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

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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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The tough job President Obama faces as he faces opposition from politicians who have interests to protect, and healthcare businesses with interests to protect. The President has to come up with a plan that is deficit neutral, because financial markets could see a healthcare bill that further widens the deficit as a signal for higher interest rates that would deepen the recession. At the same time each of the three sources of revenue puts him at loggerheads with political leaders in Congress or groups with interests to protect. Limiting income tax deductions for high earners could raise $267 billion in 10 years. It would require taxpayers in the top tax brackets deduct their mortgage interest, state and local taxes, and charitable donations, at the 28% tax rate instead of the 33% and 35% tax rates. The opposition is with democratic leaders that it would hurt charities, universities that depend on tax deductible donations, and taxpayers in high tax cities like New York city that are the home base of Democratic leaders. Yet only 1.4% of households would be affected says the nonpartisan Tax Policy Center. The Center on Philanthropy at Indiana University, says charitable giving would decrease by 2%. The other opposition on this comes from the preference of Senators Baucus and Grassley, who head the Senate Finance Committee, for tax increases or cost savings to come from the health sector. Specifically they want to see the value of workers' employer provided health benefits subject to income taxes. It is a situation in which every sensible person admits the need for healthcare reform and would see the current pace of healthcare costs as unsustainable and dangerous; and after that will just go back to his group and try to preserve as much of the status quo as possible, so as not to disturb by much the benefits or compensation they have secured from the system over the years. Then there are political leaders in Congress with their own preferences, and Congressmen who are the subject of heavy lobbying by these interests. The administration and the Presidents job is to navigate this stream with a workable deficit neutral plan, without any requirement for any group to make sacrifices, and in some situations even small sacrifices for the public interest. Would charitable institutions be hurt that much, what if charitable institutions were exempted, why would other interests the try to obtain the same exemption. Its like the unions trying to keep the old unsustainable goldplated healthcare and other benefits at GM even as the ship was going down. Taxing employer provided employee health benefits as income would raise $2.5 trillion over a decade. The opposition here is from unions which are a force in the Democratic party and which count tax free health benefits as a legacy of the labor movement. Employer provided health insurance covers 160 million American employed and their dependents under the age of 65, so it has a wide impact. Yet most economists favor ending the tax break. They say it mainly goes to upper income taxpayers, and discourages cost consciousness among consumers of health care, thus encouraging excessive spending and surging health care costs. Senior Obama advisors, Peter Orszag, the budget director, and economist Jason Furman favor this approach. So do Republicans in Congress. Senators Baucus and Grassley are not asking for the complete removal of the tax break, what they want to see is capping the value of benefits that go untaxed. If the tax-free limit is $13,000, a policy worth $15,000 would pay income taxes on $2000. A third spource is to spend less on Medicare. About two thirds of the $948 billion in savings Mr Obama has proposed over 10 years comes from a number of reductions in Medicare spending. $177 billion comes from insurance companies bidding for government reimbursements for offering private plans to seniors. $106 billion comes from cutting the subsidies to hospitals serving the uninsured as universal coverage should remove this need. And $110 billion in reduced payments to hospitals and doctors because of productivity gains. A range of industries insurance companies, hospitals, doctors drugmakers, nursing homes, home health care companies and medical device makers, all stand to lose from reduced payments from Medicare and Medicaid. And these groups with interests to protect are another factor in this process of working out a healthcare plan. ...

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This article in the NYT provides a look at the features of the Republican House Health Care Plan- Both the Affordable Health Care Act and the House Plan provide incentives for buying insurance- the ACA bases these incentives on income levels whereas the House Plan does not provide additional help for low incomes or elderly. Incomes at $20,000 would see a loss greater than  $2000 under the House Plan and as many of the elderly poor living in high cost areas may not have the resources to make up for this loss of subisidies they may forgo buying insurance or have insurance coverage that protects only in a limited way. President Trump has given assurances that all will be covered. For people with incomes of $50,000 or $75000 the loss of $2000 subisidies would also have some impact. At larger incomes or the well to do the subsidies are not handed out under either plan. Under the ACA the emphasis was on income levels and high cost insurance areas the subsidies were greater, under the House Plan the subisidies would be higher for the elderly compared to the young but very low income levels are not given additional help.     ...

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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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The first presidential debate in Denver, Oct 3, 2012. For the first time Romney came out as a recent Republican governor of Massachusetts, the most liberal leaning state in the U.S. For a reason that remains a mystery, except that Romney had to shore up support with the conservative base of the Republican party, Romney did not aggressively adopt positions that would appeal to the vast majority of Americans- from people on foodstamps which he said in this debate had increased by millions under the Obama administration, working class Americans, ordinary Americans about to lose insurance with higher premium costs from the unending increase in the cost of healthcare, seniors on Social Security, workers insecure or losing jobs as the economy fails to recover, and young people who cannot find work. As governor of Massachusetts Romney had to be able to address the needs of different income groups, the middle class and working Americans, and his own father who is his role model was a governor of Michigan, a liberal leaning midwestern state with the largest number of autoworkers in the U.S. He asked Obama directly how he could have focussed on Obama care and passed it without a single Republican vote when 23 million Americans were out of work and the first priority should have been high unemployment. Obama responded by saying he would defend the middle class but did not say what he would do in the next 4 years that was different from the economic policies between 2004-2008. Romney made clear that he was not going to reduce taxes if it would increase the deficit even though Obama said Romney planned to increase taxes by $5 trillion and worsen the deficit. At one point Romney said looking at Obama that he could own a house, a plane, but could not own the facts....

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US president Biden's multi-trillion dollar spending plans for infrastructure, climate change plans, education and healthcare, are based on a changing perception about the effectiveness of the public sector spending initiatives. The Reagan period idea that the public sector is not as efficient as the private sector that lingered through the Clinton, Bush and Obama, Trump administrations is no longer accepted. After the pandemic another perception is taking root that when it comes to health infrastructure the government has a leading and indispensable role to play. Gone are the doubts about this that hung like a cloud over the nation's plans for infrastructure in health, education and supply channels. Following the global competition with China a new factor is also playing its part. The need for government to play an active role in trade, in protecting technological resources, and in supporting US technological firms in competition with other countries. There is a new perception that the government should be determined to play this role. In the effort to be self-reliant after the pandemic the government is expected to play a role in redesigning the supply channels and providing the direction and incentives for supply channels worldwide that give America a competitive advantage and less dependence on other nations. ...

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This NYT report says US president Biden is different from past presidents in two ways. He is pushing for infrastructure spending on a big scale from the very beginning of his administration. He is also not interested in shrinking his plans for multi-trillion dollar infrastructure spending to win support from Republicans. A big reason is that he sees the opportunity to go ahead because the perceptions of the American people have changed in the last five years, and have changed even more in the last year with the pandemic. Health, education,  infrastructure, and competitive technology leadership resource development spending with government playing a leading role is seen as indispensable for the US as a nation if it is to play the leading role that it has played over much of the last 100 years. Government leadership is seen as indispensable including in redesigning the existing global supply chain so that the US is no longer dependent on other nations and taking on risks. ...

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This editorial in the WSJ describes the sharp increase in premiums under the Affordable Care Act of president Obama. The average premium increase is about 24.2% according to a Barclay's analysis, and as high as 43.9% in states such as Illinois. Bill Clinton calls it the craziest thing with small business affected, and some premiums doubling. Of the 17 million people in the individual market eight million buy without subsidies. One in five enrollees cannot qualify for subsidies. Democrats say subsidies are too small. Hillary Clinton has proposed to have a Medicare "buy-in" for people ages 55-65, and a "public option" government run plan. Republicans want to rewrite the law. But this depends on which party wins the Senate, with the election in Missouri giving Democrats an opportunity to maintain a Senate majority.

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Public opinion in the district of Steve King, a Republican in the House of Representatives favoring defunding of Obamacare healthcare law.

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The distrust in negotiations between Republicans Boehner, Ryan, Cantor and Democrats Reid, Obama, and Pelosi, during the weeks in October 2013 preceding the reopening of U.S. government after the shutdown. Republicans call attention to the rising deficit from $4.9 trillion in 1993 compared to $16.7 trillion in 2013, triple the increase in the deficit in just one decade compared to the five decades prior to this period. Democrats say sharp spending cuts would hurt economic growth and the unemployed.

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Chris Cillizza of CNN shows here that back home in Maine Republican Senator Susan Collins hears from people saying again and again that they support her stand against the Republican health care bill. The rural and elderly are hurt most by this bill and Cillizza says Maine has a lot of these people.  He also cites the opposition of Republican Senator Rand Paul who doesn't like the other costly things tagged onto this bill, and wants a clean bill free of "billion dollar ornaments."

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US president Biden's $2 trillion infrastructure spending plan is being compared to the New Deal infrastructure plans of Franklin Delano Roosevelt in the 1930's. FDR was preceded by Republican administrations under Hoover and other presidents who followed policies that can be compared to the Reagan administration policies when public sector spending was not seen to be as efficient as private sector spending. By the time of the economic collapse in the 1930's it had become clear that only the federal government could save the country in the depression. During the pandemic and collapse of the health systems it was clear that only the federal government could save the country. It is now also evident that infrastructure building led by the government can rebuild America. In the 1930's and during other periods in American history such as the building of the Erie Canal and other public sector infrastructure projects in the 19th century it was the federal government that led the way to building America. ...