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In a sign of the changes roiling the pharmaceutical industry the off patent business of American maker Pfizer is based in Shanghai. The generics business of Mylan Pharmaceutical is incorporated in Netherlands and run from Pittsburgh. Pressure is increasing in the generics industry from manufacturers in India and China. Pfizer announced the merger of its Upjohn off patent pharmaceuticals business with Mylan to fight pricing pressures. Pharmaceutical prices in the U.S. are the  highest in the world and generics offer only small relief compared to the government mandated pricing of the same pharma products in India. Generics drugs are also offered at lower prices by distributors who buy in bulk adding to pricing pressures in the U.S. The government rarely intervenes in the negotiated prices as it does in India or in other countries in Europe including Britain.  In fact many asthma patients young and old alike are forced to do without inhalers because of the exorbitant prices set by American manufacturers with scant help from government under Democratic or Republican administrations in the U.S. In this respect middle class customers in India have better access to asthma inhalers as well as hundreds of other medicines basic to healthy living. This has created a greater level of basic equity/fairness in India as well as in Europe in this regard than in the U.S.  In this sense the pricing of basic care medicines in the U.S. adds to the sense of a lack of fairness. To that is added the manner in which the banking and financial industry operated resulting in the financial crisis of 2009 and damage to the bank savings accounts of ordinary Americans hit by unemployment, underemployment, and lower savings accumulation with interest rates kept low to offset the damage done by the banks through bad lending. This is also why an astonishing percentage of Americans like never before in the last 50 years do not have basic funds for spending to manage a health crisis in the family. Just as in times of the Depression in the U.S. industry operates in a way that is oblivious to what ordinary Americans are experiencing only to be excoriated by FDR. ...

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Nate Cohn of the NYT points out that based on the way in which moderate voters shifted to vote for Cruz in Wisconsin, especially in the eastern part of the state, this could be a turning point in the Cruz campaign. Cohn cites exit polls showing 29% of moderate voters went for Cruz in Wisconsin compared to 12% in Michigan and 15% in Illinois. In Madison's Dane County, a moderate area, Cruz had 38% of the vote. If this proves to be resilient then Trump could become the underdog in California, Indiana, Maryland, and Montana, with Pennsylvania becoming competitive, says Cohn. Reasons why this shift of moderate voters to Cruz could be a lasting shift are the results on March 15, 2016, with Cruz getting 40% of the vote in Missouri, and 30 percent in Illinois.

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French president Macron is seen as aloof from voter concerns about the rising cost of living. Visiting a farmer in the Burgundy region Marie Le Pen said prices of food and vegetables have gone up 25% over 5 years since Macron became president.  To win over supporters from working class communities in north and northeast who have voted for Jean Luc-Melenchon, a former Socialist candidate, Macron visited Denian, a town in the north of France.  Melenchon's France Unbowed party got about 21.95 % of the vote compared to Le Pen's 23.15%. Getting working class voters to support Macron who had 27.84% of the vote is now crucial for Macron. Denian has an unemployment rate of 36%. Macron told voters the best way to tackle poverty is to bring down the unemployment rate which is now 7.4%.  Many of these communities in the north, northeast, and in the southeast have suffered from the two decade shift of manufacturing to China, creating a situation similar to that in the midwest of the US and posing a challenge for established parties. The Republicains of De Gaulle and the Socialists of Mitterand, the established parties did badly in the election, each getting less than 5%of the vote. It is this problem that Macron has to address to get the votes of working class voters in France. Challenging the notion that he has been aloof from this problem and the problem of cost of living for young and for pensioners Macron says he will listen, learn and act, and he is "not afraid to go into battle in the most difficult areas." On this first day of campaigning for the second round he spent 2 hours talking to people in Denian. Angry voters told him he did not care for pensioners. In his response Macron said he will increase the minimum pension from 10500 euros to 13200 euros a year. A pension reform plan for increasing the retirement age for pensions to 65 from 62 will now be put to a referendum so that voters could reject it if they chose to. Macron also responded to the sentiment that his administration was more concerned about the rich by proposing that firms paying dividends to shareholders will be required to give one off bonuses of 6000 euros to all employees earning less than 46,000 euros a year.  On his opponent Marie Le Pen's plan to cut VAT tax on gasoline to 5% from 20%, Macron told voters that this was counterfeit money, asking "can anyone really say there will be no VAT for gasoline imported from the rest of the world?" ...

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Many of the 255 Comments on this article in the NYT say it is misleading or grossly misleading title. Michael Crowley of NYT quotes Wertheim for his conclusion that there seems to be a sense that the world is out of control, there is chaos under president Biden. This is subtly presented and clearly wrong. Wertheim is the author of a book that questions America's exceptionalism, and says "isolationism" was somehow concocted by policy makers such as Eisenhower and Dulles, both Republicans for a postwar world built on American supremacy. What Crowley and Wertheim do is put their very idea of asking questions about policy which is a part of the discussion into misrepresenting through misinformation about what happened. Biden has acted with courage to close wars no other president not Reagan/ Rumsfeld who started the conflict with Iran by arming Iraq's unprovoked war on Iran, not Bush who initiated the war in Afghanistan, not Obama and Trump who did not close the war in the mountains around Kabul that is a "graveyard for Empires" - the Maratha Empire in India in the 1700's that opened the door to British rule in India, not the British Empire wisely staying out of it, the Soviet Union beginning its decline there, and the US mired in it similar to the Soviets. Crowley/Wertheim are only making things worse- Netanyahu was emboldened by the former president and made a major security failure. Putin miscalculated in Ukraine, Biden simply acted in the way any wise American president would -strengthened NATO with Finland and Sweden, providing reasons for Russian restraint yet without escalating the conflict. To say this is chaos is to misinform and misrepresent, and favor the very Supremacy that former president Trump proposes as policy based on US power. By contrast Biden' approach is peace through strength from building close relations between partners in Europe and Asia, not provocation or supremacy. Wertheim is only one voice in a larger discussion not the authority he is presented as. For Wertheim to say "isolationism" was a bogey and point to 1950 as the point when it was created is simply wrong. It existed in some form from the early days of the Republic. Washington was an advocate of not involving the fledgling Republic in foreign entanglements of France even though it was an ally. It is not that response to isolationism is the cause of America embracing the role of leading the Free World as it is now. It is simply the situation leaders faced. Truman faced it when Soviets planned insurgencies in Turkey and Greece which would not exist as democracies today without Truman. And across Eastern Europe Hungary 1956 Ike acted cautiously. Czechoslovakia 1968 LBJ Johnson acted cautiously already in the wrong war with Vietnamese nationalism.  ...