LyrArc Article Gist
The Economist magazine says Mr. Trump's claim that he could fix things because he is an outsider is now quickly proving to be false. The lack of experience works against the Trump administration as it stumbles from one crisis to another. The tweets that were used to turn voter sentiment against opponents now work the other way. There are other problems that are noted here but not emphasized to the extent they need to be. Mr. Trump, as Peggy Noonan, a Reagan aide, has pointed out in the WSJ, risks alienating the very blue collar vote, and older voters whose interests he claimed to defend. This happened with the Ryan Republican House health care bill as millions of poor Americans approaching retirement were one of the worst affected groups. The Economist points out that the next project to tackle tax reform has the same possible consequences for the Trump blue collar base, as it says Republican plans for tax reform are seen as regressive. Tax reform has eluded previous administrations, and requires more experience in building coalitions which the Trump administration lacks in its confrontational attitude towards Congressmen on both sides of the aisle who disagree with him. Improving the U.S. trade position, infrastructure investment are other areas that the administration plans to tackle, yet the first 100 days show that the lack of experience and the lack of a calm composed mind is hurting the Trump administration, to the point of policies that hurt the very voters who put their faith in the Trump administration to improve things. A similar process is unfolding in Britain as it faces a Brexit negotiation that the Economist points out has been badly handled by prime minister Theresa May, and could lead to worsening the economy if no deal is reached because the European Union sees that it is not in its interest to do so, and Ms. May realizes only later that she has taken nationalist sentiment a bit too far for a European economic arrangement to work and provide mutual benefit. A continent wide economic arrangement that it was the wisdom of past leaders from Britain, France and Germany to support for over six decades is not easily undone by one vote, or one government. ...

LyrArc Article Gist
This is an exceptionally humorous operating room story of Dr. Trump and Dr. McConnell by Kristof of the NYT. Sometimes humor tells the story- and Kristof does this using a story of a surgeon president Trump in the operating Room trying to address the concerns of the patient Janet, as he keeps telling her she needs a new heart with great benefits, great benefits, before she implodes or goes down failing. Flat out take the old heart out even if a replacement hasn't been found, believe me great benefits the surgeon tells her, just that the patient just isn't getting convinced as its happening to her. The analogy is with replacing a health care plan, not just the Obama plan, any plan without something to take its place. For a few days before this article by Kristof, the Republican effort to repeal the Affordable Care Act without having a replacement was presented as a good idea. Janet is like the three Republican women- Collins of Maine, Capito of West Virginia, and Murkowski of Alaska who wanted to keep the heart they had till a replacement was found, against the surgeon Trump's advice. In a way it is about politicians in the last decade who never had any discussions as they rushed through with their own agendas, as the Republican and Democratic health care plans were rushed through Congress with relatively little participation and debate to hear all viewpoints. ...

LyrArc Article Gist
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. ...

LyrArc Article Gist
The Congressional Budget Office analysis of the Republican healthcare plan advocated by Mr. McConnell, Senate Majority leader, is that it would add 22 million uninsured if implemented. That plan ran into opposition from Republican Senators Collins, Capito, Murkowski, Paul, and Moran, and lacked enough support in the Senate. All Democrats opposed it and with the thin majority Republicans were divided. By taking away some benefits given under the existing Affordable Care Act the plan hurt the elderly and low income people, making some Republicans listen to their constituents in home districts and not the Republican leadership. The NYT profiled two in particular who astonishingly in a sign of today's strange politics were the only ones publicly holding townhall type meetings to hear the views of people in their voting districts- Susan Collins of Maine and Jerry Moran of Kansas. Both senators were listening to rural communities and Moran stated his opposition with the words- "I am a product of rural Kansas." With it the nation takes a breather and the message goes out that it is best to listen first and then to seek middle ground, not do what both parties Democrats and Republicans did in 2009 and 2017- rush serious legislation through without support across party lines and without serious discussion.   ...

LyrArc Article Gist
This report in the NYT says Hillary Clinton has studied policy briefings, academic papers and taken advice from 200 policy experts, including experts from Bill Clinton's administration such as Alan Blinder, all in an effort to define her own policy positions on issues facing the U.S. This happens at a time different from the period of slow growth when Bill Clinton ran against George H.W. Bush. Since then middle class families face the added problems of not being able to keep up with the rising cost of college education, health care, child care, low interest rates on savings and volatile markets dampening savings growth. For working class Americans in the middle class during Bill Clinton's time in office the problems take the shape of a sharp decline in the manufacturing wages that once supported a middle class life in industrial states of the midwestern U.S., with global competition doing the damage, and few solutions available except improving technology and technical skill of the workforce to compete in higher end products. Consider the points made by Janet Yellen, the Fed chairwoman at a Boston Fed conference in Oct. 2014- Fed information for 2013 showing the average net worth of the lower half of American families representing 62 million households is $11,000. Only this conceals the situation facing one fourth of these families who have zero wealth or negative net worth, and a significant fraction owing more on their homes than they are worth. Hillary Clinton told a audience at the New School in Greenwich Village in New York, this is the defining economic challenge of our time. " We must raise incomes for hard-working Americans so they can afford a middle class life. This will be my mission from the first day I'm president to the last."...

LyrArc Article Gist
Senators Mike Lee of Utah and Jerry Moran of Kansas declare their opposition to the Republican Health Care bill proposed by Senator McConnell. This decision by the two senators makes it impossible to begin debate on the bill. Earlier two other senators, Susan Collins of Maine and Rand Paul of Kentucky announced their opposition. This means the Republican health care bill has no chance in the Senate even after changes to the bill passed by the House of Representatives. Republicans have a thin majority in the Senate make it difficult to pass legislation. Collins met with residents in Maine and Moran with people in his home state of Kansas, and both senators heard a lot about the negative effects of the Republican bill on people in their state. The bill is seen as hurting people in rural areas, elderly, and not likely to do enough to bring down premiums. Its plan to slash Medicaid spending has drawn strong opposition from all Democrats.

LyrArc Article Gist
David Brooks says the Paul Ryan Budget proposal is a bold step forward that is badly needed in this debate on health care, even though it has some grave weaknesses which need to be corrected. It is a bold step forward because he says Democrats say they want no middle class tax increases, or are not willing to say what kinds of tax increases they support, and yet they believe the Medicare and Medicaid and Social Security programs are worth preserving. This is'nt based on reality. He cites the weaknesses, beginning with the one discussed in David Leonhardt's column in the New York Times on April 7, 2011. Too many Americans pay too little into Medicare taxes and expect to collect several hundred thousand dollars more in Medicare benefits. The example given in Leonhardt's column is from a study that shows 56 year olds with average earnings pay about $140,000 in dedicated Medicare taxes over a lifetime, and then go on to collect $430,000 in benefits. Middle class and affluent boomers can't get off paying their share like everybody else. Its just the right way for their children and the nation's children. Ryan's plan excludes older people reaching retirement in ten years. The other major weakness is that the cuts are too deep. Things like the Pell grants which Ryan proposes to cut back to 2008 levels need to be preserved, and more money has to go into science, education and research and early childhood education for the U.S. to be competitive with China and India. The Ryan proposal places cuts that would be required so that tax revenues need to be at 18% of GDP. The number where a larger consensus exists is for tax revenues at 20% of GDP (also supported by business and the Wall Street Journal's editorial columns). This would preserve programs that are most productive for the economic future of the U.S. Ryan's proposal lets the hope for reducing costs of medical care rest entirely on future retirees deciding how much medical care (tests, procedures etc) they consume through larger cost sharing. Yet a structure and framework is needed to manage these costs effectively, and some combination of incentives to retirees to control costs and an effective structural framework is needed. ...

LyrArc Article Gist
This article in DW.com cites experts who point out that the Republican Party always had tensions within it because of the diverging interests of three groups that have allied together to form the party- Wealthy businessmen and corporate interests, evangelicals, and white working class people who have seen their incomes decline for several decades. The interests of each group have some overlap, are sometimes masked but frequently they diverge. Nigel Bowles, former director of the Rothermere Institute at Oxford University, says there is no particular reason that this coalition would hold together, that it was unstable to begin with, a wonder that it did not split up earlier. Scott Lucas, an expert on American Studies at the University of Birmingham, says that Reagan showed great skill in holding this coalition together, and Donald Trump has taken it apart by mobilizing only one constituency of white working class voters and leaving out others. The break between Republican party leaders Ryan, McCain, and state party leaders, with Trump is unprecedented in post war American politics, and putting it back together now looks like a lost cause in the medium term.  ...

LyrArc Article Gist
A health care practitioner says the real problem is the high cost of medical care in the U.S. when compared to other countries. She points out that the Obama bill in 2008 did not take effective steps to bring down the cost of health care before enacting legislation to cover the uninsured, leading to higher premiums for the middle class. The link between healthcare and profits is seen as the main problem. 

LyrArc Article Gist
The U.S. Senate passes a motion that allows the chamber to proceed with a debate on a health care bill. The motion passed 51-50 with Vice President Mike Pence casting the deciding vote. Republican Senators Collins and Murkowski voted against the motion. This report in the WSJ says this sets in motion a process in which debate will take place and amendments will be made. It is not clear what shape the bill will take. Under the process used only a simple majority is needed in the Senate, yet this allows for many amendments to be made.  Only hours after this motion passed by one vote, a bill replacing major parts of the Affordable Care Act failed to pass 57 votes against and 43 in favor. Senator John McCain who arrived in Washington from Arizona following brain tumor surgery, delivered strong criticism of the way the Republican healthcare bill was rushed through allowing very little debate. Experts have commented on the way the bill was rushed through with a thin majority for passage, with very little debate, first by Democrats in 2009 and now in the House by Republicans. With the same pattern now followed in the Senate by Mitch McConnell, the Republican leader in the Senate. A backup bill would remove just the individual and employer mandates and a tax on medical devices- the elements Republicans agree on, if no majority can be put together for the healthcare bill. ...

LyrArc Article Gist
Ron Wyden, Democratic Senator from Oregon, on maintaining competitive choice for 200 million Americans who have to buy insurance outside the Exchange proposed in many of the bills being put forward in the U.S. Congress. This lack of choice between seriously competitive plans will leave the situation in the same way that it is today, with little hope for controlling runaway costs and doom health care reform. The key to controlling costs says Wyden is introducing choice and competition. Wyden will introduce this plan as an amendment called Free Choice to legislation being debated in Congress.

LyrArc Article Gist
Greek yogurt sales have doubled every year since 2006. It is praised by nutritionists for its flavor and protein content. The market leader is Chobani, founded by Hamdi Ulukaya, of Turkish origin, who has dairy plants in Johnston, New York. Chobani's sales were $196 million, as of Oct 3, 2010, having nearly tripled from the prior year. The irony is hat Chobani bought Kraft's yogurt plant to set up this business. Kraft had decided to exit the yogurt business in 2005. Now with sales climbing rapidly, Kraft is back in the business. Kraft has introduced its new Athenos brand Greek yogurt at Wal-Mart stores. General Mills introduced Greek Yoplait yogurt in March 2010. A change in American eating habits is driving this trend, as more people are substituting yogurt for breakfast instead of cereal. Overall yogurt sales are up 7.8% over the past year, according to UBS analyst Palmer. The CEO of Yoplait, General Mills, says there is room for continued growth, as Americans eat yogurt less per person than people in the U.K., Australia or Canada. The No 2 yogurt maker is brand is Fage, which started in a small dairy shop in Athens. Fage began exporting to the US in the 1990's, and set up a dairy plant in New York state. To reach the main demographic for yogurt- health conscious women- this brand advertised in Women's magazines Vogue and Elle, and ran banner ads on the New York Times website, as well as ads on food and wine sites. Fage's sales were up 50% by Oct 3, 2010, and reached $123 million in the US market....

LyrArc Article Gist
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.

LyrArc Article Gist
UnitedHealthcare says it will keep parts of the healthcare law relating to preventive healthcare services without co-payments, allowing parents to keep children on insurance till age of 26, even if the Supreme Court rules against the healthcare law. Most insurers see these parts of the law that are popular quite favorably.

LyrArc Article Gist
The rarely mentioned origins of the U.S. Medicare reform proposal of Rep. Paul Ryan and Rep. Ron Wyden, which includes work done at the Hoover Institution and liberal think tanks, in a debate subject to distortions on all sides.

LyrArc Article Gist
Chief Justice Roberts let the Obama healthcare law stand arguing that the individual mandate for everyone to carry health insurance acted as a tax, and was on these grounds constitutional. Justice Roberts found middle ground by first rejecting the Obama's administration's argument that asking every American to buy health insurance was legal under the commerce clause, and following this with the a non partisan approach that found the mandate legal under the tax clause. Roberts was guided by the writings of an eminent legal authority, Justice Oliver Wendell Holmes. Roberts referred to this in his opinion saying: "It is well established that if a statute has two possible meanings, one of which violates the constitution, courts should adopt the meaning that does not do so." Legal scholars speculate whether Roberts changed his vote later on or whether the Justice had used the questions in the hearings on the law to explore the idea that the law could be constitutional on different grounds. During the arguments in the hearings Roberts said: "The idea that the mandate is something separate from whether you want to call ita penalty or tax just doesn't seem to make much sense."...

LyrArc Article Gist
Lipton, Austin and LaFraniere of the NYT tell the story of how the serious differences between the prime contractor for the federal healthcare website, CGI Federal, and the Obama administration officials handling the website, evolved into conflicts that could not be resolved. This led to the flawed website being rolled out on schedule ignoring serious problems with the website. The detailed report comes after interviews with Obama administration officials and specialists who worked on the project and looking into government and contractor documents. A month ago in October 2013 the healthcare website for the Obama healthcare law was up only 42% of the time with 10 hour failures happening frequently. Basic steps for the functioning of website backup systems in case there is a failure, testing to ensure negligible or no outages, were not secured. The government officials responsible for the rollout did not have the capabilities to handle such a project. Henry Chao, who worked in the Medicare agency for 19 years was left to oversee day to day questions for the website HealthCare.gov, but lacked a formal background in software engineering and no authority to make the decisions needed. The $630 million project was setup inside the Medicare Agency, instead of a separate agency specially setup for this project and staffed with the appropriate skills as originally proposed. Five different lower level government officials made decisions without the authority needed and no one person with the necessary skills was given overall responsibility and decisionmaking. A series of missteps were allowed to take place- settting many added requirements that made it difficult for contractors to focus on basic steps and get them right, use of the MarkLogic database system instead of systems from IBM or Oracle against the advice of contractors, multiple contractors without a way to control the overall project, shifting requirements from the government and bureaucratic delays for resolving basic issues such as use of social security numbers, all worked to create delays. With the delays came a deterioration of relations between Obama administration officials and the contractors. The government officials response was to stick to the deadline of Oct. 1 rollout, with Michelle Snyder, chief operating officer of Medicare agency telling people she would fire the contractor if possible. In the end no one took responsibility for a safe reliable rollout, even though the system failed a test of 500 users in late September and was down half the time in mid-October. President Obama or his advisors were either not kept fully informed, or did not grasp the significance of the collapse in relations between contractors and the government and a project out of control. His aloof distanced approach was not an asset in such matters- saying about the rollout and use of the website: "this is real simple" like using the Kayak website for travel bookings- and he saw no need to take action leading to the major failure for the administration that followed....

LyrArc Article Gist
The 2016 primaries with Sanders and Trump have brought to the forefront voter dissatisfaction with the agenda of both parties, especially so for Republicans with the lack of specifics and personality driven campaign of frontrunner Trump. On a whole host of issues from poverty, wages and inequality, regulatory reform, to trade, borders, security, ISIS, both parties are facing questions from voters. Particularly the Republicans who have lacked specifics during the two terms of the Democratic Obama administration with a divided Republican Congress, and the risks for Republicans running for Congress under frontrunners Trump or Cruz who have provided few details on their agenda. The Agenda project of Ryan will have about 25 meetings and prepared specific agenda, including white papers and legislation, that would give Republicans hope to run on positive proposals that are placed before the Republican Convention in Cleveland. Chairmen of House standing committees were assigned 6 areas- health care, taxes, national security, regulatory reform, poverty, and Congress reasserting constitutional authority. Ryan told the Ethics and Public Policy Center on April 19, 2016- "A lot of people don't like conservatism as they know it. For too many people Republicans seem to be caught in a time warp. They're thinking, 'We don't control our borders. Wages are going nowhere. College and healthcare keep getting expensive. ISIS continues to spread. And what are Republicans going to do about it?' So we need to adapt our policies to meet the challenges of the 21st century."...

LyrArc Article Gist
Public opinion in the district of Steve King, a Republican in the House of Representatives favoring defunding of Obamacare healthcare law.

LyrArc Article Gist
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.