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Cost of living (groceries and healthcare costs) in the Lehigh Valley of Pennsylvania. WSJ talks to the member of Congress Mackenzie and voters in this region of Pennsylvania, in a competitive House District in 2026. Voters are not dining out, using food banks, and are 50-50 in their support for DJT vs Democrats, yet plan to vote Republican. They attribute the worst inflation to Biden when it went up 20% one year, with DJT trying to cut the cost of living but failing to make the kind of headway that is needed.

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Autism therapy billing WSJ investigation showing everything that is wrong in America's healthcare system- greed, questionable billing one out of network child getting billed over $900,000. This WSJ report says only needed is a high school diploma to start a autism therapy center and easier than setting up a child care center. Therapy costing $20 an hour billed to insurance companies at $89 an hour. Until health care abuses are checked and criminal penalties imposed for abuses in healthcare to clean up the entire system,  this only goes to show thatany universal healthcare system would be loaded up with such costs making it too costly for the government to implement. This also includes the way people take care of themselves, their nutrition, their eating habits, their lifestyles, if these are not healthy, this has to be transformed before any universal healthcare system can take place as it would be loaded up with costs that should be taken care of by prevention, by healthy lifestyles, nutrition. Doing this creates a healthy people, and there can be no happiness without health and healthy nutrition, healthy lifestyles, healthy living. It is also the first job of government to create a healthy environment, to encourage and promote the literacy that enables positive health outcomes, enables cost effective delivery of health services. ...

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France per capital GDP $46000 compares to Mississippi's $55000- productivity and quality of life in the US vs France -healthcare, pharmaceutical, and vacation time, the serious drawbacks in the US. Lower taxes in the US yet the difference easily evaporating with expensive cost of healthcare and pharmaceuticals in the US, lack of maternity leave and health supporting vacation time.

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China's 15th Five Year Plan with shift to robotics, semiconductors, EV's, renewable energy, and lower investment in education, healthcare- the shift to a slowing economy, job losses. GDP per capita one third of the US much lower than most of southern Europe or Eastern Europe. China is still a middle income country. Unlike Japan which surpassed most of EU countries  GDP per capita, China with 1.4 billion people is a vast country. The shift in the emphasis in the 5 year Plan means economic growth  of 10-12% is now only 5%. With the collapse in housing construction and slowing manufacturing facing tariffs in the US means job losses.

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Obama Affordable Care Act ACA and its downfall are covered by two experienced authors over 2 book written over 2 decades. The authors are James Morone and David Blumenthal followed the healthcare issue over 25-30 years through the Clinton, Edward Kennedy and Obama efforts and wrote two books. The first was "The Heart of Power" on the healthcare situation from FDR to 2008. The last titled "Whiplash" in 2026, for which the authors are interviewed in Harvard Medicine magazine. C-SPAN has a book program on this book at a Washington DC bookstore. From the discussion on C-SPAN between Senator Michael Blumenthal, borther of one of the authors, James Morone and David Blumenthal physician, couple of conclusions are seen that may be new to readers. Q. What was the one single factor that doomed the Affordable Care Act? A. The deep antipathy towards the Obama administration influenced the response to the Obama handling of healthcare. The likelihood of Republicans accepting healthcare from a black person was simply not there say the book's authors in the discussion and Q&A on C-SPAN. Yet there were other reasons for the ACA failing. Obama had not gauged the mood of the nation well. UK Labour's Starmer won by a big majority in 2024 yet that does not reflect the mood of the British nation just 2 years later- by election year 2012 Obama's campaign was faltering and had to be rescued with Hispanic votes and a weak candidate in Utah's Mitt Romney. Obama lacked maturity and came in the way Bush came in when the list of candidates were mediocre in the US, similar to the period in the UK with David Cameron and Boris Johnson. To take on the health care issue required someone with the experience and caliber of LBJ, which Obama clearly lacked, coming from the minority community was not going to help in credibility. Obama's presidency was thus premature and to gain experience he would have done better in a key cabinet position such as at Department of State where an intellectual could have influenced world opinion in favor of emerging countries, a doable and necessary. Obama's lack of experience showed when he told Republicans two words in the first months in 2008- "We Won," perceiving arrogance it would set Republicans against him. The years 2008-2016 cost the US dearly in that the US needed a withdrawal from all of the Middle East which would require a strong president  with deep roots of support in all parts of the country including the south, to avoid recriminations. In the end by continuing the wars Obama weakened the US and let China move ahead. Q. Did Obama consider Medicare for All? A. Obama told Congressmen of his party according to Morone- if you can get 60 votes in the Senate for Medicare for All we can try.  Q. Would it take a major upheaval for Medicare for All to be accepted now that the health system is failing all Americans in 2026? A. It will take a world war or a economic depression- some major disaster for Medicare for All to be accepted in the US, say the authors. A pandemic happened in 1918 and again in 2019 the results were not positive, as the authors believe it unleashed the war on science after the vaccination for and against camps, leading to the culture wars in America seen today. Q  Obama's analytical mind thought he learned from the Clinton efforts in healthcare that failed. But he did not see things from the heart. There is good reason to think that the lessons learned of moving fast, letting Congress write the legislation, settling for what can be done not what needs to be done, were exactly the wrong lessons to be learned as opposed to writing off the Clinton experience entirely as Clinton's, and starting from scratch without preconceptions. In the end Obama if he was older, had more experience, and listened to the mood of the country would have realized that healthcare was for another day, and got right down to the most difficult challenge, to end the wars in the Middle East. Even small steps in the right direction would still have earned appreciation him today. Instead Bush and Obama, the most inexperienced of presidents will be remembered for wars they continued that weakened America.       ...

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Cost of living, of housing and healthcare, with the option of working remotely, is leading to more Americans leaving America for the first time since the 1930's than coming in. It is not just immigration policy discouraging immigration to the US. Middle class and younger Americans are seeing advantages in moving overseas if it costs much less for a better life and you can work remotely. In 2008 Gallup found 1 in 10 Americans wanted to leave, in 2026 1 in 5 want to leave for overseas locations.In 2025 more Americans left the US than came into the US. Estimates vary but one estimate is that in 2025 180,000 natural born Americans chose to leave the US. It is younger families, young people, from the southern US , from the midwest, all over the US, who are choosing to go to Europe or some other country to live and work. The State Department has no idea and does not keep track- it could be between 4 millon and 7 million Americans live overseas. Architects, engineers, professional people, are working out of small towns in teh French Pyrenees, or other parts of Europe.. Portugal - 365 increase inAmeicans in 2025. In a decade Americans living in Czech Republic, Nethelands, Spain, Germany has doubled. One couple profiled here moved to Portugal after preparing for 4 years. Portugal offers visas to stay if one can support himself, herself and family, which is the minimum wage or $27,000., which this couple could show as investment income. They could not find places to stay near good schools in LA because of the cost. Now in central Lisbon they can with $100,000 budget live a richer, fuller life, reduce hours of work, send kids to private school, no need for 2 cars as subways are nearby, and no need to put a ton of money aside every year for college. They have more time to themselves, more relaxed, and kids private school is close by. Today in the US setting aside a ton of money for college makes it difficult on $200,000 a year  in the managerial ranks as shown in reports in the WSJ. College can cost $100,000 a year for 4 years, 2 children $800,000, thats too much.  ...

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Southern Indian state of Madras in 1952 and the administration of Rajagopalachari (Rajaji) in 1952 following elections. Madras state at the time consisted of most of what is now southern India, as the Madras Presidency of the British Empire. The first governor general of India Rajaji was brought in to run the state after the Nehru Congress party failed to win an outright majority and the Communist Party and opposition made major gains. Rajaji's administration led to the successful administration of Congress leader Kamaraj still known for its school lunch programs and advancement of education and healthcare in Tamilnadu. Today Tamilnadu faces anew challenge as the upset win by the TVK party under Vijay seeks to take the state in a new direction after mismanagement of the economy  and lack of state-federal coordination under the previous administration of the DMK party. The messy period in India from the 1950's is similar to the messy period in China in the 1950's to the 1970's with the upheavals under Mao. Still China found its way by 1990 as India does today with a commitment to rapid industrialization and modernization,  federal-state coordination on industrial and infrastructure projects at scale and speed. ...

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The Obama Center in Jackson Park, Chicago, is a 20 acre complex opening on June 19, 2026, built by Todd Williams Billie Tsien Architects. The Obamas chose land that was once use for the World Columbian Exposition World Fair. Using public space was controversial, made up for by a new branch of the Chicago Public Library, a basketball court and playgrounds. The most controversial part is the Obamalisk (obelisk type) tower which is as dour as one can get. One of Obama's speeches with letters on the tower top the architect says is not legible, but thats just fine he says, as if it is empty rhetoric. Or as Kennicott says just rhetoric, ornament, did all those words 17 years back really matter or were they merely oratorical good vibes. So much has happened since then that Kennicott rightly looks at the new Obama Tower with skepticism of what Obama ever accomplished. In healthcare the Obamacare plan is now not working or being replaced. Obama continued the wars Bush started, were they really that different.  At every turn from the entry there are questions like this. At the entry itself with the Declaration of Independence there is a display of unequal treatment, questioning the very experiment of Jefferson, Washington, by placing their formative ideas for a new society that had already been born in Britain with the abolition of slavery in 1772 with Somerset vs Stewart. Ben Franklin forming the Abolition of Slavery Society in Pennsylvania as early as 1775 and becoming its president in 1787. None of the founders get any credit for envisioning a different society, than they had to live in, and which even Abe Lincoln struggled with from 1850's till the Emancipation as way to win the Civil War. The entry to the Smithsonian has done the same. Yet it is this same document the Declaration which says "All men are created equal and they are endowed by their creator with some inalienable rights, life liberty and the pursuit of happiness,"  that has inspired  and given new hope to hundreds of millions of Chinese and Indians, Africans, and other Asians by 1900 and 1950, the vast majority of people on the planet. Philip Kennicott of the Washington Post asks the questions over and over in this report-  was America sleeping when it should have been alert? Lighthizer and Jamieson says this on this page that 5 million jobs were lost, economic growth was down by 1% to 2% instead of 3% of the period 1960-2000, and $20 trillion in America's wealth transferred overseas by the combination of Bush-Obama in the 2000-2020 period, manufacturing decimated, wages stagnant, America's working class communities destroyed, all the while this high minded rhetoric went on. As Kennicott says the period of rhetoric and oratory is gone, in the past, the presidency merely decades of decadence of America's elites as Marco Rubio says in a new book. ...

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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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Where do you place a winner of the Democratic primary in Maine, Graham Plattner, an oyster farmer who dropped out of college at George Washington University, served briefly in the Middle East wars of Bush and Obama, and had PTSD. Is he working class, middle working class or is he from a downwardly mobile professional class considering he has parents who are well educated and father a prominent lawyer in Maine? Plattner easily defeated a 3 term governor of Maine with his average working class demeanor and language. He is for universal health care, (Medicare for All) universal child care, affordable housing, affordable college. Politics in the US has been moving away from the simple divisions before 1950 created by the Industrial Revolution- the workers in factories and the owners of capital allied with the professional middle class. The few owners of capital mostly college educated allied with people from the non college educated workers in factories who are conservative in their values and beliefs and on the other side the college educated professional middle class now downwardly mobile because of the many recessions and high unemployment from frequent financial crises, with college costing $80,000 a year putting them in deep debt. There is today in the WSJ a story of a professional worker who at $194,000 a year salary is not able to payoff $15000 debt which owners of capital have set at 26% interest and is in downward spiral. Some of this comes from large college and other debt. There is says WSJ Analysis $1.25 trillion in credit card debt alone with highest delinquency rates in decades in 2026. Cost of living has only made things worse and some of this happened as Biden poured money into the economy to help people hurt by the pandemic, yet with some short run consequences with demand strong businesses including hotels, restaurants and grocery stores, auto dealers, jacking up their prices by over 20% in 1 year and Biden failing to respond, getting overwhelmed by open borders migrants under Mayorkas and Harris (also hit by a sudden Venezuelan migrant influx). This is the America one has today- a confusing mix. This in reality means Democrats may take issue with Democrats, Republicans take issue with Republicans, and Democrats join with Republicans on issue by issue basis. It might actually be rational than irrational. On cultural issues if the country has gone over its head and moved too fast on some issues that are not for the general public good, people of different backgrounds can come together to get the best path. On economic issues things are never so straightforward, there are unpredictable consequences and the rules of economics are really not so straightforward either.  Providing relief can mean the government shouldering the burden as during the pandemic which it should, yet with caution as businesses can use the excess demand to raise prices and one is back to square one with everybody worse off as happened with Biden. Migrant flows and fears of insecurity in public spaces can lead to a severe public "discomfort that can waylay the best intentions of a Harris or Biden, leading to public "backlash." In fact the title of a recent book is "Whiplash." Current books include Floridan Marco Rubio's "Decade's of Decadence- How our Spoiled Elites Blew America's Inheritance of Liberty, Security and Prosperity." Rubio means it. Its authentic because as Rubio says repeatedly, his parents could make a living in the 1960's working in a factory with decent wages, low cost of living and low cost of college, the arithmetic between salaries and what you needed for decent home in suburbs and sending children to good public schools, then to college, all adding up. The result is that Rubio could go to college and serve in the Florida legislature. Rubio says in 2026, after the elites under Bush and Obama and faulty economic theory shipped all of our factories to China, that the story of his parents and his education would simply be impossible. This is what he told people in India on his first visit last week. His parents were Cuban immigrants, yet he identifies with Spain and with western civilization, a devout Roman Catholic. Rubio is a Republican, and is in large contrast with Alejandro Mayorkas, also from Cuba, and Biden's Head of Homeland Security. This is the mix of people and representatives in Congress,  business people, small business owners, professionals, that we have today in 2026 in the US. Plattner and Rubio, one a Democrat and one a Republican- both have something in common. Plattner also has general disdain for "the corporate interests, the billionaires, the Washington DC elites, and the establishment politicians."  The winds are blowing in the direction of getting things right- remembering that Eisenhower continued the work of the Kennedy and LBJ administrations (Eisenhower built the Interstate Highway System for instance, and LBJ gave America Social Security and Medicare). Before that Franklin Roosevelt a Democrat built on the work of his uncle Republican Theodore Roosevelt (TR gave America the idea of good governance and built the US Navy, FDR fought the Depression and stabilized a faltering economy after mistakes made by Republican Herbert Hoover could have happened even if Hoover was a Democrat. FDR was himself from a wealthy New York family and when he first met fellow New Yorker Frances Perkins before his struggle with polio, a haughty New York gentleman. That was before Frances Perkins as FDR's Labor Secretary joined forces with Roosevelt to give New York a modernized administration governance structure by 1940 that was applied to all 51 states after 1950. It allied labor with capital with fairness for all, and was the first such modern structure of this size the world had ever seen, which was the fundamental strength of the United States of America. It was imitated in Asia, first in the Shanghai region then China, and first in the Ahmedabad region and now India. The US is faced with the challenge of recreating and rebuilding this today, as first China, then India remind America of its roots which they have followed in their own style and culture.  First good governance, then good institutional structures, alligning labor and capital with fairness for all, strong affordable + accessible educational and healthcare systems, and investments of capital and labor for infrastructure + industrial development. ...

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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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DJT appeared on Oz's health show in 2016 as a presidential candidate, and sees OZ as a fellow tv show host, a kindred spirit with a passion for what he is doing. As head of Medicare and Medicaid after afailed effort for a Senate seat from Pennsylvania, Oz is still someone whit a keen sense for the politics as well as what is good for the healthcare of Americans. He shares apassion for good health as a goal for America that was held up by JFK, and his nephew Robert Kennedy Jr who now leads the Make America Health Again movement. Oz fervently believes the time for healthy America is now after many wasted years under Clinton/Bush/Obama when national interests were neglected for places like Bosnia in a historical conflict of Turks and Serbia that goes back centuries (Clinton), in the deserts of Iraq (older Bush), in the mountains of Afghanistan that claimed Brezhnev as a victim the younger Bush followed, two wars prolonged by Obama and closed by DJT and Biden. Something as basic as health and pharmaceutical prices was allowed to get as bad as it is in 2026 with prices through the roof. DJT's plan is to get the pharmaceutical companies to commit to certain prices, to the lowest price they sell the same medicine in Europe. This is what Dr Oz wants to see not just for the next 3 years but put into established practice for the future years.  Oz says about presenting the DJT plan on healthcare to Congress and the Nation- “We didn’t demand that they do it. We said, ‘This is something that is very popular and highly achievable.’ ” Healthcare costs, gas and automobile costs, energy costs, housing costs are all part of the 4-5 costs that are the key elements in the cost of living crisis or affordability crisis that is uppermost on the minds of Americans. Already the Medicare payments to insurers are going to be flat for 2026 compared to 2025, as part of policy to get costs down, push pharmaceutical costs down. ...

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Frances tax system places 40% tax on single earner family with 2 children compared to 20% in the US. France debates how to pass the budget and how to meet budget shortfalls in revenue, where to tax. France's top tax bracket is already at 55%, the second highest in Europe, which does not make the job of setting taxes easier. Additional 1.9 billion euros was to be raised by raising the tax rate for families that had tax liability of 20% if they made over 250,000 euros. This has raised 400 million euros only in 2025. This editorial in the Washington Post is critical of the French tax structure and says it is not just the rich who end up with higher taxes. It says that the average French single worker gets to keep only 53% of income after taxes, whereas American average single worker who gets to keep 70%. The extra 20% could be what the American worker pays for health care if as in some cases health care has become so costly in the US as to cost more than a mortgage, as reported in the WSJ in January 2026. Can government buy healthcare more efficiently and distribute it than families on their own. In the case of pharmacy products would removing the power to negotiate  prices with pharmaceutical companies conducted in government run by special interest groups as happened under US president Bush make it so expensive to buy pharmaceutical products that the advantage of smaller taxes is destroyed by a perverse healthcare system run by special interest groups with help of lobbyists. This is just to show that yes the US tax system with lower taxes can fail when other things go wrong in managing crtical costs such as healthcare and housing.   ...

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Issues of cost of living and higher taxes in states in the northeastern US and California vs the lower taxes and lower cost of living in the Southern States of the US. Whose side each of the two main parties are on in the US has switched in the period since Harry Truman and FDR in the 1940's. The Republicans represent small business and the less educated in society, the Democrats represent the more educated, affluent sections, and women, the black minority, with Hispanics divided between the two parties. Unions are now neutral and workers in factories lean more towards Republicans. On health care there is a failure for both parties. Both parties have failed miserably with all the lobbying creating obstacles-- to provide cost of living in healthcare. In comparing healthcare and the wealth of societies, it can now be noted that a well funded healthcare system with medicine within reach of the entire population of 1.4 billion people in a poor country like India does better than that of a rich society like the US with 350 million people. This makes a huge difference in the quality of life. Infrastructure investments in relatively far less affluent countries like China and now India make it possible to have better conditions of living relative to the US with infrastructure and transportation from the 19th century still awaiting rebuilding. ...

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As to financing of $6000 child tax credit costing about $100 billion a year as estimated by Office for Responsible Budget some of it would come from the $360 billion in tax savings over 10 years by Medicare negotiation of prices with Pharma, other would come from taxing corporations and high incomes at rates that are similar to what firemen and teachers pay of 20-25%. In his speech at North Carolina Aug 15, 2024 at Wake Tech in Raleigh, president Biden said- "You know how many billionaires there are in America?  There’s now a thousand billionaires.  You know what their average tax they pay — federal tax?  8.2 percent.  Anybody want to trade with a billionaire — their tax rate?  (Laughter.)  Well, guess what?  If they just paid 25 percent — it’s not the highest bracket by a longshot — 25 percent — do you know what that would do?  That would raise $40- — $400 billion over the next 10 years.  Imagine what we could do with that.  We could fundamentally sh- — slash the federal deficit.  We could make sure there’s home care.  We could do so many things — consequential — including finally making sure that we take care of Ukraine from that butcher Putin.  (Applause.) ...

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A health care practitioner says the real problem is the high cost of medical care in the U.S. when compared to other countries. She points out that the Obama bill in 2008 did not take effective steps to bring down the cost of health care before enacting legislation to cover the uninsured, leading to higher premiums for the middle class. The link between healthcare and profits is seen as the main problem. 

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The Washington Post survey of 1200 readers on how the Republican healthcare plan of Speaker Ryan and the House of Representatives looks to them, how it affects them in their lives. Here Somasekhar of the Post gives the stories of 5 Americans. Some see the prospect of losing their insurance under the Republican plan even as they reach an older age, others a smaller segment says the Post, whose premiums jumped under the Affordable Care Act say they faced high premiums and high deductibles. The Post says the large majority of opinions have expressed anxiety over the proposed Republican Ryan House plan for healthcare. One of them is an uninsured poor farmer, Mr. Woosley,  income about $18000 who gained benefit from expanded Medicaid under the Affordable Care Act,  one Mr. Smith, 32 years, a personal injury attorney who faces paying $10,000 if he did not take insurance and $10,000 if he took insurance because of high premiums so a wash either way deciding to do without it, one a tech worker Mrs. Powers, 62 years, income $22,000 on year and $4000 the next, from middle class during the tech boom but facing fewer opportunities and uncertain income from part time work, hit by the deep recession facing fewer opportunities as she gets older and now the prospect of losing insurance without government subsidies, one who is from the middle class who sees little benefit from the Affordable Care Act and is forgoing insurance because of the high premiums yet faces a penalty for not being insured under the ACA, another Mr. Blanchard, 52 years, is from the middle class, a computer programmer who lost his job in downsizing, earns $100,000 as a consultant self-employed, pays $767 in premium a month and relies on the Affordable Care Act which helps him gain freedom from working at a company that could downsize,  another is a middle class programmer Mr Riffle,age 44, and his wife, who does not qualify for a subsidy with a $71,000 family salary from working 4 jobs between himself and his wife- this person finds it too expensive for his salary to buy insurance $900 a month and $14,000 deductible under the Affordable Care Act. His views are worth listening to as they go to the crux of the problem- he says he may not be any better with the Republican plan. He sees the real problem as the high cost of health care in the U.S. and the only way this can be fixed is for members of Congress to be asked to use the insurance exchanges they create. If this sample is representative it shows that there are real problems with both the Affordable Care Act and the Republican plan, that the high cost of health care the problem lurking behind every plan that does not squarely address this, and till that happens and members of Congress experience what ordinary people face, this problem can never by fully solved.   Woosley, Smith, Powers, Blanchard, Riffle, and their personal experience is at the crux of what is right and wrong  with the Affordable Care Act, and also with the new Republican plan of Speaker Ryan and the House of Representatives. For every Woosley, Powers and Blanchard who benefit, there is a Smith and a Riffle who are indifferent or are affected by the high cost under Affordable Care Act and the current system of medical care with its high cost. The Affordable Care Act does not  tackle high cost, for that to happen the culture in America that makes it possible and acceptable to charge high prices must change. Another problem apart from bringing health care costs is that any solution needs to have the whole country behind it. If the notion that all people are entitled to basic health care is to stand, the whole country needs to believe it as they do in countries like France, Britain, Germany and Japan. If this has to be made a workable proposition health care has to be offered at a price that makes this possible to achieve, and that idea also needs the deep and broad sense of support from the culture in America similar to that in these other countries. Until that happens politicians in America will get elected and turned out of office in turns on issues such as health care, based on which side they take and which problems they choose not to face squarely and responsibly. ...

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Washington Post calls a Netherlands unrealized capital gains tax of 36% unfair. The legislation was passed in lower house of parliament. Unrealized capital losses could be used to offset gains in future years under this legislation. The US only taxes capital gains after they are realized and at 15% or 20% for long term gains and a 4% added tax for high income persons. The 36% tax would apply to all who own stocks or bonds not just the wealthy.

In Netherlands the average take of the ogvernment is 3%% compared to 30% in US. Healthcare costs are split 65% 45% between the government and average worker, and mostly all (84% of workers) get additional coverage. The value added tax rate VAT is 21% in Netherlands about 3 times the US sales tax of 6-7%. And the Netherlands is in the EU a relatively moderate tax country compared to France and UK.

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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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Healthcare and pharmaceutical costs are a major factor in expenses of American retirees. The Cost of Living adjustment of 8.7% in Social Security payments for 2022 will help retirees meet the cost of living crisis with high inflation in food and energy costs in 2022, and the continued rise in medical costs.

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The first home testing kits approved by the FDA are on their way in coming weeks to healthcare workers from LabCorp, says this report in NYT. A test is done at home and returned in an insulating packet to the lab. Cost $119. President Trump says the testing costs will be reimbursed.

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Flat payment rates for Medicare Advantage to Insurers by the DJT administration which is questioning how health care needs of the country remain unmet and US healthcare comparing very unfavorably with other advanced countries in Europe and Japan and also in India. Some of this is because of the behaviour and practices of the health and pharmaceutical industries in the US. The 2027 payment by government for Medicare Advantage is 0.09 percent. In 2026 it was about 5%. In 2025 it was -0.16 percent and in 2024 it was -1.12% under the Biden administration showing a great deal of dissatisfaction with funding Medicare Advantage. Medicare Advantage was set up by the Bush Republicans in 2003 who set it up with the nice sounding name Medicare Modernization Act. It was an effort to help the insurance companies with government money. Today in the second term of DJT in 2026 affordability is what American people care about most and the DJT administration is unhappy with the insurance companies. Dr. Mehmet Oz is in charge of Medicare and Medicaid Services Agency of the federal government and he says about Medicare Advantage and new policy to save “taxpayers from unnecessary spending (on Medicare Advantage) that is not oriented towards addressing real health needs.” The DJT Kennedy-Oz approach is for comprehensive digital information linking all medical providers, making America healthy again, cutting through the dense fog created over the last 2 decades, making pharmaceutical costs as affordable as the best in European nations, and refusing to subisidize if delivery is poor and health results are poor.   ...