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Trump was sitting next to Senate Majority Leader Pat Schumer for this event. This event the Al Smith Dinner requires a few humorous comments and jokes as a tradition. 

Contrast Harris in her video skit played at the Al Smith dinner and Clinton in 2016 making humor about her comment on workers as "basket of deplorables," changing it to "adorables" but not registering. There Harris brings back memories of her wearing a T shirt "Detroit vs Everybody," of how she was fighting for the revival of the industrial midwest by reindustrializing a deindustrialized manufacturing base and energizing workers, supporting the families of workers facing a cost of living crisis and caring for children and elderly parents. 

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Leonhardt of the NYT provides a useful look at several graphs showing how the last 2 decades have seen an accelerated level of inequality as most of the gains in income have gone to less than one person of the population. Income gains of the majority of the American people have dwindled leading to alarming levels of inequality. The nation has not yet come to grips with the problem, says Leonhardt, as the Republican healthcare bills actually hurt the elderly and most vulnerable in the population. The Trump budget used double counting, supporting tax cuts that were based on faulty accounting, raising debt for future generations.

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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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Who is this sandwich generation in America? The term refers to young people facing the high cost of raising children and lack of affordability of childcare as well as caring for elderly parents some in their eighties. The problem is acute for these families in 2024 who have already experienced the covid pandemic, loss of jobs, loss of family members. Men and women are squeezed from both sides as they care for children and elderly parents without assistance from the government. Harris's plan in America for childcare assistance of $6000, payment assistance for down payment on buying a home, assistance for starting a small business, increasing supply of housing by building 3 million new homes, has young people with children uppermost in mind.

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Lack of ammunition on the Ukrainian side. Russia losing huge numbers of casualties as a large part of its army is committed to the war. The sense of a war no side can win. Dysfunctional aspects of foreign policies in Europe that will cost $138 billion to $750 billion to fix by rebuilding damage in Ukraine, money that could have been used in the absence of the conflict to support the action against climate change and in development needs after the pandemic devastated economies of many countries. No country has surplus money after the pandemic- NYT reports today that China is struggling to meet the high health costs of the elderly during the pandemic. India has huge needs in transport, logistics, housing, healthcare. Both India and China lack a system of social security like that of the US and EU countries. 

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Four million elderly women live alone in Japan. For some like For Chikako Tanaka in Aichi prefecture in central Japan who is 85 years old, social isolation is a real problem. She had no pension and lived on her savings till the savings ran out, with no one to visit her as her dementia progressed. Chikako was an unlikely person to go to prison for shoplifting because she dresses with care and looks different, yet this was the only way out of social isolation. In prison for the first time in years her 85th birthday was celebrated. 

Physiotherapists help women prisoners over 70 years with rehabilitation, walking skills and balancing exercizes. Prison services help women to integrate back into society when they return, with service centers in each neighborhood when they return.  

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The Biden plan for families includes paid maternity leave of 4 weeks. It was shortened from 12 weeks in the original $3.6 trillion Biden Families and Workers Plan. This paid leave also applies to caretakers of ill family members such as elderly parents. The lack of such paid leave for mothers or ill parents care meant the US lacked one of the basic necessities of a decent state. Adam Smith in his Wealth of Nations paid much attention to how capital, land and labour could be combined to invest in improved quality of life, and how to build a decent society. Smith wrote this book around the time of the Industrial Revolution in England in the late eighteenth century. Capitalism taken outside this context of benefiting society in the country that started the Industrial Revolution, leads to problems that now exist in the US, China and parts of Europe.

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The draft of the new constitution in Chile is rejected by voters in September 2022 with only 38% voting For and 62% Against, a much larger margin Against than previously expected. The new constitution was drafted by a Constitutional body specially elected for the purpose, As a result Chileans will have to go back and draft one that is more likely to pass. Unlike previous votes voting was mandatory for 15 million eligible voters. Clauses on environment, abortion, and the indigenous tribal people are seen as controversial as well as a tendency to put every conceivable right into the constitution and not thinking enough about how these rights may be secured, and focusing on basic rights. The protests were about the unequal access to healthcare, education, and services, weakness in the pension system, and lack of protections for the elderly and pensioners. Income inequality was also an issue in the protests. 

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The Republican House health care bill AHCA  keeps some some of the more popular parts of the Affordable Care Act such as not taking pre-existing conditions to deny insurance, keeping children covered on parents insurance till age 26, and increase contributions to Health Savings accounts. It is different in that the expansion of Medicaid at 138% of poverty rate threshold is rolled back. Age is used for tax credits instead of income, hitting those approaching Medicare age harder. The maximum charged to older people is now set at  5 times compared to 3 times what young have to pay. In general the Republican bill is seen as targeting the elderly to keep premiums down. The elderly on low incomes are hit hardest. Fox News O'Reilly Show showed the host questioning House Republicans, citing the CBO estimates that elderly on low incomes may have to pay as much as $14,000 a year for insurance making it basically unaffordable, and 52 million Americans would be affected adversely. Large companies are no longer required to offer mandatory health insurance under the new bill. Conservatives from Freedom Caucus wanted to see the essential areas of benefits covered by the law limited to fewer than the ten areas in the Affordable Care Act. The ACHA Republican bill leaves to states to determine what are required essential benefits. At one point maternity benefits were to be dropped but this was changed to let states decide. As a result the bill is 33 votes short of the number needed for passing the house in March 2017.   Neither the Democrats Affordable Care Act or the Republican House bill of Speaker Ryan do much to tackle the real problem- the absolute amount and increases for health care dollars for treating each disease in the U.S. compared to European and other countries. As a result health care has become more of a partisan struggle between the two parties than a real effort by all to overcome the problems that have to be tackled. Republicans want to see premiums drop and keep the burden on the deficit down- but with the level of U.S. health care costs disproportionately high compared to Europe and the rest of the world the arithmetic is tough and ends up leaving out vulnerable groups such as the elderly on low incomes, thus making the whole proposition prone to fail. For the same reason the Democrats failed to keep premiums down with a wider safety net leading to calls for repeal of their version.   ...

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A stroke, a tumor, or live disease mean parents are taking care of children. WSJ shows one family in Woodbridge, Virginia coping with a son in the 50's with dementia. The Naitonal Alliance for Caregiving estimate is there are 3.1 million elderly Americans caring for a son or a daughter.

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Fewer workers will support the elderly in the U.S. and the process is accelerating, posing new problems for Social Security programs. Census figures show in 2017 there were 25 Americans 65 years or older for every 100 people in working years, by 2030 this figure goes up to 35 retirees. By 2025 it will reach 33 retirees. By comparison in 2025 Canada would be 40 retirees, Germany 44, Japan 58, and on the lower side India at 13, Mexico 16, China 22. Trustees for Social Security are dipping into the Trust fund in 2018 to pay benefits for first time since 1982.

States are in worse shape $2.6 trillion in assets cover $4 trillion in liabilities in fiscal 2016, according to data from Pew Trust.

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China adopts a two child policy nationwide in October 2015, abandoning a one child policy adopted in 1980. Experts had warned for years of a policy that would lead to fewer young people, and a rapidly aging society. UN forecasts show China will have about 400 million people over the age of 60 in 2030, 25% of the population in 2030, compared to 14% today if current trends continued. Growth of elderly people would burden the pension and health care systems. The birth rate of 1.4 children per woman is lower than in the U.S. today.

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With unemployment at 27% millions of Greeks and the elderly like Nikos Solomos, 60, cannot afford premiums and have joined the ranks of the uninsured. Greece's budget cuts have hit the health care sector hard because of mismanagement and corruption with prescription drugs costing about three times the cost in other EU countries. Cuts in heathcare are over 25% since 2009 and more cuts planned. Anthony Faiola with contribution from Elinda Labropoulou provides an exceptional account of the state of health care through the stories of ordinary Greeks like Nikos Solomos with intestinal cancer and the shortage of staff, equipment and supplies at Metropolitan Community Center in South Athens and Gennimatas General Hospital. Problems now include a resurgence of tuberculosis. Some of this pain is being felt in other EU countries with sharp cuts in public health spending, including Spain and Ireland.

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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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Medicaid Cuts - cutting costs for a program that went from $20 billion in 1980 to 918 billion in 2025, went up 45 times in 45 years. Projecting it out at this rate would leave little for other priorities for the Nation. Hence the need to set priorities- helping one means not helping the other in need. Helping a able bodied person means not helping the elderly who need help as by eliminating Social Security tax for about 90% of recipients over 65 years for instance. Medicaid was originally intended for able bodied. Critics of the plan say there is a lot of red tape and reporting at state levels. The correct solution would be to cut the stringent reporting requirements, cut the bureaucratic reporting, make it simple easy to report and not frequent. California, New York and other states will likely make the reporting easier. For impact on rural hospitals Collins and Murkowski have setup a $25 billion fund in this Big Beautiful Act to support rural hospitals. ...

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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. ...

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Retirement covers a full one third of life after a career in today's better health and life expectancy. Yet people thinking of life in retirement have either trite or vague ideas of life in retirement a study at MIT Agelab shows. Men use responses such a "hobbies,"travel," and "relax." Women in contrast after child rearing efforts as primary caregivers for children and elderly parents use terms as "peace" calm" and "time." The advantages of staying active, working part time that are shown to aid cognitive function during today's longer lives are not fully grasped.

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Two studies now show that it isn't that coronavirus just takes away the infirm or elderly who would have died anyway this year or the next. It is taking people away who still had over 10 years to live. Professor Biggs at the London School of Health Hygiene and Tropical Medicine says this is is what is happening from the study he is conducting.

A paper by Scotland based researchers published online by the Wellcome Trust a London based foundation found the average number of years of life lost to coronavirus for healthy adults is 14 for men and 12 for women. Using data from Italy and UK on the kind of long term conditions in the general population , the researchers found that for those suffering from common chronic illnesses and cancer including multiple conditions, the researchers found that people of this type lost about 10 years on average.

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The Republican House Health Care pLan in 2017 relies on tax credits of between $2000 and $4000 based on age. Under the Affordable Health Care Act the elderly poor in high cost insurance areas received additional help. These people would lose over $2000 per person and may forgo full coverage or coverage entirely under the Republican House Health Care Plan. A report by Standard & Poor's estimates about 2 to 4 million people who are in 50's and 60's not yet qualifying for Medicare might lose their coverage they now have under ACA. The Republican plan also gives incentives through tax credits higher for older people, $4000 for a 60 year ol and $2000 for a 25 year old. Under the ACA the insurers are not allowed to charge more than three times what is charged for younger people, under the Republican plan this goes up to five times. 

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Germany faces a huge shortage of workers. Even without the current loss of workers in sectors such as restaurants, hotels, airports, elderly care and other sectors, the Germany economy loses 350,000 people every year a the baby boomer generation born after World War II retires. Today there are 1.7 million open jobs in Germany. By 2035 there will be seven million fewer workers, according to labor experts.  No longer can Germany depend on Eastern European countries to fill shortages of workers. Incomes are growing in these countries and there are demographic changes in these countries. Some say the party is over. Skilled labor is in short supply. In 2020 a law was passed to get  the 400,000 foreign workers Germany needs each year to come and stay in Germany, says this report in DW.com. The number attracted? Only 30,000 which officials called a "disappointment." The law will be changed to open up the labor market to those with a contract but no recognized certification for the job, so that companies could train employees after they join. ...

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This report in WSJ looks at the Biden education, healthcare and climate change plan. It is part of the Families and Workers Plan put forward by president Biden for $3.6 trillion. This figure has now been lowered to $2 trillion and may drop crucial provisions for education such as the cost free community college which poses serious risks for working class families unable to afford community college, and skews education access even further to higher income families. It also lowers college attendance of American men, which is falling to alarming levels. The reason the plans are being whittled down is the 50-50 split between Democrats and Republicans in the Senate and the failure of Republicans and two Democrat senators Manchin of West Virginia, Sinema of Arizona to support community college access. Parts of the current bill support child care, access to affordable housing and in home care for elderly Americans. New elections for Senate and House of Representatives in 2022 would have to settle the issues related to financing assistance for families and workers as the Senate today is divided 50-50 between Democrats and Republicans. A separate Bipartisan Infrastructure package has the support of all in the US Congress to build bridges and roads, other infrastructure badly neglected by different administrations over the last 2 decades. ...

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Amar Bhide touches on the unpredictable consequences of devaluations while commenting on the supposed benefit of a country having its own currency vs a currency such as the euro. The euro takes away the advatantage of devaluing the national currency as a way to regain competitiveness. Bhide points out that devaluations hurt the elderly on fixed incomes and low wage workers. Protections have to be put in place for the sections of the population that are badly affected. Large union negotiated wage increases can also reduce the benefits of devaluation in terms of regaining competitiveness.

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UN projections show median age of Chinese citizens will overtake that of Americans in 2020. Yet China's median income is only a quarter of that in the U.S. Life expectancy in China today is 76, very close to that in America. In 1960 a Chinese person born that year had life expectancy of 44 years.  China is aging at the pace of Japan, and a bit slower than South Korea, but wealth per capita was three times higher in South Korea and Japan than China when the aging accelerated. A Chinese woman fertility rate today is 1.6 compared to 4.6 in 1973. A prominent Chinese economist says in a recent report that median age in China in 2050 will be nearly 50 compared to 42 in America and 38 in India. WSJ cites figures showing China will have gone from 9 working age adults per retired person in 2000 to just two by 2050. So how to pay for retirement of all these workers today? Government spending on retirement is a tenth of GDP, about half the level in older wealthier countries, and increase in spending will impact growth. Today this is about 6.2% potential growth rate. It also pushes wages up with a shortage of workers in cities such as Shenzen and X'ian even with the use of new technology and robots in factories.  Solutions are to raise retirement age currently set at 60 years, increasing labor force participation of women as Japan has done, and increasing productivity. China has transferred 10% equity stakes in four state owned financial firms to the national pension fund to shore up its finances as estimates from the Chinese Academy of Social Sciences show it running out of money in 2035. Traditionally children supported families in old age but the one child policy leads to situations where the child is working or in another city. In Suzhou near Shanghai, a retirement business sends 1800 helpers to private homes and 130,000 retired people, in a new trend. The city administration of Shanghai plans 400 neighborhood care centres for elderly by 2022, with health clinics, drop in facilities, and homes. 12,000 elderly people use one centrre in central Shanghai area of Changning. ...

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China's plan to lift all birth restrictions by 2025. The one child policy was replaced with a two child policy, and now with a three child policy in 2021, as China's birth rate declined below the level needed for a stable population. The plan now is to lift all restrictions as the decline in population is expected to be very steep. Not enough young people to support a growing elderly population is a major problem for the economy. A mindset has developed over 70 years for one or two children that is seen as hard to change. Women now work and pursue careers, their expectations in life have changed. Couples are also finding it hard to get access to schools and afford the costs of education and home space needed for larger families. Housing in most cities is costly, making it harder to raise families. Attitudes are hard to change. Experts see little impact of the new policies. The three northeastern provinces suffered most in the shift to a market economy. This is where the drop in birthrates is very steep. The government will remove all birth restrictions in the northeast before applying it to the whole of China. ...

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Population experts including Liang Zhongtang a demographer at the Shanghai Academy of Social Sciences, are not convinced the change in the one-child policy in 2013 will have come in time to reverse the trend in increase of elderly population relative to the younger population. Zhongtang says the whole policy should have been removed. According to UN projections China's labor force will lose 67 million workers from 2010 to 2030. During this period the elderly population is expected to increase from 110 million in 2010 to 210 million in 2030. Wang Feng, a demographer at Fudan University in Shanghai, is skeptical about how much difference the new policy will make. He says the figures by population experts showing a maximum of 2 million additional childbirths over the next 3 years, starting about 10 months from now won't make much difference, and these additions will not enter the labor force for another 20 years.