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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. ...

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The basic problems facing American health care. Douglas Elmendorf , head of the Congressional Budget Office, says none of the bills he has seen make the fundamental changes needed in how medical care is delivered and paid for. The big issue is the unwilingness of different interests to accept serious changes. THe NYT says the long run solution to the problem of rising costs is to move away from the fee-for-service system that pays hospitals and doctors for each additional service they provide and into anew system that is organized around ways that encourage low-cost and high quality healthcare. The difficulty is that the long run may be too far, considering the seriousness of the crisis. Elmendor also suggests taxing employer provided health benefits, as this will discourage the excessive use of medical care. As the NYT says this is politically risky, even though it believes this may be a way to the new system which has to discourage the use of health care in the manner it is conducted now, with too many tests being conducted. A new system requires an enlightened approach on the part of each interest group in the face of a crisis, and the failure to do that may only end up retaining some of the worst aspects of the old system just mentioned that drive up costs and make universal health care unaffordable....

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Fact checking Apple CEO Tim Cook's statements on the EU Commission ruling for $13 billion in back taxes, shows that CEO Tim Cook's statement that "we never asked for, nor did we receive any special deals," is not true. Ireland let Apple determine what it would pay in tax, and Apple had the benefit of loopholes in Irish tax laws, the fact check by experts shows here. Apple's Cook also says it would hurt investment and jobs in Ireland. Another NYT article showed that the entire healthcare budget of Ireland would be covered by the $13 billion, and 66% of its budget for social support services to the public. Apple has 22,000 employees in Europe and 6000 in Ireland in 2016. Based on the $13 billion owed in taxes, for every job in Ireland the cost to Ireland is 2.17 million euros, and for every job in the EU the cost is 590,000 euros. Apple could turn around and locate in some other place, other than Ireland, in which case Ireland does not get the 6000 jobs. This is Ireland's incentive to give Apple tax benefits. Only if all EU countries had common tax laws would it be possible to avoid this situation, and generate much needed tax revenues at a time of cuts in public spending in healthcare, education, and social services, and invest in infrastructure, worker retraining. The alternative is for the EU to look at other remedies. This is what the EU Commissioner Vestager did when she announced that this was a state subsidy and illegal under EU rules. Because the appeal by Apple goes to the EU Courts the appeal is difficult say legal experts. The EU courts look at the legal aspects of the ruling, was it justified, not at the overall aspect of the ruling by Vestager, as EU Competition Commissioner. This may be why there is so much outcry from Apple, and other digital companies.  ...

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Using the design-build method under which architects and construction experts work together as a team, Orange Medical Centre, a new 374 bed hospital in Middletown, New Jersey, has reduced the construction costs by one third. Only 9% of the total square footage of hospitals built in the USA used this method according to Modern Healthcare an industry publication, so this is one more area in which health care savings can be found- and there may be many more areas like this- which goes to show that ingenuity, experimenting with new ways and asking questions about old ways of doing things, can generate large savings, especially when it becomes a necessity. As the old proverb says, necessity is the mother of invention. Design-build differs from traditional construction in that the architect and the construction company come from the same company. They understand each other so well that they can finish each other's sentences. This cuts out the waste and back and forth that goes on with changes that are made, as the changes are minimal. This is a big source of the savings. This is similiar to the integration of design and manufacturing experts into one team in the auto and other industries. HBE Corporation of St Louis is the company that handled this work. Its asmall outfit with 500 people and this is the largest hopital it has built, so there is potential for doing alot more in this field for health care savings....

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US president Biden's effort to appeal to all American families and workers in the $2 trillion plan for investment in child care, paid leave, healthcare and education, and the importance of staying away from the divisive and polarizing effect of the Clinton years on Republicans, is part of the new approach of the Biden administration as it tackles America's most important problems with hopes for bipartisan support.

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The union representing 75000 nurses and pharmacists and other workers in California reached a settlement after a 3 day strike. Julie Shu, acting Labor secretary participated in the negotiations. Kaiser Permanente has 40 hospitals, medical offices and 213,000 employees other than doctors, serving 12.7 million people on the West Coast of the US. A sticking point was outsourcing. It is the largest strike of healthcare workers in the US for wages and benefits.

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Bernie Sanders presents the case for Medicare for All, healthcare for all legislation in the U.S. Congress introduced in September 2017. It has the support of 15 Senators. He says the current system is costly, wasteful and bureaucratic. It is time says Sanders for the U.S. to join the rest of the industrialized world, join Britain, France, Germany and other countries of Europe, Japan and Australia, Canada, with healthcare for all Americans. After all he says only 50 miles north of his electoral district in the Burlington, Vermont area is Canada, where the system of healthcare for all works better than in the U.S.  And the Canadians, Germans, French, and British do this spending less than half the U.S. does. In 2015 the U.S. spent $10,000 per person for healthcare, this means that it cost less than $5000 per person in these advanced countries and the way they do it can be studied and its best aspects adopted by the U.S.  He says this is because the U.S. healthcare system is designed to maintain profits for the medical-industrial complex. A major problem is the manner in which the issue is distorted by different sides on the issue of health care in the U.S., without a consensus being developed on what the common interest is in a civilized society. Mostly because the U.S. unlike other societies is still grappling with the issue of what values it embraces on healthcare being made available to all. Under this legislation the transition to healthcare for all would take place over 4 years. In the first year eligibility for Medicare would start at age 55 years, and children under 18 would be covered. In the second year the eligibility starts at 45 years, in the third year at 35 years, in the fourth all are covered.  ...

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See Tim Walz's full speech at the Democratic National Convention in Chicago, August 21, 2024 in his video from CBS News. Lyrarc has selected excerpts from Tim Walz's speech above showing what the Trump Republican party plans to do that will gut Social Security and Medicare, and kill the Affordable Care Act, gut efforts to lower exaggerated cost of medical drugs and healthcare. This excerpt shows what Harris will do to build a better life for workers and families and people across all 51 States, in education, childcare, healthcare, cost of living, and housing costs- "We’ve got something better to offer the American people. It starts with our candidate, Kamala Harris. From her first day — as a prosecutor, as a district attorney, as an attorney general, as a United States senator, and then our vice president — she’s fought on the side of the American people. She’s taken on the predators and fraudsters. She’s taken down the transnational gangs. And she’s stood up to powerful corporate interests. She has never hesitated to reach across that aisle if it meant improving your lives. And she’s always done it with energy, with passion and with joy. Folks, we’ve got a chance to make Kamala Harris the next president of the United States. But I think we owe it to the American people to tell them exactly what she’d do as president before we ask them for their votes. So this is the part — clip and save it, and send it to your undecided relatives so they know: If you’re a middle-class family, or trying to get into the middle class, Kamala Harris is going to cut your taxes. If you’re getting squeezed by prescription drug prices, Kamala Harris is going to take on Big Pharma. If you’re hoping to buy a home, Kamala Harris is going to help make it more affordable. And no matter who you are, Kamala Harris is going to stand up and fight for your freedom to live the life that you want to lead, because that’s what we want for ourselves, and it’s what we want for our neighbors."       ...

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Former Senator Jim DeMint lays out his reasoning for the Republican fight to defund ObamaCare, as the healthcare legislation is now called by Republicans. He points to problems with the legislation with issues about how much the added entitlements will cost in the future( more than the $250 billion by 2023 estimate of CBO insists DeMint based on the general lowballing of projections), and higher premiums for the young and elderly on exchanges. He says the 2012 elections were fought on economic issues not ObamaCare, and that the public he has met in visits to different states as president of the Heritage Foundation continues to be skeptical about ObamaCare. He sees the correct role of the Opposition party to point out the deficiencies in the law and call for corrections in the path for healthcare.

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This editorial in the WSJ shows that culture wars distract even the major candidates of the Republican party from providing the American public with positions on serious issues of cost of living, healthcare, education, infrastructure, new technologies such as EV's, and renewable energy transition. The wars in remote parts of the world acted as a distraction during the Bush, Obama and Trump administrations from these serious issues. As the WSJ points out much of it ends up being effort to gain personal advantage in some way.

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The problem of elites in the US controlling most of the wealth and funding of candidates is discussed in The Times by Matthew Syed. The distortions in the American system of democracy and lack of funding of infrastructure, basics of education, healthcare, and public services, the misallocation of capital by capital markets in the current state, a reversal of everything Lincoln, Teddy Roosevelt and FDR- Truman set out to do, that is a result of the current situation prevailing in America.

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Amazon's efforts to expand into fields outside its logistics, Prime, online retail, Amazon Web Sevices (AWS), search Advertising, which make up 90% of revenues. This includes the forays into devices with Kindle, healthcare, grocery retail stores Amazon Fresh. Amazon has less success with these ventures. Most of the success is in retail, online, Prime and AWS with 40% growth in 2019-2021. Amazon is struggling in new business  outside core online retail, logistics and AWS.

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Every day lost in the struggle with coronavirus is a big thing, which is why Itay's most affluent northern region has gone from being well equipped with resources of healthcare to seeing the health system overburdened to the point of disaster. This WSJ report shows why this has a lesson and an early warning for how the U.S. and other countries should design their response. It is also why the White House team that includes President Trump in the U.S. emphasized the plan for just the first 15 Days in the news conference at the Brady Room in the White House on March 16. It is saying the first 15 days are critical, not a day to lose.  It does not matter if you are an advanced economy with state of the art hospitals. Social behaviours must change, old rules rewritten and implemented throughout nations, quickly in days. Here WSJ shows lessons learned by Dr. Cereda at the Hospital of the University of Pennsylvania who trained in Milan and was in constant contact with colleagues in Milan and elsewhere. Many of the lessons relate to not overburdening hospitals and health systems and protecting health systems. This means mild to moderate cases are managed from home and not in the hospital, through massive deployment of outreach services and telemedicine. It means therapies can be delivered at home or through mobile clinics. The second major lesson from Italy is to protect healthcare workers and doctors. The entire White House team with Dr Faucci of CDC and Dr Brx, head of Infectious Diseases in the U.S. news conference of president Trump March 16, focused on the goal of protecting healthcare workers, doctors and hospitals, so they remained strong to take on the crisis. The second goal of the White House team is to protect the elderly with medical conditions. To do this only the most serious patients are treated in hospitals the rest for mild to moderate at home.  Studying the conditions in Bergamo and other parts of Lombardy and northern Italy, is helping U.S. medical leaders to prepare for the current nationwide effort, the 15 days plan announced by the White House. The lessons from the Papa Giovanni Hospital in Bergamo are important say U.S. medical leaders, including Dr. Brendan Carr, head of emergency medicine at Mount Sinai Health System in New York.  He says build capacity in hospital beds before we need it. Clear out hospital space and add new hospital beds.  ...

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  The hundreds of billions of dollars these American AI people talked about are needed to rebuild the nation's infrastructure, schools, water, housing, education, healthcare and other needs that directly raise living standards. DeepSeak is the AI model of Liang Wenfeng's $8 billion hedge fund Deep-Flyer. It does what Microsoft's OpenAI does at a tiny fraction of the cost. It proves that smaller competitors with less funding can tackle AI. This includes AI Mistral from France and AI startups from India and other countries.  Another immediate effect of DeepSeek as an open AI model is to provide serious competition for Nvidia and OpenAI and the big spenders such as Google, Meta Platforms that seek to dominate every niche in the IT world. It proves that the latest cutting edge chips such as Nvidia are not needed and that one can come up with other methods and software to do what others can do without the latest and most powerful chips that cost a lot lot more by huge magnitude. It is what happened in the Space Race to put satellites in space- the entities that can do it at less cost such as the Indian space program entities are the ones that dominate the field- cost matters. The hundreds of billions of dollars these American AI people talked about are needed to rebuild the nation's infrastructure, schools, water, housing, education, healthcare and other needs that directly raise living standards. ...

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Hospitals in New York City are coping better in the current wave of coronavirus variant in December 2021 as the symptoms of patients are milder and patients are going home quicker. This report covers NYU Langone, Northwell and Mt Sinai, Presbyterian  health systems. Only about 2% of healthcare workers were lost through dismissals because of the vaccine mandate at Northwell, which is the largest health system in New York City with about two dozen hospitals. About 400 covid patients turned up on Friday Dec. 17, a fraction of the 1350 last January and of the 3500 in early spring 2021. The head of integrated operations,, Dr. John D'Angelo says Northwell has enough staff to meet projected needs. Most covid patients had underlying health problems and a quarter are vaccinated up from 10-15% a month ago. Vaccinations and two years of experience make for a different picture now, though there will be challenges and I think we're going to have to think through a bit carefully, says Dr. D'Angelo. ...

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Heidi Vogt provides this exceptional account on the U.S. and international efort to build Liberia's healthcare system from scratch. Years of civil war till 2003 and the shortage of funds mean that even basic equipment such as X ray machines and blood testing equipment are lacking in Liberian hospitals. Even with a effort that includes the U.S. Army and Air Force planes, a 25 bed hospital for healthcare workers using tents will take till early November to be operational. Showing that the response is sorely inadequate here in Liberia leading to the spread of Ebola to Europe and the U.S. by December at the current pace. Liberia's head of Ebola control says the international community has failed Liberia with its inadequate response. For the U.S. and Europe an inadequate response creates new dangers as the public has lost confidence in government response.

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No one in Northern Ireland wants to go back to the sectarian clashes of the twentieth century says one resident of the region. Most people recall the divided barricaded border with watchtowers and helicopters with extreme anguish. All that was dismantled long ago. But Northern Ireland still looks to the outside for help. Will president Biden bring new investment in the region? Can the Sinn Fein and DUP be persuaded to work together with US participation. A new generation has moved away from the sectarian to the economic issues of the cost of living and provision of public services in education and healthcare across the region. This was affirmed by Sinn Fein winning 27 seats the largest bloc in the 2022 election where focus was on economic issues and the quality of life. Because of Mr. Biden's very personal connection to Ireland there is much hope in Ireland for a new chapter to be written again. There is also a different sentiment in Britain with Keir Starmer's experience as human rights adviser to the Northern Ireland Policing Board. Starmer attributes his decision to go into politics to this experience seeing the changes he could make in Northern Ireland from the inside. The switch to a government by Labour could come at a good time for Northern Ireland and for Scotland.  ...

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For the first time the public in Britain believes the Labour party under Keir Starmer can do better than the Conservatives under Johnson to improve healthcare, give respect and dignity to workers and families lost in the last two decades, improve incomes, and tackle the pandemic. Labour now is up by 4 points and Conservatives down by 3 points in a YouGov poll done for The Times. Following the lead of Scholz in Germany with the SPD in alliance with the Greens, and Biden in the US, Britain is faced with a real choice for the future.

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Many of the News properties of Rupert Murdoch take positions that negatively affect women, inequality and mobility, cost of living, income and wages fairness, climate change action, government investment in infrastructure, healthcare, and education, childcare. After Rupert the media properties go to the 4 children  Lachlan, James, Elisabeth and Prudence with each getting one vote under a irrevocable trust set up in 1999 in Reno, Nevada. Rupert and James says this story in NYT are making efforts to amend this trust to change governance provisions for the news properties so that Lachlan has majority voting rights. This is now opposed by James, Elisabeth and Prudence with courts in Nevada asked to see if this is in good faith and in the interests of all 4 children.

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Leonhardt of the NYT provides a useful look at several graphs showing how the last 2 decades have seen an accelerated level of inequality as most of the gains in income have gone to less than one person of the population. Income gains of the majority of the American people have dwindled leading to alarming levels of inequality. The nation has not yet come to grips with the problem, says Leonhardt, as the Republican healthcare bills actually hurt the elderly and most vulnerable in the population. The Trump budget used double counting, supporting tax cuts that were based on faulty accounting, raising debt for future generations.

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US Senator Lisa Murkowski gets $25 billion for rural hospitals and assistance for Alaska in One Big Beautiful Act 2025. She was the 50th vote for the Tax Cuts Bill in the US Senate, without her vote the bill would not pass. Senator John Thune worked hard to get her on board. At about 1.30 am in the wee hours she agreed to support it only after getting $25 billion for rural hospitals and special allocations for Alaska healthcare needs, and other benefits for Alaskans including $25 billion for the Coast Guard. Places are spread far out in Alaska and patients have to be flown in to Anchorage for care. Alaska is a different place for health care including needs of native tribes. Lisa Murkowski is a rare senator with a passion to serve Alaska, and her concerns for disadvantaged people.

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Distorted priorities from the last 2 decades and lack of investment allocation for healthcare are hurting states in the U.S at a critical time. With 16 million cases of coronavirus and 300,000 deaths in December, including over 3000 deaths a day by December 12, the situation is dire. Yet states lack the billions needed to conduct the vaccination program to pay for the trucks, get the refrigeration and storage, pay the nurses and the medical personnel, outreach costs, and other costs for a massive vaccination program. Some estimates are that states need about $9 billion for the vaccination programs. New York alone needs $1 billion. For years billions of dollars were wasted in distorted priorities that benefited certain groups at the expense of society as a whole. The very large companies that benefited paid little or no taxes. 

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For the first time the number of people vaccinated in a single state in India reaches 40 million. In Maharashtra state in western India, with state capital Mumbai, the vaccinations crossed 40 million on July 20, 2021, according to the state's Additional Chief Secretary for Health. India has vaccinated 410 million people by July 20, 2021. About 3 million people are getting vaccinations daily.

Maharashtra was one of the top 5 states in the first and second waves of the coronavirus in India. About 2 million healthcare and front line workers have been fully vaccinated in Maharashtra. Maharashtra has a 2021 population of about 125 million according to Aadhar and is the second most populous state in India after UP which has an effective vaccination drive. 

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President Murmu addresses the first session at the new parliament building in New Delhi, India. In the tradition of British parliamentary democracy followed by India the opening speech of parliament is done by the president outlining the government's plans for the coming years. Murmu describes the achievements in providing basic infrastructure, water, cooking gas, rail and transport, food, healthcare to over 1 billion people in the last ten years, and controlling the cost of living. Making new investments in digital and other technologies, in infrastructure development to build an advanced economy under Vikshit Bharat by 2047, the 100th anniversary of independence from British rule. It also reflects women's empowerment and diversity in a democracy in Asia as Murmu was a schoolteacher in Orissa in the northeast and the Finance Minister Nirmala Sitharaman is a woman from the Chennai area in the south.

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Out of 50 economists in a WSJ Survey on inflation in the US, 28 economists say inflation will be higher under a president Trump. Only 8 economists say inflation will be higher under a president Biden. Trump's plan to crackdown on illegal immigration and to raise tariffs will put an upward pressure on prices say the economists in the WSJ Survey. This weeks inflation figure came out at 3%. Under president Biden inflation which reached 9% has come down to 3%, a remarkable achievement that the president alluded to in his press conference yesterday. This is a result of president Biden's cost of living actions on several fronts including housing, energy, retail prices, banking, pharmaceuticals, healthcare, childcare. Biden has made it his top priority. By raising tariffs across the board on imports Trump's actions would lead to higher prices.