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The National Health Service in Britain is struggling under the effects of budget cuts, covid delays, and an aging population, says the WSJ. With the cost of living crisis and the Tory resistance to wage increases when nurses are found turning to food banks there is now a strike by healthcare workers. A former head of the NHS says the UK healthcare system is facing a crisis like nothing he has seen in his career. The UK has mistaken cheapness for efficiency in its approach to health, and it is now coming to roost. It is coming apart- people with heart attacks have to wait average one and half hours for an ambulance. Hospital beds are scarce tuning patients away. One in ten are on waiting lists for non emergency surgeries. 

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Distorted priorities from the last 2 decades and lack of investment allocation for healthcare are hurting states in the U.S at a critical time. With 16 million cases of coronavirus and 300,000 deaths in December, including over 3000 deaths a day by December 12, the situation is dire. Yet states lack the billions needed to conduct the vaccination program to pay for the trucks, get the refrigeration and storage, pay the nurses and the medical personnel, outreach costs, and other costs for a massive vaccination program. Some estimates are that states need about $9 billion for the vaccination programs. New York alone needs $1 billion. For years billions of dollars were wasted in distorted priorities that benefited certain groups at the expense of society as a whole. The very large companies that benefited paid little or no taxes. 

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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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Problems that are emerging as the AfD takes up role of Opposition in legislatures at the state level in Hesse, Thuringia and Bavaria. Finding proactive solutions to immigration, cost of living concerns and investing in infrastructure, in education, healthcare, childcare  that would improve the lives of people would go a long way to strengthening democracy at the local and state level in all parts of Germany with the help of the federal government.

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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. ...

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Efforts to increase electricity costs, healthcare costs, to rein in the deficit from 6% to 5% come at the wrong time in France from the Barnier government which faces a no confidence vote and collapse in Dec. 2024. Macron appears to have made some bad choices.

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See Tim Walz's full speech at the Democratic National Convention in Chicago, August 21, 2024 in his video from CBS News. Lyrarc has selected excerpts from Tim Walz's speech above showing what the Trump Republican party plans to do that will gut Social Security and Medicare, and kill the Affordable Care Act, gut efforts to lower exaggerated cost of medical drugs and healthcare. This excerpt shows what Harris will do to build a better life for workers and families and people across all 51 States, in education, childcare, healthcare, cost of living, and housing costs- "We’ve got something better to offer the American people. It starts with our candidate, Kamala Harris. From her first day — as a prosecutor, as a district attorney, as an attorney general, as a United States senator, and then our vice president — she’s fought on the side of the American people. She’s taken on the predators and fraudsters. She’s taken down the transnational gangs. And she’s stood up to powerful corporate interests. She has never hesitated to reach across that aisle if it meant improving your lives. And she’s always done it with energy, with passion and with joy. Folks, we’ve got a chance to make Kamala Harris the next president of the United States. But I think we owe it to the American people to tell them exactly what she’d do as president before we ask them for their votes. So this is the part — clip and save it, and send it to your undecided relatives so they know: If you’re a middle-class family, or trying to get into the middle class, Kamala Harris is going to cut your taxes. If you’re getting squeezed by prescription drug prices, Kamala Harris is going to take on Big Pharma. If you’re hoping to buy a home, Kamala Harris is going to help make it more affordable. And no matter who you are, Kamala Harris is going to stand up and fight for your freedom to live the life that you want to lead, because that’s what we want for ourselves, and it’s what we want for our neighbors."       ...

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Peas, legumes, beans are a CLEAR WINNER says the Oxford Environmental Institute, both for reducing emissions related to climate, and for fibre, vitamins and minerals, and cost.

Dr Marco Springmann, from the Environmental Change Institute, Oxford says-

 “Unprocessed legumes such as peas and beans were the clear winner in our assessment. They performed well from all perspectives, including nutritional, health, environmental and cost."

Next come tofu and tempeh and other vegetarian processed foods. Beans are the simplest and the highest in fibre, helping to increase life spans by 6%, which with good sleep and clean air, exercise and other nutritional content ,could add up to increase lifespan by a fifth and significantly improve the quality of life, reduce unnecessary healthcare visits and cost when attention is paid to the very basics of the basics.

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Brooks says no to the current health reform bill as most experts say it does little to control the bulging healthcare cost curve which will take it from 17% of GDP to 22% and beyond. He goes over the pros and cons. Passing this gets little done for health care reform in a fundamental way that is so badly needed today. Says Brooks the system today is rotten to the bone with opaque pricing and insane incentives, with consumers insulated from the costs of their decisions, this won't change with the current health care bill. In fact he says according to the chief actuary for Medicare it will cause health care spending to grow faster. At this rate we will be giving more money to insurance companies and programs that have great social value like expanded preschool and other needs that America has will be shoved aside. In coming years as the population of America ages there will be growing needs for health care. With no increase in supply, and the perverse incentives still in place, prices will continue to grow rapidly without the focus on efficiencies that is badly needed. Brooks points out that its not the politics is the chief obstacle to reform as most people say, but the reverse is the truth, unless one gets the fundamental incentives right politics will be terrible forever. ...

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Values of St Augustine are to be celebrated with Vance, and of Mohandas Gandhi with Harris. Then why the discord? End wars (Biden ending the war in Afghanistan). End migrant incursions Harris pledge to sign the Lankford-Biden legislation into law that fixes asylum entry and Closes the Border with Mexico. Cost of living that hurts the needy and middle class the most. As Applebaum writes about Housing costs Trump has no plan, Harris is willing to put government resources into it. Republicans have their hands tied by a hands off government that is supposed to do nothing and hope everything will work out. That is without corporate housing company greed in a system that doesn/t work -they set the prices too high. As Kristof writes about in the NYT the Republicans will not support paid marital leave, will not support child care assistance, will not support cuts to high pharmaceutical costs, making healthcare unaffordable even to the middle class not to speak of the lower income working class. And will not support investment in the infrastructure that is crumbling around us even as the infrastructure is crumbling around us, like the bridge in Baltimore that went down in minutes. Trump used infrastructure issue in 2016 and rightly so, and talked about it being Infrastructure Week every week, yet did nothing for infrastructure, nothing serious until Biden in 2016-2020. This a continuing project for Harris. Part of this is to end the wars (Biden's efforts in Afghanistan ending it). And end the migrants incursions, Harris 's pledge to sign the Lankford-Biden immigration bill that fixes asylum entry and closes the US Border with Mexico. ...

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The $3 billion proposed by president Biden is the first time in history that money is being allocated to tackle elder homelessness. This WSJ report shows how older boomers holding onto larger homes for retirement and aging in these homes is worsening the supply of housing. Including for younger boomers who are in their 50's and who because housing is less affordable or because of a life event or healthcare costs are facing a high rate of homelessness. WSJ's report says $3 billion is unlikely to get thorough this Republican Congress but it is not enough to tackle the problem -because people should not be destitute in this way such as these younger boomers in America as an advanced developed Nation.

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Bernie Sanders presents the case for Medicare for All, healthcare for all legislation in the U.S. Congress introduced in September 2017. It has the support of 15 Senators. He says the current system is costly, wasteful and bureaucratic. It is time says Sanders for the U.S. to join the rest of the industrialized world, join Britain, France, Germany and other countries of Europe, Japan and Australia, Canada, with healthcare for all Americans. After all he says only 50 miles north of his electoral district in the Burlington, Vermont area is Canada, where the system of healthcare for all works better than in the U.S.  And the Canadians, Germans, French, and British do this spending less than half the U.S. does. In 2015 the U.S. spent $10,000 per person for healthcare, this means that it cost less than $5000 per person in these advanced countries and the way they do it can be studied and its best aspects adopted by the U.S.  He says this is because the U.S. healthcare system is designed to maintain profits for the medical-industrial complex. A major problem is the manner in which the issue is distorted by different sides on the issue of health care in the U.S., without a consensus being developed on what the common interest is in a civilized society. Mostly because the U.S. unlike other societies is still grappling with the issue of what values it embraces on healthcare being made available to all. Under this legislation the transition to healthcare for all would take place over 4 years. In the first year eligibility for Medicare would start at age 55 years, and children under 18 would be covered. In the second year the eligibility starts at 45 years, in the third year at 35 years, in the fourth all are covered.  ...

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Former Senator Jim DeMint lays out his reasoning for the Republican fight to defund ObamaCare, as the healthcare legislation is now called by Republicans. He points to problems with the legislation with issues about how much the added entitlements will cost in the future( more than the $250 billion by 2023 estimate of CBO insists DeMint based on the general lowballing of projections), and higher premiums for the young and elderly on exchanges. He says the 2012 elections were fought on economic issues not ObamaCare, and that the public he has met in visits to different states as president of the Heritage Foundation continues to be skeptical about ObamaCare. He sees the correct role of the Opposition party to point out the deficiencies in the law and call for corrections in the path for healthcare.

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Fact checking Apple CEO Tim Cook's statements on the EU Commission ruling for $13 billion in back taxes, shows that CEO Tim Cook's statement that "we never asked for, nor did we receive any special deals," is not true. Ireland let Apple determine what it would pay in tax, and Apple had the benefit of loopholes in Irish tax laws, the fact check by experts shows here. Apple's Cook also says it would hurt investment and jobs in Ireland. Another NYT article showed that the entire healthcare budget of Ireland would be covered by the $13 billion, and 66% of its budget for social support services to the public. Apple has 22,000 employees in Europe and 6000 in Ireland in 2016. Based on the $13 billion owed in taxes, for every job in Ireland the cost to Ireland is 2.17 million euros, and for every job in the EU the cost is 590,000 euros. Apple could turn around and locate in some other place, other than Ireland, in which case Ireland does not get the 6000 jobs. This is Ireland's incentive to give Apple tax benefits. Only if all EU countries had common tax laws would it be possible to avoid this situation, and generate much needed tax revenues at a time of cuts in public spending in healthcare, education, and social services, and invest in infrastructure, worker retraining. The alternative is for the EU to look at other remedies. This is what the EU Commissioner Vestager did when she announced that this was a state subsidy and illegal under EU rules. Because the appeal by Apple goes to the EU Courts the appeal is difficult say legal experts. The EU courts look at the legal aspects of the ruling, was it justified, not at the overall aspect of the ruling by Vestager, as EU Competition Commissioner. This may be why there is so much outcry from Apple, and other digital companies.  ...

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A small town mayor who says he will fight with Biden for workers and families in every county in Pennsylvania wins the Senate seat against aTV health show host favored by Mr. Trump. The scrappy fight put up by Democrats on their own in different parts of the country is the main takeaway from this election for control of running 36 of America's 51 states and control of Congress. Fighting an election with major legislation on controlling healthcare costs and for renewable energy, infrastructure investments, Mr. Biden and fellow Democrats was forced into a back to the wall fight because of price increases from Russia's war in Ukraine. Voters took notice not falling for the message on inflation alone that is being tackled by the Fed's Jerome Powell, giving room for seeing the larger picture.

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Americans in retirement are able to rebuild their savings with interest on money market funds of over 5%. This is the result of 5% percentage points of consecutive rate increases by Jay Powell's Fed. In addition about $121 billion went to savers as they faced $151 billion in higher interest rate costs on mortgages and loans. The result with a strong labor market and lower inflation of about 3% is an economy that is resilient and can provide the 5 or 7 plus  years of growth needed for America to meet the challenges it faces with its allies in the EU, Asia and Latin America, Africa- to tackle climate change, to rebuild America's crumbling infrastructure, to invest in education and healthcare, to improve worker incomes, and build its manufacturing at home into a strong thriving sector for good paying worker incomes.

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Infratest Dimap polling institute is commissioned by DW.com to find out what Germans think of the refugee policy of chancellor Merkel one year later. In summer 2015 Merkel said on Aug 31, "We can do it." Costs related to the refugees are about $17 billion, do Germans think services are overstretched for education, healthcare housing and other services. On the other side German society is aging and for every 100 unemployed people there are 200 open positions for skilled personnel. But the refugees who are accepted do not have the skills required and have to acquire the skills or given training and education. On this issue DW.com asked the question whether it will strengthen the German economy. About 51% agree and 45% disagree on this question, and about the same number agree and disagree on the question that Germany will be overstretched providing the services for housing, education, healthcare and other services. The higher educated and young are more favorable to accepting refugees, with those over 50 and basic schooling unfavorable. On the AfD side most people are unfavorable, and in the Greens party most are favorable. On terrorist incidents probability, over 58% think this is more likely, 38% disagree. On the question of whether this will make Germany more diverse 56% agree, 40% disagree. Overall the situation appears to be balanced, with a range of views expressed, and the positive and negative sentiment "evenly balanced", says DW.com.  ...

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Americans Save Early and set aside for savings 10% of your pre-tax income, is the advice to ensure a safe and healthy savings retirement. This is absolutely critical. What the government can do is to ensure that incomes keep uo with inflation with fair wages in industry. It also can and should protect Americans from unexpected medical costs by ensuring that all Americans are covered by health care and for catastrophic situations. Then it is the task of Americans to build a culture of careful saving that their ancestors had and considered a essential part of virtue. For this to help build savings for retirement the government and the Federal Reserve together- as Biden and Powell have shown one with capital investments to build a strong economy and the other by protecting savings and cost of living action- must ensure that no financial crises take interest rates to zero or 1-2%. At interest rates of 5-6% for returns this helps build savings for retirement. For this to happen banks have to go back to their traditional work in the economy and no speculation risk, and Silicon Valley go back to inventing and not a culture of capturing capital allocation in capital markets and paying little in taxes. A new culture would put government in its right place to ensure that it plays a significant role in building manufacturing and science and technology in the US as president Biden has done through government investing in infrastructure and renewable energy, chips and science, and in education, healthcare.  ...

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This editorial in the WSJ shows that culture wars distract even the major candidates of the Republican party from providing the American public with positions on serious issues of cost of living, healthcare, education, infrastructure, new technologies such as EV's, and renewable energy transition. The wars in remote parts of the world acted as a distraction during the Bush, Obama and Trump administrations from these serious issues. As the WSJ points out much of it ends up being effort to gain personal advantage in some way.

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Howard Dean, former Governor of Vermont, where Dean helped set up health care improvements, says the bill currently in Congress for health care reform does not deserve to be called reform and may do more harm than good. He points out that it does not insert competition into insurance markets, does not significantly lower costs, and does not improve the delivery and use of health care services. And few Americans will see any benefits till 2014, by which time premiums will have increased significantly. He sees insurance companies as winers in this bill, and the American taxpayer about to be fleeced with a bailout in a situation that dwarfs even AIG. One of his keen criticisms is already apparent to the public in this health care bill, that clear thinking has been thrown out in favor of compromise and political calculus, and by political moves the bill has been stripped of real reform , the end result being a bill crafted for votes and not to reform health care. It also then sets an irreversible course of how future healthcare reform is done, doing more harm in the future. ...

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Democratic states face a sobering reality- can California, Minnesota, Illinois afford it? It turns out that they cannot and are diverting important funds away from the Nation's priorities in transportation, housing, education, rural healthcare. Here is what happened-- When California Gov. Newsom used state's Medicaid budget for poor citizens and disabled for illegal migrants to give free coverage, Medi-Cal went $6.2 billion over budget in 2025. In Illinois the program for Medicaid coverge to illegal migrants estimated at $112 million annually now costs $800 million and parts of it are now suspended. California had not thought this thing through, with free medical coverage not available to even citizens of the US, why would unrestricted borders not overwhelm a border state's Medicaid system signed into law by a Texan president Lyndon Johnson for the people of this Nation. Democratic States are running into a logical fallacy that the European Union and Germany are already experiencing, stretching straining public services, which has nothing to do with one's sentiments. Gov. Newsom now wants to give this benefit for $100 monthly premiums in 2027. ...

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Many of the News properties of Rupert Murdoch take positions that negatively affect women, inequality and mobility, cost of living, income and wages fairness, climate change action, government investment in infrastructure, healthcare, and education, childcare. After Rupert the media properties go to the 4 children  Lachlan, James, Elisabeth and Prudence with each getting one vote under a irrevocable trust set up in 1999 in Reno, Nevada. Rupert and James says this story in NYT are making efforts to amend this trust to change governance provisions for the news properties so that Lachlan has majority voting rights. This is now opposed by James, Elisabeth and Prudence with courts in Nevada asked to see if this is in good faith and in the interests of all 4 children.

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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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Voters took note of the quality of each candidate, and Democrats were scrappier  in the fight this time around to give a tight result. Voters did not know much of what Mr. Biden had done to cap healthcare costs in midterm elections for 36 governors races and for control of the US Congress. The pocket book issues mattered to voters with sharp increases in the price of oil and groceries, but less so than made out earlier and voters may have grasped the bigger picture.

The quality of candidates mattered and on the Republican side the influence of Mr. Trump in the primaries led to choosing weaker candidates because of their loyalty to Mr. Trump. In the end with a large turnout of voters on both sides the election was much tighter than expected. Democrats in each state did better using their own initiative and effort this time and were much scrappier in the fight for the Governors races and the Senate.

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How the French health care system works. France comes in first and the USA 37th in aWHO health care ranking. THe difference in deaths from respiratory disease is half that in the USA, and lower rates of death from heart disease and diabetes. IT has more hospital beds and doctors per capita than the USA. 65% of French people are satisfied with their health system compared to 40% in the USA, and yet France spends 10.7% of GDP on health care and the USA spends 16% for poorer results. THe French system is more generous to its seniors. Unlike Medicare there are no deductibles, just modest co-payments that are often dismissed for chronically ill. And diabetes and critical surgeries are covered 100%. French also buy supplemental insurance like Medigap for extra expenses like dental and eyglasses. Cancer patients are treated free of charge. Avastin treatments costing $48,000 a year are provided at no charge. France's PMI or Protection Maternelle et Infantile, is rated highly. It is anetwork of thousands of healthcare facilities, that ensure that every mother and child in the country receives basic preventive care. Mothers even receive afinancial incentive for attending their pre and post natal visits. France makes this care affordable by reibursing doctors at a much lower rate. The average yearly net income for doctors is around $55,000, about athird of what doctors in the USA make. But French doctors don't have to pay back huge student loans as medical school is paid for by the state and malpractice insurance premiums are only a tiny fraction of that in the USA. And again the French government pays two thirds of the social security tax for most French physicians- which is typically 40% of income. So the $55,000, is more like $92,000 taking that into account and more like $110,000 when student loans and malpractice is taken into account at US levels. Specialists who have 4 or more years experience can charge what they want, but as one gastroenterologist says, there in an unspoken and undefined limit to what you can cahrge or what is socially acceptable. Yet even in France there is inflation in health care costs that the government deals with through price controls and more spending. The French national insurance system is running increased deficits each year and this is now $13.5 billion, and it has led to higher taxes for employers and workers. ...