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The U.S. House of Representatives votes to repeal and replace the Affordable care Act 217-213. Moderates were won over by an addition of $8 billion  to add coverage for a popular feature of the ACA that covered people for pre-existing conditions.  The bill that passed gives credits of $2000 to $4000 a year, depending mostly on age, upto $14,000 for a family. Credits are reduced for individuals making over $75,000 a year or families making over $150,000. There is no mandated insurance coverage. This trims the federal budget deficit, yet also is expected to keep 24 million more Americans without health coverage after 10 years. The bill now goes to the Senate where moderate Republicans are worried that this may increase premiums for older people, one of the drawbacks of the earlier version of the House Republican bill.

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Only 23% of meals in America include a vegetable. The number of dinners made at home with a salad dropped to 17% in 2010 compared to 22% in 1994. Salads ordered at restaurants dropped to 5% in 2010 from 10% in 1989, according to NPD research company in its 25th edition of "Eating Patterns in America." The U.S. is going backwards in good eating habits and no enough attention is being paid to this in the debate about cost of health care. Their is a clear connection between good eating habits and health, and while invention and use of the latest research and innovations in health care are lauded, the decline in patterns of healthy living and food habits are receiving less attention.

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Even in a state that has the lowest diabetes rate in the US at 8.1% there are huge disparities in health and living. USA Today offers a look at these two Colorado's one of affluent Colorado residents who have access to trails, have the knowledge and resources for healthier lifestyles and the other around them who lack access to healthy food, and lack knowledge and education about healthy lifestyles, and face financial and other stress that aggravates their health conditions. 

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US DJT administration using Section 301 creates the tariffs the US Supreme Court struck down- the EU, Mexico, Canada at 10%, Japan,, India China at 12.5%- June 2 2026. These countries are not doing enough to control the importation of products made with forced labour. This only goes to show what was said at that time and which the SCOTUS itself said the DJT administration could do, find other laws by which the same tariffs could be imposed. By the time the US Supreme Court reviewed the case it was already clear that all these countries had accepted DJT tariffs, and most had negotiated fair deals with the US including making up for past abuses by these countries of the international trading system. The US Supreme Court its shortsightedness ignored this or did not quite grasp this as Justices legal knowledge of facts does not mean grasp of the facts of commerce, trade and business and the history underlying it. Jamieson Greer interviewed at the Council of Foreign Relations this week and Robert Lighhizer in Foreign Affairs (covered and summarized on these Lyrarc pages this week as found rarely in other places) have documented these abuses in detail leading to the US losing $20 trillion in wealth shifted to these countries and its manufacturing dependent communities devastated by loss of over 5 million jobs through the shortsightedness of Bush/Obama adminstrations who let this happen, and these countries that took advantage with reckless disregard for these communities in the US, on a scale unknown in history.  ...

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The Republican House health care bill AHCA  keeps some some of the more popular parts of the Affordable Care Act such as not taking pre-existing conditions to deny insurance, keeping children covered on parents insurance till age 26, and increase contributions to Health Savings accounts. It is different in that the expansion of Medicaid at 138% of poverty rate threshold is rolled back. Age is used for tax credits instead of income, hitting those approaching Medicare age harder. The maximum charged to older people is now set at  5 times compared to 3 times what young have to pay. In general the Republican bill is seen as targeting the elderly to keep premiums down. The elderly on low incomes are hit hardest. Fox News O'Reilly Show showed the host questioning House Republicans, citing the CBO estimates that elderly on low incomes may have to pay as much as $14,000 a year for insurance making it basically unaffordable, and 52 million Americans would be affected adversely. Large companies are no longer required to offer mandatory health insurance under the new bill. Conservatives from Freedom Caucus wanted to see the essential areas of benefits covered by the law limited to fewer than the ten areas in the Affordable Care Act. The ACHA Republican bill leaves to states to determine what are required essential benefits. At one point maternity benefits were to be dropped but this was changed to let states decide. As a result the bill is 33 votes short of the number needed for passing the house in March 2017.   Neither the Democrats Affordable Care Act or the Republican House bill of Speaker Ryan do much to tackle the real problem- the absolute amount and increases for health care dollars for treating each disease in the U.S. compared to European and other countries. As a result health care has become more of a partisan struggle between the two parties than a real effort by all to overcome the problems that have to be tackled. Republicans want to see premiums drop and keep the burden on the deficit down- but with the level of U.S. health care costs disproportionately high compared to Europe and the rest of the world the arithmetic is tough and ends up leaving out vulnerable groups such as the elderly on low incomes, thus making the whole proposition prone to fail. For the same reason the Democrats failed to keep premiums down with a wider safety net leading to calls for repeal of their version.   ...

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Ann Matthews describes how the U.S. Supreme Court ruling on the Obama health care law affects 4 managers in the health care industry and U.S. businesses.

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The arguments of both sides in front of U.S. Supreme Court Justices on the Health Care Law's expansion of Medicaid. Justice Scalia said the law gives the states no choice. Justice Kennedy pointed to the situation of the states which have no way to opt out without stripping millions of Americans of medical care. Justice Roberts pointed to the states willingness to accept federal aid for years which brings us to the current situation. The attorney generals of 27 states have objected to the Health Care Law's provisions which they believe effectively requires the states suffering tight budget constraints to cover more of the poor than they they think they can, with the alternative being dropping out of Medicaid totally, not giving them much of a choice. As the three day hearing came to a close on March 28, 2012, the Supreme Court's conservative Justices expressed doubts whether the Obama Health Care Law could surivive if some key parts are struck down. With Justices Sotomayor, Ginsberg, Kagan, on one side, and Scalia, with other conservative Justices on the other side, the Court's final decision depends on Justices Kennedy and Roberts. ...

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Krauthammer cites Congressional Budget Office numbers that show the Obama U.S. health care law continues the spiralling costs of health care with new government mandates at a time of severe budget cuts in education and other areas- for 2013-2022 the costs come to $1.76 trillion. The initial Obama administration figures of 10 year costs of $938 billion announced in 2010 reflected the fact that the new U.S. health care law would take 4 years to fully go into effect. Costs after 2021 are shown to be $250 billion each year in the CBO figures. The law is now before the Supreme Court in 2012, which has to decide on the basis of the limits of the Commerce Clause.

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Large food and beverage companies are seeing established brands sales decline as newer organic and health conscious brands increase market share. The 25 largest food company sales declined to 45.1% of food industry sales of $418 billion in 2014, declining by 4.3% since 2009. Smaller brands increased share from 32.1% to 35.3%. The more health conscious brands have seen tremendous growth, Granola bar company KindLLC increased share from 0.5% share of the snack bar market to about 6% in 2015, according to Bernstein Research. Chobani Inc. reached $1 billion in sales in 5 years. Kroger and other big supermarket chains are responding to consumer demand for buying local, buying from boutique producers, and buying from health conscious producers, by supporting these brands with marketing strategy, flavor selection, package size, and other ways, so that Kroger can carry their products on its shelves. FlapJacked pancake mix from a small Colorado company was introduced at Kroger's King Soopers chain in that state, and then taken to 500 Kroger stores in the U.S. For chains such as Kroger and Winn-Dixie in the southern U.S., it is critical to stay ahead of changing consumer preferences, especially now that eating right and eating healthy, and looking for alternatives, is changing the marketplace. ...

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Two U.S. botanists coined the term "plant blindness" for the inability to see or notice the plants in one's environment. Limited interest in plants leads to an under appreciation of plants and their value in environmental health and in medicinal research.

Plants and trees are essential to an healthy urban environment. And 28,000 plant species are used for medicines of great value for health. This BBC article looks at the ways humans can increase their exposure and awareness of plants and green environments around them.

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Professors Gluck and Graetz of Columbia Law School discuss the presumption of severability in case the Obama health care law is declared unconstitutional by the U.S. Supreme Court. Severability would mean some parts of the law could be left intact if it is declared unconstitutional.

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Baucus is a six term senator from Montana. He won easy re-election in the fall. Question are being raised about the extent of fundraising Baucus is doing even as he is conducting the negotiations for writing up the health care reform bill. He continues to accept donations from health care executives and health care companies. Public Citizen advocacy group says that Baucus's fundraising in the middle of the health care debate is very troubling. As chairman of the Senate Finance Committee, Baucus is a key person in the health care legislation development.The Washington Post says health care companies gave Baucus $1.5 million in 2007 and 2008 as he began to hold hearings for the health care reform debate. The health care industry gave $170 million to federal lawmakers in 2007 and 2008, with 54% going to Democrats, according to the Center for Responsive Politics. Senator Grassley of Iowa, the ranking Republican in Baucus's committee received more than $2 million from the health care industry since 2003. House Ways and Means Committee chairman Rangel took in $1.6 million, and ranking Republican Dave Camp $1 million. Clearly any new health care legislation will fall short on achieving the critical reduction in health care costs that is needed to help the U.S. economy as long as lawmakers are beholden to lobbyists and donations....

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Under a plan called "premium support" Paul Ryan's U.S. budget proposal would have seniors choose a private insurance plan from a federally operated exchange. Each year the government would pay private insurers a specific amount to cover the cost of premiums with the rest borne by seniors. The total amount paid by the government would go up only at the rate of overall inflation, it would not go up at the higher rate of health care inflation. By doing this the government would take off the trillions of dollars of projected spending on health care that are largely the result of the higher inflation rate in health care costs. This higher inflation rate on health care costs is something that both parties have failed to control, and remains a major weakness in all health care proposals to date, including the Obama health care legislation. Allowed to continue growing at this rate when U.S. debt to GDP is nearing 100%, health care inflation costs pose major risks to the nation's finances.

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Elizabeth Warren has announced a plan to invest $85 billion in fiberoptic infrastructure to bring faster internet speeds for broadband service in rural areas of the U.S. which are poorly served. The Trump administration has recognized this for rural areas which is its support base. Trump's broadband efforts have mostly tried to remove barriers to investment. The FCC proposed its own $20.4 billion fund to expand rural internet service over 10 years using federal service fees for funding. Warren's plan by contrast is to provide 90% of the cost for construction of public fiber optic networks. Its part of a plan called "My Plan to Invest in Rural America." It includes investment in rural health care centers, and annual payments of $15 billion to farmers for adopting environmentally sustainable practices. Warren would fund this with a 2% annual tax on wealth above $2 million, and a 1% additional tax on wealth above $1 billion. In the U.S., Germany and other countries after years of neglect infrastructure is getting top priority.   ...

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Lobbying by the pharmaceutical and health care industry and U.S. president Obama's promises to the industry as part of his shaping the health care law.

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An average of major opinion polls compiled by Real Clear Politics website shows 50.5% of Americans opposed to the Obama U.S. health care law.

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A sense of how the U.S. Supreme Court Justices viewed key aspects of the Obama Health Care Law after three days of hearings on March 28, 2012.

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Garlic, ginger, turmeric and similar products are vital for healthy living and healthy food. So it is surprising that so little has been done before the Trump tariffs on Chinese food dumped in the U.S. This BBC report by Pamela Parker says 1994 was when the U.S. confirmed dumping by China of garlic yet the tariff that was placed was of an ineffective type that could be circumvented. As a result the U.S. producers such as Vessey in California that produced garlic for 100 years and 5 generations decided to not produce it beside cauliflower and cabbage. Of the surviving producers one producer today in California produces 100 million pounds of this product that has value way beyond the actual dollars as vital for healthy food supplies in the U.S. In fact after reports of contaminated water supplies in China imports of ginger and other such food products have been shifted away from China.  It is well known that the industrial revolution in China came too quickly and at a large cost to the environment after 1990 including contamination of the water, rivers. For this reason it is stunning that the people setting trade policy in Washington could have ignored the vital need of U.S. meeting food needs for healthy living out of its own soil and trusted farming community. To not have done so and let producers of garlic or ginger or other such vital food products to sustain health to go out of business is nothing less than a part of the growing calamity of self inflicted wounds that have happened so far. At no time more compelling an issue as today in the pandemic. The truth is that when it comes to healthy food supplies it is vitally important, as important as national security. And local supplies grown in one's own state or country particularly for vegetables, herbs, and fruit, are very critical. There is no way to even compare product grown locally to product grown in any country where water supplies may be contaminated by rapid industrial growth. ...

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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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Are high prices for pharmaceutical products and healthcare services putting a severe burden on U.S. finances and defunding education, infrastructure, R&D in new technologies, which provide the underpinnings for future U.S. competitiveness? Yes say experts. In 2009 Americans per person cost of healthcare was $7,960. By comparison Canada was $4,808, Germany $4,218, and France $3,978. And without necessary efforts for educating people about caring for health and preventive care, the health conditions of Americans are no better than these countries, and poorer in some dimensions. Klein says deficits would not be a problem for the U.S. if prices for pharmaceutical products and healthcare services in the U.S. were similiar to that of the largest developing countries. Experts say the Obama healthcare law simply postponed the addressing of this problem.

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Full Yield is a startup in Boston that is trying to help address the nation's obesity problem by introducing healthier foods and meals in cafeterias. It plans to introduce a line of Full Yield branded food made from fresh items and natural ingredients for sale in corporate cafeterias and prepared food sections of local supermarkets. It is based on a simple idea that if you eat healthier food you will be healthier. A study in the Jan-Feb issue of journal Health Affairs says 75% of the $2.5 trillion in health care spending deals with obesity, Type 2 diabetes, heart disease and cancer. And how much of this traceable to obesity and bad eating habits, smoking and lack of exercize? This study says most of the cases are preventable by changing these behaviours. Dr. Kenneth Horpe, chairman of the department of health policy and management at Rollins School of Public Health, Emory University, shows that if trends continue U.S. annual health care costs related to obesity would reach $344 billion by 2018, which is 20% of total health care spending. In 2009 it accounts for 9%. Thorpe says if even the 1987 levels of obesity were reached it would free up enough money to cover the uninsured population today. For American companies the problem has grown to alarming proportions and yet no nationwide coordinated plan bringing together companies, government, universities, public interest organizations, and other groups exists in the U.S. The CEO of U.S. grocery chain Safeway, Steven Burd, says Safeway was spending $1 billion to cover health care insurance for workers by 2005, with costs rising 10% a year- this meant putting out twice in health care insurance than Safeway's earnings and hitting another $500 million by 2010. Between 2004-2009 the costs of insurance surged 31%, making this the fastest growing single corporate expense, according to Towers Perrin. This reduces incomes of workers as companies pass on part of the extra cost, and reduces the profits that can be put back in new investment for economic growth....

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Increasingly hospitals in the U.S. are buying independent medical practices of physicians and writing the contracts in their favor. This is part of a general consolidation of health care services in the U.S. In 2012 about 39% of physicians are in independent medical practices compared to 50% in 2000, according to consulting firm Accenture.

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One in six dollars generated by the U.S. economy goes to pay for health care, almost twice the average for rich countries. It hurts America in many ways; by being a burden on the taxpayer when it comes to Medicare and Medicaid paying for the poor and the elderly, on companies being one reason GM went bankrupt, it eats up federal and state budgets, rising costs make any form of future coverage for all unsustainable, and it robs other priorities such as infrastructure building and other national scale investments. The Economist says that if it had to design a system from scratch, it would go for a system based mostly around publicly funded health care. For the uninsured the solution of an employer mandate is now well accepted, so this is not an issue. What is an issue is how to make the new system affordable? Here the Economist says that whether in stages or in one move, the tax deductability of employer paid health insurance, which is costing the U.S. government $250 billion ayear, has to go. It is necessary to remove this deduction, and its something all interests involved will have to swallow, as other savings are smaller and will not be adequate. The deductability of insurance makes the true cost of insurance transparent, so it supports gold plated insurance. This does not make cost control the pressing priority it needs to be. So the deducatability of employer paid health insurance hurts both ways. The other necessary action is in the area of moving out of the current culture where most doctors work on a fee-for-service basis, where the more tests they prescribe or procedures they perform the greater their incomes. This acts as a perverse incentive, and has aruinous effect in mushrooming health care costs in America. Cutting back on unnecessary tests and procedures, and prescriptions , would save 10% to 30% of health costs says the Economist. And it says this has been proven with the Mayo Clinic in Minnesota and Kaiser Permanente in California showing that cutting back doesn't hurt care and outcomes., so much so that cutting back would occur along with improved outcomes. But Americans with employer paid insurance just take things for granted as its not much out of pocket expense for them. THis creates the lack of a force for controlling costs even as employers are shouldering abigger and bigger burden, and the employee who thinks he is doing fine actually is seeing more of his salary dollars going to pay for his health insurance. In a way the consumers of health care are stuck with the perception that they are not somehow paying for these mushrooming costs and too manytests, procedures and prescriptions. This perception leads them a false sense of comfort with the system they are in, and a fear of something new fanned by the medical lobbies, that any change will impact users negatively. This makes the whole discussion on health care or the process of finding solutions to become an exericize in which terms like "rationing" and "choice" play a distorting role. ...

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Total public and private spending on health care in the U.S. will increase by 6.1% in 2014 compared to 2014 in a revised Commerce Department forecast. The total spending will reach $4.1 trillion in 2014 from $3.9 trillion in 2013. Some of the lower rise in spending than the earlier 7.4% forecast will come from 28 states opting out of Medicaid expansion under the health care overhaul because of a June 2012 Supreme Court ruling. Employers are trying to reduce costs and the public is reducing spending because of the recession. Less generous health plans mean users are paying more out of their own pocket, paying more attention to prices and even postponing care. Growth in health care costs is a about 3.9% a year since 2009 following the recession. The costs increase in 2015 by 5.8%, in 2018 by 5.9% and 2022 by 6.5%, according to U.S. government forecasts, because of enrollment in Medicare for baby boomers. This is still higher than the inflation rate of below 2%.