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The Senate FInance Committee's $829 billion bill, would cut by $113 billion money for America's Health Insurance Plans over ten years, specifically Medicare Advantage, reducing insurer profits. The AHIP is responding with aad campaign to seniors to fight this setting up aconfrontation with the Obama adminsitration.

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The situation in farms and orchards in the U.S. as growers face shortages of labor to pick vegetable and fruit produce. A special visa program provides U.S. farms for vegetable and fruit produce with agricultural workers from Mexico. In 2019 this program brought in about 268,000 agricultural workers from Mexico.This report looks at the effort of companies to ensure that agricultural workers are well taken care of. This includes delivery of groceries to limit trips to nearby towns, offering food trucks with prepared meals. Problems of overcrowded housing and lack of access to health care are problems that are being tackled. Some companies are reconfiguring field work for health safety, and funding overtime work at local health clinics.

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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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Lobbying by the pharmaceutical and health care industry and U.S. president Obama's promises to the industry as part of his shaping the health care law.

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Philips health care division operating margins drop from 13.6% to 4.3% in the 1st quarter of 2009, a result of the severe impact of the 2008-2009 global financial crisis. Philips Electronics showed a operating loss for the 1st quarter 2009 of 74 million euros.

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US health care is not working. In UK and Canada the sytem is regulated in a way doctors and hospitals work togerhter to keep costs down. This is not happening in the US. insurers and doctors are pitted against each other and patients are in the middle. Insurers are also running about 70% of self funded employer plans that pay insurers a fee and are the responsibility of employers. Insurers then cut costs and do this for employers. Sel funded means employers pay cost of claims insurers merely get a fee. Patients are caught in the middle between Insurers and doctors/hospitals. The insurers cutting costs overbilling Medicare and skimping on payments, doctors trying to overcharge. Christopher Whaley, an associate professor at Brown University’s School of Public Health says- “We have a system of whack-a-mole, with providers trying to get paid and insurers trying to constrain costs—patients are caught in the middle,”  Obama exchanges to get people covered never thought through to come up with a better system and is a Band Aid. At some point the whole system ought to be scrapped and one built from scratch and designed to work so that hospitals and doctors provide best service at lower costs.   ...

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Wealth for top 7% of U.S. households averaged $3.2 million in 2011, compared to $133,817 for the other 93% of the population. Third quarter 2013 household net worth is 615% of after tax income, up from 570% in 2012. The uneven distribution of household wealth and the gains from the stock market recovery going disproportionately to wealthier investors, does not provide strong enough underpinnings for robust consumer spending.

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The House healthcare bill that just passed by amargin of 220 to 215. The cost would be $1.055 trillion over 10 years, with cost of $894 billion factoring in penalties for individuals and businesses that don't buy insurance. Adding increased coverage for Medicare prescirption drug coverage for seniors its around $1.2 trillion. $460 billion is from new taxes on single people with income of over $500,000 or couples with inocme of $1 million. There are $400 billion in cuts to Medicare and Medicaid, and additional money coming from penalties for not buying insurance. First column here is Senate version, second for House version and third President's version. Other features individuals must have insurance or pay afee of 2.5% of income, hardhip waivers will be available. Employers must provide insurance to employees or pay a penalty of 8% of payroll. Small businesses with fewer than 10 workers get tax credits. The threshhold is $500,000 of payroll. To help families with lower incomes and the poor the bill provides: families earning $29,000 a year pay no more than 1.5% of income for premiums. Families with incomes of $88,000 ayear would pay no more than 12% of income for premiums. ...

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Many African countries have high growth rates but this can be misleading. Much of the wealth is generated from drilling or mining for resources. There is no transparency about the wealth generated and its use, with much of the wealth siphoned off to go to the ruling elites. Even the thriving private sectors can give the false impression of progress, when they are cartels of firms run for the benefit of the ruling party and its cronies. Independent media is purchased by the ruling elites and the information is one sided, concealing the imbalanced development and widening gaps between the wealthy and the vast majority of poor. When investments are made they show a stark reality of years of neglect of education and healthcare. Angola has built 24 new hospitals with oil revenues, but has only 1500 doctors for a population of 18 million. Much of Nigeria's electricity supply comes from small generators as the government electricity system has seen underinvestment for years. State owned firms are "privatised" in Nigeria by giving them to cronies of the government in power. These countries lack a honest civil service, an ethic of responsibility in the educated and ruling classes, institutions of democracy with checks and balances, and independent media. The anti colonialist movements in African countries have failed to deliver on education, democratic institutions, and building a prosperous middle class in most of Africa with a few exceptions. Both military and civilian leaders have failed to relinquish power once in control, with the rare exceptions....

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Health and Education are the best bets for investment to revive the economy. BW's Mandel says the health and education fiscal channel is still functioning, while other ways of stimulating the economy are in breakdown mode. Taxpayer money given to banks, businesses and households will be saved to pay down high levels of debt and because of uncertainty. But funds directed to schools and hospitals will be spent to buy new equipment, modernize and update, put up new buildings, and hire workers. Health care especially is keen on hiring new nurses, medical technicians, home aides, and so on. And over the past year health care and education workers have risen by 500,000. In these hard times the hardest hit areas like Michigan have seen health and education make up 23.7 % of jobs, while manufacturing has dropped to half that, only 12.5%. And in the past decade health and education has had a stabilizing influence already. Nationally these areas have hired steadily, adding 5.3 million jobs since 1999. Meanwhile the rest of the economy has seen booms and busts, and off shoring and outsourcing overseas, with only 400,000 new jobs created in 10 years. Education has suffered neglect for needed infrastructure including broadband and internet capabilities for classrooms, and health care suffers inefficiencies such as computerization of records, and cost inefficiencies. These areas can be modernized and improved, adding to benefits years from now. They are large sectors employing 30 million workers or 22% of the workforce, and now badly needed to stabilize the economy as these employees are well paid and could help keep consumption from falling badly. A Gallup poll taken in February, shows 56% of Americans showed that education investments were "one of the most important items " for stimulus spending, coming out on top, and beating tax cuts....

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A first of its kind- getting hospitals and medical clinics to go solar with solar panels supplying all the energy needed. A solar powered medical clinic in Hollister, California.

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The broken world economy has hurt the American people, in small communities and towns across the US whose societal fabric was destroyed by a system of world trade with abuses done by China. Japan, European Union, Canada and Mexico since 2000. Shortsighted American leaders and economists allowed this to happen. Robert Lighthizer on the New World Order a new system of world trade that replaces the old in 2026. The old trading system was one in which lip service was made to free trade while all the time the system was used by Japan, Germany, China, Canada, Mexico and other nations to build non tariff barriers and other policies to support their industry  at the expense of the United States leading to disillusionment in the US. The facts are mind boggling- the loss of 5 million jobs, many small communities across the US decimated with loss of jobs. About 20 trillion in wealth transfers to China and other countries over 2000-2020, with foreigners owning $27 trillion more of US assets than the US owns of theirs. US Trade Deficits that went up by 40% in 4 years of the Biden administration from $800 billion to $1.2 trillion. Economists and weak leaders got it all wrong allowing this to happen from Geoge W. Bush to Clinton Bush and Obama. Lighthizer says "shortsighted leaders aided and abetted this process," from 1990 to early 2010. Consider that US had 17.3 million  people in manufacturing, in factories all over the US in 1970, in 1999 we had the same number of jobs, even though there were changes in technology and productivity- the US held its own with the rest of the world. The Bush, Obama years were the worst for the US industry - by 2026 we have 12.6 million - loss of 4.7 million jobs since 1999. And real median household income took a big hit growing from $72,000 to $84,000 about 17% in the last 25 years, compared to twice that in the period 1975-2000 prior quarter century. The result is the fracturing of American society- and dire consequences for healthcare as communities suffered from loss of jobs leading to drug overdoses, alcohol abuse and suicides, which are common in post industrial American communities. Think of this fact: two thirds of America's workforce that does not have a college degree, that is working class people, lives 8 fewer years than college graduates, a gap that was only 2.5  years in 1992. The wars carried on by Bush and continued by Obama in the Middle East also wracked these same communities till Biden and DJT pulled out. One has only to drive across America to see this with one's own eyes. Trade may be an abstract topic for economists and politicians- there is nothing abstract about this. And the economic growth of the US has suffered with the unfair trading system with China, European Union, Japan, Canada and Mexico. From 1945 to 2000 American growth was 3.2% a year. Since 2000 only 2 years of growth over 3%. US has not seen historically normal growth for the last 19 years and at this rate (if we continued along this path) the Congressional Budget Office says 1.8% growth for 2027-2035. There are other factors yet the the major driver of this is our trade deficit of $1.2 trillion dollars a year. It is a story of remarkable persistence in the Nation's interest through 2 adminstrations- this Lighthizer story. Lighthizer fought Japanese commercial interests as Deputy Trade Representative under Ronald Reagan, and as US Trade Representative under DJT in the first DJT administration in 2016-2020. His Deputy at the time is Jamieson Greer who is now the US Trade Representative in the second DJT adminstration in 2025. For 30 years this brave American patriot has fought to reverse the bad actions of presidents and economists that have led to devastating losses in the American countryside. He says any new trading system must be perceived as fair to working people. It will survive only if working people think it is good for them. It cannot and must entrench a small, permanent elite. The benefits going to labour must be at least as great as those going to capital. It should create fulfilling high paying jobs for the vast majority of the American people. This is America's new promise to its people, its new compact with its people. ...

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The U.S. Supreme Court lets the Obama healthcare law stand in a 5-4 vote with Justice Roberts casting the deciding vote. The Court ruled that the government could impose the individual mandate that all people carry health care insurance not because of the commerce clause but because: The provision "need not be read to do more than impose a tax...This is sufficient to sustain it."

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

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Health insurance premiums for family plans increased by 9% in 2011 according to a survey by Kaiser Family Foundation. A similiar survey by Mercer showed premium increases around 6%. Another change is that health insurance plans are becoming less comprehensive and deductibles are higher, with higher copays and employees contributing more to premiums.

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The tough job President Obama faces as he faces opposition from politicians who have interests to protect, and healthcare businesses with interests to protect. The President has to come up with a plan that is deficit neutral, because financial markets could see a healthcare bill that further widens the deficit as a signal for higher interest rates that would deepen the recession. At the same time each of the three sources of revenue puts him at loggerheads with political leaders in Congress or groups with interests to protect. Limiting income tax deductions for high earners could raise $267 billion in 10 years. It would require taxpayers in the top tax brackets deduct their mortgage interest, state and local taxes, and charitable donations, at the 28% tax rate instead of the 33% and 35% tax rates. The opposition is with democratic leaders that it would hurt charities, universities that depend on tax deductible donations, and taxpayers in high tax cities like New York city that are the home base of Democratic leaders. Yet only 1.4% of households would be affected says the nonpartisan Tax Policy Center. The Center on Philanthropy at Indiana University, says charitable giving would decrease by 2%. The other opposition on this comes from the preference of Senators Baucus and Grassley, who head the Senate Finance Committee, for tax increases or cost savings to come from the health sector. Specifically they want to see the value of workers' employer provided health benefits subject to income taxes. It is a situation in which every sensible person admits the need for healthcare reform and would see the current pace of healthcare costs as unsustainable and dangerous; and after that will just go back to his group and try to preserve as much of the status quo as possible, so as not to disturb by much the benefits or compensation they have secured from the system over the years. Then there are political leaders in Congress with their own preferences, and Congressmen who are the subject of heavy lobbying by these interests. The administration and the Presidents job is to navigate this stream with a workable deficit neutral plan, without any requirement for any group to make sacrifices, and in some situations even small sacrifices for the public interest. Would charitable institutions be hurt that much, what if charitable institutions were exempted, why would other interests the try to obtain the same exemption. Its like the unions trying to keep the old unsustainable goldplated healthcare and other benefits at GM even as the ship was going down. Taxing employer provided employee health benefits as income would raise $2.5 trillion over a decade. The opposition here is from unions which are a force in the Democratic party and which count tax free health benefits as a legacy of the labor movement. Employer provided health insurance covers 160 million American employed and their dependents under the age of 65, so it has a wide impact. Yet most economists favor ending the tax break. They say it mainly goes to upper income taxpayers, and discourages cost consciousness among consumers of health care, thus encouraging excessive spending and surging health care costs. Senior Obama advisors, Peter Orszag, the budget director, and economist Jason Furman favor this approach. So do Republicans in Congress. Senators Baucus and Grassley are not asking for the complete removal of the tax break, what they want to see is capping the value of benefits that go untaxed. If the tax-free limit is $13,000, a policy worth $15,000 would pay income taxes on $2000. A third spource is to spend less on Medicare. About two thirds of the $948 billion in savings Mr Obama has proposed over 10 years comes from a number of reductions in Medicare spending. $177 billion comes from insurance companies bidding for government reimbursements for offering private plans to seniors. $106 billion comes from cutting the subsidies to hospitals serving the uninsured as universal coverage should remove this need. And $110 billion in reduced payments to hospitals and doctors because of productivity gains. A range of industries insurance companies, hospitals, doctors drugmakers, nursing homes, home health care companies and medical device makers, all stand to lose from reduced payments from Medicare and Medicaid. And these groups with interests to protect are another factor in this process of working out a healthcare plan. ...

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The consumption of highly processed foods such as cereal, and frozen meals has been associated with anxiety, depression and cognitive decline, says this report in NYT.