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This is an exceptionally humorous operating room story of Dr. Trump and Dr. McConnell by Kristof of the NYT. Sometimes humor tells the story- and Kristof does this using a story of a surgeon president Trump in the operating Room trying to address the concerns of the patient Janet, as he keeps telling her she needs a new heart with great benefits, great benefits, before she implodes or goes down failing. Flat out take the old heart out even if a replacement hasn't been found, believe me great benefits the surgeon tells her, just that the patient just isn't getting convinced as its happening to her. The analogy is with replacing a health care plan, not just the Obama plan, any plan without something to take its place. For a few days before this article by Kristof, the Republican effort to repeal the Affordable Care Act without having a replacement was presented as a good idea. Janet is like the three Republican women- Collins of Maine, Capito of West Virginia, and Murkowski of Alaska who wanted to keep the heart they had till a replacement was found, against the surgeon Trump's advice. In a way it is about politicians in the last decade who never had any discussions as they rushed through with their own agendas, as the Republican and Democratic health care plans were rushed through Congress with relatively little participation and debate to hear all viewpoints. ...

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The Congressional Budget Office analysis of the Republican healthcare plan advocated by Mr. McConnell, Senate Majority leader, is that it would add 22 million uninsured if implemented. That plan ran into opposition from Republican Senators Collins, Capito, Murkowski, Paul, and Moran, and lacked enough support in the Senate. All Democrats opposed it and with the thin majority Republicans were divided. By taking away some benefits given under the existing Affordable Care Act the plan hurt the elderly and low income people, making some Republicans listen to their constituents in home districts and not the Republican leadership. The NYT profiled two in particular who astonishingly in a sign of today's strange politics were the only ones publicly holding townhall type meetings to hear the views of people in their voting districts- Susan Collins of Maine and Jerry Moran of Kansas. Both senators were listening to rural communities and Moran stated his opposition with the words- "I am a product of rural Kansas." With it the nation takes a breather and the message goes out that it is best to listen first and then to seek middle ground, not do what both parties Democrats and Republicans did in 2009 and 2017- rush serious legislation through without support across party lines and without serious discussion.   ...

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The Washington Post's veteran Middle East correspondent, Jim Hoagland, says there are some important lessons to take from the experience in Libya. The Arab rulers who entrenched themselves for decades wasted the bulk of their oil wealth. It was right for Palestinians to disassociate themselves from these regimes. The French took the brunt of the fight in helping Libya free itself from the Gaddafi regime. This is an understatement as without Sarkozy's initative and Cameron's unflagging support, without France and Britain's early support, Gaddafi's forces would have overrun Benghazi and ended the struggle for democracy in this part of the Arab world. U.S. President Obama and Defense Secretary Gates did little in the early days when there was dire need. Germany's chancellor Angela Merkel continuously resisted supporting France and Britain in Libya. The U.S. Obama administration and Turkey gave their support only after the perilous period- when the fate of the rebels fighting for freedom hung on a thread- was past. Hoagland calls Gates view of "feckless Europeans" shortsighted. Hoagland sees this as an opportunity for Europe to take a larger more active role. ...

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Samuelson warns that turning seniors into a protected class making no sacrifices whatsoever, will mean shrinking all other social programs, defense and investments in education and infrastructure. This is the reality of the budget deficits facing the U.S. He cites the Congressional Budget Office projections that even with cutting defense and non defense discretionary spending by a third, the U.S. risks a deficit in 2023 of about 6.75% of the economy or gross domestic product (GDP). To cover this would require $1 trillion in higher taxes, an increase of a third above the 1970-2011 average. He says Democrats are using demagoguery and intimidation on this issue, and ironically even Paul Ryan's proposal reflects a desire not to touch seniors benefits and willingness to pass on the costs to the young to pay for these programs. Social Security and Medicare are a critical part of the American fabric, and no one wants to dismantle them, it is about modernizing them to reflect higher life expectancy and larger wealth accumulated by the elderly compared to previous generations, and to reduce the burden on the young. ...

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Key takeaways from XI's speech to the 20th Party Congress of the CCP, China's Communist Party, are shown in the Guardian. Xi presented a vision of continuity. Goals that were seen as significant were self-reliance in science and technologies and building China's capacity for innovation by building up its capabilities in science education. This was stated as the main driver of future growth. It does not favor decoupling with the US even though the US sees it in its own interest and that of its working class to bring home manufacturing and rebuild supply chains for American self reliance - the pandemic showed the weakness of free markets approaches that ignored this. A promise to step up regulation on income distribution and wealth accumulation, to cut down the growing inequality gap that developed in the last two decades of hypergrowth.  To focus on the quality of economic growth after lessons learned on climate change. To double down on the zero covid policy. He lauded the "all out war on the virus." To continue the battle against "corruption on a scale unprecedented in our history." "Corruption is the biggest cancer that harms the vitality and affects the combat effectiveness of the party, and anti-corruption is the most thorough self-revolution. As long as there is the soil and conditions for corruption, the fight against corruption will not stop for one moment." ...

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About 7 million people or 10.3% of people living in France in 2021 were immigrants, says national statistics agency INSEE. Compare that with 6.5% in 1968. About one third have acquired French citizenship. What this has done to French society is to shift sentiment away from protecting workers and families struggling with a cost of living crisis by splitting the vote of traditional parties supporting working class families. Shifting some of it to the far right anti-immigration parties that have emerged since 2010. This has added to the fracturing of society that happened from neglect of manufacturing communities across France as more manufacturing was concentrated overseas in  China. Neglect of rural areas and smaller towns, the emergence of tech hubs disconnected from the larger community across France has added to this. This is true of other European countries and a similar situation happened in the US. Denmark's prime minister is very candid about this, saying immigration of this type hurts the working class families in Denmark. Mette Frederiksen of the Social Democrats is the first to have clearly stated this problem and is providing a new way of protecting Danish workers and families from these social and technological changes in society from which they have no protection. President Biden in the US has also grasped clearly the dimensions and magnitude of the problems facing workers and families in the US. The problem is not limited to worker loss of income security, it affects the whole society and the public as a whole in other ways. Opportunistic politicians using anti-immigration appeals without a true commitment to democratic principles and ideas have tendencies that threaten democracy itself. This is the real danger of concentrating manufacturing in one country such as happened with China. And of neglecting rural areas and small towns. For this reason Frederiksen in Denmark, Biden in the US, and other leaders in Europe are looking for ways to send aid and industry promoting assistance to poor countries but restricting illegal immigration. This requires handling cultural issues which have further hit society with care- "with malice towards none, with charity for all," so that the focus can be kept on the real issues affecting workers and families of the cost of living crisis and a better life, better education, health care and public services for all, to improve the quality of living. It requires a new state of mindfulness from leaders in North America and Europe, as well as from allied countries of Asia, Latin America and Africa.  ...

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A study done by the Hudson Institute shows an increase in sales of 5.5% on average in same store sales of restaurants which increased lower calorie items on the menu. The reverse is taking place for restaurants that have neglected to do this, with these restaurants experiencing a decline in sales. This was based on research firm NPD and restaurant data at 21 fast-food and sit-down restaurant chains between 2006 and 2011. Chains that include lower calorie counts on menus include Panera, McDonalds, Denny's and Au Bon Pain chain. Federal regulations will require restaurants with 20 or more outlets to post the calorie counts in early 2014. The process of moving Americans away from eating habits that lead to obesity is moving at a slow pace. Margo Wootan, director of nutrition policy at the Center of Science in the Public Interest, says large serving sizes at restaurants lead to overeating and obesity. Frequency of eating at restaurants is another problem, with studies showing women who eat out more than 5 times a week take in about 290 calories each day compared to women who do not eat out that often. The healthy options at restaurants are still restricted to a small portion of menus and healthy choices are limited....

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Prime minister Modi's visit to the US comes at a time when US president Biden is eager to show the US is fully engaged in the Indo-Pacific region with its allies in the Quad 4 countries- Australia, Japan and India. The recently announced Aukus defense agreement brought together 2 members of the Quad 4 the US and Australia, plus the UK. Aukus is designed to strengthen US presence as a naval power in the Indo-Pacific region in the Indian and Pacific oceans around India, Southeast Asia, China, and across the Pacific. After a futile engagement in Afghanistan the US is reorganizing its presence where it is strongest- in the oceans. In a way that Britain once did in the eighteenth and nineteenth century, the US is dominant in the high seas. US naval power far exceeds that of all navies in the world combined. This is meant to reassure India, Bangladesh, Sri Lanka, Thailand, Malaysia, Indonesia, Philippines, Vietnam, Australia and Japan, which together have close to twice the population of China, that the US has not diminished its presence in any way from that it had in the 1950's following the Second World War. With this new framework India enters discussions that will focus on health to deal with the pandemic and its after effects, with security and rule of law in the Indo-Pacific region, with trade, technology, new supply chain manufacturing structure in which India plays a key role. With this new focus and clearing past engagements made by other US  presidents, including some mistaken policies, the US emerges as a new force in the Indian ocean, China seas and Pacific ocean region.  On September 23 Modi meets Tim Cook for what could be new supply chain arrangements that Apple could be preparing as it and other US corporations build new supply chain structures to rebuild US manufacturing technologies capabilities that were lost to China over the period 2000-2020. During that period manufacturing technology knowhow was shifted out of the US in a mistaken policy that assumed design and invention were sufficient for the US to keep. The first step in this direction was a change of CEO's at Intel Corp with US president Biden pushing for new US technology reclaiming policy. Following that the new CEO at Intel Corp, Patrick Gelsinger, completely reassessed Intel's mistaken policies of ceding its entire semiconductor manufacturing technologies capabilities to Taiwan and China. Intel made a U turn and is now investing all or most of $50 billion in the US instead of in China or Taiwan.  On September 24 Modi meets Mr Biden to discuss trade, investment, defense, and security. On the same day the leaders of Japan, Australia, Mr. Suga and Mr. Morrison join Modi and Biden for the Quad 4 talks. Indian infrastructure capabilities and Indian economic growth would be key goals to strengthen India along its land borders along Tibet occupied region and Himalayas as part of the overall effort to build a new US and allied presence in Asia.  On September 21 Modi attends a Covid Summit that will look at the way forward in the aftermath of the pandemic and ways to vaccinate the remaining unvaccinated population in the world, as well as vaccination passports.  ...

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A study published in the British journal Lancet shows that the number of people suffering from diabetes went from 153 million in 1980 to 353 million in 2008. The study shows the U.S. having 24.7 millon diabetics in 2008, which is three times the number from 1980. About 70% of this is from population growth and aging, and the rest from obesity, lack of exercize, changing diet. The American Diabetes Association estimated the cost of treating diabetes in the U.S. at $174 billion for 2007. About 138 million diabetics live in China and India. In India there is an additional cause- malnutrition in early childhood years for the poorer segment of the population. European countries have done better than the U.S., Mexico, India and China. S. Korea and Thailand have done better than other Asian countries. And this is attributed to healthier lifestyles, diet and less obesity in these countries.

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This photos essay in The Guardian can be seen for pictures of US presidents since John Adams, at pivotal moments or moments that captured some symbolism of the times. John Kennedy is simply bending to look at a newspaper on the Oval office desk just  moments before meeting the French ambassador, yet the pressures of office show such as Cuban Missile Crisis in 1962.  On November 22, 1963, Freedland says Kennedy warned against extreme groups. Franklin Roosevelt in 1932 had warned of radicalist groups if needed action for sharing the wealth and opportunity of the Nation were not taken. Kennedy said- "America’s leadership must be guided by learning and reason, or else those who confuse rhetoric with reality and the plausible with the possible will gain popular ascendancy, with their seemingly swift and simple solutions to every world problem.” Sometimes leaders are faced with difficult situations  “I want to tell you how grateful I am, and how worthy I’m going to try to be of all your hopes.”  a phone call to Martin Luther King Jr in 1963. Who was this US president? LBJ of Texas got it right for America, but lacked in international affairs knowledge of what John F. Kennedy had learned about aspirations in Asia and colonial rule during the war years in the Pacific. One president brought about 40 years experience in Congress to four major crises – the pandemic, crumbling infrastructure, loss of manufacturing in the US, and climate change– and passed the most far reaching legislation for trillions of dollars of investment since Franklin Roosevelt.  The most famous of these photos is the one showing Harry Truman holding the Chicago Tribune in 1948, which said "John Dewey Wins."   ...

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It should be remembered as NHK points out that Mr. Obama never visited the Main Building of the Hiroshima Museum and only spent a little time in the East Building. It is the Main Building that Prime Minister Kishida- who represents Hiroshima City in parliament - wants Biden, Scholz and other G7 leaders to see. It is only in the Main Building that leaders can see the graphic images of the devastation of the atomic bomb dropped by the plane Enola Gay on Hiroshima.  A suggestion is for NHK to give a private broadcast to G7 leaders of the documentary already shown in Asia on NHK television last week.  Having seen it one can say that it in no way affects the use of nuclear deterrance. A suggestion for the Hiroshima Museum authority is for it to also show the devastation of Japanese bombing in Asia from World War II that  may have created the insular feeling in American public about the dropping of the bomb and only thinking it could have come sooner to save lives for the Allies, itself creating conflicting feelings and affecting mental health. A recent exhibition in Barcelona showed the Nazi bombing of Republican parts of Spain leading to millions of refugees crossing over to Europe. Similar situation happened in China and the images may have created America's insular feeling about the bomb dropped on Hiroshima. It is in everyone's interest to know, to comprehend the devastation in all places, the conflicting narratives that were told, and for people as spiritual values teach us to develop the virtuous conduct, the concentration and the wisdom that both the Bible and the Buddhist suttas teach Americans, Europeans and Asians. Something that was lost in the 18th, 19th and 20th centuries.    ...

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Paul Krugman reviews a book by Robert Gordon, a distinguished American economist and historian, on the improving standard of living for Americans after the war in the period 1940 to 1970. This period brought some of the major changes in the standard of living which have since stalled. Gordon points to the developments in science and technology between 1870 and 1940 providing the largest boost to standards of living as the quality of life improved- especially the conditions in which people lived using modern sanitation, electricity, automobiles, and work saving appliances. The period 1940 to 1970 enabled the spread of this to the country as a whole. The IT revolution's developments occuring between 1990 and 2005 are also behind us. This process between 1870 and 1970, with the followup period to 2000, is seen by Gordon as a one time development in the scale of change and the improvement of quality of life. The future does not hold a similar level of progress in standards of living, says Gordon. Set against the current stagnation in incomes, widening inequality of opportunity, and the political discourse, this review raises important questions about the future. Quality of life potential now rests in improvements through personal involvement in health improvement, improved education, renewable sources of energy, and other ways, which are more soft knowledge improvements than the hard improvements of the past- which may require more personal involvement than in the developments of the last century of progress, with some improvement coming from renewal of the old physical infrastucture using the new technologies available. Just as the developments of the last century required dogged persisitence and effort, these developments will require dogged persistence and effort, with some of the easy stuff currently posing as technological development not qualifying....

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How seriously are the Border Crossing encounters with migrants being taken by the Biden administration compared to the Trump administration, or earlier administrations Republican and Democrats. Pew Research Center provides these 7 charts and other data. In 2021 border crossing encounters with migrants were shown as 1.6 million. Of this 27% were repeat crossings a number much lower in previous years. It had fallen to just 400,000 in 2020 as the policy of expulsion put in place by the Trump administration was continued by the Biden administration. In 2019 the border crossing encounters with migrants after three years of the Border Wall construction under president Trump were 851,000. The Biden adminstration in 2021 had 52% expulsions compared to Trump administration 66% in April 2020 after invoking public health Title 42 which Biden continued. About 33% said the Trump administration was doing a good or somewhat good job in 2019 compared to 29% for Biden in 2021. But a much lower percentage of Republicans were saying Trump was doing a bad job than the 56% of Democrats saying that for Biden today. The previous surge in 2021 was mainly from Guatemala and Central America. The current surge is from about 400,000 migrants from Venezuela where expulsion does not work as well because the US has cut off relations with the government of Mr. Maduro in Venezuela, There are 7.1 million refugees from that country in Latin America. The Trump administration would have faced similar problems with the Venezuelan surge that the Biden administration is facing. The largest jump in 2021 is in Yuma Arizona 12 fold, two fold in Tucson and San Diego, three fold in El Paso, the Del Rio and Rio Grande up 5 times.    ...

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We show here Mette Frederiksen's opening address at the Danish parliament in 2023 because of her down to earth way of looking at things, free of abstract theory. Danish people are always learning English and learning from the UK and America. America and the UK, and the rest of Europe can learn from Mette Frederiksen and Denmark. She brought a common sense approach to immigration, saying that it was workers and families that were suffering from the distractions caused by immigration issues replacing bread and butter issues such as cost of living and future issues such as education and health care, and wages, that help determine the quality of life.  When for instance has the leader of a European nation or the US or Canada started with and devoted the better part of her opening address to parliament to teachers? And the burden placed by Aula app for parents to express concerns about their children to teachers so that teachers could not devote that time to preparing for class? And the burden placed by 1081 goals given by administrators to teachers on norms culture values -full of abstract theory no one knows what they mean- taking the time of teachers that they could devote to preparing for class? And about wind turbines on the coastline of Denmark- held up by concern for bats. Should the bats simply avoid the turbines and did anyone find out how many bats there were asks Mette Frederiksen. And  enlarging the harbor for a wind turbine factory location that built turbines too big to transport on land. Should this take 8 years she asks? ...

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Boris Johnson wins an 80 seat majority for the Conservatives in parliament in the 2019 election. He gets a mandate for a quick exit from the European Union by the end of January 2020, and billions of dollars in public spending on infrastructure, the NHS, and public services. He gets an unexpected 364 seats in parliament after winning the support of working class voters hurt by the financial crisis and by industrial decline. Working class voters in the north of England and the Midlands decided to trust Mr. Johnson. The Labour party won 203 seats, its lowest total since 1935.  The British pound surged to its highest level since May 2018, and domestic stocks surged with their best day since 2010. Part of the optimism stems from the size of the win that gives Johnson more flexibility at home and more leverage with the European Union to negotiate Brexit that works best for Britain. Working class areas that suffered for decades with loss of heavy industry, decaying infrastructure and poorer public services put their trust in Johnson's pledge to spend more to revive these areas. Johnson called his government "The People's Government" in his victory speech and promised to spend $131 billion on infrastructure, the National Health Service, schools, and public services. Johnson said in the speech that working class families may- "only have lent us your vote. I am humbled that you have put your trust in me, and that you have put your trust in us. And I and we will never take your support for granted." The other big event in this election is the election win in Scotland of the Scottish National party winning 80% of the seats and seeking a referendum on independence. Mr. Johnson has stated that he clearly opposes this. In Northern Ireland a majority of legislators were elected who favor unity with Ireland. This sets up a constitutional struggle that Mr. Johnson faces in his first elected term in office.   ...

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Prime minister Modi's address in Hindi to the nation on May 12 on "Atman Nirbhar Bharat" (self reliant India) as India looks ahead to a situation beyond the coronavirus. What would the economy look like as India moves forward? He says the emphasis will be on planning for the need for land, labor, liquidity, and laws to develop the Indian economy. A bold package of economic action for an investment of 20 lakh crore rupees or $280 billion was announced with details to be provided later. The basic philosophy of the next move forward was what the prime minister concentrated his speech on. Modi says there are 5 pillars for the Atman Nirbhar Bharat, or Self Reliant India. The first action not to go for incremental change- go instead for a quantum leap, be bold. This applies to both technology and investment and creating an environment where results can be achieved. Second action to make the kind of infrastructure that would set a new standard in the world. Third a "sabhi ke sapno ke aadhar," taking everyone along, be technology driven. Third action celebrate and build on India's vibrant demography, once seen as a weakness this will be turned into a strength. Fifth action be Demand driven - "demand or supply chain puri samtha ke saman karne ki jaruat che." The demand and supply chain  should be taken good care of. That also means be local and local manufacturing. Be vocal for local is the new message said Modi, because this is what worked and is saving us in the pandemic. As external supply chains failed countries in Europe and North America, it is the local supply chain for medicine, health care equipment, and food supplies, local technology for citizen id and bank accounts for direct deposit, agricultural supplies, strong and large national postal and rail networks and millions of employees spanning the country in all directions, that have proved of amazing value in this crisis. "Is local ne bhi bachaya, ham sabki jinnadari hai," - the local saved us and is everyone's responsibility.   ...

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As the pandemic continues to spread and numbers grow with reopening of the economy the question remains -what can we learn from other countries positive experience in controlling spread? Here the Times provides the example of German contact tracing- chancellor Merkel has emphasized that a lot depends on "total" contact tracing, and contact tracing "above all else." Germany's experience is that even if you don't get everything right, you make an honest effort with everything you've got and do it early it makes a real difference. Some of the offices across Germany are stretched and short of staff but they have been working since the beginning of March, sometimes in the early days 7 days a week. Only 33% or one third of the offices throughout Germany for contact tracing have the required 5 person team for every 20,000 people, and 35% are overstretched or at their limit, according to one survey. No apps, just a low tech effort with people from the state administrations who were not working during lockdown trying doing something else, or volunteers. Mainly using the phone, talking to people and tracing the contact chain of people testing positive. Putting this information on the computer with a central database.  The Berlin office has 115 workers and has tracked down every one of 666 virus cases it was given. Because of privacy concerns at the Munich office sometimes even the patient's name is not given and office staff have to locate the name and the person. It requires dedication, flexibility and above all resilience, says Harold Rau, the deputy Mayor of the Cologne office, cited in this Times report. The doctor alerts the local office with a test result. The office calls the person and finds out who he has been in contact with for the last 14 days. Then the people who were in contact with are grouped based on the directness of contact, face to face, so on. These people are asked to quarantine for 14 days, sometimes with the rest of their household. They get daily call to find out how their doing for symptoms. The effort goes back to Robert Koch in the 1892 cholera epidemic in Hamburg. Robert Koch, microbe hunter in Germany, was called in after the epidemic spread from Moscow. It devastated Moscow and Tokyo, but Hamburg suffered far less about 8605 deaths as a result of the contact tracing and strict closing off quarantining of affected chains after isolating them, closing off affected parts of the city. Bit by bit the cholera epidemics sparks were put out before turning into flames, says Koch. In the current pandemic Germany has suffered 8241 deaths and 178,000 confirmed cases. So far this is in line with the cholera epidemic in Hamburg 1892, and this for all of Germany. And it is not just affluent nations that can do this. where there is a will there is a way. In Kerala state in southwestern India, similar efforts have worked to limit spread  with even better results than Germany. ...

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Rachel Ensign's WSJ report shows huge disparity in incomes and spending that has happened in the US even with the best efforts and intentions of the Biden administration in 2020-2024. US cumulative excess savings by income for the bottom 90% are a mere $291 billion compared to $1.2 trillion for the top 10%, 4 times as large. As a result about half of consumer spending comes from the top 10% in incomes says the WSJ. (Moody's Analytics). It provides clues on why Biden and even less so Harris failed to convince Americans, the middle class, blue collar workers, and others that large social gaps, income disparities and wealth disparities gap were being bridged under Democrats. And makes it harder for Republicans and Democrats alike to address such huge gaps built up over time by outshoring jobs and manufacturing, the 2009 financial crisis from banks speculation, the pandemic and supply shock cost of living crisis. As the $2.6 trillion in pandemic assistance from Biden faded people in the bottom 80% dipped into savings to pay for rising cost of living as supply chain bottlenecks and price gouging sent prices of groceries, housing, apartment rentals, cars up significantly. This has'nt happened to the top 10% or even the top 20% who continue to spend in the same way as before prices went up. Something like this is also happening in Europe and in China, India fueling and anti-incumbency mood, and dissatisfaction with governments. The Net Worth of the top 20% has grown by 45% or $35 trillion since 2019 compared to $14 trillion for the bottom 80%. (Moody's Analytics) ...

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Lee Kuan Yew, passes away at the age of 91. He led Singapore for 31 years after becoming prime minister in 1959. During this period he helped transform Singapore's economy into a centre for international trade and finance by attracting foreign investment. To do this he developed infrastructure, setup training colleges for the workforce, and provided tax breaks for investors, using Singapore's strategic location on the sea lanes in Asia to best advantage. Singapore became a export hub for Japanese electronics companies, and U.S. companies such as HP and General Electric established regional headquarters there. Strategic investments were made in high tech industries and Singapore's sovereign wealth fund took stakes in companies overseas. He retired in 2011 after opposition parties won 40% of the vote in general elections. His son is now the new prime minister.

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Dow's 679 point drop on Thursday October 9, 2008, investors lose $8.4 trillion of wealth, which is sure to impact consumption spending coming after a steep drop in house prices and loss of trillions in home values. This will affect countries dependent on exports like emerging markets from Russia, China, Brazil and India to other countries around the world as the US imports less energy, less soyabeans, less from the manufacturing locations in China. This means cutting growth in Brazil, India and China as well as in the US and Europe.