Health care reforms need to control costs, cover everyone and improve health outcomes; at least that’s my opinion. The single payer (supported by Senators Warren and Sanders) does the best job, but falls down on producing a well-organized system to improve health outcomes (essentially it’s fragmented and unaccountable care). Moreover, it is very expensive to finance and is quite disruptive of existing coverage that many may prefer to retain.

It looks as if many in the suburbs have had it with the Donald J. Trump Republican Party. It also appears that Democrats are not much closer to winning back rural and small town white ex-Democratic voters in the South.

The US is projected to spend about $52 trillion on health costs over the next 10 years. About half of that is public spending from the states and federal government on programs like Medicare, Medicaid, Veteran’s Affairs, Indian Health Services, the uninsured, etc. About half is from the private sector from employers and employees for their employment-based coverage, from patients for their copays and deductibles, and from individuals for their individual health insurance.

American health care costs about twice as much as in other countries – about 18% of our GDP. It is due to high prices for hospitals, doctors, drugs and medical equipment. We are not getting better results; in fact across many aspects of care, we are getting demonstrably poorer results whether it’s life expectancy, or infant or maternal mortality. Bad results in America are also due to non-medical causes such as gun violence and spreading obesity, which require difficult but needed societal changes.

Senator Warren has just released new details and new costs projections of her Medicare for All Plan. Several weeks ago the Urban Institute released a ten-year cost projection of $34 trillion in new federal funding needed for Senator Warren and Senator Sanders’ Medicare for All Plan. She was challenged by Vice President Biden and Mayor Pete and others as to how she intended to pay for it. She was also challenged as to how to pay for it without raising taxes on the middle class.

I urge you to get involved in writing to your elected representatives of all political stripes, participating and actively exercising your rights of free speech and freedom of assembly. There are ample opportunities to get involved locally and nationally.

The impeachment inquiry is set to move beyond closed door depositions of witnesses to the President’s impeachable conduct to a series of public hearings and committee votes leading up to a decision on the President’s impeachment. https://docs.house.gov/billsthisweek/20191028/BILLS-116-HRes660.pdf The vote on the House resolution is scheduled for tomorrow (Thursday, October 31).

In California about 12 million Californians live in high fire danger zones – i.e. when the Santa Ana and Diablo winds blow in the fall, a man made spark can set off the dry brush, and people can lose their homes, their entire communities, their lives.

Business and labor undergird the Republican and Democratic parties respectively. However, many in the business community think that President Trump is driving our nation right off the cliff with his trade and immigration policies and general divisiveness and incompetence, and they are supporting Democrats in growing numbers. Likewise, too many white working class workers found President Trump’s messages on trade and immigration appealing and voted for the President in the last election despite the positions of their union leadership. White middle class men and women are split on the appeal and utter revulsion they feel for the nation’s president.

To date, Congress has been interviewing witnesses behind closed doors. Witnesses’ preliminary statements may be released, but their full depositions are not. There is selective leaking by those supportive of and opposed to the President. The media are conducting their own investigations and releasing pertinent information. The facts on their face appear damning, but we may be seeing only the tips of the iceberg.

There is an excellent new study from the Urban Institute that gives the costs and the impacts of a variety of different reform proposals. The estimated 2020 costs range from $26 billion to $2.7 trillion, depending on the details of the reform proposal. It will help you make sense of the Democratic presidential debates on health reforms and the 2020 election issues and beyond.

Mayor Pete, Amy Klobuchar and Corey Booker impressed me the most. Bernie Sanders was excellent as well.

I write in strong support of Congress’ impeachment inquiry. President Trump’s conduct in seeking to persuade a foreign government to initiate proceedings against one of his chief election rivals is an impeachable offense as envisaged by the framers of the US Constitution. In terms of violating constitutional red lines, I would liken it to driving 100 miles an hour on the wrong side of the road while drunk.

The unanimous Committee found extensive Russian disinformation campaigns on social media during the 2016 election and thereafter. It expects more of the same and in a more sophisticated fashion during the 2020 presidential contest.

The American people have already made the decision that they do not want Donald Trump as their President; however the Democrats need to nominate an individual who the American people do want as their next President. Ideally, this is a man or woman on a white steed or in an electric car coming into clean up and restore civic American virtues after the bullying, lying, incoherent caricature of a fat cat that Trump has become as our nation’s President.

The President yesterday gave Turkey the green light to invade Syria and kill our loyal Kurdish allies. It is as yet unclear what motivated him, but he is being roundly criticized in a highly unusual manner by many of his loyalist allies such as Lindsey Graham and Nikki Haley.

We may be heading towards the end of Donald Trump’s presidency. The news of his behavior gets worse and worse, and he appears to be oblivious to the crimes he is committing in the public square, or maybe he believes that doubling down, threatening, bullying will make it all go away – strategies that have worked quite well for him in the past. It won’t; the facts will come out, and so far they are becoming worse and worse for him.

In his testimony before the House Intelligence Committee this week, US ambassador Kurt Volker provided documents showing the extent of Trump’s abuse of his presidential powers in seeking to bully the Ukraine to help his political campaign.