St Louis is the company that handled this work. Its asmall outfit with 500 people and this is the largest hopital it has built, so there is potential for doing alot more in this field for health care savings....

LyrArc Article Gist
U.S. president Trump's 2017 budget is an effort to reshape spending priorities by the Republican party. Apart from Medicare and Social Security all other entitlement programs from the days of Lyndon Johnson's Great Society are subject to cuts. Deep cuts to Medicaid and food stamps, including introducing work requirements. The philosophy behind it is that compassion will now be measured not by how large these programs are but by how much the government can get people "off these programs and back in charge of their lives,"  according to Budget Director Mulvaney.  The cuts are $616 billion to Medicaid and Children's Health programs, $193 billion in cuts to Food Stamps, $143 billion in student loans, $72 billion in disability programs. The overhaul of the Affordable Health Care Act is part of this change. The reallocation would put more money into infrastructure for $200 billion, and in tax cuts, $19 billion in a parental leave program and $29 billion for veterans programs, plus added spending on the military. William Hoagland of the Bipartisan Policy Center, a Republican who worked on budget issues says it will be politically difficult as the cuts to lower income groups come with tax cuts for small businesses and higher income individuals.  Beyond the policy priorities there is an area where both Republicans and Democrats are skeptical of the budget. This is how it impacts the U.S. debt. Under Congressional Budget Office estimates the U.S. debt as a percentage of GDP which rose to about 75% after the Great Recession starting in 2008, is projected to grow to about 85%. In sharp contrast the Trump administration estimates of the Office of Management and Budget are for it to drop to 65% based on rosier estimates of 2% inflation, 3% growth for the decade ahead. Experts say this is unlikely once the Fed raises interest rates and the unemployment rate currently at 4.4% leads to rising inflation, undercutting growth which has remained below 2% for a long period. These concerns are also voiced by Hilsenrath in the WSJ based on the experience of other countries such a Britain that cut corporate taxes without seeing an uptick in economic growth. ...