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This story in the NYT describes how the flawed effort to pass the Republican healthcare bill or repeal the Affordable Care Act passed under president Obama failed after another effort. Many developments killed it. In the end the president lost interest, especially when he saw Republican Senator Rand Paul of Kentucky go on talk shows on the weekend before its collapse to complain about the bill. Senator Collins of Maine was exasperated by the way the bill was being rushed through Congress, and she voiced her strong opinions about this by talking to people back home in Maine and sharing her conversations with the media. The bill pushed by Senator McConnell, the Republican leader in the Senate, imposed annual caps on Medicaid spending. And did this without any discussion, shutting out committee debate, any public discussion, or formal drafting. Once this process was set in motion in this way the Republican Senators formed camps. Senator Grassley of Iowa and Jerry Moran of Kansas, normally conservative moved to the moderate side. Moran held a town hall meeting covered in the NYT, where older people voiced their concerns. Most of the patient advocacy groups, the hospital groups such as the American Hospital Association, and other medical groups also opposed it.  After Senator McCain of Arizona said he could not return following a surgery in Phoenix, Senators Lee and Moran announced their opposition. With this the bill's support crumbled including any effort to repeal the Affordable Care Act.  ...

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France goes to the polls on April 10. Marie Le Pen is shrinking Mr. Macron's lead in the polls. Most of the other candidates other than Mr. Melenchon show less than 10% support from voters including Valerie Pecresse of the Republicans who have failed to arouse much enthusiasm The Republicans and the Socialist party of Mr. Mitterand and Mr. Hollande were defeated in the last presidential election by Mr. Macron. Today the choice is between Le Pen with her inexperience and her policies skeptical of the European Union and Mr. Macron who is more experienced but lacking an effective social policy in addressing the social problems in France raised by the yellow vist protesters. Immigration is an issue in this campaign and Mr. Macron has taken a tougher stand on immigration and cultural issues following several terrorist incidents. There is a general lack of enthusiasm with 25% of the voters not expected to vote, many of them 25-34 years old. With 37% of the voters not decided which way they will vote and some votes cast even if the candidate selected was seen as having some drawbacks, the elections in France are a vivid contrast to the recent election in Germany with the Greens and Social Democrats ending the CDU's four terms leading the government under Merkel. Mr. Macron only campaigned in the last 8 days before the election.   ...

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What is the difference between South Korea and the U.S., Europe in the handling of coronavirus? It is tracking and testing.  President Trump and health adviser Dr. Fauci, see South Korea as the successful model to be followed in controlling the coronavirus. What has happened till now it is accepted with shortage of basic medical supplies and equipment, stress on hospital systems, are merely mitigation actions. South Korea was prepared for the coronavirus crisis because of the MERS and other epidemics, and failures resulting in corrective actions. Labs were centralized and better equipped for testing and tracking the infected. One of the key tools is testing. President Trump says the goal is for the U.S. to exceed and far surpass tests per capita in South Korea. Five million tests are planned by the end of April in the U.S. Where the U.S. falls short is in use of multipronged digital tracking using data from people's use of mobile phones, credit card usage, and use of apps designed to separate infected people from others. South Korea is a democracy with a population of 52 million people, about the size of France. People who were student activists in the democratization era in South Korea say the use of digital technology is a need today. We have to adapt in emergency situation they say. Ki Mo-ran, epidemiologist, and adviser to South Korean government says this is a key part lacking in the European and U.S. efforts to control coronavirus. She says in South Korea we know the patient's contacts, where he goes and stays, so we don't have to lock down everybody. Without digital tracking one cannot know which place is contaminated, which place is clean, so that there can be a lockdown of just that area and not the whole country, says Ki Mo-ran. She asks the question- is one person's privacy more important than the lives of a family or other people who are affected. Is it OK to lockdown every child in the country in a home as in Spain for over a month so that particular people's privacy is respected? These are serious questions for western society, are they exceptions or is democracy not just a western idea but equally cherished in Asian societies, people talk about Confucianism in China and the Asian culture forgetting that the biggest democracies are quite large and functioning well in India in addition to South Korea, Taiwan Indonesia, Malaysia, Bangladesh and Japan, far larger in area and population than China. The French government has chosen the app TraceTogether as the least intrusive one adaptable to France for use there. The U.S. is having Google and Apple develop one of its own. India will be developing one of its own. The NYT raises the question will it be watered down so much in France or in the U.S. and UK to be less effective than the  dire need for an alternative to lockdowns? ...

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Jared Bernstein of the Economic Policy Institute points to trade barriers reducing competition and free trade that should raise an outcry when free trade and competition advocates focus alone on the Trump steel tariffs. He points to estimates that show $90 billion in additional costs to Americans from the barriers that prevent Americans from paying world market prices for surgeries and medical treatment, prices similar to what is paid in advanced countries like Germany, Britain and France. A bigger barrier in pharmaceuticals prices being sheltered from market competition worldwide costs a huge $370 billion in additional costs to Americans. These two costs in healthcare would help Americans by a magnitude compared to tax cuts that do not work for average Americans with the business tax cut going more into share buybacks than into increasing wages or capital investment in 2018.  Bernstein points to Neil Irwin's column in the NYT that flags statements such as Senator Mike Lee, Republican, that the steel tariffs are a huge job killing tax hike, as being misleading. Bernstein says two actions were never taken that would have used benefits of free trade to help affected communities that lost jobs in industries such as steel and textiles, other industries affected by foreign competition.  He lists these steps as sectoral employment training, apprenticeships ,and job creation efforts in the worst affected areas. Basically no one really knows what is good trade policy, the textbook concepts and theories are out of date when countries can subsidize particular industries such as steel and dump products into the American market. At a press conference on CSPAN with the Swedish prime minister Mr. Trump stated that China was exporting more than what is officially shown as there are transshipments from other countries, some of them with no steel mills.  As Mr. Trump stated at that press conference he was elected partly because of the worst affected communities- in places such as Michigan and other states in the midwestern U.S.- that suffered from unfair trade. Bernstein admonishes the economists and politicians, media, for the headlines that are misleading in showing that bad trade policy is being pursued and trade wars are being started. This deserves attention because the Trump administration and advisors such as Lighthizer who served in the Reagan administration seek fair trade, and the Commerce Secretary Wilbur Ross successfully pushed for NAFTA trade deal renegotiation not the outright rejection of NAFTA that was mentioned in the election campaign. Ironically no one is helped by this trade rhetoric and misleading headlines. In fact the strengthening of the U.S. currency as the huge trade surplus of China goes into U.S. assets, and with the election of Mr. Trump, gives foreign competitors a continued advantage. And in fact Japan, South Korea, China, had a mild response to the tariffs as reported, because these countries are aware of global overcapacity created especially by China which produces 50% of the world's steel, and as China shifts to higher technologically value added products closing many older steel mills. ...

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The coverage of the Republican healthcare bill and how it affects the elderly, and people on Medicaid, people in rural areas, is likely to have changed public opinion in the U.S. about the necessity of ensuring all Americans have health coverage. The Pew survey cited here in this NYT report by Zernike and Goodnough was done in Jan 2017, and shows a shift. The shift would be much higher today after people look hard at the consequences of what were simply hypothetical positions or ideological positions taken without looking at consequences in daily living. On Medicaid that opinion by July 2017 compared to Jan 2017 has shifted 10 percentage points for Republicans to 53% who think Medicaid is important to them and their families, according to Kaiser research. There is stronger sentiment about people having benefits taken away.  [article-55059] The opinion has shifted to where people see that coverage is important and people should not have coverage denied or benefits taken away from them. Opinion remains strong in favor of changes to reduce the high premiums, but not to replace the existing health benefits and law with no law at all to replace it. That leaves 20 million more uninsured according to the Congressional Budget Office. Changes have to be constructive is the popular view today,  and this requires dialogue between Republicans and Democrats- which has not taken place. ...

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A NATO summit has tension and uncertainty with president Trump pushing forward his idea that Europe should take on a larger share of the burden for its own defense. Some of this goal was achieved with the jawboning style of Mr. Trump- NATO plans to increase military spending and increase EUropean governments share of defense spending. A European Defense Fund with 13 billion euros of funding is being set up to develop military capabilities. This is also what Mr. Trump hopes to accomplish by using this approach where other approaches were resisted by Germany in previous American administrations from Bush to Obama. It is also why Mr. Trump says he thinks NATO is now stronger than before, even though his approach throughout is unorthodox from Korea to NATO. Europeans see a divergence between the U.S. and EU on issues- such as Iran, Middle East and Israel, and Mr. Trump's efforts to maintain good ties with Russia meeting Mr. Putin after the Summit. This leads to a sense that the U.S. cannot be depended on in the face of threats to the EU. Mr. Trump's policy suggests the U.S. has no permanent friends or permanent enemies, will follow its own interests independently of its transatlantic partners, says one expert. At the root of the problem lies Trump's conviction that the European nations benefit economically by spending less on defense and thrusting more of the burden on the U.S. -even after 2 costly wars have diminished American desire to take on responsibility especially as other economies have prospered better than the U.S. ...

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President Trump says the U.S. could permanently cut off funding to the WHO and revoke U.S. membership if the group does not make changes in the way it operates showing a lack of transparency in its operations and dependence on China. Mr. Trump says the WHO has shown "alarming lack of independence" from Beijing. In a direct letter to the Director-General Tedros Ghebreyesus -"it is clear the missteps by you and your organization in responding to the pandemic have been extremely costly to the world." Mr. Trump gave the WHO 30 days to make "major substantive improvements" or he would cut funding and reevaluate U.S. membership. Mr. Trump said in the letter that the WHO ignored early reports of the virus spreading in Wuhan, failed to share information with other countries. The U.S. which has the largest contribution by far to the WHO was unable to influence the organization. The U.S. has influence in finance at the IMF, the World Bank, and in the tech world, yet this did not extend to important matters of public health. It could be that public health had become an afterthought in the rush to prominence in tech and finance. The contributions of the U.S. exceed anything any other country has made. During the 2 years 2018 and 2019 the U.S. contributed $893 million, according to WHO records, cited in the WSJ. During this period the contribution of China was $86 million with an additional $50 million added recently. The $2 billion Mr. Xi said China will contribute is incorrectly reported as for the WHO, it is what China says it will use to support Africa and other countries in the world to fight the pandemic. ...

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Judge Ergoron is shown here taking on the issues raised in the New York Attorney General's case on Mr. Trump for inflated asset values and loans. Judge Ergoron and Judge Chutkan in the other NY case on Mr. Trump are very much their own inimitable selves as they tackle the difficult cases involving the former president. At one point in the Trump testimony in the courtroom Judge Ergoron asks Mr. Trump's lawyer to explain the rules in the courtroom to Mr. Trump, that this was not a political rally, that he was only looking for answers to questions.

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Added sugar is the big culprit in the way we age, and in our general health, the diseases we get. This is not just about obesity, its about metabolic health- getting only the amount of sugar that is good for us. Unknowingly if we are not careful, not checking labels and without any advantage we end up taking added sugar when we eat packaged foods. About 70% of packaged foods contain this added sugar. Most adults in the U.S. and other countries get 17 teaspoons of added sugar a day or twice the 9 teaspoons that is recommended for men and three times the 6 teaspoons a day recommended for women. For children the recommended limit is 3 teaspoons. Just by being a bit careful and removing this added sugar from our diet we can enjoy much better health. It is not giving us much because we can still have some sugar in healthy natural foods, in fruits and vegetables, and a smaller amount of plain sugar. After the first couple of days of a change one may not even notice this. By so much has our sugar intake grown particularly with packaged foods, that a small change can bring big results in health and healthy living style. ...