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Jaffe and Eilperin provide this exceptional account describing the huge struggle of Agriculture Secretary Tom Vilsack to come to grips with the opioid crisis in rural America. Vilsack is from rural Iowa, where he was a small town Mayor. The opioid epidemic has personal overtones for Vilsack because of his parents addiction and growing up seeing the lack of helping hands. Vilsack. a two term governor of Iowa has witnesses these struggles in Iowa, as the state rural areas faced high poverty rates, more likelihood of being obese, less likely to go to college, and more likely to be pregnant in the teen years, than the rest of America. Vilsack is frustrated not just with the Obama administration but also with Congress, the media, the private sector with high pharmaceutical prices, for not giving enough attention to rural America. He sees rural America as providing the food grown and a disproportionate share of the military. The opioid epidemic comes at a bad time for rural America. This report provides a story that is typical where a dose of painkillers for a Navy employee leads to addiction and use of opioids. The whole experience has made Vilsack sound cranky to people in the White House. ...

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The numbers are shocking. In 2019 alone the costs of the Opioid epidemic in the U.S. was $188 billion including healthcare, child and family assistance programs, criminal activities, and lost wages, according to the Society of Actuaries. Now 3 large pharmaceutical distributors and some pharmaceutical manufacturers are hoping to settle the lawsuits by paying $50 billion. The costs to the nation are enormous in human toll and in lost economic activity.

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In this insightful essay Peggy Noonan, former spokesperson for president Reagan, says that Republicans like Speaker Ryan with the Republican Health Care bill are making the same error made by president Obama.. Noonan says she had suggested a different way for president Obama to show compassion for the uninsured- first wait till the 2008 financial crisis was tackled, tackled waste and fraud in Medicare first, then look at the option of expanding Medicare to help the uninsured, and not the approach taken of swiftly focussing on the Affordable Care Act early in the first term disregarding Republican objections. She says Republicans are making the same mistake now by ignoring the impact the bill would have on Trump's base of working class Americans who may be affected by the bill's provisions not taking into account incomes in offering incentives or subsidies. Noonan says Trump did get one thing right in calling it a "carnage" for the worsening opioid epidemic in America which has hit rural areas and parts of the midwest hard. Noonan says Eberstadt has correctly documented the collapse in working class Americans wages and standard of living, and Caldwell the opioid epidemic at another level to their health. She also supports journalist Carlson who questioned Speaker Paul Ryan's judgement about eliminating the tax on wealthy investors in new legislation in a Fox News interview, as she says responding to the sense of America at the moment means listening to the sense of being left out of ordinary Americans, who have done not as well as the wealthy who have benefitted from a surging stock market.  ...

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A new study in the Journal of the American Medical Association shows an alarming and unsettling gap in the life expectancy of men vs. women in the US. The JAMA study shows life expectancy of women at 79 years, and of men dropping down to 73 years. Combined with lower educational opportunities for men to go to college compared to women these numbers are difficult to grapple with. The pandemic hit men harder, the opioid epidemic also hit men harder, men also have higher rates of suicide, heart disease and diabetes. Action is needed. Looking back at the turn of the century in 1900 the difference was 2 years. Decline of smoking has improved the life expectancy of men- action was taken for this to happen. 

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President Trump wants to see China lower fentanyl exports to the U.S. because of a worsening opioid epidemic. The trade disputes extend into areas that have no direct connection but affect the U.S. and Mr. Trump's commitment to tackle this issue.  This report says president Trump expressed dismay on this issue.

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Thomas Frank describes how things went wrong in America by drawing the contrast between Martha's Vineyard and Decatur, Illinois. In 1946 he says a typical executive's salary was only 2 times that of a worker at a Caterpillar plant in Decatur, Illinois. By 2016 this had changed to where the top executive at Caterpillar was making over 400 times the wage of a typical worker at a Caterpillar plant. Democratic politicians he said had moved away from their working class base towards places like Martha's Vineyard. For Republicans the embrace of tax cutting, the deficit, and cuts in education and healthcare, entitlements, to the exclusion of everything else in a recession environment led to the rise of Trump and the rejection of stands on these issues- including amazingly the embrace of a $5.3 trillion increase in the deficit under the Trump plan estimated by economists and a recession after a temporary boost.  Inserted into this were the culture wars, immigration, with the change to mass deportation as a solution to immigration problems. ...