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This Economist magazine editorial says the Republican plan for health care with its roll back of Medicaid expansion by limiting funding to states after 2020, and by scaling back subsidies especially for older Americans and not basing them on income levels, is likely to have its own problems just as the Affordable Care Act. One concern is that keeping healthy people in the market with a mandate that everyone have insurance is present but in a milder form with premiums going up by 30% in one year if they change their mind. There is concern that this may not work among insurers leading to an increase in premiums, pricing people out of the market in "a death spiral." This could lead to more people being priced out of the market as premiums rise. About 12 million people were added to Medicaid by increasing eligibility level to $16400, or 138% of poverty line- this reduced the uninsured from 16% in 2010 to 8.8% today. The Economist concludes that the Republican health care bill has its own problems, and that this bill does not clear up the problems in Obamacare by substituting Ryancare as the Republican bill is called. Peggy Noonan writing in the WSJ says this may have negative consequences for the new Republican base shift to populist support. Critics on the right like Rand Paul see even the reduced subsidies as an entitlement program, yet the Republicans can only change parts of the Affordable Care Act as they need 60 votes in the Senate where they only have a small majority.   ...

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The protests in the less affluent neighborhood of Mong Wok is different from the more educated people who gather near the Admiralty and government offices. Mong Wok is visited by tourists from the mainland. People here come from different backgrounds and are older.

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In his campaign announcement for 2024 Mike Pence says "the Republican party must always be the party of the Constitution of the United States." Pence former US Vice President says he chose the Constitution over Mr. Trump on January 6, 2020. The Constitution of the United States of America says "We the People..," no one individual has importance. The actual words are- "We the people of the United States, in order to form a more perfect union, to establish Justice, ensure domestic Tranquility, provide for the common Defense, promote the General Welfare and secure the Blessings of Liberty on Ourselves and our Posterity, do hereby ordain and establish the Constitution of the United States." Mike Pence showed he understood the sacrifices of the founders and soldiers who fought for the Union against the British Empire and what it means to "secure the Blessings of Liberty on Ourselves and our Posterity."

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Tom Verde of the NYT describes the problem of too much clutter in our lives. This problem is especially acute for seniors and older people, who have along the way piled up a huge number of things that their children do not need and which they have difficulty getting rid of. As seniors downsize there is only this much space. Moving from a house in the suburbs to a smaller apartment means that much less space for all the things no one needs. This problem has led to the growth of a senior move service that can cost upwards of $2500.

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Young people are having higher cancer rates by 2024 and this is linked to the higher use of alcohol and less fruits and vegetables more processed meat in their diets. Older people are seen as having lower cancer rates by comparison. Rates of gastrointestinal cancer for young people are increasing all over the world. Each generation of young people under 50 has a higher risk than the one before.

Light pollution from cell phones laptops and other devices is also suspected as it disturbs the body's internal clock, the circadian rhythm. Plastics small particles that get into water and air are also suspected.

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New bicycle lanes in Paris, Milan, to Mexico City are changing the way cities see people getting to work or moving round. New bicycle lanes are popping up in many cities. In Paris the plan by order of the mayor is to provide 400 miles of pop-up bicycle lanes throughout Greater Paris. Car lanes are giving way and being transformed into bicycle lanes. 

Oakland has moved to have 10% of the roads for bicycle lanes. In Montreal extra 70 miles are added. Bogota added 47 miles.

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Clint Eastwood talks about stuff in politics, real people, in a way that is humorous, and is asked about his various roles in movies he has made that show relations between countries and races. He recalls the time playing golf with the president and another real estate billionaire, when both told him within earshot of the other that all the real estate deals that the other was making would go bad. This he says was funny. In all this he was always the lone guy, as in the movies. This guy is 89 and he has still got stuff for some interesting movies, and he has ideas about the country and what it needs.  Mr Eastwood was mayor of a little town in coastal California in 1986 for 2 years. And yes he did not like all the regulation in the state. He tells about his removing one in the city that banned the public sale of ice cream, besides drinking a lot of tea and chatting with everyday folks. Most have forgotten and others simply from a new generation. The 2008 movie Gran Torino is one in which a Korean War veteran faces up to immigrants from Laos in an inner Detroit suburb. And what happens? Eastwood says people liked this one that grossed $270 million because it showed how someone with views at one extreme could learn more and shift to the other extreme just from seeing and talking to different people who you have not encountered before. Eastwood portrayed the American male when it was a kind of manliness unabashed. The thing about Eastwood is  that he he is sensitive to all that this meant in an intelligent thoughtful way that takes us by surprise. Some of these characters he played did not have the niceties, abrupt he calls it or that gruffness of masculineness, even a bit dumb. Talking about relations between countries and of race Eastwood had some ideas to make the Japanese language "Letters from Iwo Jima" - to give the view of what it was like for a Japanese soldier sent out from the islands to Iwo Jima. The famous battle was one he did from the American point of view in "Flags of Our Fathers." About that Japanese soldier he is sent out and told that he wasn't ever coming back. It won Japan's equivalent of an Academy Award. The interview in the WSJ with Varadarajan closes with Eastwood feeling  for the genteel ways, not calling names out loud, of an older time, without the masculinity that he himself portrayed, or only appeared to be that way when in reality he was intelligent and sensitive to other people and their ways. Perhaps that former mayor of New York, says Eastwood, offering his own idea of a switch back to older genteel ways for the country.   ...

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Small pensions and rising health care costs are problems for China's older people. The misuse of pension funds and corruption in Shanghai raises serious concern about the future for an aging population.

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China is moving closer to the day when its population shrinks. This would be a sign of a seriously aging population with fewer young people as workers to support the older people and retired workers. The number of births fell for a fifth year in a row. In 2021 births were at 10.6 million dropping from 12 million in 2020, according to the National Bureau of Statistics.  The year 1961 the last year of the Great Leap Forward under Mao was the first time in its recent history that China actually had population decline with famine and other problems. This situation of population decline is fast approaching or already happened. In 2021 there were 10.1 million deaths. Women in China are not interested in having children. Typical is this woman in Beijing quoted in this WSJ report- she is 28 and teaches Korean language. She says she doesn't want to spend her savings on kids.  In China education is the pathway to a better life and income. And it is not cheap. Most of the savings of mothers will go into educating their children. Tutoring costs had become so high and the competition so intense that the government to tackle this problem announced that this will from now on be a non profit industry. ...

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Evidence of the multicultural society that the U.S. is becoming is shown in Census Bureau information showing that 50.4% of children under the age of 1 year were Hispanic, black, Asian American or other minority groups. This is up from 49.5% in April 2010 census information. A striking change is that the white population is growing older and the Hispanic population is much younger as a whole. Today minorities are about 37% of the population in the U.S., with the District of Columbia, California, Hawaii, New Mexico and Texas, having minority population in the majority. The median age for white non-Hispanic people is 42 compared to 28 for Hispanics, and early 30's for Asians and Blacks. The baby boom of minority children is also because the number of white women in their 20's and 30's has declined over time as the White non-Hispanic population has aged. Another change that is being seen is that immigration from Mexico has declined to the point where some Hispanics are going back to Mexico. William Frey, a demographer from the Brookings Institution says immmigrants will continue coming from other parts of the world when the economy recovers. The timing for immigration say demographers is good because without the immigrants the U.S. would have an aging society like that in Japan....

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Jeannie Rice runs Marathons at 77 years and has amazing physiology. Aerobic fitness and endurance capacity of a 25 year old. Her inspiration is Joan Benoit Samuelson who won gold at the inaugural Olympic women's marathon in 1984. Joan Benoit who is 67 says now it is she who is inspired by Rice. When exercise is done at a good level over the adult lifespan it results in cardiovascular and physical endurance and capacity to perform at a high level.  Jeannie Benoit's diet- avoid sweets and fried foods and eat lots of salads, fresh vegetables, rice, fish and nuts., some cheese. Her passion: loves running and wants to inspire young people. She also goes out socially to have fun and relax. Her personal goal - to inspire older runners. She says- “I feel as young as when I was 50, and I’d like to be doing this well into my 80s. That’s my personal goal." ...

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This story in the NYT describes how the flawed effort to pass the Republican healthcare bill or repeal the Affordable Care Act passed under president Obama failed after another effort. Many developments killed it. In the end the president lost interest, especially when he saw Republican Senator Rand Paul of Kentucky go on talk shows on the weekend before its collapse to complain about the bill. Senator Collins of Maine was exasperated by the way the bill was being rushed through Congress, and she voiced her strong opinions about this by talking to people back home in Maine and sharing her conversations with the media. The bill pushed by Senator McConnell, the Republican leader in the Senate, imposed annual caps on Medicaid spending. And did this without any discussion, shutting out committee debate, any public discussion, or formal drafting. Once this process was set in motion in this way the Republican Senators formed camps. Senator Grassley of Iowa and Jerry Moran of Kansas, normally conservative moved to the moderate side. Moran held a town hall meeting covered in the NYT, where older people voiced their concerns. Most of the patient advocacy groups, the hospital groups such as the American Hospital Association, and other medical groups also opposed it.  After Senator McCain of Arizona said he could not return following a surgery in Phoenix, Senators Lee and Moran announced their opposition. With this the bill's support crumbled including any effort to repeal the Affordable Care Act.  ...

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A heart warming story of aging well of a world class Masters swimmer who stays fit at 89, Gail Roper can be an inspiration for people wanting to live healthy into an advanced age. She was a national champion by the time of the 1952 Olympic games in Helsinki, FInland. At 44 she started swimming in Masters competitions. She thinks one should not need a walker when one is growing old, provided one has plenty of exercize. She says she could be competing even now except for her driving. She lives in a senior community and swims 2000 yards everyday in an outdoor pool. Her daily routine includes, 20 sit-ups while watching the news, 20 push-ups against her kitchen sink between washing dishes, 200 revolutions on her stationary bike, 100 steps on her stair stepper, resistance bands to stretch. Want to stay straight up and down, and not crouched or humped over, then you must work at it says Gail Roper. Its that simple. It means working lives don't end when you retire, just take different shapes and adopt new routines. She speaks to 5 people everyday as a rule to keep up social skills. And she reads as well to keep her brain active. Gail starts the day with a cup of Nespresso coffee, granola and fruit, and adds yogurt. Snacks on walnuts, almonds and dried fruit throughout the day. Her main meal is lunch which includes a salad and beverage where she spends time with other people at the seniors center. Dinners are small portions. On Sundays its pizza and wine. Thats it! Secret to healthy living for the retired and older people.   ...

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Germany and the European Union are improving their defenses as the conflict drags on. The US position DJT has articulated is to bring an end to the war to end the daily loss of lives on both sides. Looking back was it worth loss of hundreds of thousands of lives on both sides and the damage to the economy, to housing from bombing, and the millions of refugees many older people, just for the Association Agreement with the European Union in 2013-2014. This has been completely mismanaged by all sides, the EU officials responsible, the governments in Europe including Russia and Germany, and Ukraine's political parties and their appeal to the people, and by the administration of Obama in the US. DJT and administration officials have long made it clear that they don't want this war, the war in Ukraine. A conflict that has been going on in some form or other between parts of Ukraine in the west and Russian influenced regions in the east as governments changed before and after protests in Kviv in 2013 over an agreement on association with the European Union long before the current war; some favorable to Putin and some not like the current government. So it is surprising that Medvedev would make remarks about DJT and the US to draw a confrontation between the two powers US and Russia in this way in X, remarks DJT calls "inflammatory."  Especially when the US is trying its best to negotiate and end to the war by pressuring both sides. It's defending of Ukraine only to stop the missile attacks on it's cities to give peaceful resolution a chance, not to aggravate the conflict.   ...

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Indian health minister Mandaviya goes house to house in Palitana, Gujarat, to start India's Har Ghar Dastak, house to house vaccination drive. Indian government has identified 50 districts with vaccination rates below 50% for first shot, for efforts at house to house vaccination by visiting homes of the unvaccinated. PM Modi returning from Glasgow held a meeting with chief ministers of the worst affected states such as Maharastra,Tamilnadu, Karnataka and other states with officers at the district level also present, to start Har Ghar Dastak campaign. Modi told the chief ministers and district officials that his talks with leaders of developed countries had increased his awareness of the great risks in letting any slackness or loss of vigorous effort take place in the vaccination effort. Germany is today facing a pandemic of the unvaccinated with fully vaccinated stuck at 67% and facing resistance from unvaccinated and closing of vaccination centers. The US is also facing the same problem and the winter looks increasingly fraught with dangers for both US and Europe, when people go indoors. India seeks to avoid having to face the same problem by taking action in advance to get unvaccinated to enlist in the national effort. Only Spain and Portugal have rates of vaccination close to or over 80% for fully vaccinated, and this is because of the huge trust people in these two countries place in the health system, seeing vaccination as a gift of modernity, and seeing that it is important to not risk health of older family members with whom most young people live with in these countries. ...

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Community Aging in Place: Advancing Better Living for Elders, has been here since 2009, it is offered in about 65 places across 26 states. in the US. It helps people 60 and up stay in their homes such as Chikao Tsubaki 87 years shown here in the Washington Post. It brings a repair worker into the home to figure out how to make it safer for falls, in addition to an occupational therapist and a nurse. Center for Disease Control and Prevention says these falls contribute to deaths of 41,000 older Americans each year and cost Medicare $50 billion. Yet this report in The Washington Post shows Medicare does not cover it, and most private insurance plans do not grasp the idea of keeping people healthy in good settings, paying only when people fall, doing little to prevent the falls. Sarah Szanton is a nurse practitioner who worked with older Americans in home settings in West Baltimore and started CAPABLE in 2009, and is now Dean of the John Hopkins University School of Nursing. In it the client and care team work together to do problem solving and brainstorming. One study shows $20,000 in savings a year for Medicare continuing for 2 years person after one CAPABLE intervention. ...

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This Washington Post report shows elder cost where you live in the US. Out of 5.9 million Americans over 85 years 50% live with family, including spouses and adult children, 40% live alone including assisted living facilities, and only 8% live in nursing homes. A quarter live in multigenerational homes, and this is common among Asians, with Filipino families tending to live together. In Florida 57% of seniors over 85 years live with family and spouses, and in Texas 31% live in multigenerational households. Hawaii has the highest number of people over 85 years living with their families- 61%. 16% of seniors over 85 years live in nursing homes in South Dakota, highest in the US, and in Louisiana 44% of women seniors over 85 years live alone, according to Census.

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Living longer and healthier lives the sixty year old of today may look like a 40 year old. Working years may now be much longer say experts. Instead of 30 years, it could be 40 or 50 years. People may need to engage with meaningful work longer to have the stimulation that comes from work that interests them. The work may even be broken up in increments of 20 years, each devoted to different areas of interest. Experts say the friendship and stimulation from work is better than that in bingo halls, beaches or on a golf cart. Working part time or going back to school is in the works. It makes more sense too to accumulate savings longer as the official social security retirement ages are being extended to beyond 66 years. In fact the only age group where labor participation is already growing is in the over 55 years age group. In this sense the struggle to preserve older pension schemes retiring early look more like a thing of the past, even though they arouse passions such as in mass protests in France on this issue. ...

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This report by Nate Cohn of the NYT shows how the U.S. election map is changing in 2016 with Hillary Clinton strong among college educated voters and weaker with working class voters than president Obama in 2008. She more than makes up for this loss of working class voters in many red Republican states in the southern U.S.- as Cohn shows there are about 1.5-2.5 college educated voters in the southern and mountain states compared to working class voters. The pattern is reversed in midwestern states where there are only about 0.5 college educated voters for every working class voters. This is why Trump is doing better in Ohio, Iowa and Clinton doing better in Georgia, North Carolina, South Carolina, Georgia, Utah, Colorado, traditionally Republican states. Overall there is less focus on cultural wars and abortion issues in this election, with focus shifting to beneficiaries of globalization, and people hurt by trade and globalization in older factory towns. Even in the suburbs of Philadelphia, Cloumbus, Milwaukee, and in western Michigan Clinton does very well because of college educated voters, including white college educated voters. ...

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In the US 30 states have designated English as their official language. The new Executive Order rescinds a Clinton era order that required federal agencies to use other languages.  “Establishing English as the official language will not only streamline communication but also reinforce shared national values, and create a more cohesive and efficient society,” the order says. This is essential as literacy levels have dropped and there is a proliferation of many languages in the simplest of communication from agencies. As the importance of learning even mastering the use of the English language diminishes it has pernicioius effects where the lack of English skills means people fall further behind in getting jobs that require both a minimum and a desirable higher level of language and math skills. It creates an underclass in society as one effect, and also prevents people from different immigrant backgrounds from being able to move ahead in careers and in work. ...

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A study by Sentier Research from Census data shows people in the U.S. age 55-64 years make 10% less in June 2012 compared to June 2009. Every demographic has suffered income losses in this period. Median household income declined by 4.8% in these three years. Using December 2007 as astarting point shows a decline of 7.2%- $50,964 vs. $54,916. Blacks, those with some education like a high school diploma but no degree, the older Americans, and younger Americans were hit hard. Long term unemployment was the cause of the decline among older Americans. Even college graduates suffered a decline of 5.9% from $88,570 to $83,378.

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This article in The Lancet published in February 2018 throws much light on how the ban on gain of function research on virus was lifted -research that carries with it the danger of increasing transmission of virus if something unexpected happens in the manipulation of a virus. It was lifted in 2018 in the US by officials in the US Health Ministry, NIH and HHS. The Cambridge group of scientists and experts opposed lifting the ban on such dangerous research that could make the virus more contagious through manipulation. Epidemiologist Marc Lipsitch of Harvard School of Public Health wrote at the time that the lab research to create a more lethal strain of virus could lead to "an accidental pandemic" yet he was ignored. The public in America and in the world is unaware of how this created serious risks for public health in the world through the coronavirus.  Did US health officials lift the ban on such research without consulting other countries such as India, Brazil, France, Germany, Italy, and the EU on its ramifications. Were public health experts and the publics themselves in the US and around the world not drawn into the discussion of public health and the dangers that existed. Not only did officials in HHS and NIH restart the research by lifting the ban but also sent funds overseas for such research- was this a proper or thoughtful action considering the risks involved.  Is enhanced surveillance of virus- a dubious benefit from manipulation of a virus- something a few health officials can decide for the whole world in addition to the US. How are health officials in one or two countries responsible to the people in India, Brazil, Europe and the poorest populations in the world in the world in Africa, Latin America, and Asia, people who have suffered devastating consequences from transmissibility of the virus, including children and older people with health problems. India, Brazil, Italy, Spain, France, UK, and other countries worst hit by the coronavirus must ask serious questions about how they can protect their people if institutions in the US and international institutions are seen as failing to protect world public health. ...

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For a decade America's leaders remained silent on taking action on all fronts including trade on countries that were sources of fentanyl. The largest and most advanced economy in the world did not take action to protect its people when countries acted with impunity on fentanyl flows. That action is being taken now. A 25% tariff will be imposed on imports from Mexico and Canada, an extra 10% tariff on China, till the illegal flow of fentanyl and smuggled migrants from these countries stops. The new president DJT said on Truth Social media- He will impose by executive order on the first day in office tariffs on Canada, Mexico and China, “on ALL products coming into the United States, and its ridiculous open borders”, which would not be lifted “until such time as Drugs, in particular Fentanyl, and all Illegal Aliens stop this Invasion of our Country."   ...

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In this exceptional report of the housing market in Roanoke, Virgina, Neil Irwin talks to builders, home buyers, renters and young people. San Francisco and Washington D.C. are the exception in housing markets- hundreds of America's midsize cities like Roanoke are seeing smaller rates of household formation leading to a decline in demand for single family homes and fewer homes being built. This accounts for a large part of the smaller growth in U.S. GDP. There are he points out about 2.3 million missing households as a result of a significant change in home buying patterns that is reducing demand for new construction of single family homes. During the period 2001-2006, before the 2008 global financial crisis, the rate of new U.S. household formation was about 1.35 million annually. This dropped to 569,000 in 2007-2013, as the effects of the crisis were felt in a deep recession. One result is more young people are postponing buying a house and living with their parents. Faced with large student debt- the total U.S. student debt passed $1 trillion for the first time recently- purchases of homes are becoming more dfficult. Of 18-34 year olds 27% lived with their parents before 2006, according to Labor Department data. This went up to 31% following the recession. Lack of good jobs is another factor. In 2014 March only 63% of 18-24 year olds had jobs. Even young people older than 24 with jobs felt it necessary to save money by living with their parents. More retirees too are moving into apartments....

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In Britain 6500 nursing homes are seen as "not fit for purpose" of elderly care. They are now seen as possibly closing without an investment of $15 billion pounds to make them fit for use. This also shows the neglect of elderly care in countries such as the UK, and the U.S. A clear distortion of priorities when so much money is being wasted in misallocation on the fringes of tech and elsewhere, without money for basic infrastructure and basic services. It also shows a mistaken set of priorities that have taken over in recent decades,a lack of decent respect for people as they get older in life. Countries such as Brazil neglected basic sanitation in the country worsening health and epidemics while building large soccer stadiums in the north and financing the Olympics. U.S. Britain, E.U. neglected elderly care and infrastructure, in the tech led booms of the past two decades, and pushed money into the wrong places through a distorted set of priorities. ...