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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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George Bush's administration passed healthcare legislation that allowed private pharmaceutical companies not to have to negotiate with Medicare on cost of drugs. It also passed the so called Medicare Modernization Act that created a huge opportunity for profits through Medicare Advantage Plans. The chart in WSJ shows profits it calls a bonanza. What it means is that instead of reducing the costs of providing medical care to elderly Americans it has increased the cost leaving less and less money for infrastructure for roads and bridges and airports that are dilapidated in the US, and less money for essential services in education and health care, transportation, housing. This has reduced the standard of living and quality of life in America. For healthcare it is providing less for higher cost when compared to China, India, Germany, France and the UK. George W Bush administration put America into 2 wars in Asia and the Arab world which also drained resources contributing to a lack of investment in the country in essential infrastructure and services. ...

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

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Aizenman in this must-read describes the National Soda Summit and the presentation of one man Todd Putnam, a former executive from Coca-Cola that throws light on one of the truly important things that happened in the lives of Americans in the postwar period of development and growing prosperity. This is the development of marketing and advertising and its singular application in the case of Coca Cola to promoting sugary drinks. It is also related to what even business people describe as the single biggest problem in America. And it is happening at a time when the story is being repeated in developing countries such as China and India. Putnam describes the exhilaration, he and other Coca-Cola managers felt when the graphs at internal presentations showed Coke passing milk in consumption per capita in America. Several other facts stand out in Putnam's description of his experience- the ignorance on health issues among his marketing peers, the huge marketing prowess and dollars brought to bear once a goal such as increasing per capita consumption of sugary drinks was set- he was hired out of Purdue by P&G and worked at Disney before joining Coca-Cola- and the focus on the 12-24 demographic with 90% of all soft drink marketing targeted at this segment. What he regrets most is the focus on minorities who suffer some of the highest levels of obesity in America. No mention is made of the efforts underway in developing coutnries such as China and India which are seeing a surge in obesity rates and diseases such as diabetes. Coca-Cola says 41% of its sugary drinks are low calorie, but compared to milk, fruit juice and other healthier alternatives where does this rank? The cost to the nation's health care system alone would show that the performance of Coca-Cola's stock price over the postwar period came with a price tag that was never even thought about, when healthier alternatives as health drinks companies have found sell well when well marketed and formulated for different groups....

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Rural America has the same percentage of Americans that are prone to fringe views as urban America about 27%, the rest are simply trying to find ways to meet severe health, educational, lack of investment in rural areas by government, and cost of living challenges, that other communities have, says Nicholas Jacobs, professor of Colby College. He knows rural America as he shows in his new book -The Politics of Place and the Disuniting of America. Jacobs lives in rural Maine and has both studied reams of data and himself lives in a rural area. Here is the truth he says- Rural America is suffering from chronic health conditions, health worker and hospital shortages, limited employment opportunities and infrastructure deficits, rural schools suffering from funding gaps and teacher shortages. Similar to urban, yes, yet even worse, and need understanding not recrimination. What JFK rightly called, a policy "to lift all boats," from his speech in Arkansas, saying rural Arkansas was as much the Nation, as Massachusetts. He warns Americans to be careful what they listen to about rural America in talk shows or in books written to get audiences from one segment of the population or the other, with gross mischaracterizations of Rural America and its so called rage, with condescending views about people simply struggling to make sense of all the change some of it for the worse going on around them- in this period of Beaverbrook television or internet media. Beaverbook television is after a press baron in the last century in Britain who saw it fit to take advantage of crises of any sort to sell tons of newspapers for a profit, along the way promoting any bias that he had regardless of whether it was proven right or wrong. At one point UK press barons including Beaverbrook, controlled 13 million circulation the most in the world in 1947. Today instead of newsprint it is in book, television, social media or the internet video formats. This can concoct narratives of people that do not exist by using polls that are inadequate, and superficial understanding, with no effort to look for credible answers to difficult questions, and no effort to look for solutions that "lifts all boats," in America and in the World. ...

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Doctor are suffering from a "demoralization syndrome" says Eric Reinhart, physician at Northwestern University. He sites one study that shows universal access to health care in America could have prevented at least 338,000 deaths during the pandemic. Overwork comes from physicians retiring from the healthcare workforce in large numbers. In 2021 117,000 physicians retired and only 40,000 physicians joined the workforce. Another 20% will retire in 5 years. Burnout itself comes from a realization that the system is failing its people and you are working within it without the social and cultural narratives that supported previous generations of physicians. It is these narratives of honesty and service that are the essential parts of the human condition that are lacking without access to good health care for all the people and the education to promote good health.

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

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Krugman points out that about 13 million Americans without insurance gained health insurance under the Obama plan. He says if it is turned back 8 million whites without a college degree in that 13 million will lose health insurance. Of these eight million about two out of three voted for Trump, so that 5 million Trump supporters could now lose health insurance even though they are older and have more health conditions. Krugman says this aspect of the election campaign was not covered well in the misinformation and social media information of the 2016 campaign, and the lack of media focus on the important issues in the election. On manufacturing jobs he says most of the jobs lost are not returning, and only token jobs such as at a Carrier plant in the news will take their place.

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The Economist cites the Dartmouth Atlas Project which shows differences in cost across the country for health outcomes and spending involving Medicare. It cost $5000 per person in Salem, Oregon in 2006, $8000 in San Francisco, and more than $16,000 in Miami, with outcomes for health tending to be better in places where the costs were lower. This is one of the statistics that Peter Orszag of the Congressional Budget Office uses to come up with his estimate of 30% waste in health care spending in the United States. Prof. Skinner at Dartmouth and Prof. Garber at Stanford point out that of most health systems around the world the American system is "uniquely inefficient" and wasteful. The Economist cites information that the American system is twice as costly per person for healthcare than the Swedish system, and that it costs twice as much in Minnesota as in Miami. A poll done for the Economist shows 52% of the people in the UA are dissatified with the quality of care, 40% think the system needs fundamental change, and 29% think that it should be fundamentally rebuilt. The lack of uniform coverage is also causing turmoil in the system. About 49 million are uninsured, and a quarter or more are able to buy insurance and do not buy it because it is so costly, has exclusions and coverage is inadequate. But these people also end up in the emergency rooms along with the indigent costing the whole system tens of billion of dollars for costly late interventions that could have been avoided with preventive care early on. With the economic crisis and rise in joblessness, the dire condition of state and local budgets, the situation has probably drastically worsened, and the system near breakdown. ...

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People of America reflect on what has the most promise for our future?  Critics have focused so much on delivery on one night to forget what was actually said. The president's message to Congress and the American People of last week is all there for everyone to read. It states what was said in the State of the Union in January 2024 on the floor of Congress with vigor not seen since the days of FDR in 1932. Critics could read the actual text of what Biden said in the debate, and they did nothing of that acting in ways that only the uneducated would do and manipulating information about the president's health in dishonorable ways. Polling is an uncertain business and may be all wrong depending onthe sample and what questions are asked. This was proven true in last week's results of the French election. Where are the people relying on polls who predicted RN National Rally on top when it ended up in third place. The pundits have not reflected on the meaning of the French election and the British election where parties that made cost of living action, fighting for working families, and infrastructure investment coming out on top. Who is going to fight for and take climate change action and going delinquent on climate change is that an answer the American people will make? Who has done the most for climate change action, health care and education? How does the US compete with China without investing at home a fight which president has fought with economic theory from the Reagan/Friedman era that let American industry wither while China took the lead in industry after industry?  ...

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About the title it depends- costs have come down for food made at home and eating at home, it is the cost of eating outside that has doubled from 3% in 1960's the Kennedy years to 5.7% in 2024 as a share of personal disposable income.  Costs of eating at home are now half of what they were in the Kennedy years when they were about 13% of personal disposable income, as shown in USDA data and charts.The American public says in voting preference and other surveys  that inflation is a key concern, food prices  are mentioned as a key concern. Food prices fell by about 8% during the pandemic 2020 and rose quickly by 2022 by 12%.    Eating at home declined from about 13% of personal disposable income in the Kennedy years in 1962 to about 9% in the Reagan era in 1990 and down to 5.7% today. The real culprit in food inflation is people paying higher prices to eat outside at restaurants. In that period obesity has increased and general health has declined by these spending habits and lack of food savy cooking knowledge that not only cuts costs but also makes it possible to eat healthier by controlling intake of the fat, oil, and other poor ingredients by cooking for oneself at home. At home one avoids packaged goods and cooks the food from healthy ingredients. A correction is badly needed and will help not only health but also the family budget. Its a crazy way to do things not to educate children on healthy foods starting early in school, including in designing lunches and gradually increasing interest in making simple items from scratch. And instead to neglect food and food intake ending up with increase in cost plus poorer health outcomes. Hitting not just the family budget, also the nation's budget with higher and higher expenditures on healthcare. American habits need a change to make more at home like mothers and grandmothers in the 1960's and reverse obesity, poor health outcomes. As for the manufacturers of packaged foods President Biden talked recently about shrinkflation putting less in each bag of food at the same price. "The American public is tired of being played for suckers. I've had enough of shrinkflation. It's a ripoff." WSJ looks at food prices in 1991 and other points in the past and today. In 1991 as a percentage of disposable income food was 11.3%, according to Agriculture Department. This was after an inflationary increase in the 1970's. USDA data shows it has reached 11.2% in 2022. The public is responding by eating less outside and making its own granola and other items, and generally buying less that cuts into sales, a healthy trend. This is expected to lead grocery stores and manufacturers to reduce prices in 2024. ...

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What the French take for granted today- 99% of the French people are covered by national health care- started when Charles De Gaulle faced rising scial discontent in the postwar period, and accepted a demand for worker protections. During the postwar period Frenchmen are paying higher taxes, but in the first 30 years because French salaries were growing fast this was not noticeable. With slow growth and rising healthcare costs its getting harder to increase these tax deductions for overall social security, which have reached one third of apaycheck at the low end, say for ataxi driver in Marseilles. So you have the government running deficits of $15 billion in 2004, even after increasing co-payments for routine care and doctors visits. Experts say this could reach $40 billion in 2010 and $90 billion in 2020. In 2007 health care cost the government $300 billion, or 11 % of GDP, (OECD numbers) and the bureaucracy and rules are getting more complicated. This 11% is well below what Americans pay for asystem that leaves out about 50 million people. France ranked 8th on the OECD list in cost per capita, the US at the top. And the French life expectancy is higher at 80.98 vs. 78.11 for the USA, higher by about 3 years. For this cost the system is cost effective according to the OECD. And the French find the American debate abouthealthcare public option "altogether surreal", as the newspaper Le Monde put it. To keep the system in viable form the government is increasing copayments, such as the decrease in reimbursements from 80% to 65% for routine care and doctors visits in 2004. As aresult the deficit dropped to $6 billion in 2008. ut the global economic crisis and rising unemployment has made this grow to estimated $13 billion for 2009. Measures under consideration: increasing hospitalization copayments to $28 a day from $22. To fill this substantial gap for routine care and other costs the French system has private insurance companies called mutuals that offer different policies. Which is where the Fench notion for equal treatment in health care gets distorted because different people can have different coverage. The French though compare their system to the British system and say theirs is not as nationalized as it appears and the Brisih one is much more so. The French system though supervised by the government is different from government run health care as in Britain. French people are free to choose their own doctor who is often a private practitioner. ...

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The $3.5 trillion bill of president Biden to help America get back on its feet after the pandemic and after years of neglect of infrastructure, manufacturing technologies, child care, health and education, is that much only if offsetting tax increases and spending cuts are not included. When this is taken into account the US is spending about $871 billion to rebuild its economy and for a better life for Americans. That is the estimate provided in the report September 13 by the Congressional Joint Committee on Taxation.

Experts say that if president Trump's bill- Tax Cuts and Jobs Act of 2017 was calculated without offsetting cuts and tax increases the same bill would be $5.5 trillion package.

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This is a very informative interview with Joe Biden. So far Biden has given few interviews where he talks freely at length about how he plans to run his administration and what is most important to his heart. The title is very misleading in this respect. Unlike the inexperience of Obama with his "we won" we must be doing something right, Biden with his years of experience comes closer to Lyndon Johnson or Truman and the same drive to get things done. He says in this interview "there is no elation." He just wants to get somethings done as quickly as he can and he knows Congress as well as Lyndon Johnson did when he tried to get his vision of "the Great Society." It is almost as if the Biden sequel to the inexperience of Obama, is like the Johnson sequel to the inexperience of Kennedy.   To understand Biden is to know what hurts him most. Biden feels the pain that every rural county in America did not vote for him. He knows something is deeply wrong that this should happen as it has never happened before. It may be time to define diversity differently - people of diverse backgrounds not just ethnic or race but also whether with rural or urban backgrounds as they are today totally different. He also feels the pain that seventy two million Americans voted for Trump. He will judge his success or failure in winning over about half of them to bring this down from 47-48% to 25%. These issues will define and shape the Biden presidency. Can he deliver to the rural counties, health care, education, broad band connectivity, everything that has disrupted life in rural America from the way it was in the Truman and Eisenhower administrations when it comes to the social fabric. The China issue simply fits into this. European societies are feeling the pain of the fragmentation in their social fabric with starkly different opportunities for life in rural vs urban. Respect for fellow Americans comes before respect for China- or Japan, or India, or Europe. Biden understands what three decades of shift of manufacturing jobs to China and other countries have done to American communities, to small towns and the rural areas surrounding them in America. For this reason Biden does not plan to change the Agreement China made with the Trump administration for 25% tariffs on a portion of imports from China and China's written agreement to buy $200 billion of American products. For this reason his response to China's challenge emerging from trade policy set in motion by the Clinton administration, and allowed to continue by the Bush and Obama administrations with the addition of foreign wars that dissipated the country's finances urgently needed for infrastructure building and investments in education and advancing science and technology, is to reverse all the negative trends. Biden plans to make the investment in America that Mr. Trump started but to do this more effectively, he says.   ...

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The WSJ looks at Elizabeth Warren's Medicare for All plan that marks a major shift for the U.S. economy.  Households would see their costs go down by $11 trillion, boosting their ability to spend on other goods and services. Because income and wealth was highly skewed in the past three decades in one direction, the spending capacity of lower and middle income households was pushed down. This and other similar plans would help restore a higher level of spending and with it an essential element of inflation of 2-3% to the U.S. economy which was missing in the last decade. This sets the tone for the kind of broad based recovery that happened after 1950 that strengthened America's middle class and made it the core of the economy, the core of the post World War II recovery in America and Europe. The plan would be paid for by higher taxes on corporations, tax rate of 21% for corporations going back up to 35%, and reverse depreciation schedules in the 2017 Republican tax law. The argument that this would reduce business investment does not hold that much says the WSJ because amid new trade tensions business investment has declined over the last 2 quarters, and has been sluggish overall. The other source for the estimated $13 to $20 trillion cost of Medicare for All plan of Elizabeth Warren is a 6% annual wealth tax on billionaires, in an attempt to have all pay their fair share and reduce wide disparities in wealth. Mark Zandl, chief economist of Moody's Analytics, says his sense is at the end of the day from a macroeconomic view- because $11 trillion in the hands of 80% of households who could boost spending after lagging behind in the last decade- the negative effect on business investment will be cancelled out by the higher consumer spending. The overall effect and today's context is infused in this analysis. Private insurance, premiums for insurance, and out of pocket cost that the public pays would disappear in this new system where all health payments pass through the government. Health insurance premiums paid by employers would convert into a new employer Medicare contribution to the government starting at an amount employers pay now and adjusting gradually toward national averages over time. Smallest businesses are exempted. Mr. Zandl says the most important aspect of this now is that Mrs Warren has shown that her plan's revenue sources match the cost so that the plan would not lead to deficits increasing and pushing interest rates higher, leading to negative effects on the economy. Republicans under Mr. Trump have paid little attention to expanded deficits caused by their tax law, and economists across the landscape have also shown less concern. Still attacks are made if the plans don't add up. For this reason a sound assessment in today's context of depressed consumers and an overall impact becomes essential. The WSJ quotes from a pre- assessment of Warren's plan by Simon Johnson, a Massachusetts Institute of Technology economist who co-wrote it with Mr. Zandl and Betsey Stevenson of the University of Michigan. What they point out is that putting cash in the pockets of the lower and middle class for spending makes a lot of sense today, and taking money out of the pockets at the way upper wealthy end,  does not contract the economy at all. Other effects they say are constructive by letting all workers get health coverage from the government instead of employers, this makes it easier to change jobs increasing labor mobility and productivity. A worker getting a better job and better utilization of skills could then shift without looking at the employer health care plan. Warren says there would be a five year transition so that workers in health care insurance industry can work in other insurance fields and in Medicare, no one would be left behind. The important thing being to build America's middle class again. ...

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Tyler Cowen, Professor of Economics at George Mason University, points out some basic truths about health care as it is practiced today in the USA, and healthcare spending as it stands today. He questions whether starting out with extra spending plans to provide coverage to all will help solve the basic problems facing American health care. Too many tests and diagnostic procedures used by doctors is not aproblem that will be solved by spending more money to cover everyone. And government taking on more spending to cover all will not address all the other major shortcomings of the American way of practicing medicine, like prescribing a battery of tests, that tend to drive up costs, to just mention one of the problems. And it will not address any of the shortcomings in the way Americans take care of their health, diet, exercize and healthy lifestyles. THese are critical to get good health outcomes for the people, and which combined with careful spending of dollars where it will provide the greatest benefit, is the only way the health care solutions can be found....

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Are there costs or are there savings from the Obama health care bill? Does it affect jobs and how? The Congressional Budget Office says the health care law will save $230 billion in ten years based on a whole set of calculations and assumptions. Commonsense and basic math leads others to question how spending $930 billion on insuring 32 million Americans could end up with significant savings. The different view argues that the Budget Office erred in making some calculations, by counting $70 billion in premiums from long term care because they would be used to pay benefits later, omitted $115 billion in spending to adminster the law, and omitted $208 billion needed to prevent scheduled reductions in Medicare payments to doctors. The money needed on the Stimulus, on two wars in Iraq and Afghanistan, and the uncertain prospects of the US economy in the longer term till debt and other issues are resolved, injects the critical element of difficult choices and priorities. If state and local budgets are severely strained in 2011-2012 would that require federal help and will there be other needs that will have to be met by the federal government that are critical such as another unexpected downturn, or a resolution of unresolved bad debt at the large US banks There is also a sense that the health care law does not do enough to reduce the cost of health care that will be needed over the next decade so that other priorities are not neglected. Both parties are not up to the task in this respect for running the country's finances withot using the numbers to tell different stories....

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In a sign of the changes roiling the pharmaceutical industry the off patent business of American maker Pfizer is based in Shanghai. The generics business of Mylan Pharmaceutical is incorporated in Netherlands and run from Pittsburgh. Pressure is increasing in the generics industry from manufacturers in India and China. Pfizer announced the merger of its Upjohn off patent pharmaceuticals business with Mylan to fight pricing pressures. Pharmaceutical prices in the U.S. are the  highest in the world and generics offer only small relief compared to the government mandated pricing of the same pharma products in India. Generics drugs are also offered at lower prices by distributors who buy in bulk adding to pricing pressures in the U.S. The government rarely intervenes in the negotiated prices as it does in India or in other countries in Europe including Britain.  In fact many asthma patients young and old alike are forced to do without inhalers because of the exorbitant prices set by American manufacturers with scant help from government under Democratic or Republican administrations in the U.S. In this respect middle class customers in India have better access to asthma inhalers as well as hundreds of other medicines basic to healthy living. This has created a greater level of basic equity/fairness in India as well as in Europe in this regard than in the U.S.  In this sense the pricing of basic care medicines in the U.S. adds to the sense of a lack of fairness. To that is added the manner in which the banking and financial industry operated resulting in the financial crisis of 2009 and damage to the bank savings accounts of ordinary Americans hit by unemployment, underemployment, and lower savings accumulation with interest rates kept low to offset the damage done by the banks through bad lending. This is also why an astonishing percentage of Americans like never before in the last 50 years do not have basic funds for spending to manage a health crisis in the family. Just as in times of the Depression in the U.S. industry operates in a way that is oblivious to what ordinary Americans are experiencing only to be excoriated by FDR. ...

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NY Times analysis shows upper and middle income groups support 33 year old Zohran Mamdani,  black and Hispanic residents support Cuomo for NYC Mayor. Mamdani has a good ground presence with 50,000 volunteers knocking on 1.6 million doors in an unprecedented effort in one American city as it became less and less affordable (WSJ). Paradoxically large numbers of higher income resident and middle income residents favored Mamdani over Cuomo, and Cuomo did better in black and minority neighborhoods. Mamdani promised better housing, freezing stabilized housing rents and going after landlords who do not fix rental properties, free buses, and city run lower cost grocery stores, free child care. For the funding Mamdani says $5 billion by making corporate tax 11.5% similar to New Jersey, and by a wealth tax of 2% on incomes over $1 million (which at $20,000 would not affect their standard of living), as the property owners supported Mamdani. Mamdani is a immigrant who came to America from Kampala, Uganda at the age of 7 with Indian parents. His father taught at Columbia University, Mamdani attended Bowdoin College in Maine. ...

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The startling truth about health "reforms," - they won't control spending, and without that the whole system of health care will rapidly become unaffordable and unsustainable. Obama's Council of Economic Advisors points out in new report that since 1975 annual health spending per person, adjusted for inflation has grown 2.1 percentage points faster than overall economic growth per person. At this rate health spending which was 5% of the GDP in 1960, and is 18% of GDP today, would grow to 40% of GDP in 2040. Medicare and Medicaid would increase from 6% of GDP now to 15% in 2040, or equal to three fourths of federal spending. Employer paid insurance premiums for families which grew 85% in inflation adjusted terms from 1996 to $11,941 in 2006, would increase to $25,200 by 2025 and $45,000 in 2040. This would force employers to reduce take home pay. Samuelson says the uncontrolled health spending is singlehandedly determining national priorities, reducing discretionary income, raising taxes, widening budget deficits and squeezing other government programs, while it is producing large amount of waste in medical spending. See the link to Prof. Tyler Cowen of George Mason University in NYT, 6/14/ 2009, who cites the habit of doctors to write many expensive tests as one of the prime culprits in the wasteful spending. And in the process it delivers higher cost for lower overall quality of health for the American people. This at a time when many European countries provide live examples of doing it in a better way- lower cost, better health. The serious problem with the Obama health reforms says Samuelson is that it talks about restraining spending but may end up increasing spending. Its talk about controlling spending he says is good intentions, but based more on hopeful thinking, public realtions and risks becoming cosmetic reform. Because to really control spending will require coming to grips with its fundamental cause- hospitals and doctors are paid mostly on a fee-for-service basis and reimbursed by insurance, private or governmental. Such a system encourages doctors and hospitals to provide more services, expensive tests, favors heavy use of expensive medical technologies to increase profits, and for patients to expect them. Samuelson puts his finger on the root of the problem - there is no incentive and every disincentive for all the players in this game , doctors, hospitals and patients to seek reform of this system. For doctors and hospitals the hope would be that this cosmetic "reform" would leave the system basically unchanged, and patients to continue with a lifestyle and expectations that do not not acknowledge the fact that a lot of healthcare does not come from spending but from preventative care, education, good eating and exercize habits, and healthy lifestyles. And the uninsured are no exception, they would simply start consuming the expensive care for lower quality of overall health like everyone else. With this kind of situation confronting us, the views of Samuelson, and Professor Tyler Cowen of George Mason University, as welll as a growing chorus of informed public opinion on this subject, is that insuring the uninsured is a good idea, but doing it within the bounds of the present system, can only increase the costs. And too much is at risk, to rely on what Samuelson calls a scattershot of measures to control costs made up by Congress such as "evidence -based guidelines," "electronic record-keeping," "bundled payments to hospitals, to give the illusion of progress that won't make a serious difference. A sweeping restructuring of health care is needed, that would overhaul "fee-for-service" payment and reduce the fragmentation of care. It will also need what has not even be touched on adequately in the debate. This is the massive need for education in the schools about nutrition, eating, exercize, healthy lifestyles. It would also require opinion leaders in each field from sports and other fields to lead by example and with constant public presence, the media, and companies to form a partnership with private institutions to change existing eating habits and lifestyles that encourage obesity, smoking, fast food eating habits, large portions in restaurants....

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This WSJ report looks at the efforts of sugarly cola companies such as Pepsico under a new CEO to push their cola products aggressively with advertising, and modern logistics. It cites Barry Popkin, nutrition professor at the University of North Carolin School of Public Health that they are making products that are killing us more slowly. With less sugar than before but still at a time of dangerously high obesity levels in the world just as dangerous or more dangerous to humans, because they are not as healthy as previous generations. The pandemic proved the danger of higher obesity levels. The numbers say it all-1% of children 5-19 years obese in 1975 going up by 8% to 9% in 2020, and doubling to 19% in 2035, says the WSJ. That is doubling by 2035 to 19%-  simply astounding. Popkin says the fact that Americans are living more years with disabilities, and fewer disability free years, is very much linked to the food intake. On The Guardian's pages was an article about a surgeon who has a startup in Austin, Dr. Attia of Early Medical, that promotes "healthspan." It focuses on getting healthy living habits  through better nutrition, exercize, to start at an early age as being critical for a healthy life span. It is not the same starting at an early age with good food and exercize habits vs starting later in life as this means fewer disability free years when starting later in life.  ...

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What is behind the anti-vaccine movement in the US? This NYT report looks at some of its unlikely origins- the anti-vaccine efforts of Robert Kennedy's son, Robert Kennedy Jr.. Mr. Kennedy is planning to run against Mr. Biden for the White House. Kennedy's opposition to vaccine's is traced back to his getting involved in cases as an environmental lawyer. Parents who had intellectually disabled children from other chemicals asked Kennedy to look into vaccines. Around 2010 Thimerosal, a mercury based preservative which been used for many years to prevent bacteria from growing in multiple dose vials of vaccine, was suspected to cause autism.  Already by 1999 the American Academy of Pediatrics, federal health agencies and pharmaceutical manufacturers agreed that thimerosal should be removed from childhood vaccines.  Yet it is still used, says this report.  This led to Mr. Kennedy's getting into vaccines in general by the time of the pandemic. He had a book out that was critical of Dr. Faucci, during the pandemic. Mr. Kennedy cautioned about the unintended effects of vaccines. He has another book out called the Wuhan Coverup that looks into the origins of the coronavirus. It refers to research conducted at the Wuhan Institute of Virology that was funded by the US. Mr. Kennedy believes that more transparency is needed on decisions made in the health care sector, and that critical views need to be aired for the public to be able to decide the right course of action. Vaccination is generally supported by people in America though there is a subsection of people who have concerns about side effects. On issues outside of vaccination there is a sense that America's health sector needs more transparency.     ...

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AARP shows 29 million Americans working and taking care of older parents. Many work 40 hours a week and work an additional 20 hours helping elderly parents. About six out of ten people of this 29 million work full time. In 2024 a lot more people are living longer and older people prefer staying in their own homes and need help from family members. A simple fall or a cancer diagnosis can lead to long hospital stay, months of treatment, and worrying for family members. Company benefits in 2024 do not include senior or eldercare support or even accomodating employees caring for their parents. In America today federal and state laws do not protect people caring for elderly parents from discrimination in the workplace. Consider how this is affecting companies, as about one third who are caregivers say they are going to leave, and half of the employees leaving are senior manager and executives with much experience. This comes to about 5 million senior managers and executives that American industry can ill afford to lose as it competes with China, India and Europe. About half of all companies are making this a priority in 2024, according to Care.com. Citigroup added 2 weeks of paid leave to care for immediate family member. Companies allow employees to add older parents on their health insurance. These benefits are being added to maternity and paternity leave. The fact that Congress and state legislatures have failed to enact laws protecting caregivers is one more reason for the discontent and unrest in the US after the pandemic. ...

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Robert Putnam a 79 year old Professor of Public Policy at Harvard answers the question what is happening now- when everything seems to be stalling and solutions offered by parties of centre, right and left are all failing to deliver for improving lives of poor white people, black people, middle class white people. Failing to deliver on health care for all, on access to medicines, access to infrastructure, on access to public services. He sees this as a result of the over focus on "I' and on the concentration of wealth in the hands of a few people in the financial world or in Silicon Valley without concern for the needs of the country or the people.  Putnam compares this to the period of the 1870's onwards in America. when for several decades the emphasis was on selfish pursuit of money and wealth with everyone focussed on individual gain. It was only after this period brought America as a nation and the people of America into hard times people was the whole culture of "I" and overfocus on individual gain questioned and repudiated. The period of "we" began with Theodore Roosevelt breaking up the monopolies and Franklin Roosevelt fighting for a New Deal for American workers and the people of the United States. Putnam sees this happening again and America at a crucial juncture of repudiating the existing culture and values in the same way as it did in the past. The change in culture in America is part of a wider trend that includes all English speaking countries Britain, Canada, Australia and India. In all these countries the shift is towards rebuilding the culture that brings opportunities and hope to the working class and middle class, to rural areas, through a new vision for infrastructure, public services, healthcare and education. Putnam brings long experience studying the development of America starting with the book "Bowling Alone" published in 2000 which described the trend to rampant and unrestricted individualism in public and business life. In 2015 Putnam's "Our Kids" covered the issue of declining upward mobility and  failing to give opportunity for young people to make improvement in their social and economic aspects of their lives. The three books have extensive research and look at a lot of data making them academic of nature but they also serve a useful purpose. Any intuitive grasp of the situation also leads one to think in the same direction that the past carries lessons for the future, that there is a better way out, and that this situation cannot go on for much longer without damaging the nation and the people, not just America, but other English speaking nations Britain, Canada, Australia and India that share the same problems of lack of development, lack of infrastructure and services, and neglect of the common man, of everyman.   ...

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Questions about the true cost of the Obama health care legislation and the assumption that the legislation cuts the deficit by billions of dollars. This WSJ editorial says one has to look at this closely, and not merely look at CBO projections, which may be based in a certain context and not reflect the true costs, especially because many accounting gimmicks and use of numbers to present a particular picture is taking place. The information this editorial cites is that: it uses 10 years of taxes to fund six years of subsidies, Social Security and Medicare revenues are double-counted to the tune of $398 billion, a new program funding long-tem care frontloads taxes but backloads spending, and the assumption of an automatic 25% cut to physician payments that Congress is unwilling to authorize. Rep. Rand Paul has tried to present an alternative view which needs to be studied just as closely, because of the enormous impact of a jump in spending at a time when the public finances are fragile. WSJ also cites the work of Richard Foster, the chief Medicare actuary, as an alternate perspective of how things could turn out, Doug Holtz-Eakin, and Eugene Steuerle. It calls for common sense in evaluating programs, entitlements, defense or other government spending. They not only cost money, but costs escalate over time as history has shown over decades, till they eventually are discovered to be not affordable unless the middle class is willing to dig deeper into its finances to pay for them. Alternate perspectives from a range of informed opinion, Howard Dean, Martin Feldstein, and the head of Harvard's Medical School show that the issue needs to be looked at closely and carefully and cannot be something in which CBO numbers can be trusted to tell the whole story. Especially when common sense, history, and informed opinion across a spectrum of thought advises caution, and fragile public finances also suggest caution. Howard Dean, former Governor of Vermont, says the health care bill is not real reform, and may do more harm than good. He says in a Washington Post article, December 17, 2009, the Obama health care bill does not insert competition into insurance markets, does not significantly reduce costs, and does not improve the delivery and use of health services. It was he says done with a political calculus and crafted for votes not real reform. Jeffrey S. Flier, Dean of the Harvard Medical School, gave the Obama health reform bill an "F" grade, saying in a Nov 18, 2009, WSJ article, that it was disingenuous to call this reform, Congress and the White House were simply deceiving the public. He said the bill will accelerate US health care spending, postpone most of the major health care problems, expecially the ones that drive cost, including the "fee for service" system and delivery of health care. He says in his discussions with economists and other health care leaders the opinion was unanimous that the bill will accelerate health care spending. He cites Massachusetts as an example, where access to care was expanded under the same dysfunctional system, and spending went up, and it doesn't work. Feldstein, who in early 2008 suggested proactive solutions to the mortgage debt crisis which were never adopted, says that the Obama health care law means higher taxes in the long run to pay for the $1 trillion cost of health care for the uninsured group over 10 years. Feldstein says that the Obama plan is to cut Medicare to cut spending, and will reduce the amount of medical services, as reduced spending comes from fewer services, not reducing payments to providers. And he asks if the cost reductions are weighted too heavily towards reduced services and not reduced payments to providers ,would this result in large cuts to services to affect the quality of healthcare for the 85% of the American people who are accustomed to a different pattern of healthcare. ...