LyrArc Article Gist
When so much of infrastructure healthcare and education still needs more funding, and when St Paul's Cathderal lacks essential funds for basic maintenance and is in danger of closing, the Greensill scandal shows how much reallocation of funds to infrastructure, health, and education to help workers, students and families is needed. How much the existing culture distorts allocation of capital in ways that are vital to the future of families, students and workers, and lobbying acts in ways that are against the national interest. Here the WSJ says the lobbying of David Cameron, former UK prime minister extended to getting access to funds for Greensill, a  company that operated in  supply chain finance, lobbying for funds from the emergency financing facility provided by the Bank of England. Treasury rejected 56 messages sent by Cameron to top British politicians over several months to have rules changed. Greensill went into bankruptcy in March 2021, stranding investors who had put in $10 billion. A parliamentary committee is now looking into this case of Greensill. The company was founded by an Australian Lex Greensill, and does little more than provide companies a cash advance to stretch out the time to pay bills. One question no parliamentary committee will ask is why when the needs for infrastructure, health and education are so great $10 billion in funds, public or private even go into something like supply finance that does so little for the country. This is an example of the kind of distortion in the uses of capital that has become commonplace today, creating societies and countries with poorly  funded infrastructure and essential services in the advanced countries of Europe and the US. ...

LyrArc Article Gist
Rappaport of the NYT asks how it is possible that the U.S. Treasury is critical of the EU Commission's ruling that Apple pay back $13 billion in taxes because of its low tax rate of .005% in Europe, when Treasury is strongly critical of tax avoidance. The negligible tax by Ireland, base of Apple operations, is seen as a state subsidy not available to competitors. It also, as the EU Commission says, does not correspond to economic reality because the revenues are mostly made outside Ireland. An arrangement that is basically a strategy of tax avoidance. Today the leading candidates for president, Trump and Clinton, the major parties, and Congress, all are critical of tax avoidance strategies which deprive Treasury of much needed revenues. Restoring upward mobility is a priority today and programs to provide tution free access to public colleges, healthcare access, and infrastructure development, require public funding. Then why is the U.S.Treasury critical of the EU ruling? It is because Treasury sees this as money that should be coming to Treasury not the EU. However Treasury has failed to make this clear. The Financial Accountability and Corporate Transparency Coalition's Clark Gascoigne, calls it very ironic. And other experts say the money would not be coming to the U.S. anyway unless a low tax rate induces Apple to repatriate profits to the U.S. One expert calls it hypocritical. Senator Schumer says he agrees with Paul Ryan that tax legislation for a low tax rate for repatriation of profits back to the U.S. should be the next step, so that an infrastructure fund can be setup. Senator Levin and transparency advocates sees the EU action as normal and to be expected, as the anti-establishment sentiment today comes from such dealings that create the impression that the system is rigged in favor of some corporations. ...

LyrArc Article Gist
Amazon expands during the pandemic when retail on line delivery has helped people reduce trips to the grocery or retail stores. Amazon hired 427,000 people to expand its workforce to 1.2 million people by November 2020, 9 months into the pandemic. Almost doubling the employee workforce. These workers are mostly at warehouses, with some software engineers and hardware specialists. This includes hiring in India and Italy and is worldwide hiring. This does not include 100,000 temporary workers for the holidays, and 500,000 delivery drivers working for contractors.  Only hiring of 230,000 people by Walmart about 2 decades a ago in one year comes close. Walmart hired 180,000 people during the pandemic. Walmart has 2.2 million employees. With the expansion underway Amazon looks to become the largest private employer in the world in 2 years, say experts.  Amazon pay is $15 an hour after an increase of $2 recently. Its coronavirus safety practices have been upgraded after early criticism in April and May. Recent expansion in Italy and in India are also part of worldwide expansion after Walmart has pulled back from its worldwide expansion. This also shows how quickly major aspects of life are changing during the pandemic as some companies in online business are becoming more prominent than others. Target and Walmart have also increased in size. Best Buy has changed its focus with its conversion into a company that leads with personal service in online plus store hybrid retail and a focus on seniors and older people for healthcare service and product delivery. Companies are changing the way they run or getting a new life in remaking their business. This is also a time when other aspects of business such as social media are becoming evident. Subtle aspects such as reports of higher rates of mental depression through use of social media platforms. There is also the awareness that information technology companies in Silicon Valley generate most of their money in advertising and this advertising of $100 billion is only a small fraction of the $12 trillion U.S. economy. Should Silicon Valley based in California decide priorities on where capital allocation should go through the part it plays in moving startups based less on America's priorities than other considerations. Healthcare, education, cities, and infrastructure have not received funding they need and capital allocation by financial markets has failed the American people, as it has failed in Europe and other parts of the world for similar reasons. This has hit hard communities and people across the U.S. and Europe and also in Latin America, Africa and Asia, with the loss of manufacturing to China and other countries from the U.S. India and Europe. ...

LyrArc Article Gist
What is behind Pew Research Report finding showing an unacceptable concentration of wealth that endangers democracy. Higher income groups making $244,000 a year in 2024 gained 19 percentage points of the total US Household Income moving from 29% in 1970 to 48% in 2024. About 50% of the nation's income going to 20% of its people and most of that to 2%-5% of the people of the US. The gains meant loss of 17 of these percentage points for middle income households making $106,000 a year that went from 62% in 1970 to 43% in 2024. Another 2 percentage points was suffered by vulnerable Lower Income groups making $35,000 a year who owned 10% of US wealth in 1970 went down to 8%.  The problems of divisiveness in the Nation come from three distinct areas. First money for state financed education for all being put into wars in the Middle East from Reagan through Obama and Trump and some wasted through capital misallocation to low priority investment by faulty capital market allocation. Second the high cost of pharmaceuticals and healthcare putting a heavy burden on low income and middle income households making $35,000 or 106,000 a year. Third the neglect of manufacturing that cutoff the opportunities for middle and lower income households and their one chance to move up the ladder. And the parallel shift of resources to technology and financial sectors that created opportunities for a smaller group of immigrant and higher middle income households with these skills.  These are the sources of America's distress and each problem is being attacked at its source by president Biden- exit from Afghanistan, canceling student loans that are egregious and prevent the investment in education America needs, large sustained investment in manufacturing and new supply chains, antitrust action on tech monopolistic behaviour, redrawing the shape of America's pharmaceutical sector to provide access to medicine to all parts of the population.    ...

LyrArc Article Gist
Only 12% of Americans take the minimum daily recommended fruit for healthy living, and only 9% of Americans take the minimum daily recommended vegetables, according to the Centers of Disease Control and Prevention (CDC). The minimum for fruit is daily taking one and half cups fruit. For vegetables it is daily taking two to three cups of vegetables. Women consume a bit more at 15% for fruit. An interesting finding in this study that explains the widespread obesity in the U.S. regardless of incomes is that of affluent and wealthy Americans only about 12% consume enough vegetables. This is very close to the percentage of poor people eating the recommended 2-3 cups of vegetables a day, which is at 7%. This is an alarming fact in that all sections of society are doing very badly, creating acatastrophic effect for healthcare. A diet without fruits and vegetable brings higher rates of obesity, cancer, heart disease, diabetes. If rich and poor upper middle class and lower middle class are all sharing the same lack of awareness it points to the lack of education in eating right as the big culprit. This is one area where government, universities, and the informed private sector, can change things if they wanted to. A challenge as big as that in literacy and education for the U.S. Alarmingly even though it is in the top ten read articles in the Guardian newspaper online edition on November 16, 2017, we checked the other sites. We could not find it under Health in CNN, where other topics such as sexual harrassment, and sugar cravings, were covered. NBC covered a different CDC report showing 71% of Americans are overweight or obese with BMI over 25, but made no mention of this report by CDC. Equally alarming is the statistic cited in the Guardian from the Union of Concerned Scientists that shows only 2% of American farmland is used to cultivate fruits and vegetables. That this would have to go up at least to 4% if all Americans are to get their daily required fruits and vegetables. Meanwhile little change is to be seen, and no alarm bells are ringing in the U.S.. These facts are hardly mentioned in any healthcare discussion in media, as if they can be ignored or shoved under the carpet. This is the kind of thing that will never go viral, as a discussion on sexual harrassment or some other topic would, yet deserves just as much attention and education. ...

LyrArc Article Gist
The tech boom bust since 2000 that has hurt America and Europe and which also laid the foundations for the loss of manufacturing and technology to China, ceding American leadership and critical advantage, is shown here in the WSJ. The role of the finance sector  is explained here. That has added one more factor to the factor of endless wars in the Middle East, where American and European investment in healthcare, education and new infrastructure was somehow diverted away, and much of America's and Europe's resources wasted- or not turned to the benefit of the people of America or Europe.  One financial firm that rode the tech boom to the hilt finds itself with unacceptable losses except in a severe recession. Tiger Global Management was using tens of billions of dollars from pensions, endowments and rich clients riding on some of Silicon Valley's hottest stocks.  With the plunge in tech stock values including startups in which Tiger pushed into aggressively now facing large losses after hyper valuations, Tiger's hedge fund which managed $23 billion at the end of 2021 was down 52% in 2022. Another of its funds that managed $11 billion has lost 62%. WSJ says this wiped out two thirds of the gains Tiger has made in the tech stocks since its founding. In addition large writedowns are expected on its venture funds valued at $64 billion at the end of 2021, says WSJ.  WSJ says cheap money (money somehow diverted from infrastructure and funding manufacturing in China instead of the US now goes by the misnomer cheap money) reshaped Silicon Valley in the last decade, as pension funds, rich investors and celebrities turned to well connected money managers such as Tiger to put money in tech stocks and startups. This WSJ report says compared to Sequoia Capital and an earlier generation of venture companies Tiger Global is simply not interested in management of companies it invests in, taking a broad brush approach, using Bain Capital for research, and trying to haul in a large load of fish like trawlers at sea hoping for some companies to make big gains. Many pension funds such as Calpers California's public pension fund invest in Tiger with a $400 million investment. WSJ also reports that Tiger Global's venture funds do not reflect the realities of the tech business as venture stocks will reflect the drop over 2022 and 2023, including its ByteDance Chinese tech investment which will need larger writedowns. Tiger has also not hesitated to get into cryptocurrency which has loss of about $1.5 trillion dollars. It is of interest to note that Julian Robertson, hedge fund manager of the 2000 period (when Clinton-Bush were US presidents) who ran Tiger Management provided the impetus for Mr. Coleman, then 25 years old, for the start of Tiger Global. Julian Robertson closed his fund in 2000 during the dot com bust. Coleman hired a Blackstone analyst and started on the next cycle of tech with social media platform Facebook now Meta, followed by China's JD.com as investments in a new China boom were started. The end result is that during a period of Middle East wars under Bush and Obama, and building dependence on Russian oil and gas supplies under Schroeder and Merkel, China was the gainer as the US and EU lost much of its manufacturing and technology to China. During this period US and Europe neglected investment in infrastructure that would benefit the people of America in ease of living and quality of life. Just as money was wasted in wars much of the tech investment was wasted. The companies that added value over time were started long before and relied on sales growth and new products that revolutionized their field such as Apple with smartphones that started well before the nineteen eighties, Amazon with logistics and its own style of management, Microsoft from an even earlier era. Tech monopolies Facebook, Google, and others would not be missed much in terms of real progress for the people of America. The cost is many decades of ceding manufacturing and technology advantage to China by US and the EU led by Germany. China 2030 and the war in Ukraine with China's support have shown how fragile the foundations have been with weak political leadership and a finance sector running backwards in terms of America's and Europe's strengths in new infrastructure, better healthcare, services and education for the people of America and Europe. Leaving it to the Biden administration and a new coalition of Greens and Scholz in Germany to begin the task of rebuilding America and Europe on strong foundations, including the dignity of the workers and families, that makes who we are and what we believe in, and why the free world believes in us. ...

LyrArc Article Gist
The growing middle class in Brazil, new aspirations and the demand for better public services in transportation, education and healthcare. Alexandre Peppe, a 29 year old from the outlying parts of Sao Paulo, is a new member of the middle class, being the first to go to college in his family and finding a job in the state government. He was one of the protesters on the streets of Sao Paulo. The growing middle class has new hopes and aspirations that see serious shortcomings in the corruption of political leaders, neglect of public services such as transportation and overspending on the soccer stadiums for the FIFA and World Cup championships. Economic growth is slowing to about 1% in Brazil for 2013, creating new constraints for public spending just as demand for infrastructure and services is growing for the now large middle class.

LyrArc Article Gist
Einer Elhauge, professsor of law and founding director of the Petrie-Flom Center in Health Law Policy at Harvard University, says there are limits to Congressional powers under the Commerce clause such as enacting a law requiring Americans to eat broccoli. If the health care law required all Americans to subject themselves to health care this would be the case. But the law only requires all to buy insurance so that insurance can cover the costs of healthcare for all. He points to the "necessary and proper clause" as also authorizing the health care mandate. That clause gives Congress the power to pass laws that are "rationally related" to execution of constitutional powers, such as criminalizing the interference with mail, on the basis of the constitutional power to setup post offices. In this case the health care law mandate is related to the constitutional power to regulate premiums and prohibit rejecting the sick, says Elhauge.

LyrArc Article Gist
In a new twist drugmaker AbbieVie will bring out less costly versions of Humira in Europe where its patents have expired and still keep the U.S. market at higher Humira prices using a thicket of patents. Reports show pharmaceutical drug pricing as a major issue in U.S. midterm elections. Biologic drugs are costly. In this case Humira will sell at a 10-20% discount in Europe. Abbie Vie countered by getting hundreds of new patents in the U.S. to continue selling at high prices.

LyrArc Article Gist
Epic Systems of Verona, Wisconsin, is one of the companies engaged in digitizing health records. It has helped develop records for 40 million patients in hospital systems such as Cedars-Sinai Medical Center in Los Angeles, Kaiser Permanente, the Cleveland Clinic, and John Hopkins Medicine in Baltimore and the Weill Cornell Physicians Organization of New York. Epic provides the software, the IT systems, the training and support. Epic is one of the pioneers in this, having been in the business for 30 years. About 40% of primary care doctors in the U.S. and 25% of hospitals use electronic patient records. The Federal government has provided $2.7 billion in funding from $27 billion of Stimulus funds assigned for the purpose of conversion to electronic medical records. This is likely to speed up the conversion. Other providers are Cerner, Allscripts, Meditech, Siemens Healthcare, G.E. Healthcare, and IBM. Epic Systems is considered the defacto standard in the industry for medical schools and some of the major hospital systems in the country. New contracts are leading to a major expansion of Epic Systems which employs 5100 people. Epic plans to hire an additional 1000 people. Revenue for the privately owned company are estimated at $1.2 billion, a 45% increase over the prior year. Epic is expected to have 127 million patients under medical records by mid 2013. To get the feedback essential for such a large conversion, CEO Faulkner relies on feedback from 250,000 doctors who use the Epic systems software, and on nurses and doctors from Epic who visit customer's sites to see first hand how it works and what needs improvement. Judith Faulkner started Epic more than 30 years ago. A project for the Psychiatry department led to other projects after she graduated in computer science from the University of Wisconsin. Epic continues to attract programmers to Wisconsin by making the Epic campus a fun environment and a great place to work. ...

LyrArc Article Gist
This editorial in the Wall Street Journal says faster approvals at the Food and Drug Administration have helped bring more generic drugs to market lowering prices for the public. In 20 months the Trump administration approved 1617 generic drugs, 81 a month on average or a 17% increase over the preceding 20 months. Council of Economic Advisers in October said this was a saving of $26 billion for the public.

President Trump is looking at price controls as a way to bring down drug prices. With increasing outcry about high drug prices in the U.S. the Trump administration and Democrats in Congress are looking for new approaches to bring down prices.

LyrArc Article Gist
The US House of Representatives led by Speaker Kevin McCarthy passes a debt ceiling bill with a close vote on largely party lines 217 to 215 votes. The bill raises the debt ceiling in exchange for spending cuts of 14%. President Biden cited Moody's analysis showing a loss of 780,000 jobs with such large spending cuts. The bill has no chance of approval in a Democrat led Senate.

LyrArc Article Gist
On Jan 19, 2023 the US hit its debt ceiling of $31.4 trillion. Republicans control the House of Representatives by only a few votes after a strong showing in midterms by Democrats who control the Senate. A small section of the Republican party insists that raising the debt ceiling- a task performed by the House of Representatives- should only be done with serious cuts to Biden programs to help workers and families during a cost of living crisis. Biden says he will not negotiate, simply won't.  This report in NYT by Jim Tankersley, says president Biden in the last resort could resort to the 14th Amendment which says: "The validity of the public debt of the United States, authorized by law, including debts incurred for payment of pensions shall not be questioned." What this means is that in the last resort if Republicans insist on serious cuts because of a faction within the party, and not because the whole party supports it, Mr. Biden could continue public borrowings to pay social security and make other payments. Moody's says this would lead to a rise in borrowing costs temporarily but would not lead to a recession, and have long term benefits as the debt ceiling could not be applied in the future. It would be challenged by Republicans and go to the Supreme Court which would have to decide on the issue: "the validity of the public debt of the United States shall not be questioned." This drew 1338 comments on NYT. ...

LyrArc Article Gist
Paul Krugman in NYT outlines the options president Biden faces if Republicans decide not to increase the debt ceiling in the House of Representatives. All the alternatives are better than defaulting on the national debt. All options also create some short term volatility in financial markets before things stabilize. Biden and Democrats refuse to allow a repeat of negotiations of the kind Mr. Obama made with Republicans on the debt ceiling. The cuts a small faction in the Republican party is asking for come from spending that has already been approved by the House. It is also spending that meets the needs of the American people during a cost of living crisis, and for national priorities in fighting climate change, health and defense. Krugman also points out that cuts to welfare spending won't put more people to work as the unemployment rate is at a new low, and the theory behind it in this situation only deprives the neediest from getting help during a cost of living crisis. ...

LyrArc Article Gist
The title says this but Biden has not blown it by conducting discussions on the debt ceiling with Kevin McCarthy, Republican leader in the House of Representatives. Krugman presents MAGA Republicans as controlling the House. The situation is a bit more complicated than that as the Republican margin is only 222-213 with moderates who could move in Biden's direction if a default is impending. Previous articles in the NYT and WSJ have shown how the president has his own set of options including  simply ignoring the ceiling or citing a part of the Constitution of the US that gives the president the authority to conduct the business of the country in such a situation. Mr. Biden is taking the situation as calmly as possible, as the midterms have also given the president a situation where he sees the country on his side with Democrats needing only a few moderates in the Republican party to support him. Mr. McCarthy has his own reasons to support Biden as he supports president Biden in the task of backing up NATO and Ukraine. Having discussions with McCarthy keeps the country together at a time when Ukraine has a planned counter offensive to defend the country. Biden was able to achieve legislative achievements that are comparable to FDR and Lyndon Johnson because of his calm and patient approach. ...

LyrArc Article Gist
Democrats in the House of Representatives need about five votes of moderate Republicans to get approval for spending that exceeds the debt ceiling if no agreement can be reached with the Republicans under Speaker McCarthy. This is one of the options Democrats under president Biden are keeping open if the spending cuts Republicans are asking for hurts workers and families in ways unacceptable to values of fairness to all segments of society supported by Lincoln, Wilson, FDR and Truman that have shaped America over two hundred years. T Though it is not readily apparent in an America where about 22% of 8th graders are able to get a passing grade in civics and history in NAEP tests, a rereading of the writings and speeches of Abraham Lincoln show the same concern for the rights of all segments of society that are found in Wilson and FDR or Truman. This is also what Biden means when he calls this a struggle for the soul of America. More not less funding for education, more not less funding for health after the pandemic and cost of living crisis, more not less funding for public services at a time like this where there is a fracturing of society as well as isolating certain segments of society from others such as the growing distance between workers and families from places such as Silicon Valley and capital markets in America.  ...

LyrArc Article Gist
Binyamin Applebaum of the NYT Editorial Board says the gap from 1972 to 2021 of 21% of GDP in spending and 17% of GDP in taxes taken in is a serious problem because it creates $31 trillion in debt and over 475 billion in interest payments each year. And much of the spending is wildly popular 63% that goes to Social Security and Medicare, and vital spending on health care and education, social services that takes up 15%. The rest is defense and interest payments. The rest of the G7 spend about 50% more on average he says. This is why he says Republicans holding up raising the debt ceiling is not the issue that needs to be faced each year there are better more direct and sensible solutions that also address the need for the Renewal of America after years of underinvestment in everything from infrastructure to health and education. And capital markets that overcrowded essential government spending to finance massive capital misallocation by tech companies, the costs of which are only now being understood in America. ...

LyrArc Article Gist
Daniel Henninger says in the WSJ that the debt ceiling will be raised, and Republicans should not be pitting program against program. He says the narrative though should be framed around the trillions being spent by the Biden administration on climate change action, US manufacturing and technology in chips, with interest on debt at over $400 billion a year. Yet this does not take into account that for two decades there has been an overcrowding of US government initiated capital investment for essential needs by massive Tech industry misallocation of funds even as productivity of this capital invested by tech was dropping, with much wasted capital. Today because these essential needs in infrastructure and for manufacturing and technology were starved for so long of capital the productivity of capital in these areas is high and will have ripple effects to help rebuild America.

LyrArc Article Gist
This is the higher education equivalent of the moonshot says one education expert. The community college initiative of President Obama would double the numbe of people graduating out of community colleges. About six million students a year enroll for credit at America's 1200 community colleges, but only about 555,000 earn a two year degree, and another 295,000 a year earn a vocational certificate. The administration is putting a big emphasis on community colleges. Martha Kanter, the former chancellor of the Foothill-De ANza Community college district in California, has been appointed to the No.2 position in the Education Department. Arne Duncan made his first official visit to Miami community college, and Joseph BIden's wife teaches at acommunity college. The way community colleges have functioned in the American system of higher education, is that they provide post-secondary schooling for low-income studetns who have few other options. This works through open admissions. And most students are employed adults attending parttime; and according to some studies more than half need remedial courses before tackling college level work. The Obama effort is to require community colleges to work harder to retain students until graduation, and to encourage partnerships between community colleges and employers to offer workforce training. Without the access to the additional funding community colleges would actually find themselves in a bind, with rising enrollment rates just as their funding access deteriorates with state spending budget cuts. Debra Bragg, co-director of the Forum on the Future of Public Education at the University of Illinois, says that most new graduates produced under the Obama proposal would complete certificate programs, usually lasting 6 months to ayear , offering specific credentials for middle skill jobs. These jobs could be in healthcare, information technology, or other growing areas. See the article in BW showing the problem that is growing of unfilled jobs in many growing fields during a period of high joblessness, because of amismathc between the qualifications of jobless people and the requirements in the new fields. An example id autoworkers in Michigan taking up new skills for jobs in other fields. In this sense this program can be immensely useful in closing the gap. Results will take time as these resources take effect and graduation rates increase over time. ...

LyrArc Article Gist
This editorial in the Economist points to the long term effects of a crash in China's stock markets. This would reduce access to equity markets for corporate funding. It would pose larger risks because of the increase in total debt in the Chinese economy from 150% in 2008 to more than 250% in 2015. The fallout would not be as large as in the U.S. after a stock market bubble collapsed in the U.S., because market capitalization is about 40% of GDP, and households have put about 10% of their wealth in stock markets. Coming at a time when China's economy is slowing, and it faces other problems such as addressing pollution, healthcare and other issues, this could lead to a further slowdown for a prolonged period. Most economists from Krugman to Summers, say China is no exception to basic rules of finance and economics. The indexes have accelerated in the past year- CSI300 index of China's largest mainland stocks doubling in the past year, and ChiNext market for startups tripling in the past year, and at P/E ratio of 140 times prior year earnings. 4 million new brokerage accounts opened in one week of April 2015, and a study shows about 66% of people buying stocks for the first time have no schooling beyond the age of 15. Margin financing has increased to 2 trillion yuan or $325 billion. Clearly unlike the U.S. investors and stock market authorites have not experienced the collapse of a bubble with all the economic distress for a prolonged period....

LyrArc Article Gist
The Washington Post survey of 1200 readers on how the Republican healthcare plan of Speaker Ryan and the House of Representatives looks to them, how it affects them in their lives. Here Somasekhar of the Post gives the stories of 5 Americans. Some see the prospect of losing their insurance under the Republican plan even as they reach an older age, others a smaller segment says the Post, whose premiums jumped under the Affordable Care Act say they faced high premiums and high deductibles. The Post says the large majority of opinions have expressed anxiety over the proposed Republican Ryan House plan for healthcare. One of them is an uninsured poor farmer, Mr. Woosley,  income about $18000 who gained benefit from expanded Medicaid under the Affordable Care Act,  one Mr. Smith, 32 years, a personal injury attorney who faces paying $10,000 if he did not take insurance and $10,000 if he took insurance because of high premiums so a wash either way deciding to do without it, one a tech worker Mrs. Powers, 62 years, income $22,000 on year and $4000 the next, from middle class during the tech boom but facing fewer opportunities and uncertain income from part time work, hit by the deep recession facing fewer opportunities as she gets older and now the prospect of losing insurance without government subsidies, one who is from the middle class who sees little benefit from the Affordable Care Act and is forgoing insurance because of the high premiums yet faces a penalty for not being insured under the ACA, another Mr. Blanchard, 52 years, is from the middle class, a computer programmer who lost his job in downsizing, earns $100,000 as a consultant self-employed, pays $767 in premium a month and relies on the Affordable Care Act which helps him gain freedom from working at a company that could downsize,  another is a middle class programmer Mr Riffle,age 44, and his wife, who does not qualify for a subsidy with a $71,000 family salary from working 4 jobs between himself and his wife- this person finds it too expensive for his salary to buy insurance $900 a month and $14,000 deductible under the Affordable Care Act. His views are worth listening to as they go to the crux of the problem- he says he may not be any better with the Republican plan. He sees the real problem as the high cost of health care in the U.S. and the only way this can be fixed is for members of Congress to be asked to use the insurance exchanges they create. If this sample is representative it shows that there are real problems with both the Affordable Care Act and the Republican plan, that the high cost of health care the problem lurking behind every plan that does not squarely address this, and till that happens and members of Congress experience what ordinary people face, this problem can never by fully solved.   Woosley, Smith, Powers, Blanchard, Riffle, and their personal experience is at the crux of what is right and wrong  with the Affordable Care Act, and also with the new Republican plan of Speaker Ryan and the House of Representatives. For every Woosley, Powers and Blanchard who benefit, there is a Smith and a Riffle who are indifferent or are affected by the high cost under Affordable Care Act and the current system of medical care with its high cost. The Affordable Care Act does not  tackle high cost, for that to happen the culture in America that makes it possible and acceptable to charge high prices must change. Another problem apart from bringing health care costs is that any solution needs to have the whole country behind it. If the notion that all people are entitled to basic health care is to stand, the whole country needs to believe it as they do in countries like France, Britain, Germany and Japan. If this has to be made a workable proposition health care has to be offered at a price that makes this possible to achieve, and that idea also needs the deep and broad sense of support from the culture in America similar to that in these other countries. Until that happens politicians in America will get elected and turned out of office in turns on issues such as health care, based on which side they take and which problems they choose not to face squarely and responsibly. ...