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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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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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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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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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Questions China faces on AI- 17% high youth unemployment and 200 million young people in the gig economy in low wage demanding work. Chinese Communist party wants to see a stable China that can pursue industrial progress for decades like the European Union and the US. For this reason it is not going to let this level of dissatisfaction with high youth unemployment and low wage demanding work for young people to go to the next level. For this reason it will carefully make investments in AI -not the hyper investments in AI that are taking place in the US. The competition with China is going to take place on many fronts, and the industrial bloc created by the EU with India and Nordics has a 15 year plan during which it and the US are likely to far exceed anything China does at a slower rate of growth. As in the US choices will have to be made in China, investment in one area means disinvestment in other areas that have equal or more priority. Today's capital markets are in complete dysfunction in the US operated by a few banks and tech company leaders, similar to the situation prevailing in pharmaceuticals and healthcare. Investment priorities and planning are needed. It is a major error to say US cannot plan that capitalism does not have planning, because it is absolutely true that planning goes on at every level in American companies with Xerox, IBM, Oil Companies and other large companies, all having a Long Range Plan as well as planning for individual projects and investments in plants. If a good infrastructure plan, project by project, state by state, and at the local level, is not put in place this will simply not take place. If no good reindustrialization plan, project by project, state by state, and at the local level, is not put in place, this will simply not take place. In that case the competition with China would surely be lost before it had begun. Yet that is surely not the case, as every good American company has a long term plan. And this plan looks at all the potential investments the Nation can and should make in priorities and in the interests of the Nation and the People. All have to compete for resources and AI surely would not get the lions share of resources in China, or in the US, in a fair and well run market system where planning rightly takes place, because it would displace the very basic structure of a fair and well balanced economy that serves the American people, or the people of European Union and India, or the people of China. ...

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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....

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William Galston in WSJ points to the failure of governance as the cause of so much of the uncertainty and sense of unease felt by people in America, not decline in religion. He looks back and sees wars in the Middle East under Reagan, Bush, Obama and Trump that wasted resources while neglecting the rebuilding of infrastructure and investing in education and healthcare. Tech monopolies have not led to better educated citizens, and instead lowered the literacy required for a democracy to function well, leaving sites like Lyarac.com with the hard work of doing this. The 2009 financial crisis led to financial speculation by Banks and hurt the middle class. The shipping out of manufacturing destroyed hope for workers in America's factories. The pandemic caused about a million deaths.It is only now that America is coming out of it. Supply chain disruptions have led to higher cost of living. President Biden is taking action on each of these problems and the plan is bringing hope to the middle class, restoring America's manufacturing base, investing in infrastructure in a way that has not happened since the 1950's and 1960's, and investing in healthcare and education.  This not looking to religion is what would restore faith in the Nation and the democracy that America is, for the US and no less for the world, says Galston. Behind the cultural issues is a deep sense of ignoring the needs of the middle class and the workers in America's factories, and the people in lower income groups. It is now about restoring the spirit of the New Frontier of John F. Kennedy that was our misfortune to be cut short in 1963, about an America ready to meet the new challenges it faces from now on to 2050. ...

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Doctor are suffering from a "demoralization syndrome" says Eric Reinhart, physician at Northwestern University. He sites one study that shows universal access to health care in America could have prevented at least 338,000 deaths during the pandemic. Overwork comes from physicians retiring from the healthcare workforce in large numbers. In 2021 117,000 physicians retired and only 40,000 physicians joined the workforce. Another 20% will retire in 5 years. Burnout itself comes from a realization that the system is failing its people and you are working within it without the social and cultural narratives that supported previous generations of physicians. It is these narratives of honesty and service that are the essential parts of the human condition that are lacking without access to good health care for all the people and the education to promote good health.

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More revelations such as Pandora papers may not do much because the inertia is institiutionalized and the political system is available for hire, says Prof. Prem Sikka of the University of Sheffield, UK. He says armies of accountants, lawyers and financial experts support this system, the regulatory system in the UK is ineffective, and too many MP's are on the payroll of corporations, says Prof. Sikka in The Guardian. It is the sheer size of the problem that is staggering and could be an indication of how it reduces upward mobility in society, leads to financial crises, and defunds infrastructure, defunds healthcare and housing in US, Europe, Britain and India. The size of illegal money and tax evasion money in the world today is according to this article in The Guardian simply astonishing- $3.6 trillion. 

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The WSJ provides an excellent summary of the positions of the candidates in the U.S. presidential election of 2016 on key issues, education, healthcare, immigration, taxes, national debt, infrastructure spending, and economic growth. Clinton is clear on specifics, Trump has not made clear the details of policies and talks in general terms. On immigration the 2 candidates are far apart, on issues of infrastructure Clinton plans a $275 billion effort to repair the country's infrastructure and Trump says he would make a big effort. On taxes Clinton plans to pay for spending with higher taxes on the rich. Trump says he would provide huge tax cuts, yet make large infrastructure spending without clarifying how this would be done with sharply lower taxes. Both candidates oppose the TPP and oppose trade agreements that lead to loss of U.S. jobs.

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A retired American moves in to the 15th Arrondisement in Paris near Eiffel Tower. His advice learn French. He enjoys the parks and finding everything nearby, excellent healthcare, and most of Europe an easy distance from the rail stations.

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Romney promises to focus on everyday concerns of jobs, family, and budget deficits with his 5 step plan to revive the economy. He says he will not raise taxes on the middle class. The 5 step plan is to make America energy independent by making full use of domestic oil and gas resources, create jobs and provide skills for new jobs, make trade work for America, support small businesses with fewer regulations and smaller tax burden and smaller burden of healthcare, and reduce the deficit. His plan he says will create 12 million new jobs.

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The bulk of this or 7.5 billion euros goes to increase monthly pay by 183 euros for nurses and healthcare workers in France, long overdue.