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The $1.8 trillion Biden Families Plan for workers, students and families takes on the unfinished work for the New Deal, says Binyamin Applebaum in the NYT. Women were not out in the workforce in the way they are today under Franklin Delano Roosevelt in the 1930's and US president Biden is making them and childcare a big part of his Families Plan. Women have been hit harder than men during the pandemic shouldering a greater burden of the home and childcare. Healthcare and education are essential for quality of living- never has there been a greater realization of this than today after years of underinvestment in infrastructure and the foundations of democratic society.

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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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Asked about it yesterday January 16 DJT tells the press outside the White House after a meeting announcing his Great Healthcare Plan, it is a good thing that Canada has signed a trade deal with China. It reflects the new view not clearly understood or told in the press what US trade policy is about. US trade policy in 2026 is about bringing investment and jobs back to the US to rebuild communities and towns across 51 states- once destroyed by the foolish trade policies of the Bush-Clinton-Bush-Obama 3 destructive policy decades. Supplementing this with the investment favorable policy of instant depreciation for investments in plant and equipment in the Big Beautiful Bill of 2025. Using tariffs to level the playing field and ensure fairness in business practices by industries and nations towards America after over 3 decades all else has failed. All the time protecting Rural America, and communities and towns across the US devastated by outshoring. Using Tariffs to make certain that drug and migrant trafficking, and hostile unelected governments in the western Hemisphere cannot take place with direct and  indirect intervention in the western hemisphere by foreign powers. To do this with the Monroe Doctrine Corollary set by Teddy Rooosevelt in his Annual Message to Congress of 1905- "A great free people owes it to itself and to all mankind not to sink into helplessness before the powers of evil." Under such a policy Canada can pursue trade deals with China as the US has done. The clear rationale for the US policy is nowhere evident in the press today, how trade and domestic policy and foreign policy converge to protect all Americans, even though this was something that was pursued under the Biden administration with mistakes made in handing the Border management to Mayorkas and Harris incompetence. In the use of Tariffs doing this in such a way that US economic interest, investments, capital and stock markets are protected by carving out areas of exemptions in the policy. This has given the US an highly advantageous use of Tariff policy in ways not reflected in the press version of Tariffs. As TR pointed out, as Lincoln pointed out over a century ago, the interests of both Labor and of Capital are both legitimate and vital for the Nation. It is time to see this as one whole and not separate to rebuild America.   ...

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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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Three million additional Americans get access to Medicaid as a result of the Obama Healthcare Law (Affordable Care Act). Under the law states could expand Medicaid to people less than 65 years old with income of 133% of the federal poverty level of $15,521 for individual or $31,721 for family. About half of U.S. states expanded Medicaid and the rest kept the prior income guidelines. The figures are from a report by the Centers for Medicare and Medicaid Services, which show 58 million Americans on Medicaid in third quarter of 2013, and up to 61 million in March 2014.

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Estimates show the 50 million Americans enrolled in Medicare today will increase to 80 million by 2030, according to the program's actuaries. Simple demographics as the baby boom generation ages is making controlling the deficit without controlling increase in health care costs as both sides in the fiscal cliff negotiations are attempting to do can only lead to defunding critical areas such as education, R&D and infrastructure, and breaching the safety net for lower income Americans. Health care spending took up 7% of GDP in 1960, increasing to 17.9% of GDP in 2010. Federal spending on healthcare has grown to about 25% in 2012 from 10% in 1960, and is projected to increase to about 33% in ten years by the Congressional Budget Office.

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Margot Sanger-Katz of the NYT provides an excellent summary of winners and losers under the new Republican House healthcare bill that passed the House in a 217-213 vote on May 4, 2017. On the whole middle income people and higher income people stand to benefit, with sharp cuts in Medicaid, and higher premiums as well as smaller subsidies based on age affecting older people. Pre-existing conditions and minimum benefits are included as in ACA, with the provision that states can in some ways limit that coverage. Employers are no longer required to provide mandatory health coverage, helping large and small business owners.

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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 present state of affairs only puts all countries in a race to the bottom as companies seek the lowest tax rate to base their headquarters, leading to tax systems that are unstable and tax revenues that cannot support essential public goods and services such as healthcare, and essential infrastructure. US central bank head Janet Yellen called for a globally coordinated tax rate which would apply regardless of where a global company is located. In her speech to the Chicago Council of World Affairs she redefined what competitiveness should mean today- "Competitiveness is about more than how US headquartered companies fare against other companies in global merger and acquisition bids...It is about making sure that nations have stable tax systems that raise sufficient revenue to invest in essential public goods and respond to crises, and that all citizens fairly share the burden of financing the government." For too long the burden of  investing in essential public goods such as healthcare, education, environment, and infrastructure has not been fairly shared by all citizens in advanced nations of Europe and in the US and essential investment has been neglected in the process. The pandemic today has only exposed the major cracks in the system that prevails today. President Biden's infrastructure plan of $2 trillion to fund renovation rebuilding of roads, bridges, water systems, electricity systems, and the entire network of infrastructure including for health and education, is only possible in an environment that encourages essential investment and provides sufficient revenues to do this. Europe is in the same situation, and so is much of Asia, Africa and Latin America. ...

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US jobs reports May June 2025 revisions suggest slowdown.14000, 19000,  and 73000 US job gains May June and July 2025 suggest slowdown in the economy. Layoffs are low but hiring is slowing as companies tackle uncertainty. Number of people unemployed 27 weeks increases from 1.65 to 1.83 million in July 2025. Healthcare and social assistance added jobs. Government layoffs were 12000. Unemployment rate increases from 4.1% to 4.2% in July 2025.

In 2024 166,000 jobs were needed for unemployment rate to be steady, now just 86,000 jobs because immigration has dropped to new lows. This is important to note for rest of 2025 to 2030.

Also jobs reports are seeing downward revision because smaller companies tend to send in data late to the Labor Department in the current uncertainty.

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Medicare Supplemental insurance (also called Medigap) covers out of pocket cost that are not covered by Medicare Advantage. Over long period of retirement thes plans offer the best protection from unanticipated costs. The Plans use alphabetical leters A B C D F G K L M N with F discontinued. And are standardized, meaning regardless of insurer or state you are in they are the same being set by the US federal government. These plans are sold by private insurers the largest being AARP plan by United Healthcare. One can join when enrolling for Medicare Part B when premiums are usually better yet one can also join afterwards. About 36% of Medicare holders have Medicare Supplemental or Medigap policies for health insurance.

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 High school geography teacher Tim Walz says of actions taken such as the universal school meals signed into Minnesota law earlier this year, as simple common sense. “What a monster! Kids are eating and having full bellies so they can go learn and women are making their own healthcare decisions,” Walz says. Walz has the common sense that is lacking  when a failed cultural mindset puts everything into neatly labeled boxes such as "liberal" and "progressive." It took 50 yeas to get to this point after Reagan and four southern politicians two from Texas and two from Georgia and Arkansas left America in this mess where school meals vs going hungry is debated in political terms.

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The rotting carcasses of the minks that were culled will be dug up to be incinerated. Environmental inspectors found that some water sources might have been contaminated by bacteria. The 17 million minks in Denmark were the target of culling after fears of coronavirus in minks. The whole issue has shown the problems in some of the Nordic countries that were seen as models for healthcare and public services. Sweden's treatment of the elderly in nursing homes was seen all over Europe as shabby and the king of Sweden called it a "failure.

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About 53% of the uninsured Americans disapprove of the Obama health care law, in comparison to 51% of the insured with health care coverage who disapprove of the new law. About 35% of the uninsured say they are likely to pay the penalty for not carrying insurance, and six of ten uninsured say it will make their health better. Overall the approval of the law is at 39% and disapproval at 50% in the Dec. 2013 poll. A striking part of the poll result is that 57% of the uninsured say it will increase their health care costs, compared to 52% of the insured. Only 20% say it will decrease their health care costs. This reflects the lack of serious controls on the surge in healthcare spending in the law. A separate research shows that more of the costs are passed on to users who will pay higher out-of-pocket costs after the law.

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Fox News and WSJ are taking differing positions on Epstein case with Fox News ignoring it and the WSJ carrying the story. Murdoch and DJT have a complicated relationship in July 2025 following the $10 billion DJT lawsuit against Murdoch filed in late July after a story in the WSJ. WSJ parent company Dow Jones says it stands by the story and will defend the accuracy of its reporting. Both the DJT Republicans and the Fox News network appeal to conservative viewers of television, and people in business. WSJ has carried stories questioning the tariff policies of the president, and is critical. It is also not fully supportive of policies to handle migrants. Fox News another Murdoch news outlet is through programs like "Hannity" supporting the president and DJT supports it. This creates a dichotomy in the support when DJT and Republicans are putting forward an agenda that is moving fast on the economy, migration, crime, and world trade requiring support to keep the conservative groups together in the US. This is not a situation encountered before as the nation is moving to a crossroads in which direction it should take. And this does not even take up the issues of climate protection which will come up, and of pharmaceutical companies overcharging Americans for healthcare, other battles that will take place.   ...

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Job growth in healthcare, hospitality, state and local governments led to 275,000 jobs added in February 2024, the Labor Department shows. The resiliency in the jobs market is expected to continue.

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Elizabeth Rosenthal looks at Obamacare's contribution to cost containment in 2013-2014. Rosenthal says its is a kind of delicate maneuvring at the edges, because serious work needs to be done. The fee-for-service and many of the drivers for increases in medical costs, the old system of pricing, are still in place. In 20 years at the current rate and after Obamacare health care will still take 25% of the U.S. budget if nothing is done. Healthcare costs are about half that of the U.S. in some of the advanced European countries. She calls Obamacare a trickle down theory of cost containment becaue it leaves most of the drivers for cost increase in place and works at the margins. Princeton economist Uwe Reinhardt calls it an ugly patch on a somewhat ugly system. Rosenthal cites the armies of consultants anticipating every move to reduce prices, and working on "strategic billing'' to increase revenues for hospitals and doctors. For those who say the prices are now up more slowly than in the past, Michael Chernew of the Harvard Medical School, has this to say- its like a diet, reminding us that that we haven't even lost weight, just gaining weight slower than before. ...

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China's healthcare system is overburdened and overwhelmed, says this report in the NYT. The changes in living and investment in infrastructure and housing are not matched by similar investments in the health system. Shortages of hospital beds and doctors is making tackling the coronavirus in the Wuhan region more difficult. A new hospital is being built in 6 days in late January 2020 in Wuhan for the coronavirus patients, showing how severe the situation is. 

The lack of strict regulation and lack of enforcement at the local level is leading to the situation where the virus was detected in twice- in 2003 in wild animal meat and again in 2019. Public anger and call for a ban on wild animal meat is happening today.

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The $3 billion proposed by president Biden is the first time in history that money is being allocated to tackle elder homelessness. This WSJ report shows how older boomers holding onto larger homes for retirement and aging in these homes is worsening the supply of housing. Including for younger boomers who are in their 50's and who because housing is less affordable or because of a life event or healthcare costs are facing a high rate of homelessness. WSJ's report says $3 billion is unlikely to get thorough this Republican Congress but it is not enough to tackle the problem -because people should not be destitute in this way such as these younger boomers in America as an advanced developed Nation.

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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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This columnist opinion in Le Monde reflects the view in Europe that the US is in retreat, and in some quarters such as NYT that the new US foreign policy that sets the Monroe Doctrine as key aspect of foreign policy is a retreat- US setting the rules in the Western Hemisphere around democracy and governance. It says the US has set aside the ambition first proclaimed in 1945 and revived in 1991 after the fall of the Soviet Union. US administrations under Clinton and Bush took this posture after 1991 of dominant position but it did not reflect reality. US like Russia was dragged into many remote conflicts that had little to do with the standard of living, and economic advancement of the US. The US has a dilapidated infrastructure, broken healthcare system, and operates in a world trading system that has deindustrialized the nation and shipped out jobs and factories for 20 years, and worse is exposed to drug and people trafficking gangs in Mexico and Venezuela. The Monroe Doctrine 1823 asserted the US right to keep European colonial powers out of America, and it was possible only because the British also supported it in the 19th century till the US built up its Navy under TR and FDR. With Russia recognized as a European power the US is able to get its support for the US to tackle the situation in the Western hemisphere presented by drug and people trafficking gangs in Mexico and Venezuela. Tariffs are intended to get a new world trading system with new rules. Infrastructure building is underway on a scale that will far surpass China by 2030. This is not a retreat but an advancement for the Nation and the American people after three decades of failed policy. It lets the European powers Germany, France and Britain deal with Russia's requirement that NATO withdraw from its borders and recognition of Russia as a Northern European power. European history has shown that since 1700 that when faced with a majority of nations in Europe any dominant power in Europe is forced to negotiate a peaceful resolution of conflict because of it's limited resources to carry on a conflict. This should lead to a peaceful resolution in Ukraine, that allows rebuilding, and also gives the US an opportunity to rebuild its economy and standard of living for the American people. This will be a win-win for both the Russians and the Western Europeans, and both Latin America and the US, China and the US, India/Japan/Brazil and the US. ...

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Canadian prime minister, Justin Trudeau, calls for fresh elections on September 20, 2021. His term ends in 2023. Trudeau called for elections early as government aid programs have helped Canadians during the pandemic, and Canada has managed to vaccinate 70% of the population over age of 12. The economy is expected to increase by 6% in 2021. Trudeau's party, the Liberals, are popular and Trudeau hopes to increase his progressive base. He currently leads a minority government making it difficult to pass legislation on the government's priorities for child care, clean environment, healthcare, and affordable housing.

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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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WSJ looks at the changes in the way medicine should be practiced in the light of what we have learned from the pandemic.  Medicine practiced before the pandemic and still today relies mainly on a visit to the doctor or specialist who is short of time. There is a shortage of doctors. Patients have many illnesses as a result of decades of neglect of proper nutrition, and exercize habits. Obesity is at about 40% in the U.S. about 30% in the UK and 17% in France, and high also in other parts of the world. These high rates were unknown throughout history and result in many illnesses and increase by four times the vulnerability to the coronavirus. One authority in medicine calls obesity pouring gasoline on a fire for effects of the virus.  A doctor's appointment with doctors short of time with no coordination around a whole range of factors related to obesity, illnesses, health checkups, mental health, is now seen as a heavily handicapped way to practice medicine or for patient healthcare and wellbeing. The alternative is discussed here as the way forward. A  team will be responsible for a patient's care not just an individual doctor. The team would care for general health after a patient's checkup, cover individual illnesses, weight issues, mental health, exercize nutritional needs and other good healthcare habits. Instead of relying on doctors at a time of shortages of doctors the team would be led by nurse practitioners.  A nurse practitioner is someone with a bachelors degree and a masters degree or doctoral degree in nursing with 1000 hours of clinical training. Studies have shown that they are effective and even more effective than individual doctors. Today particularly with the problem of doctors with limited time compounded by the built up problems of decades of bad habits in nutrition and exercize and poor "cultural" habits getting entrenched, there has never been a greater need for a better way to practice real healthcare for a person's wellbeing. Particularly in rural areas with an even larger shortage of doctors the health practitioner led team will play a big role. Patients will under this setting receive more care virtually and get more followup care by phone and video messaging. The numbers tell the story- there are shortages of doctors in USA, Europe, Africa, Latin America and Asia. In the U.S. shortage of doctors is 55,000 projected to 2033 by Association of American Medical Colleges. There are 290,000 nurse practitioners licensed in the U.S. and 131,0000 physician assistants. The goal will be to get an adequate number of nurse practitioners licensed in this decade to take care of these teams. The pandemic has made virtual visits to doctors and nurse practitioners popular. Medicine reimbursement should and would be practiced on the basis of how well a patient is doing not on a fee for each micro service that is delivered. For this to happen the teams led by the nurse practitioner have to commit to patient education of the benefits from good practices and good habits for nutrition, exercize, caring for oneself. A doctor short of time is hardly the person to carry on this patient education which is where the major opportunities for a new system arise. The virtual care also provides a new medium for patient education and awareness of the risks of getting illnesses, preventive actions to be taken in advance. One approach being tested in California and Texas is for a monthly fee for patients more payments by health plans to doctors or healthcare teams if the patient is healthier. Additional health professionals are added to the team including health coaches, dietitians and medical assistants to increase its effectiveness in counseling and education and monitoring.  The nurse practitioner team approach is already being practiced in parts of the U.S. including the example of New Hampshire shown here, and is predicted to be the approach for primary care in the next decade. ...

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This WSJ editorial in September 2014 says many of president Obama's statements and decisions on Obama healthcare legislation and implementation, Syria, NSA and privacy, the Middle East, Russia, showed poor judgement. It refers to a piece by Peter Baker in NYT where it is said that Obama mocked how people see him as too professorial, diffident, in a sarcastic statement. The problem says WSJ is that president Obama has poor judgement. Being academically credentialed and quick grasp of subject matter is not the same as having the ability to discern things, instinct and grasp of the essence of the matter. George Bush senior had a long resume and was academically credentialed. By comparison Truman had a short resume and was not academically credentialed or quick with data and analysis. He had something more essential and important- a discerning mind and grasp of the larger picture, as well as listening abilities for exceptional advisors such as General Marshall and Acheson he gathered around him....