LyrArc Article Gist
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.

LyrArc Article Gist
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....

LyrArc Article Gist
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.

LyrArc Article Gist
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. ...

LyrArc Article Gist
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. ...

LyrArc Article Gist
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?  ...

LyrArc Article Gist
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. ...

LyrArc Article Gist
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.

LyrArc Article Gist
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.   ...

LyrArc Article Gist
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. ...

LyrArc Article Gist
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....

LyrArc Article Gist
The NYT covers the GAESA tourism enterprise of Cuba (that operates independent of the government of Cuba) that overinvested in Tourism at the expense of agriculture industry and infrastructure during the Obama administration, leading to collapse with Trump's 2014 embargo on Cuba. GAESA controls about 50% of Cuba's economy, run by military and people from Castro's family.  That left 121 hotels built in the boom years of tourism at 30 percent occupancy. The Iberostar high rise hotel is one of these hotels that rises over dilapidated housing in Havana, the Cuban capital. The investment in tourism by the GAESA enterprise that runs about 50% of the Cuban economy is 13 times what is spent on healthcare and education, says the NYT. The Castro family, Raul Castro family, runs this business venture that was started when the Soviet Union as sponsor of Cuba had collapsed by 1991. The NYT says this 'devolved' the ideas and promise of the revolution. "Devolved?" What kind of word to describe a complete loss of faith, and enormous failure with severe hardship for the Cuban people? It means the whole idea of communism or Marxist revolution has been proven false, even as it survives in Mexico and parts of Latin America. One can be against the Batista regime- similarly against corrupt regimes in Latin America or Asia- that ruled Cuba before the Castro Cuban revolution and still look for better choices and alternatives than what Castro came up with as an answer to Cuba's needs. Much of Latin America is suffering from the same problems of dictatorships and turning to Marxist alternatives - particularly the alternative put forward by Castro in Cuba- that has also destroyed the Venezuelan economy with Chavez's turn to Castro's Cuban revolutionary slogans and ideology. That came up with temporary solutions for the poorer sections of society, yet failed badly for all sections of society in the long term. How else can one explain one fourth of Venezuela's population and about the same of Cuba's leaving the country, some of those who left the critical human capital that would form the core of the human input to combine with capital and technology for advancing the economy. If Cuba were like the Dominican Republic or other parts of the Caribbean to depend on tourism for its national income then would it not be better to have friendly relations with the US, the main source of tourism revenue. The Obama administration was only holding up a failed idea by holding out a helping hand to tourism in Cuba knowing full well that a change to a Republican administration would simply lead to heavy investments in tourism at the neglect of infrastructure, public services and the economy, of health and education, to become large economic losses. This is what has happened.  As China and India have proven and are proving there are no magical ways to economic development- the same route that was traveled by the nations of Northern and Western Europe with scientific advances, technological advances, have to be taken, the same route that was traveled by the US in its industrial revolution and building of infrastructure, that same route has to be taken by all nations. It does not have to take a time period of centuries as in Europe. The US accomplished it faster with new technologies and vast human and natural resources over 100 years, Japan in 50 years, China in 30 years. India in 25 years ongoing.There is room for intelligent solutions to problems, for speed and tapping into new technologies, yet the same inputs of land, labour, capital and technology have to be put together for development. For states or regions, cities, within China and India, the same inputs, the same access to foreign investment and new technologies is the only route to rapid development. Long range plans are set in motion, decades of stable efficient, clean governance is put in place, and alliances are built with the nations of Europe and with the US. This road is traversed though hard work as Japan and China have done, and India today is thoroughly engaged in. ...

LyrArc Article Gist
Where do you place a winner of the Democratic primary in Maine, Graham Plattner, an oyster farmer who dropped out of college at George Washington University, served briefly in the Middle East wars of Bush and Obama, and had PTSD. Is he working class, middle working class or is he from a downwardly mobile professional class considering he has parents who are well educated and father a prominent lawyer in Maine? Plattner easily defeated a 3 term governor of Maine with his average working class demeanor and language. He is for universal health care, (Medicare for All) universal child care, affordable housing, affordable college. Politics in the US has been moving away from the simple divisions before 1950 created by the Industrial Revolution- the workers in factories and the owners of capital allied with the professional middle class. The few owners of capital mostly college educated allied with people from the non college educated workers in factories who are conservative in their values and beliefs and on the other side the college educated professional middle class now downwardly mobile because of the many recessions and high unemployment from frequent financial crises, with college costing $80,000 a year putting them in deep debt. There is today in the WSJ a story of a professional worker who at $194,000 a year salary is not able to payoff $15000 debt which owners of capital have set at 26% interest and is in downward spiral. Some of this comes from large college and other debt. There is says WSJ Analysis $1.25 trillion in credit card debt alone with highest delinquency rates in decades in 2026. Cost of living has only made things worse and some of this happened as Biden poured money into the economy to help people hurt by the pandemic, yet with some short run consequences with demand strong businesses including hotels, restaurants and grocery stores, auto dealers, jacking up their prices by over 20% in 1 year and Biden failing to respond, getting overwhelmed by open borders migrants under Mayorkas and Harris (also hit by a sudden Venezuelan migrant influx). This is the America one has today- a confusing mix. This in reality means Democrats may take issue with Democrats, Republicans take issue with Republicans, and Democrats join with Republicans on issue by issue basis. It might actually be rational than irrational. On cultural issues if the country has gone over its head and moved too fast on some issues that are not for the general public good, people of different backgrounds can come together to get the best path. On economic issues things are never so straightforward, there are unpredictable consequences and the rules of economics are really not so straightforward either.  Providing relief can mean the government shouldering the burden as during the pandemic which it should, yet with caution as businesses can use the excess demand to raise prices and one is back to square one with everybody worse off as happened with Biden. Migrant flows and fears of insecurity in public spaces can lead to a severe public "discomfort that can waylay the best intentions of a Harris or Biden, leading to public "backlash." In fact the title of a recent book is "Whiplash." Current books include Floridan Marco Rubio's "Decade's of Decadence- How our Spoiled Elites Blew America's Inheritance of Liberty, Security and Prosperity." Rubio means it. Its authentic because as Rubio says repeatedly, his parents could make a living in the 1960's working in a factory with decent wages, low cost of living and low cost of college, the arithmetic between salaries and what you needed for decent home in suburbs and sending children to good public schools, then to college, all adding up. The result is that Rubio could go to college and serve in the Florida legislature. Rubio says in 2026, after the elites under Bush and Obama and faulty economic theory shipped all of our factories to China, that the story of his parents and his education would simply be impossible. This is what he told people in India on his first visit last week. His parents were Cuban immigrants, yet he identifies with Spain and with western civilization, a devout Roman Catholic. Rubio is a Republican, and is in large contrast with Alejandro Mayorkas, also from Cuba, and Biden's Head of Homeland Security. This is the mix of people and representatives in Congress,  business people, small business owners, professionals, that we have today in 2026 in the US. Plattner and Rubio, one a Democrat and one a Republican- both have something in common. Plattner also has general disdain for "the corporate interests, the billionaires, the Washington DC elites, and the establishment politicians."  The winds are blowing in the direction of getting things right- remembering that Eisenhower continued the work of the Kennedy and LBJ administrations (Eisenhower built the Interstate Highway System for instance, and LBJ gave America Social Security and Medicare). Before that Franklin Roosevelt a Democrat built on the work of his uncle Republican Theodore Roosevelt (TR gave America the idea of good governance and built the US Navy, FDR fought the Depression and stabilized a faltering economy after mistakes made by Republican Herbert Hoover could have happened even if Hoover was a Democrat. FDR was himself from a wealthy New York family and when he first met fellow New Yorker Frances Perkins before his struggle with polio, a haughty New York gentleman. That was before Frances Perkins as FDR's Labor Secretary joined forces with Roosevelt to give New York a modernized administration governance structure by 1940 that was applied to all 51 states after 1950. It allied labor with capital with fairness for all, and was the first such modern structure of this size the world had ever seen, which was the fundamental strength of the United States of America. It was imitated in Asia, first in the Shanghai region then China, and first in the Ahmedabad region and now India. The US is faced with the challenge of recreating and rebuilding this today, as first China, then India remind America of its roots which they have followed in their own style and culture.  First good governance, then good institutional structures, alligning labor and capital with fairness for all, strong affordable + accessible educational and healthcare systems, and investments of capital and labor for infrastructure + industrial development. ...

LyrArc Article Gist
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....

LyrArc Article Gist
Share of US Counties where 95% of Kindergarteners are vaccinated against Measles drops to 28% from 50% in Washington Post Investigation of 44 states December 2025. 95% vaccination rate is what experts say is needed for "herd immunity" or overall protection in a class. Washington Post examination of data shows marked deterioration from 2018-2019 school year to 2024-2025 school year data and public records. That is 5.3 million children are exposed from lack of herd immunity from measles now compared to 3.5 million children earlier increase of 1.8 million children. This Wash. Post investigation shows 19,000 schools are exposed and one can go to this article to find on a map how your school district and country are doing in the 44 states. A big problem is emerging from public skepticism and politics in vaccination. For generations schools required vaccination proof- by 1980 all 50 states had laws covering students first entering school. And caught in vaccine politics legislatures are creating religious and other exemptions that have weakened laws. Wash. Post says it's examination shows not a single County in Idaho, Louisiana, Oregon Tennessee, Utah, and Wisconsin meet the 50% vaccinated requirement for measles required for herd immunity. This could mean more of these diseases will be brought back home including whooping cough to affect elderly and infants. Democratic districts such as in St Louis and Chicago also see drop in measles vaccination rates. In the sense that newly decolonized countries since 1950 such as China and India have emerged with good health systems and mandated vaccination , other public health action, there is a great need for the US to focus on bringing back the public awareness that existed after the 1940's in the US that resulted in significant advances in public health in the US in the FDR, Eisenhower, Kennedy, LBJ and Reagan administrations. It shows there is no victory in public health. A lot of work needs to be done, as much of the gains can get undone by events and public awareness is necessary. As pharmaceuticals, chemicals and plastics and bad nutritional habits took over American lives there is an effort under Kennedy at HHS to tackle that health crisis, but it brings with it challenges that date from the pandemic and different responses in different parts of the US to mandatory vaccination which also have to be met through education not social media. ...

LyrArc Article Gist
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. ...

LyrArc Article Gist
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....

LyrArc Article Gist
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.  ...

LyrArc Article Gist
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.     ...

LyrArc Article Gist
Elite universities with a third foreign student enrollment displacing Americans, are facing US government funding cuts. This report shows these universities turning to pharmaceutical companies and big tech monopolies that have placed added burdens on cost of living of ordinary Americans, and mental health of children, on the ability for basic literacy by 4th grade. Somewhere the basic goal of the university to educate Americans is being lost. For no more than 5 to 7% of funding these universities are willing to turn to companies that have exacerbated the cost of living crisis or monopolistic behaviours in the Nation, particularly the pharmaceutical companies, showing alevel of misguidedness in management that fails to understand the real interests of ordinary Americans. In pursuing science alone at the expense of everything else and derelict of leadership where it is needed such as cost and value, this behaviour ignores the fact that the greatest dangers to public health come from cutting chemicals in food, in healthy food and exercise habits cultivated in schools, raising the consciousness for healthy living and healthy environments in the Nation. The schools of public health at the Nation's leading universities needed to take a better stand on the dangers of proliferation of  research into viruses, and to single out breakdowns when they happened that are seen by many to have led to the pandemic.  ...

LyrArc Article Gist
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. ...

LyrArc Article Gist
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.   ...

LyrArc Article Gist
This report in the WSJ points to president Biden's speech to a joint session of the US Congress that providing two years of free community college would "change the dynamic" for education in America taking the first step to correct a dangerous drop in college enrollment for young men in America and ensuring working class families have access to college education. The last thirty years of skewed wealth distribution, loss of manufacturing in America, have created alarming distortions in  the access to college education for working class families. Mrs. Biden is a fervent advocate for community college access in today's America, as a community college teacher for 30 years. Biden's $45.5 billion 5 year plan would waive tution for 2 years of public community college. States would have to opt-in to participate, and federal government would provide 100% funding in the first year, decreasing contribution by 5% each subsequent year, with states picking up rest of the cost. It is quite shocking that this is being dropped from the Biden $3.6 trillion Families and Workers Plan that is now being whittled down to $2 trillion. Not because it is not badly needed for American economic competitiveness, and helping workers and families. But because following narrow parochial interests the National Association of Independent Colleges and Universities opposes it. And because the US Congress is evenly split between Democrats and Republicans 50-50 in the Senate. The Association of Independent Colleges sees a shift to community colleges and a sharp drop in its enrollment. Community colleges saw a dangerous drop in enrollment of 12% to 4.5 million students in 2020 from the spring of 2019, according to National Student Research Center. Never was a program more badly needed, as American men are alarmingly falling behind in enrollment. Here are some responses to the failure to take even the first steps to broaden college access so that America can return to economic competitiveness. "What kind of world do we want to live in?" Martha Kanter, College Promise. "That's kind of a devil's choice, isn't it? The whole system has to work from infant care all the way through." Senator Tina Smith, Democrat of Minnesota. This is because child care and children's education will be funded yet a struggling generation of college students will be left out. US Chamber of Commerce opposes a $45 billion program that is critical to American competitiveness with China and other countries. US Congress drops a program that at $45 billion is only about 2% of the $2 trillion package and which is critical to economic competitiveness. Former Republican Governor Bill Haslam of Tennessee supports community college access as a pillar of economic development and it passed the supermajority in 2014. Mike Krause, Republican former director of the state higher education commission says- "I have been surprised by the lack of enthusiasm for what is really a massive workforce development concept that also provides a path to the middle class. You'd think that would hold some appeal for Republicans and Democrats." The lack of clarity and concentration, lack of unity of purpose to get all vaccinated,  is visible in America's vaccination drive. That same lack of clarity and concentration, lack of unity of purpose, is visible in America's faltering efforts at correcting serious and alarming problems for access to college and American competitiveness in the world. Julie Bykowicz and Douglas Belkins wrote this article in the WSJ.   ...

LyrArc Article Gist
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. ...

LyrArc Article Gist
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.  ...