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A Pew Research poll shows Democratic voters now favor a bold ambitious agenda by large margins. Voters seeking compromise swung sharply going downwards from 69% to 46%. Many are calling for Medicare for All. In the Republican Party the shift is slight from 46% to 44%.

In the House the Congressional Progressive Caucus now has about 90 members. Of the 50 newly elected members who are House Democrats 20 are part of this Caucus pushing for bold action.

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Health insurance premiums for family plans increased by 9% in 2011 according to a survey by Kaiser Family Foundation. A similiar survey by Mercer showed premium increases around 6%. Another change is that health insurance plans are becoming less comprehensive and deductibles are higher, with higher copays and employees contributing more to premiums.

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Progressive caucus in the US House of Representatives led by Pramila Jaypal, a first time Indian American Congresswoman defeats an attempt by Josh Gottheimer of the Problem Solvers caucus to separate much of the president Biden's agenda in health, education and social policy and risk it being defeated by Senators Manchin and Sinema in the US Senate. Without the efforts on child care, education and health, climate change and social services part of the Biden Workers and Families Plan much of the Biden agenda would remain unfinished and Democratic party promises not kept. This also means that Manchin a Senator from West Virginia with a population of 1.8 million and Arizona with a population of 7.2 million, both conservative leaning Democrats could sink the entire agenda of president Biden to support American families and workers for a population of 331 million people. That two states with a population of less than 3% of the American population could sink the entire agenda of president Biden shows how fragile a situation has been created within the Democratic party to support workers and families even during the pandemic following the leadership of Carter, Clinton, and Obama Ms. Jaypal, a three term Congresswoman from Seattle, Washington state, was first elected in 2016 with an endorsement from Bernie Sanders who was the Democratic Party's leading candidate for president till the late stages of the 2020 US presidential primaries. Bernie Sanders says of Jaypal- "I think she is doing an extraordinary job. And I think the Progressive Caucus is doing an extraordinary job." Sanders founded the Progressive caucus after getting elected to the Senate from Vermont 30 years ago. Even though it is hard to imagine the Democratic party being the Democratic party without bold policies in climate change, affordable housing, reducing income disparities,  investing big in childcare, education and healthcare, attempts were being made to sink the entire Democratic party and national agenda going back to Franklin Roosevelt. Jaypal is described in the WSJ as diplomatic and firm, saying "I am so proud of our caucus; I have never seen our caucus so strong. And I am a very good vote counter also." Fifty members of the 100 member Progressive Caucus held firm in support of president Biden's original agenda without which the president would have little to show in keeping promises he made to the American people in the election and little to differentiate him from Mr. Trump who also supported infrastructure spending. Separating the infrastructure bill would have risked sinking Mr. Biden's plan for recovery of America from the pandemic and the devastating policies pursued by American presidents in the last two decades. Policies by previous presidents that have impoverished the country, created huge income disparities, weakened America in the world in trade and technological leadership, and wasted resources in foreign wars. There are no centrists or far left- these are just labels. When Ms Japal said "Let's just remember the Speaker (Nancy Pelosi) is a great champion of this agenda. I think she was trying to do as much as she could to get this done," she could have said it is Mr. Biden's own agenda pushed forward with conviction to help workers and families during the pandemic, and build a solid American recovery, restore American leadership in the world. Pramila Japypal is the first Indian American woman in the US Congress, and one of only two dozen naturalized American citizens in the US Congress. That she could play such a critical role for good in the US Congress shows that with the right convictions, determination, experience, much can be done for the common good in America and the world.   ...

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Healthcare, climate change, pensions and social benefits, are three issues uppermost in the minds of German voters. Three million new young voters most of them only about 2 years old when Merkel started 16 years in office, look for change. They are well informed and for these young voters climate change is the most important issue. DW.com shows three voters and how they plan to vote. One voter has cast a mail in ballot for The Greens party. The second voter will vote for the Greens. Both because of climate change concerns. The third voter Thurid says her mother is a geriatric nurse and is not vaccinated. She is vaccinated but had talks with her mother and understands her worries about vaccination. She will vote for the Free Democrats because they oppose compulsory vaccination. The three leading parties for young voters are the Greens party, the Free Democrats, followed by the Social Democrats all in the range of 16-18% of support. The Greens have sent out 2 million brochures to voters. Out of 60 million voters in a German population of 80  million, 3 million is only 5% of the vote. What makes a difference is that it is consistent with the general direction of voters young and old, all looking for change in Germany as the CDU party attracts only about 20% or one fifth of German voters. Social Democrats Scholz is way ahead of Christian Democrats Laschet in how voters view each candidate. Will German voters be well informed enough to make a decision based on their desire for change after 16 years of Merkel or will the CDU bringing back in the last days of the campaign the old fears that the communist Left party would somehow find its way into the government using the Greens as a way in- this is a question for German voters. In1994 during the Cold War with Soviets Kohl used this to keep the Social Democrats out and Greens out and formed a coalition with the FDP. Yet today Merkel has grown close to both Russia and China and away from the Western alliance in a way that was unimaginable under Adenauer who helped build the new Federal Republic of Germany after the war. Merkel refuses to even immediately accept a call from a new US president Biden, American president who is closest in style and temperament to Harry Truman who faced off the Soviets in Berlin in 1948.  The FDP opposes a wealth tax or any form of taxes in which the wealthier pay a fair share of what is needed to build crumbling infrastructure in Germany neglected in the Merkel years. In Germany social and economic disparities have grown during the pandemic with poverty increasing during the pandemic as has happened throughout Europe and the world. The US is already committing to increase taxes for the upper incomes. This is where voters have a choice- do nothing with infrastructure, health or climate change or do something by increasing taxes. The choice is now before the German people.  With this question comes a choice for western civilization, with the recent election in the US, and two elections in Germany and then France. Will it look with optimism to the future or will it huddle up in a deeply cautious and slightly pessimistic view of the world that is embedded in Angela Merkel's cautious vision that ended up only responding to crises- some self inflicted as in migration policy, and even self inflicted in tackling euro problems created in the euro currency's faulty design. In fiscal policy as in migration policy Merkel has reversed her position- by supporting European solidarity. Will Germans vote for optimism or never ending caution? Are lessons learned?     ...

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China plans $29 billion of local bond sales (200 billion yuan) through the central government, to meet the needs of cash strapped local governments. Its proceeds would go to projects approved by Beijing, for airports, power plants and railroads. In earlier year local governments depended on land sales as abig source of money. China's tax system sends most revenue to the central government, while provincial and municpal governments are left to handle most of the spending on education and healtcare, which is why these needs may not be getting the funding they need. Land sales are now drying up as asource of money as the property market declines. This does not mean that the local governments are not indirectly taking on debt. Chinese law prohibits cities and provinces from taking on debt without Beijing's approval, but companies owned by local governments have borrowed heavily to fund public works projects. Shanghai Chengtou Corporation, a municipal government company that builds infrastructure has taken on 200 billion yuan in debt in 15 years. Economists say this kind of debt may be 20% of annual GDP, which added to the central government debt of 20% of GDP, would bring the combined debt to 40% of GDP. What this new effort does is make the taking on of new debt official and more transparent. The principle behind the earlier tight control of debt issued by local governments was to prevent local governments going overboard and the central government having to take responsibility, as happened in the 1990's in India, Mexico, Russia and in the USA....

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Having an adequate supply of N95 masks is critical for each hospital tackling the coronavirus pandemic. The lack of enough masks leaves health care personnel without the basic protection and is a grave emergency. Hospitals are resorting to reuse of the masks in this crisis and this is not a good practice as it increases the chances of infection. President Trump has invoked the Defense Production Act on April 2 against 3M. This gives the federal government more control over 3M's operations to ensure that it goes all out to make the healthcare N95 masks that the hospitals need in this grave emergency. This report in the WSJ covers the situation as of April 3 on the supply of M95 masks for health workers and others. N95 masks block 95% of very small particles. Supply in the U.S. is for 50 million N95 masks. Demand in the U.S. is for 300 million N95 masks as estimated by the Department of Health and Human Services. in March- this is how many are needed by health care workers to fight this pandemic in the U.S. The principal manufacturer is 3M. 3M company has doubled its production since January 2020. The trend before this pandemic was to send production over to China and other countries. This is changing now with the pandemic and the U.S. policy shifting to be self sufficient in medical supplies in the event of an emergency. A policy Peter Navarro, who heads the agency in charge of getting medical supplies, says President Trump is insisting be implemented. Hospital buyers supported the earlier trend to keep costs down, but this appears to be a costly mistake, putting health care workers in hospitals across the U.S. without the basic protection they need. Minnesota based 3M invented the first modern disposable masks in the 1960's. Interestingly 3M continued to make millions of masks in the U.S. even though competitors moved manufacturing overseas. The 50 million disposable masks 3M made globally went to workers in industries where it provided extra safety from metal shavings or other substances, and medical workers. Now 90% of masks go to medical workers. 3M ramped up production globally since January 11 when the pandemic first hit to 100 million masks a month globally, and 35 million a month in the U.S. at plants in South Dakota and Nebraska. 3M says that it will import 10 million masks from its factory in China, which earlier this year was restricted from shipping it outside China as China needed masks for the pandemic. About 10 million more masks are made by two other manufacturers Alpha Pro and Louis Gerson Co.  U.S. Department of Health and Human Services ordered 600 million N95 masks from 5 companies to distribute to hospitals and build up the national medical supply stockpile. 190 million each of this is from 3M and Honeywell and 130 million Owens & Minor Inc.  3M says it will make 50 million a month in the U.S. by June. Honeywell which had moved production overseas, plans to bring back production to the U.S. by making 10 million masks by May at its Rhode Island and Phoenix plants. There is a company in Singapore that makes one million masks a day in China and other Asian countries, Pasture Pharma Pte, but most of it is committed to government agencies in China.   ...

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China's fiscal 2014 budget plans laid out at the March 2014 NPC meeting show an increase in the budget deficit by 12.5% to 1.35 trillion yuan ($221 billion). The deficit will be about 2.1% of inflation adjusted GDP, according to the Finance Ministry.

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This editorial in the WSJ raises questions about Chief Justice Roberts' written majority opinion, and says Justice Scalia's comment about SCOTUScare should be replaced with the term RobertScare. It says Justice Roberts has emerged twice as a "political" Justice in the way he has interpreted the law in this case.

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The $350 billon in proposed cuts to Medicare and Medicaid in the 2011 deficit reduction talks will do little to reduce the rapid rise in medical costs. Instead it shifts the costs to seniors, state governments and public hospitals. Gail Wilensky, former head of Medicare under the first President Bush and now a senior fellow at Project Hope, says this should not be confused with real reform to Medicare which reduces the rapid increase in costs. It does little in the way of fundamental changes that would reduce the growth in costs. About $53 billion comes from reductions to senior's ability to buy extra Medicare supplemental insurance or Medigap. Another $14-26 billion would have the government reduce payments to hospitals for unpaid debt. The few items to curtail fraud in the use of CT scans or purchase of power wheelchairs would provide savings of $2-3 billion over 10 years. $4 billion comes from lowering Medicaid payments to hospitals treating a high percentage of low income patients, hospitals such as Cook County Hospital in Chicago, San Francisco General Hospital, and Parkland Hospital in Dallas....

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A study by Dr. McCormick of the Harvard Medical School and professors at the City University of New York School of Public Health at Hunter College, shows that the anticipated savings from conversion to medical records may not materialize to the extent expected. This study of data from 1100 doctors of 28,000 patient visits shows that with access to digital records doctors actually increased the number of tests ordered- from 12.9% of visits without digital records to 18% of visits with digital records. For more advanced tests such as MRI and CT scan the rate was 70% higher. Dr. McCormick says this may be because the new digital technology may have made it easier to order tests.

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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.