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Melania Trump and her documentary "20 Days to History" with Amazon support in production and marketing. Melania says at the premier that she wanted to show what it was like to be in her role, to "show other people what it takes to go from being a private citizen to first lady again." Melania has been underestimated and has shown leadership in mental health issues, on how internet and social media affects children, on housing in disaster relief, and on a range of issues that affect women and children. She also brings originality in her thinking about issues. For someone from Slovenia to come to the US as an immigrant and to be thrust into roles that she never would have anticipated she has shown exceptional composure and ability to learn and absorb from events happening so quickly around her. TR would have recognized her abilities and her softspoken and effective ways to assert herself on issues relating to the social media and how it affects children, one of the key issues facing the US for the next generation. ...

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Baby boomers and older Americans are beginning a huge wealth transfer, the largest in modern history. Americans over 70 years in age had net worth of nearly $35 trillion, according to the Federal Reserve data. This is 27% of all US wealth, up 20% from 1990. This wealth is 157% of US gross domestic product, more than double what it was in 1990. Gift tax exemption today is $11.7 million for individuals and $23.4 million for couples. It is scheduled to go down to 2017 level of $5.49 million per person adjusted for inflation in 2026. Annual gifts were $75 billion in 2016. The Biden administration proposed reducing a $40 billion annual tax break in some of these wealth transfers. Some of this would go into infrastructure spending. Other ways the transfers could help the communities in the US revive after the twin crises of 2009 and 2020, one financial and one health, is how some of this money goes into funding many of the needs of communities in America today. $9 trillion is expected to go into helping communities from the $35 trillion. The Buffett children foundations have purchased farmland to create an agricultural hub in Kingston, New York, on the Hudson River north of New York city. They also set up a food cooperative in an old Honda dealership, and setup a ad free community radio station Radio Kingston. More of this kind of work is needed from individuals and couples in the American tradition of community awareness and solidarity, and in communities across Europe, Asia, Africa and Latin America during this pandemic following the same practice. ...

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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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The dangers to public health from Tobacco use in China are huge. About 1 in 3 cigarettes in the world are smoked in China says the WHO prominently on its site. The result high levels of cancer, lung and heart disease that could be prevented. A similar situation exists in India and South Korea. Asian countries have performed badly in tobacco use and production creating catastrophic public health risks, even countries that have adopted new technologies and caught up with Europe and the US. 

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A report by the Longevity Science Panel for the UK says the life expectancy gap between the richest and poorest neighborhoods in England has increased since 2001. In 2001 this was 7.2 years, by 2015 this increased to 8.4 years. The government points to cancer rates, the Longevity Science Panel report authors say income inequality was the main factor. To do this report LSP looked at data from the Office for National Statistics for 2015, which divided England into 33,000 residential areas and rated them on factors ranging from income levels, health, education and crime. This report points out that men and women from the bottom fifth were 80% more likely than the top fifth to die in any given year. 

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The UK is open to American proposals for a global minimum tax rate given that it includes a fairer split of the taxes from US tech companies. Discussions are taking place under the umbrella of the OECD, the Organization for Economic Cooperation and Development. This is intended to prevent tax escape by large companies which choose the lowest tax jurisdictions that are set up just for that purpose. The result has been that Europe and the US have suffered from decades of underinvestment and neglect of essential infrastructure and weakened the health and education systems leaving essentials of quality of living underfunded in cities and towns across Europe and the US. The pandemic has brought the lesson home in many ways. The UK has already increased the corporate tax rate to 25% in March to help pay for pandemic related help packages. The US Biden administration has proposed a 28% tax rate, and Treasury Secretary Yellen has suggested 21% as the minimum corporate tax rate. ...

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Problems older workers face as they try to remain active, stay healthy with active participation, contributing to the economy. In societies like the U.S. where age has different meanings compared to Asian societies, older workers have to conceal their age. This goes against the need for greater workforce participation of older workers to make up for the effect of aging societies and fewer younger workers.

It is a good thing that labour force participation rates of workers in their 50's, 60's and 70's are growing, good for the health of the workers, good for their financial health nearing retirement and good for the productive contributions to the economy. Imagine all that experience going to waste.

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Much of the reward for Labour goes to Health, Nutrition (food choices), and Education (schooling choices for children). This is the backbone for any Nation that is going to be strong and have a good future. Yet economic structures in 2026 and for decades has swung too far in one direction away from Labour and more and more for Capital, creating grave risks for the Nation, and setting the US as the wrong role model. Labour and Capital in 1980 vs 2026- increasing reward for Capital from 7% to 12% of GDI decreasing for Labour 58% to 52% in same period. In some areas this is not so because other regions have set their own priorities and this is a good thing Europe has a strong and fair access healthcare system, India has a strong and fair access pharmaceuticals healthcare system, which act as role models for the US. In 2026 RFK Jr, Dr. Oz at HHS and DJT are focused on getting US pharmaceuticals prices down to levels in the European Union. The real dangers of the skewing in the direction of Capital of rewards is creating a class that is not sensitive to the lives of ordinary people resulting in fracturing of society. Something like that happened in 1600-1800 in India and China leading to the disintegration of society and becoming overcome by foreign European powers which had more dynamic societies from the bottom up that led to discoveries in science leading to the industrial revolution. One detects something like this happening by accident by poor governance and bad decisions for wars (Bush-Clinton-Bush-Obama), and the same administrations pushed by bad advice from economists to ship the productive manufacturing resources of the Nation to China. If not reversed it would lead to the kind of decline Asia witnessed after 1600- hitting all classes of society and destroying the economic structures as foreign powers get the upper hand. The surrendering of research labs and higher education in advanced science fields to foreigners at US and European universities poses similar risks as fractured society with Capital dominant and unaware of the risks. Such societies have less perception of such risk than a bottom up built social, economic and political framework with large numbers of aspiring local citizens seeking these positions in science and technology in the Nation. ...

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Obama Affordable Care Act ACA and its downfall are covered by two experienced authors over 2 book written over 2 decades. The authors are James Morone and David Blumenthal followed the healthcare issue over 25-30 years through the Clinton, Edward Kennedy and Obama efforts and wrote two books. The first was "The Heart of Power" on the healthcare situation from FDR to 2008. The last titled "Whiplash" in 2026, for which the authors are interviewed in Harvard Medicine magazine. C-SPAN has a book program on this book at a Washington DC bookstore. From the discussion on C-SPAN between Senator Michael Blumenthal, borther of one of the authors, James Morone and David Blumenthal physician, couple of conclusions are seen that may be new to readers. Q. What was the one single factor that doomed the Affordable Care Act? A. The deep antipathy towards the Obama administration influenced the response to the Obama handling of healthcare. The likelihood of Republicans accepting healthcare from a black person was simply not there say the book's authors in the discussion and Q&A on C-SPAN. Yet there were other reasons for the ACA failing. Obama had not gauged the mood of the nation well. UK Labour's Starmer won by a big majority in 2024 yet that does not reflect the mood of the British nation just 2 years later- by election year 2012 Obama's campaign was faltering and had to be rescued with Hispanic votes and a weak candidate in Utah's Mitt Romney. Obama lacked maturity and came in the way Bush came in when the list of candidates were mediocre in the US, similar to the period in the UK with David Cameron and Boris Johnson. To take on the health care issue required someone with the experience and caliber of LBJ, which Obama clearly lacked, coming from the minority community was not going to help in credibility. Obama's presidency was thus premature and to gain experience he would have done better in a key cabinet position such as at Department of State where an intellectual could have influenced world opinion in favor of emerging countries, a doable and necessary. Obama's lack of experience showed when he told Republicans two words in the first months in 2008- "We Won," perceiving arrogance it would set Republicans against him. The years 2008-2016 cost the US dearly in that the US needed a withdrawal from all of the Middle East which would require a strong president  with deep roots of support in all parts of the country including the south, to avoid recriminations. In the end by continuing the wars Obama weakened the US and let China move ahead. Q. Did Obama consider Medicare for All? A. Obama told Congressmen of his party according to Morone- if you can get 60 votes in the Senate for Medicare for All we can try.  Q. Would it take a major upheaval for Medicare for All to be accepted now that the health system is failing all Americans in 2026? A. It will take a world war or a economic depression- some major disaster for Medicare for All to be accepted in the US, say the authors. A pandemic happened in 1918 and again in 2019 the results were not positive, as the authors believe it unleashed the war on science after the vaccination for and against camps, leading to the culture wars in America seen today. Q  Obama's analytical mind thought he learned from the Clinton efforts in healthcare that failed. But he did not see things from the heart. There is good reason to think that the lessons learned of moving fast, letting Congress write the legislation, settling for what can be done not what needs to be done, were exactly the wrong lessons to be learned as opposed to writing off the Clinton experience entirely as Clinton's, and starting from scratch without preconceptions. In the end Obama if he was older, had more experience, and listened to the mood of the country would have realized that healthcare was for another day, and got right down to the most difficult challenge, to end the wars in the Middle East. Even small steps in the right direction would still have earned appreciation him today. Instead Bush and Obama, the most inexperienced of presidents will be remembered for wars they continued that weakened America.       ...

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15% or 1000 of 6800 Yale Students get free tution at $75,000 cutoff income level for free tution since 2020.  With $200,000 as the new cutoff for incomes getting free tution it would cost Yale $72 million more, $72,000 being the tution cost per year and additional 1000 students getting free tution at the new cutoff income level. This suggests it only costs Yale $72 million to look like it is doing something for the middle class that cannot afford Yale's high undergrad tution. But what is Yale doing about the high undergrad tution? Yale Tution goes up from 31,000 in 2005 to $48,000 in 2015, and up further to $72,000 per year for undergrads in 2025. In percentage terms the increase in last ten years is 50% and comparing 2025 to 2005 over 20 years it is up 232%, and comparing 2015 to 2005 it is up 55%. There is no slowdown in the increase in cost of tution at Yale for affordability. Middle class is being squeezed. Parents have to go into savings to send a child to these upper tier schools, as reported in WSJ, with incomes of $250,000 not enough to payoff huge tution fees of undergrads when there are 2 or 3 kids going to college. For Yale it is about business as usual as it can afford the additional $72 million for 1000 more students to be added at free tution- its endowment is at an hefty $44 billion which can easily handle that $72 million added cost to look good in front of the public while leaving things the same in terms of affordability and cost. All down the line at the second tier schools the situation is the same, only down the line when it comes to state universities do things change, but only a bit. It leaves Americans with the feeling that this system is also fundamentally flawed like the health care system and needs complete overhaul. ...

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Tyler Cowen, Professor of Economics at George Mason University, points out some basic truths about health care as it is practiced today in the USA, and healthcare spending as it stands today. He questions whether starting out with extra spending plans to provide coverage to all will help solve the basic problems facing American health care. Too many tests and diagnostic procedures used by doctors is not aproblem that will be solved by spending more money to cover everyone. And government taking on more spending to cover all will not address all the other major shortcomings of the American way of practicing medicine, like prescribing a battery of tests, that tend to drive up costs, to just mention one of the problems. And it will not address any of the shortcomings in the way Americans take care of their health, diet, exercize and healthy lifestyles. THese are critical to get good health outcomes for the people, and which combined with careful spending of dollars where it will provide the greatest benefit, is the only way the health care solutions can be found....

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Nurses of the National Health Service on strike for fair wages to meet rising inflation in the UK are shown here in The Guardian.

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48% of British voters see immigration as the most important issue, says Ipsos. And 31% say their local area is housing more than its fair share of asylum seekers growing to 61% of Reform UK voters. Reform UK is now leading party with 34% of the vote to Labour's 25% and Liberals 11%. The report in the WSJ on Augu 28 shows how the Labour government did not live up to it's talk on immigration. It also shows how the Conservatives and Boris Johnson failed by opening up non EU immigration from Asia on the grounds that it would bring in the brightest and yet dropped the basic college degree requirement paradoxically or carelessly. Lobbying from health care home care hugely increased migration for this field under Conservatives and is only now being reversed by Labour. Labour has been too slow and the culture of Britain and Labour has not changed enough to grasp the problem. Their are vested interests in Britain such as universities and home care health care that have influenced the conduct of policy so that migration on non-eu has replaced eu migration after Brexit, but not attracted the most qualified immigrants. The 4% of the British population that entered Britain after Brexit as immigrants, millions arrived and now when Labour is trying to bring this down faces a large number of dependent applications. University students are now bringing in their dependents at rates that have skyrocketed. ...

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Shorter work hours can provide time for yoga classes, time with children, travel overseas, and other activities for a healthier and more satisfying life. This report in WSJ shows people in different professions from medicine to environmental engineering taking a different approach to life. After the pandemic there is a rethink of what is a better way to work and combine work with attention to healthier living. Healthier living provides the concentration power that enables doing a lot more work in fewer hours creating a new way of working with time for healthy activities outside work. WSJ shows how this works in the lives of 5 workers and their families. For many workers it is possible to earn close to what they made with longer hours by utilizing the time more effectively, with all the added benefit of healthier lives- this adds up over the years reducing many of the health problems that come from neglecting healthy activities during prime work years. 

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Churchill came up with the idea of British restaurants that serve nutritious meals at reasonable cost so that no family would suffer from lack of access to healthy food at moderate prices. This would insulate people from the high prices during the war in the 1940's for food and energy. The Guardian shows these public diners in 1940's Britain. At its peak there were more British restaurants of this kind than McDonalds's or Weatherspoon's exist today. There is a need for this type of government supported food place that serves affordable meals serving quality food ethically produced as a new form of national infrastructure. Nourish Scotland is calling for reviving it today. It tackles health inequality and food insecurity. Abigail McCall, project officer at Nourish Scotland, says- "For other aspects of our wellbeing – water, transport, healthcare, even wifi – we have built the public infrastructure to ensure that everyone has quality, universal access. We are missing that in relation to food,” said Abigail McCall, project officer at Nourish Scotland. “Poor diets have overtaken smoking as the leading cause of preventable ill health for some time now. We need the government to make a bold intervention in our food environment, and invest in delivering what the market doesn’t: healthy, climate-friendly food in a convenient way and at an affordable price."   ...

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Britain's National Health Service IT initiative failed because of a top down emphasis and focus on procurement. The project was started by Labor in 2002 and budgeted for 12 billion pounds. Lohr talks with Dr. David Brailer, and Dr. David Blumenthal, who headed the program for health IT in the Bush and Obama administrations, and with Richard Alvarez of Canada Health Infoway, which is the nonprofit corporation setup for conversion to electronic health records in Canada. Dr Brailer says the program in the UK was forced top down on doctors and nurses, and seen as a procurement program, ignoring the human aspects related to doctor preferences. Dr. Blumenthal empasized the need for collaborative effort all the way with doctors and nurses in a program of this kind. The confrontation that resulted from the lack of participation by health care professionals led to failure. Britain's new Cameron government ended the program.

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Britain's National Institute for Health and Clinical Excellence (NICE) says Glaxo's drug Benlysta for lupus is not "good value for money." The drug is priced at 10,000 pounds a year in the U.K. ($15,600) and much higher at $35,000 a year in the U.S. Benlysta is covered by insurers in the U.S. and some European state run health systems according to Glaxo. NICE also rejected a new multiple sclerosis drug Gilenya, which costs 19,000 pounds a year in the U.K. ($29,700), and $48,000 a year in the U.S.

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Prime minister Theresa May of Britain announces her plan to spend an additional 20 billion pounds a year on the National Health Service. Over five years the commitment is for an additional 70 billion pounds. By 2023 this will bring the UK to the point where it is spending the same proportion on health care as France. This also fulfills a promise made by the pro Brexit campaign. May says some of this would come from higher taxes, and 9 billion pounds that the UK contributes to the European Union each year would go to pay for the additional funds to the NHS. The 2017 British election with Labor winning 40% of the vote has affirmed the shift in public sentiment to greater commitment of funds for health and education. Poorer communities in Britain that were left behind tended to vote for Brexit, with a large gap widening between London and the rest of the country. Higher commitment to NHS is part of the shift in perception that the needs of health, education and underserved communities are the new priorities. ...

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US $1.5 trillion budget request for 2027 fiscal year by the president for military and defense spending is about 4.7% of US GDP forecast of $31.8 trillion in 2026. In 1960 it was 9% following the Korean War. It dropped to 3.1% of GDP by 2000 and stayed around 3.4% till the current effort to modernization of the US military is thought to require about 5% of GDP.  (World Bank charts). The US spent far higher during an earlier period reaching 14% of GDP in 1953 during the Cold War with the Soviet Union. This report shows WSJ Analysis of where the $1.5 trillion request for Defense is going-  $1.1 trillion for War Department and $350 billion for critical munitions. The munitions are in short supply and war in Iran shows that it plays a critical part in defensive systems such as intercepting of missiles as missiles in short supply affect overall capabilities. An additional $200 billion for Iran War. Pay raises for Defense personnel. $66 billion for shipbuilding- 34 ships to put the US back in the lead for shipbuilding it has lost to China, with the help of Japan which is also ramping up the shipbuilding it has lost to China. US and Japan were leading shipbuilders in the  1930's and in the 1960's, then lost it to South Korea and China. About a 12% decrease in other Department's budgets including Health and Human Services, Treasury, Commerce, Interior, Housing and Agriculture.  These cost reductions some of it coming from more efficient functioning and from concepts such as zero based budgeting where every line item in the budget gets reviewed every year for how much is needed for the purpose, is the purpose still valid, and can it be done more efficiently costing less. $660 billion is coming from the savings. The Nation's capital will also get a facelift, a major renovation, after being ignored for years. In the new Budget is $10 billion for the Presidential Capital Stewardship Program within the National Park Service for beautification projects in Washington D.C., which will give the National Capital a much needed new look for millions of visitors from the 51 states in the Union.    ...

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The Guardian shows pictures of empty vaccination center in Erfurt, Germany, as the use of the Astra Zeneca vaccine is temporarily paused. The European Medicines Agency says the vaccination benefits far outweighs any side effects from rare blood clots. UK Health and Medicine Regulatory Agency and health experts also confirm this. Astra Zeneca says its trials showed fewer blood clots in those people who were vaccinated than in the people not vaccinated.

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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....

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The contrast between modernizing, developing East and South Asia ( from Mumbai to Shanghai) with war torn desolate West Asia (from Tehran and Baghdad to Kabul and Islamabad) is so striking today that it is something to reflect upon for wisdom and understanding. UAE support for Sudan's RSF Rapid Strike Force and Saudi support for the military - fracturing of Sudan, errors piled on errors led to the civil war in Sudan. A civil war in a country neighboring Saudi Arabia just across the Red Sea. Saudis and UAE were on opposite sides briefly after UAE pulled out of Sudan, UAE acting in this way to object against Saudis requesting US sanctions on UAE.  Once close partners have moved apart as they spread their influence in different conflicts in the Middle East.  This has not created a region that can grow economically without the disruptions of conflict in the way other parts of Asia have emerged to modernize the countries as in Taiwan, Korea, China and India. In neighboring Pakistan another conflict has emerged as partners split, with looming conflict between Afghanistan and Pakistan. Yemeni Houthis are in conflict with the US and affect the Persian Gulf shipping lanes.  Iran with it's pursuit of weapons programs and nuclear weapons is using capital that is badly needed to improve the economic situation on arms buildup for the regime and for allies in Lebanon and Yemen, leading to protests and crisis. In this way the Middle East has failed to use oil wealth to modernize the entire region. Much of it was wasted in Iraq and now in Iran by policies that led to war and regional conflicts not modernization and technological transformation that has happened in Asia. The US has inadvertently becoming a partner to this as when the Obama administration helped fund Iran's economic rebuilding which was instead used to fund the military, and before that the Reagan administration support for Iraqi socialist ideology regime. The challenge for China was how to modernize after the Japanese invasion and civil war. In Korea it was how to modernize after the civil war. In India it is how to modernize with a smaller neighboring country Pakistan promoting terrorism and wars now with China's support. In Asia all these challenges were and are being met to steadily and persistently modernize to European standards with a singleminded focus and determination to meet the aspirations of the people with the US business working alongside Taiwanese, Korean, Chinese, and Indian governments and private industry. In West Asia various ideological (Iraq), military (Pakistan), religious Shiite (Iran), religious + modernizing (Saudi +UAE) with erratic leaders and little representation of the people, has destroyed the tranquillity of the region and destroyed democratic forms of government, destroyed bottom up education and health of the population except for priviliged groups in countries in the region of West Asia. Involvement of US and Europe or Russia in West Asia has led to distintegration of Soviet Union (Boris Yeltsin) and deindustrialization of US and Europe (Reagan, Bush, Clinton, Bush, Obama administrations) with business shipping out manufacturing to China while wars engaged the attention of American and European elites in Iraq, Iran, Pakistan, Afghanistan. The entire west Asian scene for 1950-2030 has been a disaster, one massive disaster for all involved. The contrast with East Asia and South Asia reminds one of the words from Robert Frost of New England in Mowing- that reflects on the enduring value of honest labour. "My long scythe whispered to the ground. What was it it whispered? It was no dream of the gift of idle hours, or easy gold at the hand of fay or elf: anything less would have seemed too weak to the earnest love that laid the swale in rows. The fact is the sweetest dream that labour knows. My long scythe whispered and left the hay to make." ...

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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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Omicron cases are up in an almost vertical line on a graph with cases doubling every 2-3 days in the UK, similar to the pattern in South Africa during the beginning of the spread in South Africa. Since then early data in South Africa show the trend in the province of Gauteng, center of the omicron outbreak in South Africa in the Johannesburg area, has reached its peak. On Dec. 16 it recorded 27% of national infections compared to 70% the week before. Head of the National Institute of Communicable Diseases in South Africa, Michael Groome, says "we had areally dramatic increase in Gauteng, which has now leveled off."  Hospital admissions in South Africa show a different pattern than earlier hospital admission rates in previous waves, with only 1.7% of cases being hospitalized in this Omicron wave compared to 19% for the Delta variant wave at a similar point in the wave, says Health Minister Joe Phaahla. In UK as of Dec. 14, this WSJ report cites health authorites saying 73% of cases in London are omicron variant, doubling every 1-2 days, with omicron making up 41% of all cases in England. In the US the Centers for Disease Control show Omicron variant making up 2.9% of all cases in US as of Dec. 11, with highest concentration in New York, New Jersey of 13.1%. Proportion of positive tests went up from 3.3% to 5% in New York City. A convention in New York City, Anime convention at Javits Center, November 23, 2021, shown in a recent NYT report, could potentially have acted as a super spreader event in New York according to NYT though not confirmed, similar to football stadiums events in Italy in March 2020. Dense atmosphere and large crowds increase the risk of a super spreader event happening, say experts. ...

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Questions may relate more to how these situations affected the role of Gates and similar individuals in protecting the interests of the US, Europe, India, Latin America and Africa in health organizations such as the World Health Organization. As globalization spread governments in the West surrendered some of the essential role they played in world health organizations to individuals and NGO's, and countries lacking experience needed for such an important task. The mishandling of the pandemic is partly a result of this retreat by western governments from the role that they have played during the nineteenth and twentieth century. In the US letter to the WHO by president Trump the role of Gro Harlem Brundtland of Norway was shown in handling an earlier virus epidemic that originated in Asia so that it would not spread and could be controlled. This is the H1N1 crisis in 2003 cited in Mr. Trump's letter to the World Health Organization. Brundtland took strong action that was missing during this pandemic after the US and western nations surrendered the essential role they have played for centuries based on role in medical science discovery for maintaining public health. Surrendering this role or seeing it erode is one of the biggest mistakes of our time and a mistaken form of globalized behaviour. It is only now being corrected as the realization dawns on major nations such as US, UK, France, Japan, Russia, India and other countries about the essential stability provided by western nations knowledge, experience and resources to this task of maintaining global health. Even a nation like India has to base its role on hundred or more years of work in medical science and commitment to public health that transcends political preferences or national interest to take on and be a worthy participant with the advanced nations that have played so great and beneficial role for the world in public health. What to speak of transient interest of nations in the developing world or countries where national interest or political preferences play a part in public health of the peoples of the world. This responsibility for world's public health can never be delegated to individuals, foundations or any one country, or small countries, or a combination of these, only to the collective experience of the last 300 years in medical science discovery and the role of Europe including Russia, and the US in leading the way.  The Biden administration has the same underlying concerns as the Trump administration about this mishandling of the pandemic and the disasters that followed bringing so much death and suffering This excerpt on Brundtland of Norway is from the letter the US sent to the World Health Organization- "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." ...