LyrArc Article Gist
Krauthammer cites Congressional Budget Office numbers that show the Obama U.S. health care law continues the spiralling costs of health care with new government mandates at a time of severe budget cuts in education and other areas- for 2013-2022 the costs come to $1.76 trillion. The initial Obama administration figures of 10 year costs of $938 billion announced in 2010 reflected the fact that the new U.S. health care law would take 4 years to fully go into effect. Costs after 2021 are shown to be $250 billion each year in the CBO figures. The law is now before the Supreme Court in 2012, which has to decide on the basis of the limits of the Commerce Clause.

LyrArc Article Gist
An average of major opinion polls compiled by Real Clear Politics website shows 50.5% of Americans opposed to the Obama U.S. health care law.

LyrArc Article Gist
The full text of the letter is given here. In this letter the U.S. sets out some important facts about events that happened during the coronavirus crisis during the crucial 4 month period from December 2019 to March 2020. Every week lost in this time due to reasons of a lack of transparency, openness meant hundreds of thousands of people more infected and tens of thousands of deaths worldwide. There are questions of transparency, of openness and this raises questions about the manner in which the World Health Assembly operates with hundreds of small countries in Africa and Asia having votes equal to that of the U.S., India, Brazil, Mexico with votes taken of over 200 countries. The entire election process can now be seen as questionable, when over a billion people in one country alone such as India or hundreds of millions in Brazil and Mexico would have to bear the consequences of poor decisions made by small countries that can be swayed in one direction or another based on political bias and other considerations that have nothing to do with global health.  At the conclusion of the letter by the U.S. to the current WHO shaped by a controversial election in 2017 the following is stated about the standards set by Gro Harlem Brundtland and which helped the world prevent the SARS crisis which originated in China in 2003 from spreading to the large countries of the world India, Brazil, Mexico, and other such countries in Asia and Africa, Latin America, and the U.S. European Union. "In 2003, in response to the outbreak of the Severe Acute Respiratory Syndrome (SARS) in China, Director-General Harlem Brundtland boldly declared the World Health Organization’s first emergency travel advisory in 55 years, recommending against travel to and from the disease epicenter in southern China. She also did not hesitate to criticize China for endangering global health by attempting to cover up the outbreak through its usual playbook of arresting whistleblowers and censoring media. Many lives could have been saved had you followed Dr. Brundtland’s example." Even this does not come to grips with the flawed way in which the election of WHO head is done. It can no longer be relied on when there is the danger that lack of transparency can emerge in the WHO leadership itself because of a flawed process. It risks endangering the lives and livelihoods of hundreds of millions in countries such as India, Brazil, Mexico, as well as in the relatively small countries of Africa and Latin America where even basic water supplies are at risk but which could tilt elections at the World Health Assembly. Consider that a cyclone just hit the Indian state of West Bengal and Bangladesh on May 20 just as the coronavirus pandemic is spreading. That this region of 1.5 billion people had just 2 votes out of over 200 cast at the World Health Assembly in 2017 shocking. And even these votes cast based on old geopolitical considerations not how good the candidate is, and how good the country he is coming from is in terms of its record  on public health. The irony here is that private foundations in the advanced countries in the U.S. and Europe some of whom are major donors to WHO did not think that more experienced candidates in their own countries with a better record of public health such as in France or Germany are better qualified, in a flawed NGO support mentality left from the Clinton years. Basically the people in these large countries such as India, Brazil, Mexico were disenfranchised, when the austerity policies were consuming the European Union, and the U.S. had just elected a new administration itself groping for ways to reverse years of neglect of public services and infrastructure priorities. They would trust good leaders no matter where they come from, who have a record of transparency, leadership, and all the values we cherish together no matter where we come from. ...

LyrArc Article Gist
Full Yield is a startup in Boston that is trying to help address the nation's obesity problem by introducing healthier foods and meals in cafeterias. It plans to introduce a line of Full Yield branded food made from fresh items and natural ingredients for sale in corporate cafeterias and prepared food sections of local supermarkets. It is based on a simple idea that if you eat healthier food you will be healthier. A study in the Jan-Feb issue of journal Health Affairs says 75% of the $2.5 trillion in health care spending deals with obesity, Type 2 diabetes, heart disease and cancer. And how much of this traceable to obesity and bad eating habits, smoking and lack of exercize? This study says most of the cases are preventable by changing these behaviours. Dr. Kenneth Horpe, chairman of the department of health policy and management at Rollins School of Public Health, Emory University, shows that if trends continue U.S. annual health care costs related to obesity would reach $344 billion by 2018, which is 20% of total health care spending. In 2009 it accounts for 9%. Thorpe says if even the 1987 levels of obesity were reached it would free up enough money to cover the uninsured population today. For American companies the problem has grown to alarming proportions and yet no nationwide coordinated plan bringing together companies, government, universities, public interest organizations, and other groups exists in the U.S. The CEO of U.S. grocery chain Safeway, Steven Burd, says Safeway was spending $1 billion to cover health care insurance for workers by 2005, with costs rising 10% a year- this meant putting out twice in health care insurance than Safeway's earnings and hitting another $500 million by 2010. Between 2004-2009 the costs of insurance surged 31%, making this the fastest growing single corporate expense, according to Towers Perrin. This reduces incomes of workers as companies pass on part of the extra cost, and reduces the profits that can be put back in new investment for economic growth....

LyrArc Article Gist
U.S. healthcare spending of about $3 trillion comes with poor results. The cost per person is about three times that of countries such as France, Britain, yet the results show U.S. doing extremely poorly. The author points out that less spending on healthcare and more on social services in areas such as education, nutrition, housing and other services would improve the outcomes and results. It is this missing factor that is helping other countries in Europe, Japan and China achieve better outcomes and returns per dollar spent.  Social spending can affect such things as nutrition, exercize levels, lifestyles, housing and result in dramatic improvements in obesity levels for instance, or inflammation levels in the population that play a role in many diseases. The idea is prevention. This is not happening because higher health dollar spending has lobbies to support it. Social spending also is a dollar expense that shows up immediately whereas results are spread out into the future as a longer term benefit with healthier populations that need to consume less healthcare and treatment. Elizabeth Bradley, president of Vassar College is an expert on this subject. She says social services spending gives more bang for buck  in health outcomes.  The point is relevant also for countries in South Asia and Africa that have taken some on some aspects of the U.S. health system resulting in health care spending that does not deliver the most for the dollar spent, and ignores the critical role of prevention.  The solution lies in moving these health care dollars out of the health care spending and into education for health outcomes, lifestyles, exercize habits education, and into social services that enable prevention and better health. ...

LyrArc Article Gist
Canada does better with only 28,000 cases of the virus compared to 3 million in the U.S. by early July 2020, 300 infections a day compared to 28,000 a day. Three things Canada got right are its health system that provides universal health care to all Canadians, not having culture wars about accepted practice such as face covering and social distancing, and Trudeau adopting an approach of bringing Canadian opinion around a common fight against the virus.

LyrArc Article Gist
The coverage of the Republican healthcare bill and how it affects the elderly, and people on Medicaid, people in rural areas, is likely to have changed public opinion in the U.S. about the necessity of ensuring all Americans have health coverage. The Pew survey cited here in this NYT report by Zernike and Goodnough was done in Jan 2017, and shows a shift. The shift would be much higher today after people look hard at the consequences of what were simply hypothetical positions or ideological positions taken without looking at consequences in daily living. On Medicaid that opinion by July 2017 compared to Jan 2017 has shifted 10 percentage points for Republicans to 53% who think Medicaid is important to them and their families, according to Kaiser research. There is stronger sentiment about people having benefits taken away.  [article-55059] The opinion has shifted to where people see that coverage is important and people should not have coverage denied or benefits taken away from them. Opinion remains strong in favor of changes to reduce the high premiums, but not to replace the existing health benefits and law with no law at all to replace it. That leaves 20 million more uninsured according to the Congressional Budget Office. Changes have to be constructive is the popular view today,  and this requires dialogue between Republicans and Democrats- which has not taken place. ...

LyrArc Article Gist
The Times correspondent in Beijing says he sees two Chinas one that is showing technological advancement in 5G, in space technologies, in information technologies, infrastructure building in big cities. The other China is in rural areas away from the big cities, in smaller towns in regions away from Beijing and Shanghai. These areas have suffered neglect and have changed little over decades, with the focus during industrialization on larger cities and the coastal areas. This is evident in the manner health services infrastructure and development of medical personnel and doctors were neglected in the rush towards building manufacturing and infrastructure of road and rail. There is a shortage of doctors and hospitals, health services are costly, and waiting lists for beds at hospitals is huge. Doctors are also not held in high esteem because the focus is on profit in the market economy that has taken over the health sector.  Education of citizenry on respecting the common welfare which is expected and normal in Europe and America has also suffered during the rush to industrialization. Efforts to ban and eliminate use of certain wild animal foods not being respected by fellow citizens can be seen in this context. This caused the SARS virus epidemic and the epidemic today from the coronavirus. Seen from this angle a slowdown in construction, infrastructure building, and a slowdown in the economy, can even be healthy, so that focus can be shifted to better health, better sanitation, and better medical infrastructure including medical human resource capabilities. Investment in public education on health and self enforcement of rules by citizenry for a better society is indispensable for progress. It is in these conditions that the challenge of the national and international emergency of the coronavirus can be seen today. It also provides an opportunity to reflect on progress so far and the needs of the future. These challenges are even tougher than repeating what one has done before such as building more and more infrastructure, as they involve building a better society through public discipline along with investment in health and education services. This provides a lesson for many Asian, Latin American and African countries in the rush to industrialization. Turning over the health sector to a market economy making services costly and distributed unevenly in the population has not worked in the U.S. for the betterment of all citizens and a healthy society. Carrying this over from U.S. to China and not learning from Europe in what Europe has done well in the less costly and broad distribution of health services for the people, is one of the poorer lessons learned. This is also true for India and South Asia, South East Asian countries in their rush towards industrialization.  ...

LyrArc Article Gist
Tory MP's rebels in the southern part of England are opposed to prime minister Boris Johnson's second lockdown for the whole of England. This report in The Times of London looks at how Johnson's conservative government might have to get Labor party support to pass the lockdown measures in parliament. Or Labor may decide to abstain from the vote. Mr. Gove says the NHS risks being overwhelmed if the lockdown does not take place. Responding to the statements that southern England does not have high or has falling rates of coronavirus Mr. Johnson says it has been shown that a low rate catches up in one area when it is next to a high rate area for coronavirus so that the result is the spread of the virus to the point where the NHS cannot cope.  The NHS like the French health system and other health systems in the European Union, U.S.  India, and other countries are strained to the limit. Most healt care workers in hospitals have felt severe strain on themselves and their families during the first wave. Most are exhausted and are in a situation of fatigue with the added factor of some healthcare workers on leave from the virus illness. This puts additional burdens on the system. Without the action taken the health system may be overwhelmed in many countries leading to disaster.   ...

LyrArc Article Gist
The kind of early effort needed to control the public health crisis of the coronavirus. Steps taken in Washington State on social distancing and action underway in the U.S. so that a proactive approach takes place, acting early and decisively.

LyrArc Article Gist
The WSJ looks at Elizabeth Warren's Medicare for All plan that marks a major shift for the U.S. economy.  Households would see their costs go down by $11 trillion, boosting their ability to spend on other goods and services. Because income and wealth was highly skewed in the past three decades in one direction, the spending capacity of lower and middle income households was pushed down. This and other similar plans would help restore a higher level of spending and with it an essential element of inflation of 2-3% to the U.S. economy which was missing in the last decade. This sets the tone for the kind of broad based recovery that happened after 1950 that strengthened America's middle class and made it the core of the economy, the core of the post World War II recovery in America and Europe. The plan would be paid for by higher taxes on corporations, tax rate of 21% for corporations going back up to 35%, and reverse depreciation schedules in the 2017 Republican tax law. The argument that this would reduce business investment does not hold that much says the WSJ because amid new trade tensions business investment has declined over the last 2 quarters, and has been sluggish overall. The other source for the estimated $13 to $20 trillion cost of Medicare for All plan of Elizabeth Warren is a 6% annual wealth tax on billionaires, in an attempt to have all pay their fair share and reduce wide disparities in wealth. Mark Zandl, chief economist of Moody's Analytics, says his sense is at the end of the day from a macroeconomic view- because $11 trillion in the hands of 80% of households who could boost spending after lagging behind in the last decade- the negative effect on business investment will be cancelled out by the higher consumer spending. The overall effect and today's context is infused in this analysis. Private insurance, premiums for insurance, and out of pocket cost that the public pays would disappear in this new system where all health payments pass through the government. Health insurance premiums paid by employers would convert into a new employer Medicare contribution to the government starting at an amount employers pay now and adjusting gradually toward national averages over time. Smallest businesses are exempted. Mr. Zandl says the most important aspect of this now is that Mrs Warren has shown that her plan's revenue sources match the cost so that the plan would not lead to deficits increasing and pushing interest rates higher, leading to negative effects on the economy. Republicans under Mr. Trump have paid little attention to expanded deficits caused by their tax law, and economists across the landscape have also shown less concern. Still attacks are made if the plans don't add up. For this reason a sound assessment in today's context of depressed consumers and an overall impact becomes essential. The WSJ quotes from a pre- assessment of Warren's plan by Simon Johnson, a Massachusetts Institute of Technology economist who co-wrote it with Mr. Zandl and Betsey Stevenson of the University of Michigan. What they point out is that putting cash in the pockets of the lower and middle class for spending makes a lot of sense today, and taking money out of the pockets at the way upper wealthy end,  does not contract the economy at all. Other effects they say are constructive by letting all workers get health coverage from the government instead of employers, this makes it easier to change jobs increasing labor mobility and productivity. A worker getting a better job and better utilization of skills could then shift without looking at the employer health care plan. Warren says there would be a five year transition so that workers in health care insurance industry can work in other insurance fields and in Medicare, no one would be left behind. The important thing being to build America's middle class again. ...

LyrArc Article Gist
The arguments of both sides in front of U.S. Supreme Court Justices on the Health Care Law's expansion of Medicaid. Justice Scalia said the law gives the states no choice. Justice Kennedy pointed to the situation of the states which have no way to opt out without stripping millions of Americans of medical care. Justice Roberts pointed to the states willingness to accept federal aid for years which brings us to the current situation. The attorney generals of 27 states have objected to the Health Care Law's provisions which they believe effectively requires the states suffering tight budget constraints to cover more of the poor than they they think they can, with the alternative being dropping out of Medicaid totally, not giving them much of a choice. As the three day hearing came to a close on March 28, 2012, the Supreme Court's conservative Justices expressed doubts whether the Obama Health Care Law could surivive if some key parts are struck down. With Justices Sotomayor, Ginsberg, Kagan, on one side, and Scalia, with other conservative Justices on the other side, the Court's final decision depends on Justices Kennedy and Roberts. ...

LyrArc Article Gist
Are high prices for pharmaceutical products and healthcare services putting a severe burden on U.S. finances and defunding education, infrastructure, R&D in new technologies, which provide the underpinnings for future U.S. competitiveness? Yes say experts. In 2009 Americans per person cost of healthcare was $7,960. By comparison Canada was $4,808, Germany $4,218, and France $3,978. And without necessary efforts for educating people about caring for health and preventive care, the health conditions of Americans are no better than these countries, and poorer in some dimensions. Klein says deficits would not be a problem for the U.S. if prices for pharmaceutical products and healthcare services in the U.S. were similiar to that of the largest developing countries. Experts say the Obama healthcare law simply postponed the addressing of this problem.

LyrArc Article Gist
Professors Gluck and Graetz of Columbia Law School discuss the presumption of severability in case the Obama health care law is declared unconstitutional by the U.S. Supreme Court. Severability would mean some parts of the law could be left intact if it is declared unconstitutional.

LyrArc Article Gist
A sense of how the U.S. Supreme Court Justices viewed key aspects of the Obama Health Care Law after three days of hearings on March 28, 2012.

LyrArc Article Gist
Lake county with 230,000 population in Ohio received 60 million pills. Ohio Counties say after the $650 million settlement verdict by US courts for CVS, Walgreens, that it cost them $1 billion for law enforcement, social services, and health services. The opioid crisis dealt another blow to communities in the US already devastated by the behaviour of banks in the 2009 economic crisis, the outshoring of entire manufacturing to China, followed by the pandemic in 2020. America is only now coming to terms with the failure of previous adminstrations as the Biden administration takes on this task of bringing America, its workers and families back to healthy thriving communities.

LyrArc Article Gist
Total public and private spending on health care in the U.S. will increase by 6.1% in 2014 compared to 2014 in a revised Commerce Department forecast. The total spending will reach $4.1 trillion in 2014 from $3.9 trillion in 2013. Some of the lower rise in spending than the earlier 7.4% forecast will come from 28 states opting out of Medicaid expansion under the health care overhaul because of a June 2012 Supreme Court ruling. Employers are trying to reduce costs and the public is reducing spending because of the recession. Less generous health plans mean users are paying more out of their own pocket, paying more attention to prices and even postponing care. Growth in health care costs is a about 3.9% a year since 2009 following the recession. The costs increase in 2015 by 5.8%, in 2018 by 5.9% and 2022 by 6.5%, according to U.S. government forecasts, because of enrollment in Medicare for baby boomers. This is still higher than the inflation rate of below 2%.

LyrArc Article Gist
China's GDP declines by 6.8% in the first quarter 2020 year over year, and 9.8% from the previous quarter, the first such decline since 1992, even going as far back as 1976 with the passing of the Mao era. It is not power production or coal consumption which have returned to prior levels. It is the demand from the U.S. and Europe, other countries which are in lockdowns. Estimates are that 80 million people in a population of 900 million working age people lost their jobs, with another 10 million expected to be lost, about 10% of the total. Global trade companies are hardest hit.  Consumers inside China are reducing spending. Some are using only the small government issued vouchers designed to get people to go out and spend.  The Trump administration plans to bring back some of the production lost to China in essential areas such as public health and security back to the U.S. The supply chains are already shifting to other countries from U.S. tariffs. As a result some estimates show zero growth in 2020 for China. Financial instability and prior leveraging concerns remain to prevent any serious stimulus. By contrast the U.S. is cushioning the impact with $2 trillion aid package benefitting from a strong dollar and healthy economy before the virus. ...

LyrArc Article Gist
Elizabeth Warren's Medicare for All plan in the U.S. draws support from about 60% of people polled for the New York Times. Over 66% support Warren's 2% wealth tax on people with wealth over $50 million. The support is consistent among all groups, gender and race. Only a group of Republican men with college degrees which is likely to include the bulk of the people with wealth over $50 million oppose the wealth tax and Medicare for All. Over the past year wealth tax and Medicare for All support has grown with about 60% of people supporting Medicare for All, a plan similar to government plans in most of Europe and in Canada which have worked over many years.

Warren's plan wins support by showing how it will be paid for and why most people will pay no more than they are paying today, and overall much less because of unnecessary costs taken out of the system.

LyrArc Article Gist
The Cass Commission of the National Health Service in Britain looked at the serious risks to health of children and mental health of parents from transgender medical activities.

The Cass Commission in Britain of the National Health Service NHS has raised serious concerns about transgender medicine and its impact on the health of young people. Parents across the US and in European countries are very seriously worried about the impact on their children creating a great deal of stress, coming so soon after the pandemic when elder care caused much distress.

LyrArc Article Gist
The dire need for international scientific collaboration, sharing of information and economic coordination for relief measures in tackling the health crisis posed by coronavirus. U.S. president Trump says it would have helped if U.S. had more information earlier from China. U.S. medical personnel are in constant contact with medical personnel in Italy as reported in WSJ. This has helped American doctors understand the nature of the challenge they are facing and come up with better strategies that can work in America in anticipation of what can happen in the next 15 days.

LyrArc Article Gist
This article is a must read for everyone to know where our plastic and other paper waste is ending up. With China's ban on importing plastic waste the stuff is being shipped to India, Malaysia, Philippines and Vietnam. Now these countries are turning it back. Who needs sometimes contaminated waste. In the U.S. it ends up mostly on landfills. It is a health hazard as one recent story of waste shipped out to a part of Chile shows- with health problems for people in the vicinity. The WSJ has done an excellent story with diagrams and pictures in this exceptionally good story we recommend for our readers to know what is happening worldwide with plastic waste.  There is increasing education of the harmful effects of plastic and there is a government campaign in India supported by the prime minister Modi to reduce use of plastic bags and find ways to dispose off local plastic waste. In the light of this why would India or Malaysia or any other Asian or Latin American or African country want any other country's plastic waste, particularly when it is a health hazard. In fact China for so long allowing importing of plastic waste till recently so it could be processed with low cost labour and reused for plastics production is incomprehensible, considering the health risks involved. ...

LyrArc Article Gist
Baucus is a six term senator from Montana. He won easy re-election in the fall. Question are being raised about the extent of fundraising Baucus is doing even as he is conducting the negotiations for writing up the health care reform bill. He continues to accept donations from health care executives and health care companies. Public Citizen advocacy group says that Baucus's fundraising in the middle of the health care debate is very troubling. As chairman of the Senate Finance Committee, Baucus is a key person in the health care legislation development.The Washington Post says health care companies gave Baucus $1.5 million in 2007 and 2008 as he began to hold hearings for the health care reform debate. The health care industry gave $170 million to federal lawmakers in 2007 and 2008, with 54% going to Democrats, according to the Center for Responsive Politics. Senator Grassley of Iowa, the ranking Republican in Baucus's committee received more than $2 million from the health care industry since 2003. House Ways and Means Committee chairman Rangel took in $1.6 million, and ranking Republican Dave Camp $1 million. Clearly any new health care legislation will fall short on achieving the critical reduction in health care costs that is needed to help the U.S. economy as long as lawmakers are beholden to lobbyists and donations....

LyrArc Article Gist
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. ...

LyrArc Article Gist
The startling truth about health "reforms," - they won't control spending, and without that the whole system of health care will rapidly become unaffordable and unsustainable. Obama's Council of Economic Advisors points out in new report that since 1975 annual health spending per person, adjusted for inflation has grown 2.1 percentage points faster than overall economic growth per person. At this rate health spending which was 5% of the GDP in 1960, and is 18% of GDP today, would grow to 40% of GDP in 2040. Medicare and Medicaid would increase from 6% of GDP now to 15% in 2040, or equal to three fourths of federal spending. Employer paid insurance premiums for families which grew 85% in inflation adjusted terms from 1996 to $11,941 in 2006, would increase to $25,200 by 2025 and $45,000 in 2040. This would force employers to reduce take home pay. Samuelson says the uncontrolled health spending is singlehandedly determining national priorities, reducing discretionary income, raising taxes, widening budget deficits and squeezing other government programs, while it is producing large amount of waste in medical spending. See the link to Prof. Tyler Cowen of George Mason University in NYT, 6/14/ 2009, who cites the habit of doctors to write many expensive tests as one of the prime culprits in the wasteful spending. And in the process it delivers higher cost for lower overall quality of health for the American people. This at a time when many European countries provide live examples of doing it in a better way- lower cost, better health. The serious problem with the Obama health reforms says Samuelson is that it talks about restraining spending but may end up increasing spending. Its talk about controlling spending he says is good intentions, but based more on hopeful thinking, public realtions and risks becoming cosmetic reform. Because to really control spending will require coming to grips with its fundamental cause- hospitals and doctors are paid mostly on a fee-for-service basis and reimbursed by insurance, private or governmental. Such a system encourages doctors and hospitals to provide more services, expensive tests, favors heavy use of expensive medical technologies to increase profits, and for patients to expect them. Samuelson puts his finger on the root of the problem - there is no incentive and every disincentive for all the players in this game , doctors, hospitals and patients to seek reform of this system. For doctors and hospitals the hope would be that this cosmetic "reform" would leave the system basically unchanged, and patients to continue with a lifestyle and expectations that do not not acknowledge the fact that a lot of healthcare does not come from spending but from preventative care, education, good eating and exercize habits, and healthy lifestyles. And the uninsured are no exception, they would simply start consuming the expensive care for lower quality of overall health like everyone else. With this kind of situation confronting us, the views of Samuelson, and Professor Tyler Cowen of George Mason University, as welll as a growing chorus of informed public opinion on this subject, is that insuring the uninsured is a good idea, but doing it within the bounds of the present system, can only increase the costs. And too much is at risk, to rely on what Samuelson calls a scattershot of measures to control costs made up by Congress such as "evidence -based guidelines," "electronic record-keeping," "bundled payments to hospitals, to give the illusion of progress that won't make a serious difference. A sweeping restructuring of health care is needed, that would overhaul "fee-for-service" payment and reduce the fragmentation of care. It will also need what has not even be touched on adequately in the debate. This is the massive need for education in the schools about nutrition, eating, exercize, healthy lifestyles. It would also require opinion leaders in each field from sports and other fields to lead by example and with constant public presence, the media, and companies to form a partnership with private institutions to change existing eating habits and lifestyles that encourage obesity, smoking, fast food eating habits, large portions in restaurants....