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The Dec. 2013 CBS/NYT poll showed only 39% overall support the Obama health care law, a majority say it increases their health care costs. 57% of the uninsured without health coverage say it increases their costs and only 20% say it decreases their costs, for the very group it was designed to help. For the uninsured a third say they will not sign up for the law and pay the penalty. Annie Lowrey of the NYT looks at these numbers and says part of the reason for the lack of enthusiasm for the law is the sharp increase in deductible costs of insurance coverage- the percentage of Americans in health insurance plans with deductibles over $1000 has jumped to 38% in 2013 from 18% in 2008, according to a survey by the Henry Kaiser Family Foundation. During these 5 years the average deductible has increased to $1097 from $735. This is happening as incomes are stagnant or declining in inflation adjusted terms for many working Americans.

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Eric Schmidt, former chairman of Google, says that dependency taken to this extreme where TSMC makes 92% of the advanced semiconductors needed for every smartphone, laptop and missile systems, needs to be quickly corrected. He says America's technology advantage could face serious damage with the Taiwanese production lost in the event of war or missile attack. The supply chain is already at risk with over 70% of supplies of silicon, tungsten, and gallium in the supply chain under China's control. Surprisingly Schmidt does not ask for action beyond Congress authorizing the $50 billion investment proposed for American manufacturing of semiconductors. What is needed as Andy Kessler has proposed in WSJ is to ask Taiwan and South Korea to invest in the US and allies such as  India where production cost challenges can be met with the engineering manpower and facilities as has been done in health care and vaccines manufacturing. Only token or small investments have been made by South Korea and Taiwan in the US compared to what is required. The US should ask for this to be done as part of the exchange for security guarantees that the US is already making for South Korea and Taiwan. It is also the responsibility of South Korea and Taiwan to make these and other investments in other technologies considering it as its obligation to the Free World. For too long countries in Asia that have benefited from US assistance have ignored their reciprocal obligations to the US. Japan, South Korea, Taiwan, and China have all benefited from US technology sharing and assistance. It is only an egregious example that China has put itself in the situation where Japan found itself or placed itself in the first half of the twentieth century.  ...

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With the death toll over 10,000 on March 7, and a rise of 16% over the previous day, French public health authorites have set new rules for exercize with a daytime jogging ban. Jogging is allowed only when the streets are at the quietest in Paris and not allowed between 10.00 and 19.00 local time.

France's lockdown is strict unlike that in America. Anyone going outside has to carry a document giving the reason- shopping for necessities, visiting a doctor, or exercize within 1 kilometre or half a mile of their address. Police have fined hundreds of thousands of people for breaking these restrictions.

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What is behind Pew Research Report finding showing an unacceptable concentration of wealth that endangers democracy. Higher income groups making $244,000 a year in 2024 gained 19 percentage points of the total US Household Income moving from 29% in 1970 to 48% in 2024. About 50% of the nation's income going to 20% of its people and most of that to 2%-5% of the people of the US. The gains meant loss of 17 of these percentage points for middle income households making $106,000 a year that went from 62% in 1970 to 43% in 2024. Another 2 percentage points was suffered by vulnerable Lower Income groups making $35,000 a year who owned 10% of US wealth in 1970 went down to 8%.  The problems of divisiveness in the Nation come from three distinct areas. First money for state financed education for all being put into wars in the Middle East from Reagan through Obama and Trump and some wasted through capital misallocation to low priority investment by faulty capital market allocation. Second the high cost of pharmaceuticals and healthcare putting a heavy burden on low income and middle income households making $35,000 or 106,000 a year. Third the neglect of manufacturing that cutoff the opportunities for middle and lower income households and their one chance to move up the ladder. And the parallel shift of resources to technology and financial sectors that created opportunities for a smaller group of immigrant and higher middle income households with these skills.  These are the sources of America's distress and each problem is being attacked at its source by president Biden- exit from Afghanistan, canceling student loans that are egregious and prevent the investment in education America needs, large sustained investment in manufacturing and new supply chains, antitrust action on tech monopolistic behaviour, redrawing the shape of America's pharmaceutical sector to provide access to medicine to all parts of the population.    ...

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Remarks by president Biden in Accokeep, Maryland, at the International Union of Operating Engineers Local 77, April 19, 2023 outlining his vision for American workers and for its economy. "I am pro-union because union workers are the best workers in the world. Not a joke. That's the God's truth. That is the God's truth. You are the best in the world. It's better  for them to hire you, because you get the job done, you get it done on time, and ultimately it costs them less when they hire you." "So I've said many times Wall Street didn't build America. The middle class built America. And unions built the middle class. That's a fact. Unions. One of the reasons I ran for president was to rebuild the backbone, the backbone of this country, the middle class, to grow the economy from the middle out and the bottom up, not from the top down. Because when the middle class does well the poor have a ladder up and the wealthy do very well still. And we middle class can get a shot. We do well as well." "And that's in clear contrast to my friends on the other side of the aisle these days. DIdn't used to be. Did'nt used to be, but it is now. For decades they've said the best way to grow the economy is from the top down- trickle-down economics. Well, growing up, I didn't see a whole hell of a lot trickle down on our three-bedroom house with four kids at our dad's kitchen table. You know what, Trickle-Down did'nt work for us, and it did'nt work for a long time." "And by the way it's not just what's been with MAGA Republicans. For the last three, four decades we have been losing ground. And you know- it's hollowed out the middle class, you know rewarding wealth, not work; rewarding companies moving overseas because they get cheaper labor. Look at all- a lot of you know- and maybe you come from neighborhoods and small towns, like Scranton, Pennsylvania, where I come from, or Claymont, Delaware- where there used to be a lot of pride, because we had businesses, we had factories that were working, operating. In Scranton, and Claymont, there were 4500 steelworkers. There are none today. And not only do you lose jobs, you lose a sense of pride, lose a sense of who are you. You begin to wonder. Does anybody see me? I mean it sincerely." ...

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The head of the Germany Program at Institut Montaigne in Paris, France, Robinet Borgomano looks at the renewal of German society under the ideas of "respect" put forward by Olaf Scholz of the SPD party. What does Olaf Scholz see as the main issue of our time? - Borgomano says it is the disintegration of European and American societies under the combined effects of technological progress and globalization. Where does Scholz get his ideas of "respect" for workers and families? Isn't Mr. Biden sharing the same ideas in the US? The SPD party got its start at the Bad Godesberg Convention in 1959 when it embraced the idea of a social market economy as a party of the people. Wily Brandt as chancellor from 1969 to 1974, whose personal struggle against the Germany of World War II was based in the Nordic countries, embodies best this renewal aspect of the SPD. Scholz sees his role as renewal of Germany, Europe, hand in hand with Mr. Biden's renewal efforts in the US on the same basic ideas of respect of the dignity of the worker and families that in Germany were seen with Wily Brandt and in the US with Harry Truman who followed FDR. Scholz rejects the overemphasis on the of merit in German society, European society, or American society, in the way it has taken shape in the last fifty years. Scholz cites Michael Sandel's Essay "The Tyranny of Merit" rejcting it because it makes a case for inequality based on merit, on capital allocation on an implied idea of merit of free markets managed in damaging ways for personal interest. It is wrong because it robs the worker and families of the basic dignity that is the right of every individual and of every person. It is wrong because it makes a false justification for growing inequality, and makes those who do not succeed feel that it is their fault. Meritocratic elites have made the idea that those who work hard and play by the rules get all the benefits and wealth even if the rules were first set in a way that benefits them alone. When these rules become implicit they are rarely questioned as happened in the period after 2000. It is not just in Europe and America that this happens, and not just in the 20th century.  Strange but true- During the 1850's in the heyday of industrialization in Britain the Ethnological Society of Britain justified the inequality between the British and Indians in the British Empire by saying Indians were inferior in exams and did not have the motivation or the aptitude and energy to excel in the way British students did. Dadabhai Naoroji, the first Indian member of the British parliament in Mr. Gladstone's Liberals singlehandedly took up the job Sandel and Scholz and Mr. Biden are taking on today to restore the respect of workers, farmers, and families in America and Europe and in all parts of the world. Sandel goes on to say what Scholz has heard clearly- "the parties that made the offer of upward mobility to workers and families have missed the insult implicit in it to a large number of working people." In a way it is going back to the roots, to the founding fathers in America who said in the 18th century that "all men are created equal and they are endowed by their Creator with certain inalienable rights, and among these are life, liberty and the pursuit of happiness," -nothing less.   ...

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Biden as president for 2024 and the matter of age is the subject of this report in WSJ. For too long the press has looked at president Biden's age as drawback ignoring his vast experience, and not Trump's only 3 years younger with poor food and exercise habits and overweight, as pointed out by Duke University Prof. Frank Bruni in the NYT. Here the WSJ at last shows that half of Americans born in 1942 are alive, with many of them about 650,000 working, 18% more than a decade earlier, according to Census Bureau. The saying is that 80 years is the new 60, because of advances in medicine, given healthy habits and exercise. 

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Governor Newsom of California is joining Republican Governors of Montana and Alabama to allow cities to act to limit encampments of the homeless in American cities, taking the case to the US Supreme Court. The Biden Administration is walking a delicate path by supporting rights of the homeless that lower courts support  yet not wanting to see the spread of homeless encampments affect the overall safety and health of cities where homeless encampments affect quality of life in neighborhoods. Homelessness of 600,000 people in the US, with more than half sleeping outside in open spaces and parks is now before the US Supreme Court. The pandemic, the large increase in housing costs in the western states, and the cost of living have pushed many people over the edge, at an alarming rate for four years. Justices ask city attorneys of Grants Pass, and in effect other cities in the US, where are people supposed to go if no other shelter is offered by the city, that they have a right to sleep, and breathe. "Sleeping is a biological necessity- Justice Elena Kagan. "Are they supposed to kill themselves, not sleeping," Justice Sotomayor.  Justices Kavanaugh and Roberts questioned whether judges should be making decision that should be made by policymakers. US Supreme Court is reviewing a lower court ruling upholding rights of homeless people in the US  under the 8th Amendment that is opposed by the city of Grants Pass, Oregon. A small western town of 40,000 people facing a problem of a significant portion of its population, about 8%, having to sleep in parks and in open public spaces because they have nowhere to go. It has only 138 beds from the Gospel Rescue Mission for homeless situations with strict rules. It faces in today's America rising homelessness- affordability of housing affecting people in many states. In 2022 an three judge panel of the 9th Circuit Court of Appeals which covers western states Oregon, California, and Washington upheld a lower court decision barring the city of Grants Pass from enforcing a citywide ban on sleeping in parks at night if no other shelter was available with fines ranging $75 -$295. As a result of this decision encampments of the homeless are increasing in the western states because restrictions on public camping no longer play a deterring role. Cities say this increases crime and drug use, disease, and hazardous waste.  ...

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All sides joined the President at the White House, as part of his consensus building efforts, and to get aseat at the table in restructuring health care. The insurers and health care providers, including technology providers, all committed to cutting the cost of health care. New social insurance programs to cover 45 million uninsured Americans, and to make health care affordable for businesses and individuals, will be unworkable at currently projected rate of increase in health care costs of 6.2% a year for the next decade. The industry promised to reduce that by 1.5% through voluntary efforts, even though there is skepticism about whether they will deliver. The insurers are against a government sponsored health plan fearing it will drive them out of business. Insurers and health care providers are lobbying against the cuts in their Medicare payments, and insurers are fighting Obama's cuts to their private Medicare Advantage plans by a total of $176 billion over 10 years. Doctors are fighting a 21% cut in their Medicare fees scheduled to take place in January 2010. Pharmacuetical companies and makers of medical devices are concerned that new products will have to pass a cost-benefit test before being approved for coverage under Medicare. Its just that they all see the continued rise in costs as somehow unsustainable, especially in the current economic crisis, and share the feeling with business and the rest of the country that the system is broken. At the same time like the banks and bank executives, health care companies and their executives go on lobbying aggressively and doing things the old way, which raises questions about how well these systems that are broken can be put on the right path....

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The top 1% of Americans owns more wealth than the 90% at the bottom, according to the Economic Policy Institute. The Economic Mobility Project points out that the U.S. provides less intergenerational mobility than most other industrialized countries. A key factor is less educational investments to give better educational opportunities to the less advantaged. Michael Spence, a nobel prize winning economist, says we have in America gone from one propertied man, one vote; to providing voting rights to all regardless of color or gender or property, and back to where it is now one vote for so many dollars. The financing of political campaigns has made good policy decisions for the financial sector based on merits and wise judgement impossible, as Congress and the White House are beholden to interests that finance political campaigns, says a former head of the Commodity Futures Trading Commission.

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Gerald Seib of the WSJ points out that the winners in the passing of the Republican healthcare bill in the House by a 4 vote margin are Speaker Ryan who never wanted the job in the first place, and president Trump who showed he could cajole Republicans into getting it passed because he likes winning. Now comes the hard part says Seib, when it goes to the Senate- House conservatives are not going to be happy when they find major changes they dislike. If the bill clears the Senate in a modified version Republicans will now have to own any issues with healthcare, including says Seib things that may not work out for pre-existing conditions- or for groups that are disadvantaged, including older people.

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Gerald Seib of the WSJ says president Biden is coming back with new actions to revive the Democratic agenda after a challenging period in the first year. Yesterday's first formal press conference of 2022 gave Biden an opportunity to respond. Why the WSJ, NYT, did not cover on their online edition front pages president Biden's first formal press conference on Jan. 19, after 1 year of the Biden administration, will remain a mystery. With the American press acting this way it did not take much for Germany's DW.com to run the story with the title "Biden's first year weighed down by disappointment," with a thoughtful Biden at the press conference replaced by a picture of Biden staring downwards.  This is only the first year of the Biden administration. Actions are planned to ease the supply chain situation and bottlenecks at ports. Much is made of inflation, Afghanistan, Ukraine, by Republicans assailing the Biden record. President Biden responded to this by asking at the press conference what Republicans are for. On Afghanistan Biden held firm on not investing billions of dollars every week when there is so much need in America and the rest of the world at this time of the pandemic after a failed adventure for 20 years in "a graveyard for empires."  Biden pointed to the bright spots in 2022- vaccination and testing achievements in the face of anti-vax sentiment with 200 million vaccinated, the job creation in the economy with unemployment way down and wage increases by employers, and the $1 trillion in infrastructure spending tackling much needed projects state by state with immediate impact. Rarely has a president faced so many challenges in the first year as Biden pointed out- vaccination drive in the face of the Delta variant and anti-vax sentiment, the Ukraine crisis with a president Truman period like event of the Berlin Wall coming up just potentially around the corner, and efforts to tackle problems left untackled for a generation in infrastructure, for working families and climate change. Scoring on infrastructure spending, one of the three, with the other two for working families and climate change to be tackled in the remaining three years and beyond.  Biden also told the American audience at the press conference that he was reminded of what his father used to tell him- that if all goals are equally important, nothing is important. In saying this he said help for working families through child tax credit, child care assistance, community college education funding, health care costs, climate change investment were priorities for his administration that would be tackled step by step. And he pointed out from the outset of the conference that only one or two senators were blocking the party's plan for children and working families. All 48 other senators were united in the Democratic party behind his plans for workers and families. As were 5 Republican senators who he said he would not disclose because of confidentiality. In that sense president Biden already has the majority he needs in Congress. This is not happening because of the peculiar situation of the 2016 and 2020 elections in the US and also in Europe- the historical problem of administrations of Democrats in US, Social Democrats in Germany, and Labor in Britain having give up on their working class families and middle class roots. Tech revolution and internet has further complicated the situation with economic changes, tech companies not paying taxes normally due, and tech workers shifting to Democrats yet living in a world distant from working class families fracturing social cohesion. This is changing in Germany with Scholz in Germany with the help of the Greens determined to restore the dignity of working class families, for Biden with a similar coalition, and a process underway in Britain as Labor returns to its roots. In essence Biden was saying- the process of unwinding decades of unwise policy that hurt America as a nation and leader of the free world would take time, requiring a patient step by step approach. To bring America closer to its own roots and Jefferson's immortal words of "all men are created equal and endowed by their Creator with certain unalienable Rights, and among these are Life, Liberty, and the pursuit of Happiness." Jefferson went on to say in the Declaration that when government becomes destructive of these ends it is the Right of the People to alter it.   ...

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Peter Coy of Bloomberg Business Week points out that the debt ceiling and proposed deficit reductions in the range of $4 trillion really obscure the real size of the problem which is much larger. The real problems hit when the U.S. faces a larger graying population by 2020 with sharply higher per capita health care spending; and at the same time workers from this generation retire and become beneficiaries of Social Security and Medicare with fewer younger workers to support the system with tax revenues. Another problem is that older Americans are likely as a voting bloc to vote themselves benefits that will cost the younger generation, benefits that the younger generation will not be able to enjoy. Even the Paul Ryan plan with its cuts to Medicare insulated todays seniors from the sharp cuts, as it becomes political necessity for both Republicans and Democrats to shy away from touching the current beneficiaries.

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In this essay in Der Spiegel, Charles Hawley says that the Trump movement has become a movement of patriotic downtrodden whites, with a whole range of interests-of extreme right talk show hosts, Tea Party politicians, white power supremacists, those left out by globalization in the working class especially in the midwestern states. The danger he says is that this movement of which Trump has become a part, rejects the narrative on which America is based of the Constitution and the Founding Fathers establishing a country based on principles of "the inalienable rights of man," that have evolved through the years to include black people, women, and minorities.  To put this in perspective, president Obama writing for The Economist magazine in October 2016, puts this movement in a different context- that of the Alien and Sedition Acts of 1798, Know Nothing Movement of the 1800's, the anti-Asian sentiment in the late nineteenth and early twentieth century, periods when anti-immigrant or anti-foreign sentiment gained prominence. Obama's view is that it is not fundamentally economic. In this he is right in that some of the forces on the far right do not stem from globalization. Yet he would be missing a great deal if he did not address the economic problems for the middle and working class that have given such views the support of a broad segment of the population, especially in some midwestern and older industrial states compared to say the economy of California or New York. Obama is aware of the problems in his essay as he points to the problems of workers trying to get a decent wage, of job losses through globalization, and the aggravation of these problems by the financial crisis of 2008 when some of the potential physicists and engineers as he calls them went into the financial sector to create faulty mortgages. Yet he goes back to the free trade and global networks of supply chains as having reduced global poverty, without showing a keen awareness of how it has through a combination of events and decades of policy indifference to manufacturing communities in the U.S.- as documented by experts and shown in Lyrarc, with David Autor and Gordon Hansen in the WSJ, 2016- 08-16. A Gallup Study, WSJ, 2016-05-16, supports Obama's assertion by showing that many of Trump supporters are actually self-employed and not in economic distress. Yet the movement would not have taken its proportions without the merging of different groups particularly largely disadvantaged working class voters, and fortunately Hillary Clinton, Bernie Sanders, have a better sense of this than the president. It is by their efforts that income and wealth disparities can be tackled in a way that restores the social fusion of all parts of society- in Hillary Clinton's emphatic words in the final debate by "growing the middle," growing the middle class. This is the task of the next decade, or possibly two decades. (For Gallup study see WSJ, How Economic Anxieties Explain Trump's Appeal- And Where They Fall Short, Nick Timiraos, 08-16-2016. And for Autor, Hanson, see Tallying the Toll of U.S.-China Trade, Justin Lahart, 08-27-2011)   ...

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President Xi's struggle to bring 43 million people out of extreme poverty in China in 3 years as shown in this BBC video. Xi Jinping's focus is on the people left out in the boom years in which the wealth gap expanded to astounding levels and many were left behind. Communist era society under Mao went for leveling up after the 20's and 30' capitalism under the Nationalists. Then came the Japanese invasion in 1931 and chaos out of which Mao built Communist China by 1947. The years with the Nixon opening in 1971 led to another experiment with capitalism to modernize China under Deng and Jiang Zemin in the 80's and 90's to this day after the experiment under Mao had collapsed by 1976. This led to a fading away of the Communist Party's ethos and reason for existence till its revival under Xi Jinping. For Jinping the efforts to guide China's progress started by Deng appeared to derail with the widening wealth and inequality gaps in China, the sense of corruption and misuse of power at local levels that people could see, and the gradual sense in America that the experiment of outsourcing manufacturing and jobs to China was failing for Americans. From 2013 to 2017 a complete rethinking was underway which shaped Jinping's ideas for the future for China. Some of it may be still underway after the realization that Russia and China had diverging views of the world also, following China's sense that the prolonged war in Ukraine affecting its relations with the European Union does not help a country such as China as a middle income country with large pockets of poverty. Russia was seen as a non colonial power in the Soviet era yet it was a major part of the western colonial powers that suppressed the first revolution for an independent China in 1901.   ...

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Studies by Mexico's Interior Ministry show that 62% of the $23 billion in remittances to Mexico by Mexicans living in the U.S. go to the lower middle class. As migration to the U.S. diminishes to zero Mexicans who are illegal aliens in the U.S. are returning to Mexico as small entrepreneurs using earnigs made in the U.S.. This offers them a chance for upward mobility and a return to families that they never had in the U.S., and is aiding the growth of a Mexican middle class. About 12 million Mexicans, or 15% of Mexico's labor force lives legally or illegally in the U.S., according to the Pew Hispanic Center. Experts say that in the first 3-5 years remittances go to help their families, after 7 years the money goes into savings and investment fueling growth of small towns such as Santa Maria in Mexico. About half of Mexico's 112 million people have family living in the U.S., which is having an influence on atttitudes and ways of thinking of the lower middle class that emigrated to the U.S.and is now returning to the country. Other factors are reinforcing the trends such as the lower price of consumer goods with the entry of retailers such as Wal-Mart and Costco into Mexico. Nestle, P&G, and Unilever, all sell at low price points in Mexico. The government's effort to setup a basic safety net subsidizing schooling, health care and food has also helped in this direction. Rapid change in demographics in all of Latin America, including Mexico with a shift to smaller families is creating new opportunities to invest in children for better educational opportunities and working lives....

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Brooks says no to the current health reform bill as most experts say it does little to control the bulging healthcare cost curve which will take it from 17% of GDP to 22% and beyond. He goes over the pros and cons. Passing this gets little done for health care reform in a fundamental way that is so badly needed today. Says Brooks the system today is rotten to the bone with opaque pricing and insane incentives, with consumers insulated from the costs of their decisions, this won't change with the current health care bill. In fact he says according to the chief actuary for Medicare it will cause health care spending to grow faster. At this rate we will be giving more money to insurance companies and programs that have great social value like expanded preschool and other needs that America has will be shoved aside. In coming years as the population of America ages there will be growing needs for health care. With no increase in supply, and the perverse incentives still in place, prices will continue to grow rapidly without the focus on efficiencies that is badly needed. Brooks points out that its not the politics is the chief obstacle to reform as most people say, but the reverse is the truth, unless one gets the fundamental incentives right politics will be terrible forever. ...

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The Congressional Budget Office analysis of the Republican healthcare plan advocated by Mr. McConnell, Senate Majority leader, is that it would add 22 million uninsured if implemented. That plan ran into opposition from Republican Senators Collins, Capito, Murkowski, Paul, and Moran, and lacked enough support in the Senate. All Democrats opposed it and with the thin majority Republicans were divided. By taking away some benefits given under the existing Affordable Care Act the plan hurt the elderly and low income people, making some Republicans listen to their constituents in home districts and not the Republican leadership. The NYT profiled two in particular who astonishingly in a sign of today's strange politics were the only ones publicly holding townhall type meetings to hear the views of people in their voting districts- Susan Collins of Maine and Jerry Moran of Kansas. Both senators were listening to rural communities and Moran stated his opposition with the words- "I am a product of rural Kansas." With it the nation takes a breather and the message goes out that it is best to listen first and then to seek middle ground, not do what both parties Democrats and Republicans did in 2009 and 2017- rush serious legislation through without support across party lines and without serious discussion.   ...

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Paul Krugman in NYT outlines the options president Biden faces if Republicans decide not to increase the debt ceiling in the House of Representatives. All the alternatives are better than defaulting on the national debt. All options also create some short term volatility in financial markets before things stabilize. Biden and Democrats refuse to allow a repeat of negotiations of the kind Mr. Obama made with Republicans on the debt ceiling. The cuts a small faction in the Republican party is asking for come from spending that has already been approved by the House. It is also spending that meets the needs of the American people during a cost of living crisis, and for national priorities in fighting climate change, health and defense. Krugman also points out that cuts to welfare spending won't put more people to work as the unemployment rate is at a new low, and the theory behind it in this situation only deprives the neediest from getting help during a cost of living crisis. ...

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This is an exceptionally humorous operating room story of Dr. Trump and Dr. McConnell by Kristof of the NYT. Sometimes humor tells the story- and Kristof does this using a story of a surgeon president Trump in the operating Room trying to address the concerns of the patient Janet, as he keeps telling her she needs a new heart with great benefits, great benefits, before she implodes or goes down failing. Flat out take the old heart out even if a replacement hasn't been found, believe me great benefits the surgeon tells her, just that the patient just isn't getting convinced as its happening to her. The analogy is with replacing a health care plan, not just the Obama plan, any plan without something to take its place. For a few days before this article by Kristof, the Republican effort to repeal the Affordable Care Act without having a replacement was presented as a good idea. Janet is like the three Republican women- Collins of Maine, Capito of West Virginia, and Murkowski of Alaska who wanted to keep the heart they had till a replacement was found, against the surgeon Trump's advice. In a way it is about politicians in the last decade who never had any discussions as they rushed through with their own agendas, as the Republican and Democratic health care plans were rushed through Congress with relatively little participation and debate to hear all viewpoints. ...

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

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Microsoft's Satya Nadella got his start at age 24 at Bing search engine. He is now 56 years. During this period he worked with both Bill Gates and Steve Ballmer who succeeded Gates at Microsoft. He is now remaking the Bing Search engine by using AI. This has happened since 2018 when he met Altman at the Sun Valley Tech conference in Idaho. He invested $1 billion in Altman's OpenAI, and has recently brought in Suleyman of Inflection who is a competitor of  Altman's OpenAI into Microsoft with the idea of setting up an internal AI business as well. To do this he has invested $10 billion in advanced AI chips that he has bought from chipmakers which have reduced the capital available for Microsoft's other businesses. This WSJ report by Dotan and Jin says Altman started his venture because he did not want to let AI to be led by Google silently developing its own version and doing leapfrog over competitors. A At this point in 2024 Google, Facebook and Amazon are building their own AI talent and making large investments in the chips that support AI. It is rapidly becoming an oligopoly of a few tech companies that makes deals among themselves for strategic advantage and protect themselves from public or government regulatory scrutiny. The controversy surrounding the firing and rehiring of Altman at OpenAI has brought new scrutiny from the FTC. The monopolistic behaviour of tech companies and their splitting the tech market among themselves as Google and Apple have done show the need for government action to prevent a repeat of this in AI. And to take action to break up existing monopolies in Search engines and in the Internet as Theodore Roosevelt did at the turn of the century for the oil business, breaking up Rockefeller's Standard Oil and Esso. Only when that happens can the true potential of the Internet be realized for Education, Health and other fields. Who can say that the iPad or iPhone or Google's Search engine has increased global literacy or American literacy? By freeing up these technologies- that belong to the people of America and the world- for education, health and other fields of human development mankind can advance once again. By regulating provide the ground rules for good use instead of the current danger of the Internet acting in ways to reduce public knowledge to levels that cannot sustain democratic process, and create stratified society where each group only sees what it has seen before and does not explore the world or knowledge in all its variety, all its ability to surprise us with new discoveries. ...