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Comparative effectiveness research will be conducted to evaluate what is the best treatment for any ailment or disease or health problem under the $1.1 billion allocated for this in the Stimulus Plan. What are the alternative methods of treatment, what is the effectiveness of each treatment, what are the comparative costs and so on. Is it better to treat neck pain with surgery or acombination ofphysical therapy, exercize and medications? If there is ablockage of arteries in the lower leg and leg pain, how does drugs and watchful waiting compare with surgery? For chronic heart failure how does home monitoring of blood pressure and weight and exercise in addition to medications provide an alternative route as opposed to just medications. Dr Fisher of Dartmouth Medical School cites these as examples of questions that can be asked in comparitive effectiveness research. The money will be available to the Health and Human Services Department and will be used over several years. About 15 federal employees will form a council to coordinate the research and advise President Obama and Congress on how to use the money. In 2007 the US spent $2.2 trillion, or 16% of GDP, on health care, and the Congressional Budget Office says it will grow to 25% of GDP at the rate its growing by 2025 if left to its own devices. ...

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All you need is this article in the WSJ of Sept 16, 2015, showing forecasts of rapid growth of coffee consumption for an aspirational western lifestyle consumer in China, and a small mobile app investment to attract investors in a startup -if you refashion the coffee retail outlets as a tech company by selling coffee for delivery and takeout by mobile app. Luckin Coffee in China shown in the podcast in today's articles did this and attracted billions of dollars in investment from investors, including large banks and financial companies in Europe, U.S. and China, only to collapse in 2 years with losses and investigations in China and the U.S. Luckin Coffee soared after its NASDAQ stock exchange listing in 2018 only 1 year after its founding. WSJ calls it "brazen" the effort to add tech hype to a coffee company and have it listed on NASDAQ in just over a year, only to see its sales and value collapse just as quickly. For U.S. investors the problem is that Chinese companies can list on the NASDAQ or other stock exchanges in the U.S., but U.S. investors cannot look at financial records of companies in China. Yet there are basic questions- why is it a tech company? Why are investors like big banks and other large financial investors pushing so much money into such places when there is so much that needs to be done in health and infrastructure investment, and real tech investment? 5G or 6G? Health systems? Ocean Grounds has a coffee store in Shanghai, Pacific Store has coffee retail outlets in China, and Starbucks is still in the business with retail outlets - remember none of these companies are tech companies. In 2017 Luckin Coffee started by making it look techy with a mobile app and refashioned itself as a tech company.  What is so big about a mobile app as there are hundreds of millions of apps. The rest came from making it look like Starbucks, right down to baristas, fancy coffee machines, and opening stores near Starbucks, according to the Podcast in the WSJ.The difference between Starbucks and Luckin Coffee - the price Luckin Coffee would sell for about $2 compared to about $4 for a Starbucks latte. Yet do this by pricing at closer to Starbucks and issuing promotions discounts constantly on the mobile app, that would bring the price to about $2. That is all it takes to make a tech company nowadays. No scientific research, no science and technology, no technical experience, nothing of the kind that led to the invention of the computer chip or the vaccines that are now being developed, or research activity of any sort. Banks, financial companies are willing to channel huge amounts of money into these places and lose it, as they did in We Work, and are doing at companies such as ride sharing app companies, as well as other app companies without any core technological component or value added such as infrastructure or health products. At the same time as investments in much needed infrastructure and health, education, services that really matter to us as a society, are neglected and starved of capital.   ...

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It depends- only if you look at it in actual millions of people. In percent of people Voice of America and this WSJ report show that US obesity rate is much higher with 22 states above 35% and the rate overall at about 25%, compared to China's at about 14%. The fact that this was reported in this way is happening as this issue is taken far too casually in the US, when the quality of life is largely dependent on health. And such high levels of obesity in the US, catastrophic levels in some southern and midwestern states, means one is not doing things right and heading for a poorer quality of life. This report in the WSJ cites estimates of obesity in China of as high as 200 million and likely to grow by another 100 million by 2034, about 14% of the population being obese today and obesity increasing to about 20%. In China the demand for weight loss drugs is growing. The government has a program to reduce the intake of salt, sugar and oil and increase health foods in the diet. Meat in the diet has tripled and there is a need for more health conscious attitudes in China, even more so and urgently in the US. Both the US and China are too auto centric in their culture, particularly the US where public transportation has not been given high priority leading to a lack of enough exercise getting to work. ...

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Questions about the true cost of the Obama health care legislation and the assumption that the legislation cuts the deficit by billions of dollars. This WSJ editorial says one has to look at this closely, and not merely look at CBO projections, which may be based in a certain context and not reflect the true costs, especially because many accounting gimmicks and use of numbers to present a particular picture is taking place. The information this editorial cites is that: it uses 10 years of taxes to fund six years of subsidies, Social Security and Medicare revenues are double-counted to the tune of $398 billion, a new program funding long-tem care frontloads taxes but backloads spending, and the assumption of an automatic 25% cut to physician payments that Congress is unwilling to authorize. Rep. Rand Paul has tried to present an alternative view which needs to be studied just as closely, because of the enormous impact of a jump in spending at a time when the public finances are fragile. WSJ also cites the work of Richard Foster, the chief Medicare actuary, as an alternate perspective of how things could turn out, Doug Holtz-Eakin, and Eugene Steuerle. It calls for common sense in evaluating programs, entitlements, defense or other government spending. They not only cost money, but costs escalate over time as history has shown over decades, till they eventually are discovered to be not affordable unless the middle class is willing to dig deeper into its finances to pay for them. Alternate perspectives from a range of informed opinion, Howard Dean, Martin Feldstein, and the head of Harvard's Medical School show that the issue needs to be looked at closely and carefully and cannot be something in which CBO numbers can be trusted to tell the whole story. Especially when common sense, history, and informed opinion across a spectrum of thought advises caution, and fragile public finances also suggest caution. Howard Dean, former Governor of Vermont, says the health care bill is not real reform, and may do more harm than good. He says in a Washington Post article, December 17, 2009, the Obama health care bill does not insert competition into insurance markets, does not significantly reduce costs, and does not improve the delivery and use of health services. It was he says done with a political calculus and crafted for votes not real reform. Jeffrey S. Flier, Dean of the Harvard Medical School, gave the Obama health reform bill an "F" grade, saying in a Nov 18, 2009, WSJ article, that it was disingenuous to call this reform, Congress and the White House were simply deceiving the public. He said the bill will accelerate US health care spending, postpone most of the major health care problems, expecially the ones that drive cost, including the "fee for service" system and delivery of health care. He says in his discussions with economists and other health care leaders the opinion was unanimous that the bill will accelerate health care spending. He cites Massachusetts as an example, where access to care was expanded under the same dysfunctional system, and spending went up, and it doesn't work. Feldstein, who in early 2008 suggested proactive solutions to the mortgage debt crisis which were never adopted, says that the Obama health care law means higher taxes in the long run to pay for the $1 trillion cost of health care for the uninsured group over 10 years. Feldstein says that the Obama plan is to cut Medicare to cut spending, and will reduce the amount of medical services, as reduced spending comes from fewer services, not reducing payments to providers. And he asks if the cost reductions are weighted too heavily towards reduced services and not reduced payments to providers ,would this result in large cuts to services to affect the quality of healthcare for the 85% of the American people who are accustomed to a different pattern of healthcare. ...

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The head of the U.S. Department of Health and Human Services, Mr. Alex Azar, repeatedly assured the president as early as January 29, that there never had been a better interagency response to coronavirus, says the WSJ. This WSJ report says based on interviews with administration officials and others that Mr. Azar waited for weeks to brief the president on the threat from coronavirus, did not coordinate effectively across the health divisions,  failed to ramp up testing development, and oversold what had been done. Testing is one of the key issues raised at this time about the coronavirus effort. Mr. Trump tweeted on April 12 that Mr. Azar "told me nothing until later." The president was dissatisfied with Mr. Azar's handling of the flavored e-cigarettes ban. This report says Mr. Azar was slow in working with other agencies such as FEMA, and in involving directly the FDA, CDC, and other agencies, to create a strong and effective response to a fast developing public health crisis of enormous proportions. In February White House advisors were critical of Mr. Azar for delays in the testing program. As the delays progressed this report says Mr. Pence and the White House gave more responsibility to FEMA, and Dr. Hahn and CMS's Ms. Verma were made active members of the White House Task Force. FEMA also played a bigger role with greater funding.    ...

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Mr. Trump says he will wear a mask on a visit to soldiers at Army's Walter Reed Hospital. Trump says its "a very appropriate thing. I have no problem with a mask." As cases hit 3 million in the U.S., close to 1 million in India and Russia, Mr. Trump joins the movement for masks worldwide. Early on Mr. Trump  took up the issue of transmission from Wuhan by banning flights from China, failed to get WHO and China to respond quickly to the pandemic requests from U.S. by providing information and allowing a team to visit Wuhan quickly in January. A stumbling block appeared within the health ministry in the U.S. with poor leadership which Trump had to overcome by relying on Vice President Pence to lead the stop coronavirus team at the White House.   Trump's reopening decision came under criticism and he says he had to balance the damage to jobs and economic well being that also affected health. Some of the states and young people responded in ways that led to public gatherings that have led to surges in the south and the western states such as Calfornia. The WSJ reported that in Los Angeles County on June 20 half a million people went to bars after they reopened, showing that culturally even counties in states like California lacked what is accepted good sense. For instance Tokyo bars were paid by the Japanese government not to reopen, according to one report. By wearing a mask Trump is simply acknowledging facts about transmission - a German study shows 40% reduction in cases with face coverings. ...

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Even today mask use can vary widely in the U.S. as seen in this map from the NYT. After repeated surge across the U.S. from the northeast to the south and west mask use has increased in the U.S. Texas has made it mandatory and president Trump wore a mask at Walter Reed Army hospital. Ypu.gov and other surveys show mask use as high as 80%, not universal as health agencies want to see, higher than Canada, Finland or Denmark.

Other factors such as gatherings at beaches, restaurant and bars, and earlier sport stadiums gatherings are additional factors for a surge. Young people's cooperation has lagged behind accounting for about 50% of cases in some southern states recently being among young people.

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The WSJ editorial board opinion is offered in the spirit of free markets and free people from Jefferson's Declaration and Adam Smith's Wealth of Nations. Yet it is a complete misreading of Adam Smith as Smith had a social side which called for corporate interests of that time such as the East India Company of Britain to behave in a responsible manner with public interests and social sentiment in mind. Smith also sought to preserve the national interest of Britain and its role as dominant power. Whereas for for three decades WSJ is taking enormous risks with the national interest of the US in remaining a dominant industrial power. No one at the WSJ can explain how this can be done by shipping out the manufacturing industrial capacity and technological knowhow of any Nation, especially the United States over 3 decades. Worse it risks the entire period and the ideas of the awakening in Europe in ideas and science that powered the Industrial Revolution, that did not happen in Asia,  and led to so many of the advances in science and industry that we enjoy today, and share with large Asian nations China and India. That amazing period of awakening and the Industrial Revolution and its achievements is not part of the collective memory of the nations of Asia, of China India and Japan, and this kind of attitude of neglect of this essential part of our mindset and makeup in the US and Europe, acts to our detriment, and to the detriment of China, India and Japan. ...

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This NYT editorial on June 26, 2015, says the arguments of the plaintiffs before the U.S. Supreme Court for the Affordable Care Act were specious, based as they were on a reading of four words phrase in the Act leaving ambiguity about what exchanges were covered by health care subsidies. It says the plaintiffs with strong emotions on the subject decided to pull their argument out of thin air. That only one Justice acted as the swing vote, Justice Anthony Kennedy, shows the Supreme Court like the rest of the nation is not above emotion- Justice Scalia called the 6-4 decision based on "jiggery-pokery" and not "honest jurisprudence"- and needed Chief Justice Roberts to provide the larger view in 2015 as he did in 2012.

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Obesity in the US is as high as about 40% in West Virginia, Louisiana, and Oklahoma. It is lowest about 25% in Colorado, Vermont and Hawaii. About 22 states have obesity rate over 35%. Compare this with China which is seeing obesity increase from about 15% in 2023 to 20% in 2034. Real competition between the two countries starts with areas like health care coming out of the pandemic when looking at the true interest of both peoples instead of geopolitics creating a huge distraction from problems of health, climate change and education. Meat intake has tripled in China and a return to more vegetable and fruits and ancient grains is something that is needed badly, also helping tackle climate change. The states in the South and midwestern US have higher rates of obesity followed by northeast and western states. This includes in the South Kentucky, Georgia, Texas, Alabama, Tennessee, South Carolina, Mississippi, Arkansas. In Midwest it includes Ohio, Indiana, Wisconsin, North Dakota, South Dakota, Iowa and Kansas. It is useful to note that this is in Voice of America news which is aimed at an overseas audience and this kind of information is not seen widely in US media. Robust food programs ae needed especially for people living in poverty. Health consciousness needs to be emphasized in all aspects of life and worklife, workspaces, living locations and transportation options all need to be devised around this. Bussel of the Robert Woods Foundation says even ten years back no state had over 35% of the population being obese. Clearly headed in the wrong direction with all the discussion in media run by billionaires on everything but what most affects the quality and ease of living of ordinary people. ...

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

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This podcast in the WSJ takes up a Chinese startup Luckin Coffee that had major investors in the U.S. and China, including big banks in the U.S. and Europe.  The idea is simple- sell coffee in China to aspirational coffee drinkers following western lifestyles using mobile app. It is the story of huge investments and losses, and collapse of a NASDAQ listed company with what the WSJ investigation calls fabricated sales. Why are infrastructure and health, education products starved of capital left high and dry, while billions are poured into such investments with huge losses. All you need is this article in the WSJ of Sept 16, 2015, shown in today's articles. Showing forecasts of rapid growth of coffee consumption for an aspirational western lifestyle consumer in China, and a small mobile app investment to attract investors in a startup -if you refashion the coffee retail outlets as a tech company by selling coffee for delivery/takeout by mobile app. Luckin Coffee in China shown in the podcast in today's articles did this and attracted billions of dollars in investment from investors, including large banks and financial companies in Europe, U.S. and China, only to collapse in 2 years with losses and investigations in China and the U.S. Luckin Coffee soared after its NASDAQ stock exchange listing in 2018 only 1 year after its founding. WSJ calls it "brazen" the effort to add tech hype to a coffee company and have it listed on NASDAQ in just over a year, only to see its sales and value collapse just as quickly. $400 million in convertible bonds losing 90% of their value, the stock losing most of its value and NASDAQ delisting the stock after $311 million in fabricated sales were found as reported in the South China Morning Post. For U.S. investors the problem is that Chinese companies can list on the NASDAQ or other stock exchanges in the U.S., but U.S. investors cannot look at financial records of companies in China. Yet there are basic questions- why is it a tech company? Why are investors like big banks and other large financial investors pushing so much money into such places when there is so much that needs to be done in health and infrastructure investment, and real tech investment? 5G or 6G? Health systems? Ocean Grounds has a coffee store in Shanghai, Pacific Store has coffee retail outlets in China, and Starbucks is still in the business with retail outlets - remember none of these companies are tech companies. In 2017 Luckin Coffee started by making it look techy with a mobile app and refashioned itself as a tech company.  What is so big about a mobile app as there are hundreds of millions of apps. The rest came from making it look like Starbucks, right down to baristas, fancy coffee machines, and opening stores near Starbucks, according to the Podcast in the WSJ.The difference between Starbucks and Luckin Coffee - the price Luckin Coffee would sell for about $2 compared to about $4 for a Starbucks latte. Yet do this by pricing at closer to Starbucks and issuing promotions discounts constantly on the mobile app, that would bring the price to about $2. That is all it takes to make a tech company nowadays. No scientific research, no science and technology, no technical experience, nothing of the kind that led to the invention of the computer chip or the vaccines that are now being developed, or research activity of any sort. Banks, financial companies are willing to channel huge amounts of money into these places and lose it, as they did in We Work, and are doing at companies such as ride sharing app companies, as well as other app companies without any core technological component or value added such as infrastructure or health products. Only it is not the bank's money but the people's money and savings that are deposited at banks and channeled into investments. At the same time as investments in much needed infrastructure and health, education, services that really matter to us as a society, are neglected and starved of capital.     ...

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About 5.7 million Americans fewer Americans were on payrolls in July 2021 even as the unemployment rate drops each month and job openings increase. There is a mismatch between job seekers goals and job openings. The service sector, especially in hospitality and leisure industry, is not seen as a favored goal by some job seekers because of its precarious nature and uncertainty of income security, health risks, during the pandemic. Job seekers were looking for stability in income, health and other goals. The US added 943,000 jobs in July 2021, yet this gives an incomplete picture of the health of the jobs part of the economy.

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The World Trade Organization is about to choose a new director-general to succeed Mr. Azevedo, a career diplomat from Brazil. The two candidates are a former finance minister from Nigeria,  Ms. Okonjo-Iweala supported by the European Union and the trade minister of South Korea, Ms. Yoo Myung-hee, supported by the U.S. Japan supports the Nigerian candidate because of its trade disputes with South Korea. The role of head of WTO is important today because of trade issues between countries particularly the trade issues between China and the U.S., U.S. and other countries. And the sense that the WTO arrangement is not working for many countries in recent years without a level playing field in many industries from improper subsidies. Before the U.S. withdrawal from the World Health Organization not much attention was given by the U.S. to how it had changed after new elections. As a result non profit foundations like the Gates Foundation from the U.S. played a leading part in representation of American interests and China played a leading role leading to the crisis facing WHO today. During the coronavirus pandemic the WHO lacking adequate influence of U.S. or European Union countries was not able to act in a way that met the needs and concerns of these countries with advanced health systems. In the past pandemics were better addressed worldwide when the U.S. and EU played a major role from the beginning because of long experience and technological resources,  a role that was missing in the current pandemic. Ebola and other virus were tackled in Africa only when the U.S. or European countries played a leading and critical role. This role was sorely missed in the current crisis. This is why changes at the World Trade Organization matter. World trade is important for the world economy and can best operate when the concerns of U.S. and European Union about a level playing field and fair competition are met. This level playing field and fair competition also meet the interests of developing countries such as India which are industrializing rapidly and need to protect their own markets from unfair dumping, as well as Indonesia and other parts of Asia, Latin America and Africa that are part of the supply chain for the world economy. ...

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This account in the WSJ shows how Masayoshi Son is making huge bets with money from Saudi, UAE borrowed at 7% interest, and his own and partners money. The first Vision Fund  which raised $100 billion was invested quickly over 2 years in startups in the U.S. with an uncertain future and the WSJ says it is unusual that a fund would pile up debt to invest in companies that are unproven and which cost the Fund billions of dollars a year in interest payments. Many of the people hired are not from venture capital and have backgrounds in speculative Wall Street deals, including Deutsche Bank, according to the WSJ. Critics say money invested in every pet walking or hotel renting website is not going to make healthy returns. Creditor are being paid back with money they lent, with interest at about $2 billion this year, according to this report.  Beyond the question of returns there is the larger question of how capital markets are malfunctioning today. Money badly needed for infrastructure and keeping up with technological developments such as 5G and new technologies, for research and development, and for vital public services in health and education to build strong societies, being diverted to highly speculative deals and dealmaking. ...

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The U.S. Census Bureau shows incomes of American households, the median household income, surged in 2015 by 5.2%. This increased by $2800 to $56,500. This is the largest increase since 1967. It shows that steadily improving employment and hiring is leading to improvement in incomes for the middle and working class. Ris in minimum wage has also helped . The largest increase was for the lowest 20% of the income tiers. Full time working women did better than men, with increase annually of 2.7% for women, and 1.5% for men. Nocitizen incomes increased 10.5% to $45,100, native born households went up 4.4% to $57,200. The number of people without health insurance also declined from 33 million or 10.4% of the population to  29 million people or 9.1%. Another way the changes are helping lower income households is the decline of the official poverty rate to 13.5% in 2015 by 1.2 percentage points from 14.8% in 2014. Through a series of small incremental steps the path is being set for a recovery of household incomes for the middle class and working class. A bright spot is that the improvement has affected all age groups, household types, regions and ethnic groups, though among full time workers women did better than men. In this recession older white men have had more difficulties getting back into the workforce. This is reflected in the political scene in 2015-2016 for the election season. ...

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Where does US president DJT get his "good genetics" for his health? It comes from his mother's side where for generations his grandparents and previous generations were fisherman on the shores of the northern British Isles islands. Specifically Tong, a village on the island of Lewis in Scotland. These were rugged coastlines where fisherman fought hard to make a living in the 19th century. His mother immigrated from Scotland to the US as a young girl seeking a better life. She later married a up and coming builder of homes in New York state.

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Venezuela's Maduro faces trial in the US and Judge Alvin Hellerstein 92 years old in the Southern District of New York is presiding over that case. There is no mandatory retirement age for judges which means they can be practicing well into their 90's. The concern expressed by experts is that the case could go on for years and the judge's health had to be good for that period.

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This report in the WSj looks at the Silicon valley approach of pursuing rapid torrential growth at any cost. It shows the victims as investors looking for outsize returns to the point of turning their attention from the facts showing the products as highly hyped improperly as tech for WeWork or having health risks in alternative smoking products in the case of Juul Labs Inc. Both company CEO's were asked to resign. This discussion is on the the limited number of new ideas as the tech really creative stuff  peters out and the tens of billions of dollars pursuing a few ideas even if they as in the case of WeWork basically a real estate company subleasing space were not really tech. The neglect of top priorities in infrastructure, in priorities for health, education and other pressing needs are a result of the misallocation of capital by capital markets structures of funds, banks and investors. Juul started at Stanford University and quickly raised $14 billion. Soon three million high schoolers in the U.S. were using the vaping product as e-cigarettes causing alarmed parents to bring up the issue and the Food and Drug Administration to look into it. As the tech boom results in fewer new ideas practices fail to change in the allocation of capital and wasted capital, resulting in gross neglect of priorities for infrastructure, health and education, wide gaps in income.   ...

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Arguments that are expected to be used by both sides before the U.S. Supreme Court on the health care law. At the heart of this is the 1942 decision, Wickard v. Filburn, on the limits of federal power. Mr. Filburn, was an Ohio farmer who questioned a 1938 federal law that imposed a penalty on every extra bushel of wheat on his farm beyond the stipulated amount. The decision was unanimous and went against Filburn. At issue is whether the federal government can impose a penalty on individuals for not buying health insurance. Justice Robert Jackson wrote in that case: "Even if appellee's activity be local, and though it may not be regarded as commerce, it may still, whatever its nature, be reached by Congress, if it exerts a substantial economic effect on commerce." The Obama administration's argument in its brief is that the decision of individuals not to buy insurance, like that of Filburn to plant that extra bushel, has larger effects beyond the local one and serious consequences for the whole country- it raises insurance rates of people in states across the country and makes hospitals bear the burden of caring for these uninsured people. For over 50 years the Supreme Court has largely supported the idea behind the Filburn decision, except in 1995 and 2000- these two decision invalidated laws made about guns near schools and violence against women. The Court ruled that the activities were local and noncommercial and beyond the federal power to regulate interstate commerce....

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Us promises of aid to India during the current coronavirus outbreak. Anthony Blinken, US Secretary of State said - "Our hearts go out to the Indian people in the midst of the Covid outbreak. We are working closely with our partners in the Indian government, and we will deploy additional support to the people of India and India's health care heroes."

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House Democrats in the U.S. see the Republican health care plan making the same mistakes in 2017 that the Democrats made in 2008. With the passage of the bill in the House of Representatives with a vote margin on May 4, 2017, rushed through in the way the Obama bill was also rushed through, the nation remains as divided as ever on the issue of health care. The Republicans favoring limiting subsidies and cutting Medicaid, and using some of the savings for a tax cut. The Democrats favoring mandated coverage for all and large subsidies to reduce the number of uninsured Americans, with expansion of Medicaid for very low incomes. Democrats in the House say the Republican House bill will result in Republicans losing seats in the House in midterm elections.

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Van Dam says its not that great being a worker in the U.S. because it is hard for the unemployed resulting from competing with workers in other countries with lower wages, and for those who are unemployed harder because worker collective bargaining is weakened over 3 decades. He cites a 296 page OECD report showing very little government support for unemployed and at risk American workers. It says this has contributed to higher income inequality and larger share of lower income people than almost any other advanced a nation. Only Spain and Greece are shown as having more households earning less than half the median income- showing large numbers of people are poor or close to being poor. In the U.S. an average of 1 in 5 lose their jobs each year, and 23% of workers 15 to 64 are in their job less than a year in 2016. The job churn hurts workers because of firing and layoffs being frequent, more than is healthy for a economy. The U.S. and Mexico are the only two countries not requiring advance notice before firings. And fewer than half of workers find a job within a year in the U.S. Two in three families with a displaced worker fall in poverty for some time. Unemployed workers with typically 26 weeks support get less support than any other country in the study. Only 12% of workers in U.S. are covered by collective bargaining. ...

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Peter Orszag's role in the healthcare debate and the formulation of health care policy proposals. One proposal of Orszag, who heads the Congressional Budget Office, is to set up a new agency with powers to cut spending and implement changes in Medicare. Says Orszag, "one of the reasons we have such disjointed and skewed incentives is that we have an excessively political process." At a recent meeting with House Democrats, one Congresswoman said her top priority is winning higher payments for oxygen suppliers, and Orszag was taken aback. For years officials have been trying to cut payments to oxygen and medical equipment suppliers, which are said to be inflated. When a new competitive bidding process was set to take effect last year, industry supporters in Congress were able to delay the plan, and these supporters are still fighting to block changes says the WSJ. Here is a 40 year old Orszag, with degrees from Princeton and London School of Economics, who got his early experience in the Clinton adminstration at age 24. He then followed this with a number of policy oriented jobs, ending with appointment to head CBO in 2007. And he faces the whole system of Congressmen from both parties beholden to interests in the healthcare industry, who provide the donations for them to finance their election campaigns. Dan Eggen describes this in the Washington Post, 7/21/2009. Max Baucus of Montana, and to some extent Grassley of Iowa, are senators from both parties who Eggen points out are beholden to the healthcare industry because of large donations they receive from the interests in the healthcare industry. These interests want to see their payments system protected. The further escalation in health care costs, which would make the whole healthcare system unaffordable even as it delivers poor results, can only be prevented by making cost control an exercize that is not influenced by healthcare industry donations. Jackie Calmes describes the huge hurdles in achieving a deficit neutral move to universal health care in the U.S. in the NYT 6/26/2009. See the link. The exchange between Grassley and Orszag on the issue of the $177 billion in savings needed from the payments to health insurers under the Medicare managed care plans- which allow seniors to obtain Medicare coverage outside the government run program -went as follows. These are dubbed overpayments by outside experts and efforts have been made to cut them in Congress. When Mr Grassley raised concerns about the impact of such cuts in a hearing, -and Grassley has opposed the cut for this overpayment to insurers- Orszag responded saying: "I very firmly believe that capitalism is not founded on excessively high subsidies to private firms. This is what this system delivers right now." ...

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RFK Jr. nomination heads to the full Senate for confirmation as Health Secretary to bring new ideas and solutions to tackle obesity and disease in the US. He called the US health condition dismal as it is, not just for what is spent. RFK Jr called the US a sinking ship when it comes to the health of its people as he answered questions from Senators at Senate hearings. Ron Johnson, Senator from Wisconsin, said RFK Jr. was an answer to his prayers for someone who could help tackle this crisis. RFK Jr. said he was pro-vaccine and his opposition was only to some aspects of vaccines in certain situations. He also said that his father Robert Kennedy who died in 1968 when RFK Jr. was only 14 years old had told him when he was just 13 that it was important to have a fierce skepticism.  The magnitude of the crisis is so large and the budget is so large that only someone with the experience and one who has fought hard won battles against coal and for the environment for decades, and with the tenacity of RFK, is capable of taking the action needed today. Many senators applauded Make America Healthy Again, even as others asked RFK Jr. to support all vaccines at a time of public skepticism of the government. ...