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Obamacare and other similar efforts were never the solution needed to a broken healthcare system in the US, and acted with a mere band aid patching up effort not getting at the root causes for the breakdown in the healthcare system in the US. Pharmaceutical companies act with impunity in the US to price medicine in ways that are inimical to the lives of the people of the US. This is true also of other companies in the healthcare system in delivery of insurance plans and delivery of medical services.

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Much of the reward for Labour goes to Health, Nutrition (food choices), and Education (schooling choices for children). This is the backbone for any Nation that is going to be strong and have a good future. Yet economic structures in 2026 and for decades has swung too far in one direction away from Labour and more and more for Capital, creating grave risks for the Nation, and setting the US as the wrong role model. Labour and Capital in 1980 vs 2026- increasing reward for Capital from 7% to 12% of GDI decreasing for Labour 58% to 52% in same period. In some areas this is not so because other regions have set their own priorities and this is a good thing Europe has a strong and fair access healthcare system, India has a strong and fair access pharmaceuticals healthcare system, which act as role models for the US. In 2026 RFK Jr, Dr. Oz at HHS and DJT are focused on getting US pharmaceuticals prices down to levels in the European Union. The real dangers of the skewing in the direction of Capital of rewards is creating a class that is not sensitive to the lives of ordinary people resulting in fracturing of society. Something like that happened in 1600-1800 in India and China leading to the disintegration of society and becoming overcome by foreign European powers which had more dynamic societies from the bottom up that led to discoveries in science leading to the industrial revolution. One detects something like this happening by accident by poor governance and bad decisions for wars (Bush-Clinton-Bush-Obama), and the same administrations pushed by bad advice from economists to ship the productive manufacturing resources of the Nation to China. If not reversed it would lead to the kind of decline Asia witnessed after 1600- hitting all classes of society and destroying the economic structures as foreign powers get the upper hand. The surrendering of research labs and higher education in advanced science fields to foreigners at US and European universities poses similar risks as fractured society with Capital dominant and unaware of the risks. Such societies have less perception of such risk than a bottom up built social, economic and political framework with large numbers of aspiring local citizens seeking these positions in science and technology in the Nation. ...

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The major provisions of the Republican House healthcare bill that passed by a vote of 217-213 are- 1. To help people buy insurance coverage the bill offers $2000 to $4000 a year, upto $14,000 a year in credits based mainly on age, reducing them for families making $150,000, individuals making $75,000. 2.  Under the Affordable Care Act insurers cannot charge older Americans more than 3 times for same coverage they offer to younger people, the new bill makes this 5 times. This would increase premiums for older Americans and reduce it for younger Americans. This is the most controversial part of the bill. Older Americans supported the Republican party in the presidential election. 3. The new bill ends Medicaid as an open ended entitlement and places this on a budget with cuts of $880 billion over 10 years. 4. To mollify conservative Republicans a provision allows state to opt out some provisions of the ACA that requires minimum benefits such as maternity care and emergency services. It retains coverage for pre-existing conditions to mollify moderate Republicans. The bill provides states with $138 billion over 10 years to subsidize premiums, provide coverage for pre-existing conditions, mental healthcare and drug addiction. 5. The bill removes the taxes imposed under the Affordable Care Act (ACA) on high income people of about $300 billion over 10 years by repealing a payroll tax increase and tax on investment income. This bill and the ACA offer 2 competing visions on healthcare, both bills passed only by a margin of 4-5 votes in the House. The ACA overlooked the impact on premiums causing discontent among middle income Americans. The new bill lets premiums rise for older Americans in order to keep premiums down for other Americans. This shows the many tradeoffs involved and choices being made, and the lack of a consensus on the issue of healthcare in the U.S., becoming a highly politicized issue instead of the way it is treated in western Europe.     ...

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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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High 2025 ACA premiums showing the failure of Obama patchwork on the failing US healthcare system.

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Higher exports and lower imports boosted GDP growth by 1.59%, higher investment in equipment and AI related intellectual property investments, and consumer spending on healthcare services, pushed US GDP up to 4.5% for third quarter 2025. The annual rate of growth was pushed up to 2.5% matching the 2.4% growth in GDP for 2024 under the Biden administration. As the benefits of the rebuilding of American manufacturing, the benefits of the rapid depreciation of equipment and plant investments under the BIg Beautiful Bill are still in the future the GDP number is expected to be higher for 2025 and 2026. The formula for GDP estimates is to take total domestic spending and minus imports which are part of domestic spending in the US on imports, and to add the exports number, as these are goods produced in the US. An administration such as DJT administration today that promotes US exports, takes strong action such as tariffs against unfair trade goods pushed into the US, promotes US jobs and growth, ensures fair trade prevails, and invests in the US, is far more likely to get better GDP growth and jobs growth results. ...

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A advisor to U.S. president Obama lists the gains in U.S. healthcare made by March 2014, after the passing of the Affordable Care Act or Obama healthcare law. He cites on access to care the reduction of the percentage of uninsured Americans from 18% in the middle of 2013 to 15.9% in the first quarter of 2014, according to a Gallup poll.

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Bernie Sanders presents the case for Medicare for All, healthcare for all legislation in the U.S. Congress introduced in September 2017. It has the support of 15 Senators. He says the current system is costly, wasteful and bureaucratic. It is time says Sanders for the U.S. to join the rest of the industrialized world, join Britain, France, Germany and other countries of Europe, Japan and Australia, Canada, with healthcare for all Americans. After all he says only 50 miles north of his electoral district in the Burlington, Vermont area is Canada, where the system of healthcare for all works better than in the U.S.  And the Canadians, Germans, French, and British do this spending less than half the U.S. does. In 2015 the U.S. spent $10,000 per person for healthcare, this means that it cost less than $5000 per person in these advanced countries and the way they do it can be studied and its best aspects adopted by the U.S.  He says this is because the U.S. healthcare system is designed to maintain profits for the medical-industrial complex. A major problem is the manner in which the issue is distorted by different sides on the issue of health care in the U.S., without a consensus being developed on what the common interest is in a civilized society. Mostly because the U.S. unlike other societies is still grappling with the issue of what values it embraces on healthcare being made available to all. Under this legislation the transition to healthcare for all would take place over 4 years. In the first year eligibility for Medicare would start at age 55 years, and children under 18 would be covered. In the second year the eligibility starts at 45 years, in the third year at 35 years, in the fourth all are covered.  ...

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US added 22,000 jobs in August 2025, with job losses in construction and manufacturing, and gains in healthcare.

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US adds 22,000 jobs in August 2025 with losses of jobs in manufacturing and construction, and gains in healthcare.

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Healthcare coverage of illegal migrants is at the center of the fight between Democrats and Republicans leading to the government shutdown on October 1, 2025. A slight majority of Americans favor deportation of illegal migrants is shown in a recent NYT poll. Even higher numbers are likely to see higher priorities in the Nation than funding of housing and healthcare for illegal migrants when most families in the US are living from paycheck to paycheck and government subsidies and assistance are being cut after Covid.

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Heidi Vogt provides this exceptional account on the U.S. and international efort to build Liberia's healthcare system from scratch. Years of civil war till 2003 and the shortage of funds mean that even basic equipment such as X ray machines and blood testing equipment are lacking in Liberian hospitals. Even with a effort that includes the U.S. Army and Air Force planes, a 25 bed hospital for healthcare workers using tents will take till early November to be operational. Showing that the response is sorely inadequate here in Liberia leading to the spread of Ebola to Europe and the U.S. by December at the current pace. Liberia's head of Ebola control says the international community has failed Liberia with its inadequate response. For the U.S. and Europe an inadequate response creates new dangers as the public has lost confidence in government response.

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John Cochrane, professor at the Booth School of Business, University of Chicago points to the simple truths about U.S. healthcare- out of control pricing because of the pathologies created by previous laws and regulations. He points out that costs are high in healthcare because regulations keep them high. Supply of new doctors is controlled because Congress and the AMA made it that way with a cap on residency programs and AMA opposing the expansion of medical schools. In a system of open competition new hospitals and health care businesses would challenge old ones which is not happening in a regulated market with regulations working to limit competition for the firms already in the business and with the influence to limit competition. Insurance costs for major expenses in an open and deregulated competitive market without the regulations would be so much lower than todays costs that its likely we would not even need a mandate such as the one the Obama healthcare law imposes.

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Poliovirus could be present in New York wastewater as early as April 2022 evidence shows. In UK this could as early as February 2022. It shows the need for rigorous polio vaccination programs. Rockland and Orange counties in the New York City area have polio vaccination rates for eligible children as low as 60%, compared to a national rate of 93%. Decades of neglect of healthcare, and lack of investment in healthcare infrastructure and healthcare services, and in education for healthcare that was a major priority in the postwar years in the fifties and sixties have led to a situation where this is happening today. Vaccination rates are wholly inadequate and a 100% consensus that existed on key things such as vaccination needs to be recovered in the US, by changing the entire sense of priorities in society and the way it invests in its people.

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US is shutting down 10% of airport traffic because of government shutdown in November 2025. Democrats are holding up the passing of the new budget till Obama's Affordable Care Act healthcare subsidies for low income Americans are restored. Republicans who control both houses of Congress are unwilling to restore these subsidies saying it will cost $350 billion over 10 years. Editorials in the Washington Post in November see Obama's Affordable Care Act as a bandaid approach for a broken healthcare system in the US. Public opinion in the US supports this assessment. Trade unions and labor have called for an end to the government shutdown. Democrats are acting as though the party is for low income Americans and labor yet this is not the party of FDR who fought hard for labor over vested interests, Democrats today are the vested interests whether from Tech which is taking a disproportionate share of the Nation's wealth and resources and pouring it into projects that do not reduce the cost of living or rebuild crumbling obsolete infrastructure, or from Banks which were not sanctioned for their part in the 2009 financial crisis, or from healthcare interests that oppose restructuring the entire healthcare system for fairness in insurance, pharmaceutical pricing and wellness. Republicans are making an effort to displace Democrats in the role of FDR and Lincoln under newcomer DJT who rejects both the incompetent Bush (Republican) and Obama (Democrat) administrations that wasted money and resources in foreign wars while overlooking America's many challenges and strengthening foreign powers including China, while weakening the US. The US government is cutting airport traffic to relieve unpaid traffic controllers. Also at risk are SNAP benefits which are for the loew income Americans. The US president is asking the Senate to drop the filibuster rule which requires 60 votes in the Senate for the biudget to pass it and pass it by majority vote. The Senate Majority Leader Republican Thune wants to keep the filibuster because it acts as a brake for hasty legislation passed by whichever party is in government. ...

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Kathleen Sebelius, a former Governor of Kansas, pushed forward implementation of the Obama Healthcare Law as U.S. Health and Human Services Secretary, 2008-2014. She resigned in 2014 after IT problems made it difficult to use the government's Healthcare.gov website in 2013.

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Flat payment rates for Medicare Advantage to Insurers by the DJT administration which is questioning how health care needs of the country remain unmet and US healthcare comparing very unfavorably with other advanced countries in Europe and Japan and also in India. Some of this is because of the behaviour and practices of the health and pharmaceutical industries in the US. The 2027 payment by government for Medicare Advantage is 0.09 percent. In 2026 it was about 5%. In 2025 it was -0.16 percent and in 2024 it was -1.12% under the Biden administration showing a great deal of dissatisfaction with funding Medicare Advantage. Medicare Advantage was set up by the Bush Republicans in 2003 who set it up with the nice sounding name Medicare Modernization Act. It was an effort to help the insurance companies with government money. Today in the second term of DJT in 2026 affordability is what American people care about most and the DJT administration is unhappy with the insurance companies. Dr. Mehmet Oz is in charge of Medicare and Medicaid Services Agency of the federal government and he says about Medicare Advantage and new policy to save “taxpayers from unnecessary spending (on Medicare Advantage) that is not oriented towards addressing real health needs.” The DJT Kennedy-Oz approach is for comprehensive digital information linking all medical providers, making America healthy again, cutting through the dense fog created over the last 2 decades, making pharmaceutical costs as affordable as the best in European nations, and refusing to subisidize if delivery is poor and health results are poor.   ...

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How is it that Britain's regulatory agency approved the Pfizer vaccine before the U.S. FDA agency? This report in the NYT says FDA looks at the raw data. Britain's Medicine and Healthcare Products Regulatory Agency looks at the information provided by the company. It still does the testing batch by batch and has access to the data and looks at thousands of pages of data. What about the European Union? The European Union Medicines Agency meets on December 29. It takes days after it meets to get input of 27 countries so that vaccination cannot start till January. The U.S. president summoned the FDA to the White House to find out how soon the FDA could act. Both Britain and the U.S. are feeling the impact of the second wave of coronavirus.

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What is the difference between a K95 mask and a N95 mask. A K95 mask is based on a Chinese standard. A N95 mask is based on the American standard. The N95 masks was first made by 3M a company making masks for industrial and healthcare use based in Minneapolis, U.S. Tests on K95 masks have shown that many fail to meet basic filtration quality test standards.

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Few will believe Jill Biden taught aclass on the day of her husband's inauguration as U.S. president. Times change and anew president takes office. With him is Jill Biden a dedicated teacher for all her life. She has two masters degrees and a doctoral degree on the problems in higher education with dropping out in community colleges in the U.S.

As the U.S. goes back to the days of the Truman presidency in 1952 when it was all about rebuilding the country- education and access to education, healthcare and access to healthcare, infrastructure and funding the infrastructure from bridges, roads, airports, terminals. A new focus takes shape.

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This columnist opinion in Le Monde reflects the view in Europe that the US is in retreat, and in some quarters such as NYT that the new US foreign policy that sets the Monroe Doctrine as key aspect of foreign policy is a retreat- US setting the rules in the Western Hemisphere around democracy and governance. It says the US has set aside the ambition first proclaimed in 1945 and revived in 1991 after the fall of the Soviet Union. US administrations under Clinton and Bush took this posture after 1991 of dominant position but it did not reflect reality. US like Russia was dragged into many remote conflicts that had little to do with the standard of living, and economic advancement of the US. The US has a dilapidated infrastructure, broken healthcare system, and operates in a world trading system that has deindustrialized the nation and shipped out jobs and factories for 20 years, and worse is exposed to drug and people trafficking gangs in Mexico and Venezuela. The Monroe Doctrine 1823 asserted the US right to keep European colonial powers out of America, and it was possible only because the British also supported it in the 19th century till the US built up its Navy under TR and FDR. With Russia recognized as a European power the US is able to get its support for the US to tackle the situation in the Western hemisphere presented by drug and people trafficking gangs in Mexico and Venezuela. Tariffs are intended to get a new world trading system with new rules. Infrastructure building is underway on a scale that will far surpass China by 2030. This is not a retreat but an advancement for the Nation and the American people after three decades of failed policy. It lets the European powers Germany, France and Britain deal with Russia's requirement that NATO withdraw from its borders and recognition of Russia as a Northern European power. European history has shown that since 1700 that when faced with a majority of nations in Europe any dominant power in Europe is forced to negotiate a peaceful resolution of conflict because of it's limited resources to carry on a conflict. This should lead to a peaceful resolution in Ukraine, that allows rebuilding, and also gives the US an opportunity to rebuild its economy and standard of living for the American people. This will be a win-win for both the Russians and the Western Europeans, and both Latin America and the US, China and the US, India/Japan/Brazil and the US. ...

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With a shortage of nurses and healthcare workers, some hospitals are dropping the vaccine mandate for healthcare workers. Shortages existed before the pandemic. The burnout for healthcare workers led to people dropping out. The lure of high pay has also led to nurses to travel to hot spots further crimping supply of workers. Recently workers who do not want ot get vaccinated have quit the industry or lost their jobs, some have left for facilities that do not follow the vaccine requirement. CDC estimates 30% of healthcare workers at 2000 hospitals in the US are unvaccinated as of September 2021. The Biden vaccine mandate would be effective for second shots by Jan. 4. A federal judge in Louisiana has ruled in Nov. questioning the president's authority for a vaccine mandate. Following that ruling HCA, AdventHealth, Tenet, Cleveland Clinic are among the hospital chains reversing earlier decisions for vaccine mandate. Other hospital chains in California Kaiser Permanante and in New York Northwell Health have kept the vaccine mandate. Kaiser had 98% staff vaccinated, with a similar situation at Northwell. Kaiser has 210,000 employees and Northwell 77,000. Utah Mountain also has 98% vaccinated.  Research on vaccine mandates suggests them to be effective. U Penn psychology research shows people are more likely to get encouraged to get vaccine than discouraged with a vaccine mandate not vaccinated working in healthcare in September will shrink considerably by January. ...

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The European Union Commission says Ireland must recover 13 billion euros in back taxes for giving tax preferences to Apple that are against EU rules. The EU Commission says Ireland allowed Apple to pay a corporate tax rate of 1% on its European profits in 2003, and .005% in 2014. The EU Commissioner says the use of Ireland as the place where Apple pays taxes on operations in Europe has no base in reality, as most profits are earned in other countries outside Ireland. Taxable profits of Apple "did not correspond to economic reality," according to Ms. Vestager, the EU Commissioner.  In the current environment where political upheaval is unsettling the democratic process in the U.S., Britain, Spain, France and Italy, as well as in Brazil and other countries in the developing world- because of deep recessions, and efforts to cut the deficits with deep cuts in state spending including in education and healthcare, basic services- the moves by companies to reduce taxes to these absurdly low levels such as .005% when other companies in the EU are paying 12.5%, is becoming increasingly unpopular. As pointed out in this BBC News article this sounds like the way Carnegie, Rockefeller and Vanderbilt operated during the late 19th century, and were seen as operating in a manner that was above the law. Janet Yellen pointed out at a Boston Fed Conference on inequality in Oct 2014 that the bottom half of the distribution or 62 million households in the U.S. in 2013, had a net worth of about $10,000, One quarter of these households had a net worth of zero dollars. The working class and blue collar workers in the U.S. provide much of the support at Trump rallies. Younger college educated people support Sanders, because of the situation of the working and middle class in the U.S., and a similar situation exists in Europe. It is for the sake of the democratic process and delivering services in education, healthcare, and other basic areas to all, that companies small and large need to pay their fair share of taxes, regardless of size, influence, or technological advantages. Today this is is seen by most leaders who draw public support as the right way forward for the U.S., Latin America, Europe and Asian countries, including proper allocation of resources to best serve the needs of working people. For example the 13 billion euros is equal to all of Ireland's healthcare budget, and 66% of its social welfare budget.    ...

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Asked about it yesterday January 16 DJT tells the press outside the White House after a meeting announcing his Great Healthcare Plan, it is a good thing that Canada has signed a trade deal with China. It reflects the new view not clearly understood or told in the press what US trade policy is about. US trade policy in 2026 is about bringing investment and jobs back to the US to rebuild communities and towns across 51 states- once destroyed by the foolish trade policies of the Bush-Clinton-Bush-Obama 3 destructive policy decades. Supplementing this with the investment favorable policy of instant depreciation for investments in plant and equipment in the Big Beautiful Bill of 2025. Using tariffs to level the playing field and ensure fairness in business practices by industries and nations towards America after over 3 decades all else has failed. All the time protecting Rural America, and communities and towns across the US devastated by outshoring. Using Tariffs to make certain that drug and migrant trafficking, and hostile unelected governments in the western Hemisphere cannot take place with direct and  indirect intervention in the western hemisphere by foreign powers. To do this with the Monroe Doctrine Corollary set by Teddy Rooosevelt in his Annual Message to Congress of 1905- "A great free people owes it to itself and to all mankind not to sink into helplessness before the powers of evil." Under such a policy Canada can pursue trade deals with China as the US has done. The clear rationale for the US policy is nowhere evident in the press today, how trade and domestic policy and foreign policy converge to protect all Americans, even though this was something that was pursued under the Biden administration with mistakes made in handing the Border management to Mayorkas and Harris incompetence. In the use of Tariffs doing this in such a way that US economic interest, investments, capital and stock markets are protected by carving out areas of exemptions in the policy. This has given the US an highly advantageous use of Tariff policy in ways not reflected in the press version of Tariffs. As TR pointed out, as Lincoln pointed out over a century ago, the interests of both Labor and of Capital are both legitimate and vital for the Nation. It is time to see this as one whole and not separate to rebuild America.   ...

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US president Biden's State of the Union address comes at a new inflection point in history for the US, the European Union and India. The Ukraine crisis and setting the US response, as well as US response to the neglect of infrastructure, healthcare, social cohesion during the last two decades.