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It is no surprise what we see in the US today- the loss of the middle class, the unaffordability crisis for education, healthcare, childcare, and poor, broken infrastructure. Over 10 years the US trade deficit with China has led to loss of about 25 million jobs and $250 billion in taxes that support local infrastructure and public services. Where 20% of the people do 80% of the spending, 80% of the people only 20% of spending (Moody's Analytics). This is how the uneven trade led to the destruction of manufacturing centers and communities across the 51 states in America, devastating families and young people. This is no longer Washington's, Lincon's or FDR's land of opportunity. Each $1 billion in additional imports to the US costs 4252 jobs. (CPA) This can be read as how many jobs are being lost in the additional trade of goods when one side is exporting more than the other.  There are three levels of losses. There is also an indirect job loss in the number of jobs created by that one job in manufacturing to serve the needs of these factory families in communities. This can be estimated at 1 job that depends on 1 manufacturing job. Together this means 8500 jobs lost for every $1 billion of goods in a trade deficit. US trade deficit of $295 billion in 2024 with China translates into about 2.5 million jobs lost every year. Over 10 years this is about 20-25 million jobs, enough to decimate America's entire manufacturing capabilities and manufacturing infrastructure, whole communities and towns disappearing or suffering destruction across the country.  With the loss of these jobs comes a third cost, the taxes paid that maintain small town infrastructure and public services like libraries, schools and health centers where these factories are located. At $10,000 in taxes lost per job, for 8500 jobs lost per $1 billion in uneven trade there is a loss of $85 million.  For the $295 billion deficit the US has with China this loss adds up to $25 billion per year. Over 10 years this means taking out this much in local infrastructure and public services like libraries, schools and health centers worth $250 billion.  ...

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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. ...

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Asked about it yesterday January 16 DJT tells the press outside the White House after a meeting announcing his Great Healthcare Plan, it is a good thing that Canada has signed a trade deal with China. It reflects the new view not clearly understood or told in the press what US trade policy is about. US trade policy in 2026 is about bringing investment and jobs back to the US to rebuild communities and towns across 51 states- once destroyed by the foolish trade policies of the Bush-Clinton-Bush-Obama 3 destructive policy decades. Supplementing this with the investment favorable policy of instant depreciation for investments in plant and equipment in the Big Beautiful Bill of 2025. Using tariffs to level the playing field and ensure fairness in business practices by industries and nations towards America after over 3 decades all else has failed. All the time protecting Rural America, and communities and towns across the US devastated by outshoring. Using Tariffs to make certain that drug and migrant trafficking, and hostile unelected governments in the western Hemisphere cannot take place with direct and  indirect intervention in the western hemisphere by foreign powers. To do this with the Monroe Doctrine Corollary set by Teddy Rooosevelt in his Annual Message to Congress of 1905- "A great free people owes it to itself and to all mankind not to sink into helplessness before the powers of evil." Under such a policy Canada can pursue trade deals with China as the US has done. The clear rationale for the US policy is nowhere evident in the press today, how trade and domestic policy and foreign policy converge to protect all Americans, even though this was something that was pursued under the Biden administration with mistakes made in handing the Border management to Mayorkas and Harris incompetence. In the use of Tariffs doing this in such a way that US economic interest, investments, capital and stock markets are protected by carving out areas of exemptions in the policy. This has given the US an highly advantageous use of Tariff policy in ways not reflected in the press version of Tariffs. As TR pointed out, as Lincoln pointed out over a century ago, the interests of both Labor and of Capital are both legitimate and vital for the Nation. It is time to see this as one whole and not separate to rebuild America.   ...

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Problems with China's health care system stem form years of underspending. About 1% of GDP went to healthcare in 2006,according to the WHO, ranking China at No. 156 of 196 nations. This underinvestment has caused great hardship to the rural poor who have postponed or been denied access to healthcare because of exorbitant expenses. It shows up in the number of trained medical workers- only 17% of China's medical workers are university graduates. In village and township clinics the number falls to 2%. The government has dedicated $121 billion for health care through 2011. But this may not be enough. Aobut 300 million in the rural areas have no coverage at all. The government's plan is to get farmers insured through county level rural- cooperative insurance plans. These programs begun in 2003, offer only scanty coverage. Outpatient services and medications are not covered and coverage varies from county to county for hospitalization bills. The goal of th health ministry is to get the coverage for hospitalization bills up to 50%....

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The private sector ignores health insurance. And state coverage in China is inadequate. More than two thirds of China's 1.3 billion people have no health insurance at all. If you have insurance you still pay up front in cash, if you do not have the cash up front you cannot get a surgery, treatment of any kind or any drugs, even if the insurance will later reimburse you. The Chinese health care system is dysfunctional and in a crisis because of the way it is structured, and the faulty policy incentives. It caps prices for basic drugs and procedures at below market rates, yet it lets hospitals profit from everything else from advanced drugs to sophisticated diagnostic tests. So hospitals invest heavily in technology and expensive testing. and drug sales account for 45% of revenues. And enforcement is lax. Doctors in Shanghai make monthly incomes of about $400, about what a taxi driver makes, so they supplement their income with bonuses earned by prescribing more expensive tests and drugs. There is no utilization review so the state reimburses for whatever the hospitals charge regardless of whether the test was needed or not. So the system is dysfunctional and lurching towards a crisis. In fact heavily burdening the middle class. The private outlays and burden of total health care spending has increased from 20% to 60% of total health care spending from 1978 to 2003, as the the health care system got the same dose of unfetterred capitalism as the rest of the system. The Government's share of total health care spending has dropped sharply. In addition there are design flaws that push expensive care and build in incentives for expensive care at the expense of good medical care. The government recognizes this problem and sees it as athreat to social stability. It has committed to increase spending on healthcare. ...

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President Biden removes one of the costly boondoggles thrust on the American people with Bush's Drug Improvement and Modernization Act of 2003, which was anything but an improvement. .The following are the 10 pharmaceutical drugs that will be negotiated for Medicare prices under the Inflation Reduction Act- Eliquis and Jardiance (strokes), Jardiance, Xarelto (diabetes), Entresto (heart failure), Enbrel (arthritis). Laws passed under Republican president younger Bush incomprehensibly took away the right of the government to negotiate drug prices with pharmaceutical companies in one of the most egregious and costly decisions in postwar history by the government of the United States. It has only aggravated the problems and cots of healthcare for the American people. President Biden reversed this with the passage of the Inflation Reduction Act during the pandemic. Strangely it is part of the real culture war in America in which about 80% of both Republicans and Democrats support this but the media allowed the Bush legislation to be passed without saying it made no sense to say this negotiation was a form of price controls by the US government. This is how low the US policymaking had fallen by 2003 with legislators and press unable to make a simple point. Bush's legislation was called even more incomprehensibly the Medicare Drug Improvement and Modernization Act, when it was one of the biggest financial disasters for the American people costing them hundreds of billions of dollars in their savings and incomes to pay inflated prices of pharmaceuticals that people in Europe and Asia (India and China) were not paying.  ...

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With a mere 1% of GDP invested in public healthcare India remains backward in its commitment to the welfare of the rural poor. Prime minister's Modi's plan is laudable says this BBC report, but the record of implementation is spotty at best at the state level for such plans. The new plan announced in the 2018 Indian Budget is for a health plan covering 500 million Indians with 5 lakh rupees coverage, something never tried before but with a cost of a mere $1.7 billion is something that the country woefully lacked or neglected to tackle.

This plan may be better implemented at the national level, and particularly where the reputation of the governing party and its plans for industrialization are at stake in the coming year's national elections. If accomplished and the Modi government is eager to take on these challenges it would be a significant step to balanced and overall development of the Indian economy.

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This columnist opinion in Le Monde reflects the view in Europe that the US is in retreat, and in some quarters such as NYT that the new US foreign policy that sets the Monroe Doctrine as key aspect of foreign policy is a retreat- US setting the rules in the Western Hemisphere around democracy and governance. It says the US has set aside the ambition first proclaimed in 1945 and revived in 1991 after the fall of the Soviet Union. US administrations under Clinton and Bush took this posture after 1991 of dominant position but it did not reflect reality. US like Russia was dragged into many remote conflicts that had little to do with the standard of living, and economic advancement of the US. The US has a dilapidated infrastructure, broken healthcare system, and operates in a world trading system that has deindustrialized the nation and shipped out jobs and factories for 20 years, and worse is exposed to drug and people trafficking gangs in Mexico and Venezuela. The Monroe Doctrine 1823 asserted the US right to keep European colonial powers out of America, and it was possible only because the British also supported it in the 19th century till the US built up its Navy under TR and FDR. With Russia recognized as a European power the US is able to get its support for the US to tackle the situation in the Western hemisphere presented by drug and people trafficking gangs in Mexico and Venezuela. Tariffs are intended to get a new world trading system with new rules. Infrastructure building is underway on a scale that will far surpass China by 2030. This is not a retreat but an advancement for the Nation and the American people after three decades of failed policy. It lets the European powers Germany, France and Britain deal with Russia's requirement that NATO withdraw from its borders and recognition of Russia as a Northern European power. European history has shown that since 1700 that when faced with a majority of nations in Europe any dominant power in Europe is forced to negotiate a peaceful resolution of conflict because of it's limited resources to carry on a conflict. This should lead to a peaceful resolution in Ukraine, that allows rebuilding, and also gives the US an opportunity to rebuild its economy and standard of living for the American people. This will be a win-win for both the Russians and the Western Europeans, and both Latin America and the US, China and the US, India/Japan/Brazil and the US. ...

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Negative interest hurt the vulnerable the most- consider how much in interest would have to be deposited in retirement accounts savings of retirees to make up for lost interest over two decades. It could be in the hundreds of billions of dollars. It has added to the poverty in the Nation as interest income went gradually to negligible amounts. It also disincentivised savings,  and reduced the cost of capital so that hundreds of billions of dollars of retirees and other people's income was shifted into startups and dubious investments that did little to add to essential public services, education, healthcare, that would improve the quality of life for workers, families and children.It was in effect a misuse of economic policy to serve one section of the population at the expense of the large majority of the people in the Nation, and a shift of hundreds of billions of dollars over two decades from the vulnerable who needed it most to other uses. And aggravating the situation resulting from the failures in investing in manufacturing in the US that put whole communities at risk, neglecting the investment in infrastructure that helps ordinary people the vast majority in the nation the most. Only now are these investments being taken up by the Biden administration reallocating funds to infrastructure, manufacturing and clean energy, to retirees, and to communities across America. During this time of two lost decades for America, and into the future, the great nations of Asia, China and India, have advanced and are advancing with focused attention on the needs of all the people in their nations, and most importantly of all in advanced infrastructure and advanced manufacturing.  ...

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Orlik says higher inflation means China's gdp growth in 2012 was actually about 5.5%. Stephen Green of Standard Chartered Bank includes rising prices of health care and education in an alternative measure of inflation and based on this GDP growth is 5.5%. This is lower than the official estimate of 7.8% for 2012. Labor markets are tight suggesting China can still manage at this slower level of growth without risking the problems from high unemployment. The additional flexibility gives China's new leaders room to address problems of inequalty, rural-urban disparities, pollution, healthcare, education, and the need to refocus development away from state owned companies, for a balanced development approach.

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Most people would not guess or recognize that this place where elderly people in society were treated shabbily is a country in northern Europe, and a country where citizens pay high taxes for precisely better healthcare across different age groups. Sweden is where about half of the 6000 people dead from coronavirus were elderly people.  Over the last two decades Sweden has cut hospital capacity and discouraged elderly people from entering hospitals during the early period of the pandemic, says this report in the NYT. The for profit nursing homes in the centre of Stockholm were unable to cope. Having turned the work in these homes to low wage workers, it put these workers and the elderly at risk with lack of staff, lack of adequate PPE oreven  basic masks, says this report in NYT.  One of the lessons of this pandemic is the failure not just in turning over manufacturing of health care equipment and pharmaceuticals to China, but also turning over the basic care of elderly to for profit institutions that were totally unprepared and could not give elderly the dignity and care they deserve. Year of cuts to public services and health services now showed in a glaring way what can happen when this is done. It has lessons for countries from Europe to North America, and to Latin America, India and other Asian countries as they redesign policy and allocate resources to public services in the next 10-20 years. ...

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

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Amazon expands during the pandemic when retail on line delivery has helped people reduce trips to the grocery or retail stores. Amazon hired 427,000 people to expand its workforce to 1.2 million people by November 2020, 9 months into the pandemic. Almost doubling the employee workforce. These workers are mostly at warehouses, with some software engineers and hardware specialists. This includes hiring in India and Italy and is worldwide hiring. This does not include 100,000 temporary workers for the holidays, and 500,000 delivery drivers working for contractors.  Only hiring of 230,000 people by Walmart about 2 decades a ago in one year comes close. Walmart hired 180,000 people during the pandemic. Walmart has 2.2 million employees. With the expansion underway Amazon looks to become the largest private employer in the world in 2 years, say experts.  Amazon pay is $15 an hour after an increase of $2 recently. Its coronavirus safety practices have been upgraded after early criticism in April and May. Recent expansion in Italy and in India are also part of worldwide expansion after Walmart has pulled back from its worldwide expansion. This also shows how quickly major aspects of life are changing during the pandemic as some companies in online business are becoming more prominent than others. Target and Walmart have also increased in size. Best Buy has changed its focus with its conversion into a company that leads with personal service in online plus store hybrid retail and a focus on seniors and older people for healthcare service and product delivery. Companies are changing the way they run or getting a new life in remaking their business. This is also a time when other aspects of business such as social media are becoming evident. Subtle aspects such as reports of higher rates of mental depression through use of social media platforms. There is also the awareness that information technology companies in Silicon Valley generate most of their money in advertising and this advertising of $100 billion is only a small fraction of the $12 trillion U.S. economy. Should Silicon Valley based in California decide priorities on where capital allocation should go through the part it plays in moving startups based less on America's priorities than other considerations. Healthcare, education, cities, and infrastructure have not received funding they need and capital allocation by financial markets has failed the American people, as it has failed in Europe and other parts of the world for similar reasons. This has hit hard communities and people across the U.S. and Europe and also in Latin America, Africa and Asia, with the loss of manufacturing to China and other countries from the U.S. India and Europe. ...

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Jared Bernstein of the Economic Policy Institute points to trade barriers reducing competition and free trade that should raise an outcry when free trade and competition advocates focus alone on the Trump steel tariffs. He points to estimates that show $90 billion in additional costs to Americans from the barriers that prevent Americans from paying world market prices for surgeries and medical treatment, prices similar to what is paid in advanced countries like Germany, Britain and France. A bigger barrier in pharmaceuticals prices being sheltered from market competition worldwide costs a huge $370 billion in additional costs to Americans. These two costs in healthcare would help Americans by a magnitude compared to tax cuts that do not work for average Americans with the business tax cut going more into share buybacks than into increasing wages or capital investment in 2018.  Bernstein points to Neil Irwin's column in the NYT that flags statements such as Senator Mike Lee, Republican, that the steel tariffs are a huge job killing tax hike, as being misleading. Bernstein says two actions were never taken that would have used benefits of free trade to help affected communities that lost jobs in industries such as steel and textiles, other industries affected by foreign competition.  He lists these steps as sectoral employment training, apprenticeships ,and job creation efforts in the worst affected areas. Basically no one really knows what is good trade policy, the textbook concepts and theories are out of date when countries can subsidize particular industries such as steel and dump products into the American market. At a press conference on CSPAN with the Swedish prime minister Mr. Trump stated that China was exporting more than what is officially shown as there are transshipments from other countries, some of them with no steel mills.  As Mr. Trump stated at that press conference he was elected partly because of the worst affected communities- in places such as Michigan and other states in the midwestern U.S.- that suffered from unfair trade. Bernstein admonishes the economists and politicians, media, for the headlines that are misleading in showing that bad trade policy is being pursued and trade wars are being started. This deserves attention because the Trump administration and advisors such as Lighthizer who served in the Reagan administration seek fair trade, and the Commerce Secretary Wilbur Ross successfully pushed for NAFTA trade deal renegotiation not the outright rejection of NAFTA that was mentioned in the election campaign. Ironically no one is helped by this trade rhetoric and misleading headlines. In fact the strengthening of the U.S. currency as the huge trade surplus of China goes into U.S. assets, and with the election of Mr. Trump, gives foreign competitors a continued advantage. And in fact Japan, South Korea, China, had a mild response to the tariffs as reported, because these countries are aware of global overcapacity created especially by China which produces 50% of the world's steel, and as China shifts to higher technologically value added products closing many older steel mills. ...

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Issues raised by the huge mismatch between revenues and investment for AI. $400 billion estimated investment by 5 Tech firms in 2025 alone with revenue of about $40 billion and huge uncertainty about when AI will produce returns. Articles seen this week of November 17 in the WSJ and NYT on this issue, podcasts, discussions in other media outlets. Could this lead to a dot com bubble type economic crisis? Could that lead to a recession? Alongside these articles another article in the WSJ on Nov 17 shows the benefits small firms get by using AI, benefits which are on the fringes of their business, not essential but with some experimenting firm owners/managers able to tweak AI information for use in business. Nothing significant which firms will pay much money for. The uncertainty is a major factor. Should geopolitics trump all these concerns? Is the competition with China require this scale of investment, and is China following a more utilitarian approach as reported in a WSJ article this month, of investing in AI in a utilitarian way targeting its use in improving manufacturing, improving infrastructure, and not wildly throwing money at experimental uses that are unlikely to yield much result. In geopolitical sense would the country that not only promoted AI but used it efficiently and cost effectively, used it in ways that promote the overall public good, get the WIN. In short it behooves everyone of us to ask hard questions of AI, to dehype the hype, to look for the public good that comes out of this from it's efficient use. To ask the tough questions when $400 billion generates only $40 billion in 2025 and the $3 trillion planned investment over 5 years is half unfunded, is it going to crowd out energy needs for homes and business, push renewable energy targets back, crowd out essential investments in the crumbling aging infrastructure of the US and Europe, crowd out essential investments in education, healthcare, pharmaceuticals, and manufacturing, that hold better promise for our People. Will it also put retirees at risk when corporate bonds from retirees money fund the unfunded portion of AI? This means making the political dimension not about migration, settling the illegal migration issue that was meant to be settled a long time back, or about cultural issues that have little day to day impact on our lives which are about groceries, childcare, housing that are non ideological. Making the political dimension not about remote countries that one knows little about except when it affects public safety and health as with fentanyl. Capital allocation decisions to the vital needs of America can then be free of politically induced error, so that it can be subjected to the test of how best it serves the public interest and the people of the Nation. ...

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Indonesia is a country with a long history of Hindu and Buddhist culture before conversion to Islam through traders from Malaysia and Sufi saints in the sixteenth and seventeenth century. Hanuman and other deities from India are also part of the existing culture and traditions. Communist influence has been alien to this culture and tradition as in India. It was part of the Dutch empire in the east and a source of European trade in spices from the seventeenth century. It is also a extensive island chain of Java, Sumatra and other islands with a population of 280 million very closely linked to India culturally and with links to America since independence. Indonesia was given a great deal of importance during the Cold War with Robert Kennedy and other leaders visiting Indonesia during the period after Sukarno in the sixties. By 2000 the US engagement with China had evolved to the point that neglected India, Indonesia and the entire south east Asian region in a preference for links with China.  The British division of India led to the US links with India and Indonesia being shaped by that division and the Cold War with Russia. The confusion of the struggle against colonial rule of the British and Dutch led to leaders such as Nehru and Sukarno who compounded the difficulties of the Cold War and perpetuated with it the old British idea of a divided South Asia on a religious basis that had supported British rule and set the conditions that made it possible for a small group of English civil servants to run the country. This led to the Indian and Indonesian relationship with the US being stifled as the US struggled to rid itself of the British obsession with a divided India. Culturally India and Indonesia are part of an extended region in Asia with development aspirations and a youthful population that aspires to better infrastructure, better education, healthcare and ease of living, and the better opportunities in life. This is what migration did for Europeans who left for America for a new life on the east coast and on the prairies of America. It has little to do with the obsessions of the British and the Dutch that divided the region between the Indus and the Ganges and divided the Indonesian islands. That phase is now coming to an end as China reverts to its Communist period leadership under a new generation led by Mr. Jinping, a son of one of the veterans of the Communist Revolution of 1949. The US has to evolve its relations with India, Indonesia, Vietnam and other countries into new ties of trade, culture and technological exchange. This is needed as it winds down its close trade relations with China in its supply chain to rebuild a new supply chain after the trade wars and the pandemic revealed the deep flaws of that supply chain. What is needed is not the efforts of one changing adminstration after another, but an effort started by president Biden that will last through different administrations as the US engages with Asia in the way that it engaged with Europe after FDR and Truman for most of the twentieth century. And one that rids itself of the obsessions of divided regions from the colonial period of the Dutch and the British. The1.6 billion people in India and Indonesia share a  common aspiration of being a major part of the Free World with America. ...

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China's new prime minister Li Keqiang makes his first foreign trip with a trade delegation for talks with Indian representatives and business leaders, showing the importance he places on India. India offers China's companies access to large opportunties in infrastructure development, and China can benefit from India in the area of information technology and pharmaceuticals. Trade is envisioned as expanding from $70 billion in 2012 to $100 billion by 2015, and expanding rapidly as the two economies grow. Economic contacts also would provide an anchor for future relations as China faces difficulties in its relations with Japan, and S. E. Asian countries, and a U.S. wary of China's capabilities. This was pointed out in the joint statement. Li Keqiang also emphasized this in an editorial page article in India's daily newspaper, the Hindu, saying India and China have "to work hand in hand," to promote Asia as "an anchor for world peace." A peaceful India-China trade and economic relationship opens the way for investment and participation in development by China alongside Japan, Germany, France, UK and the U.S. in India, as the next major source for global economic growth. This also serves to defuse Asian tensions as both economies grow, and increased contacts between cities in India and China with the twining of cities program launched in the meetings. India can use China's capabilities in infrastructure development, the two countries share the need for information sharing on lowcost solutions in healthcare, in managing urbanization, and solutions for clean water in rural areas, and use of IT solutions in development, where much remains to be accomplished through cooperation. Some of these themes are the focus of Li Keqiang in his efforts for urbanization in China. ...

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The Chinese market for medical care is growing. China will spend $125 billion on a three year plan to boost medical care. This means funding 31,000 new hospitals by 2012. Medical equipment market is estimated to grow at 13.5% a year to $15.5 billion in 2012, according to Philips Electronics. And Credit Suisse sees the pharma market up from $44 billion in 2008 to $110 billion in 2015. GE is designing inexpensive imaging equipment for fast growing rural markets, with cost at 10% of urban markets.

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It is not a story that most people grasp or understand- the long term effects of the US immigration surge of 2023 and its source mostly from Venezuela. The  US Congressional Budget Office says labor force in 2033 ten years from now will be larger by 5.2 million people and younger as a result of the immigration surge in 2023 from about 1 million immigrants each year in the 2010's to 3.3 million. About 2.5 million crossed the southwestern border in 2023. Much of it the result of the collapse of the Venezuelan economy and its middle and upper classes leaving the country. This was worsened by the US sanctions on the Maduro government including under president Trump, say experts in an adjoining NYT article on the 7 million people who left Venezuela to go to Colombia, Peru, Ecuador and Chile since 2012, then making their way up the Darien Gap to the US. Something that could have happened under a Republican president if the US Congress could not reach bipartisan agreement on correcting asylum and parole policy. As a result of this surge US Gross Domestic Product  in 2033 will be 3% larger. When the large Asian economies are seeing a aging workforce, Japan for the last decade and China now following Japan, the US labor force will be younger than it would be without this unusual surge in immigration of the last 2 years. The federal deficit will be smaller at 6.4% instead of 7.3% in 2033 as immigrants will pay taxes on income. Another aspect of this larger infusion of immigrants is that after the pandemic shut down immigration entirely there were severe shortages in the hospitality and restaurant, construction, healthcare industries. And with the trillions of dollars in investment that the Biden administration is making with more factories - this will absorb most of the immigrant surge by 2033. With some positive effects in the competition with rising Asian economies China and India. Particularly consider with the younger demographic India of 1.4 billion people. It will mean more factories can be built in the US and there will be workers for these factories in the US at wages that keep the US economy competitive years from now in 2033. This is a sobering aspect of the current situation viewed from what will be seen by America's younger generation. And under the bipartisan compromise in Congress correcting asylum and parole policy that was shut down by the former president, Republican senators understood very well that the immigration surge of 2023 would have some constructive effects for the long term, while its effects on the short term would be mitigated by Biden's commitment to close the border in 2024. This did not happen, yet the future for America's younger generation is bright under the Biden plan for massive investment in manufacturing and jobs in the US, and with the millions of immigrants needed to fill the jobs that investment will create by 2033. It will make America with a younger work force than Europe or China, only India having a younger workforce in 2033. ...

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Under Mette Frederiksen immigration which reached 21,000 in 2015 was down to a little over 1000 a year. She is a strong fighter for workers and families and labor rights and yet tough on illegal immigration. She has been proven right about this as Britain and the US under Biden are seeing illegal immigration as a threat to workers and labour, are seeing the risks of distraction from illegal immigration doing a serious disservice to workers and families by making it hard to fight for workers and families on wages, cost of living and other issues.  Even with a strong record of fighting for workers and families, Frederiksen was one of the first European leaders to see the dangers of illegal immigration to society. It gave parts of the political spectrum that had no interest all along in workers and families doing well, an issue to run on that would come to cause grave harm to workers and families. This turned out to be the error of Angela Merkel a CDU leader brought up in Communist East Germany, who had no idea of the risks of her approach for open immigration. As Merkel let this chapter unfold it created fissures in Europe, with Tories and Nigel Farage taking Britain out of the EU and laying waste to its economy for 5 years till Labour's Starmer adopted a tough immigration policy and became prime minister in 2024. That danger then spread to the US in 2016 which also suffered as Republicans and Trump did the same in the US around rhetoric but without serious action on immigration till the Lankford- Biden legislation.  That bill would have closed the border with Mexico and ended immigration as an issue forever if passed into law in December 2023, as Senator Lankford says would have happened. Ending immigration as an issue forever alongside foreign wars as an issue, so that a concentrated effort could be made on improving badly damaged lives of workers and families. And on rebuilding badly damaged manufacturing in the US, rebuilding collapsing infrastructure, and competing with better education and healthcare with the large Asian countries China, Japan/ South Korea, India. ...

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This editorial in the HIndu newspaper says more than the Rs. 2000 crore allocated for Ayushman- for covering 10.74 crore families with Rs 5 lakh health  coverage- is needed. This should have been setup earlier and it is now time to upgrade the public health infrastructure so that it can handle the much needed care of 40% of the population given free coverage upto Rs 5 lakh under PMJAY.

Not all states have joined. The challenge of tight cost control has to be met through defined treatment packages for which rates are prescribed so that the challenge of standardization of facilities and reasonable rates for procedures is met.

Prevention is also of great importance and here the 150,000 health and wellness centres across India of the National Health Protection Mission have a special role to play.

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Kerala state of 35 million people who speak the language Malayalam, is one of the rare places today that has only 4 deaths from coronavirus, 524 cases confirmed and no community transmission. Here the Guardian looks at the reasons why. The Health minister KK Shailaja started very early on January 23, with a meeting of her rapid response team when the virus was still in China.  She setup a control room and instructed Kerala's 14 districts to do this on Jan. 24. When the first case arrived on Jan. 27 on a plane from Wuhan, Kerala had already adopted the WHO  protocol of test, trace, isolate and support. These passengers were checked for temperature, tested and quarantined. With some at a nearby hospital and others in home isolation. This is all the more amazing considering that Kerala is a state in southern India on the west coast that has a large number of people living and working overseas. Many are in the Gulf countries and the arrival of these refugees could have triggered a second outbreak. This was prevented by careful testing, and contact tracing of clusters.  When one group was evasive and concealed information from an airport surveillance team -arriving from Venice, Italy,  in late Feb- a case was detected back to them.  Contact tracers tracked down all of the hundreds whom they had been in contact with and quarantined them.  By 23 March all flights to 4 Kerala airports from overseas were stopped, including Cochin and Trivandrum. On March 25 India went into lockdown.  Some of the achievements in Kerala include quarantining 170,000 people early. with strict surveillance, which is now down to 21,000. Accomodating and feeding 150,000 migrant workers from other states, before returning them on charter trains to their home areas. A big reason for the success is the high literacy rate in the state. A big emphasis on education and healthcare is a part of the Kerala model. Shailaja is a secondary school teacher, and Health minister. From the days since independence of India in 1947 the state has a strong socialist tradition of taking care of the basics- health, education and public services. It also generates a part of its GDP with income from workers who are overseas.  Another reason for the success in dealing with coronavirus is experience. The state had a virus epidemic called Nipah in 2018 which has become the story for a movie called Virus in Malayalam. There is decentralized public health system in the state and people value their health care facilities, understand and trust the health care authorites. There are hospitals at every level of administration and 10 medical colleges. But trust and education, experience tackling the virus before, are key. Kerala is showing that poor countries can deal effectively with the virus, and create a better life by adopting the right model of creating good societies that value education, healthcare services, better economic structures and distribution of wealth, and  a degree of trust and responsibility found in a state that values public spiritedness. ...

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Biden's very conservative choices for his cabinet which one British reader of The Times calls UK One Nation type choices. Many of the cabinet members could easily have served under a Republican administration before Trump or a Democratic administration in the tradition of Harry Truman in the 1950's. No members of the cabinet belong to the Bernie Sanders wing of the Democratic Party.  A look at the Truman administration after 1950 shows John Wesley Snyder, who headed a bank in St Louis and worked for the Reconstruction Finance Corporation under Franklin Roosevelt performing a key role for integrating 8 million GI soldiers into the economy, and implementing the Marshall Plan. A similar job awaits another banking official Janet Yellen in Biden's cabinet to keep people employed during the pandemic. Xavier Becerra, currently attorney general of California, and formerly Congressman for 24 years, who endorsed "medicare for all" is the new Health Secretary. He grew up in a one room apartment with his Mexican parents. Secretary of State goes to Anthony Blinken, Dean Acheson was in this role under Truman as the Cold War surged with the Berlin crisis and the Iron Curtain in Eastern Europe. Today the challenges from Russia and China are taking the shape of a revival of tensions. George Marshall who led American forces in the war, was secretary of defense. This position is given to a soldier Gen. Lloyd Austin who led forces in the wars in the Middle East. This has the potential to deliver better results after the years when America veered off course under the administrations of Reagan, Clinton, Bush and Obama, following the Truman, Eisenhower administrations that setup the recovery after World War II. Today after the banking crisis of 2009, disastrous healthcare and infrastructure neglect in the U.S., followed by the pandemic, a recovery like the one after World War II is needed.   ...

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Questions about whether the emerging market countries are looking ahead at a period of lower growth in the next decade. If the slowdown in 2013 is structural then these countries have to to make changes in economic policies that will help them return to higher rates of growth. If the slowdown is cyclical then this is temporary and emerging market countries will return to higher growth rates. Countries such as Brazil, Mexico and India need to improve infrastructure and educational systems, and invest in research and development to generate more growth. Turkey and India depend on foreign capital, which puts limits to growth, creating a need to boost domestic savings and investment for long term growth. Lower rate of about 7% compared to the 9-10% of the last decade in China are because the wave of investment in construction and infrastructure building through huge state investments is now slowing, says Peter Aslund of the Peterson Institute of International Economics. It is a positive prospect for China, according to Kalpana Kochhar, a deputy director of IMF, because of the asset bubbles developing in real estate. It is seen positively by China's new government as it tackles problems created by a rush to industrialization of widespread pollution of the environment, and lack of balanced development without attention paid to healthcare, worker wages and social security. Stephen Schwartz of BBVA bank, says urbanizaton will drive further gains, especially in India, which has lagged behind the gains made in China and is likely to follow the rapid urbanization seen in China. New elections in India in 2014 are likely to lead to more growth oriented government policies. A pause in the U.S. Federal Reserve's policy of withdrawing economic stimulus gives emerging markets, especially India, and opportunity to come up with new economic policies to restore growth....