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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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Of the people asked the question "what issue do you see as the most important for health care" 44% in a NBC/WSJ poll said they considered Cost as the biggest issue, and 37% said that they considered the Uninsured as the biggest issue, 11% said quality of care was the biggest issue. The President is focussing on cost as he develops the health care plan. He is also saying that to provide health care for all and cover the uninsured without controlling costs would break the bank. Another thing that the White House shows it has learned from previous failed attempts, is that it is doing this with an open Health Care Forum with participation of different sides in the health care discussion. Clinton's effort in 1993 ran into problems because it was developed secretively, and without much discussion, and little effort to get different people's views. The previous attempt also waited too long after the election, and this time the President is moving quickly when he enjoys large popular support. Its also true now that there is serious concern especially in this downturn of what a threat spiralling costs of health care are becoming to the future prosperity of the American people. This time the leaders in Congress are setting an aggressive schedule to get health care palns legislation on the floor by June and get a floor vote in August 2009....

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In the Senate Obama backed bills favoring importation of drugs,of cheaper prescription medicine from Canada and other countries. But with the pharmaceutical industry and its lobbying groups contributing heavily in federal elections and its clout with the administration Obama turned his back on the bill. This happens as Americans are paying as much as ten times the prices Canadians and Europeans are paying for drugs and prescription medicne for identical medicine often produced in similiar facilities aby the same manufacturers. On this issue an impressive coaltition was assembled among bothe Democrats from Bernie Sanders of Vermont to Senator McCain of Arizona, but the bill introduced by Senaor Dorgan was defeated with the help of the Obama administration. Senators from states with big presence of drug manufacturers like New Jersey (Menendez), New Jersey (Lautenberg), Delaware (Carper), North Carolina (Kay Hagan) all argued to defeat the bill to allow importation of drugs to help the heavily burdened American public. The Obama adminsitration's FDA Commisssioner Margaret Hamburg issued a statement expressing concern about the "safety" of imported drugs....

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The sense that is growing in the House that the healthcare bill has made compromise after compromise ending up with abill that is good for insurance companes and the pharmaceutical industry. Mr Obama's opposing the bill permitting importation of drugs to help Americans is on more evidence to these members of Congress and the Senate of being sold out by Obama.

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Full Yield is a startup in Boston that is trying to help address the nation's obesity problem by introducing healthier foods and meals in cafeterias. It plans to introduce a line of Full Yield branded food made from fresh items and natural ingredients for sale in corporate cafeterias and prepared food sections of local supermarkets. It is based on a simple idea that if you eat healthier food you will be healthier. A study in the Jan-Feb issue of journal Health Affairs says 75% of the $2.5 trillion in health care spending deals with obesity, Type 2 diabetes, heart disease and cancer. And how much of this traceable to obesity and bad eating habits, smoking and lack of exercize? This study says most of the cases are preventable by changing these behaviours. Dr. Kenneth Horpe, chairman of the department of health policy and management at Rollins School of Public Health, Emory University, shows that if trends continue U.S. annual health care costs related to obesity would reach $344 billion by 2018, which is 20% of total health care spending. In 2009 it accounts for 9%. Thorpe says if even the 1987 levels of obesity were reached it would free up enough money to cover the uninsured population today. For American companies the problem has grown to alarming proportions and yet no nationwide coordinated plan bringing together companies, government, universities, public interest organizations, and other groups exists in the U.S. The CEO of U.S. grocery chain Safeway, Steven Burd, says Safeway was spending $1 billion to cover health care insurance for workers by 2005, with costs rising 10% a year- this meant putting out twice in health care insurance than Safeway's earnings and hitting another $500 million by 2010. Between 2004-2009 the costs of insurance surged 31%, making this the fastest growing single corporate expense, according to Towers Perrin. This reduces incomes of workers as companies pass on part of the extra cost, and reduces the profits that can be put back in new investment for economic growth....

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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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Having an adequate supply of N95 masks is critical for each hospital tackling the coronavirus pandemic. The lack of enough masks leaves health care personnel without the basic protection and is a grave emergency. Hospitals are resorting to reuse of the masks in this crisis and this is not a good practice as it increases the chances of infection. President Trump has invoked the Defense Production Act on April 2 against 3M. This gives the federal government more control over 3M's operations to ensure that it goes all out to make the healthcare N95 masks that the hospitals need in this grave emergency. This report in the WSJ covers the situation as of April 3 on the supply of M95 masks for health workers and others. N95 masks block 95% of very small particles. Supply in the U.S. is for 50 million N95 masks. Demand in the U.S. is for 300 million N95 masks as estimated by the Department of Health and Human Services. in March- this is how many are needed by health care workers to fight this pandemic in the U.S. The principal manufacturer is 3M. 3M company has doubled its production since January 2020. The trend before this pandemic was to send production over to China and other countries. This is changing now with the pandemic and the U.S. policy shifting to be self sufficient in medical supplies in the event of an emergency. A policy Peter Navarro, who heads the agency in charge of getting medical supplies, says President Trump is insisting be implemented. Hospital buyers supported the earlier trend to keep costs down, but this appears to be a costly mistake, putting health care workers in hospitals across the U.S. without the basic protection they need. Minnesota based 3M invented the first modern disposable masks in the 1960's. Interestingly 3M continued to make millions of masks in the U.S. even though competitors moved manufacturing overseas. The 50 million disposable masks 3M made globally went to workers in industries where it provided extra safety from metal shavings or other substances, and medical workers. Now 90% of masks go to medical workers. 3M ramped up production globally since January 11 when the pandemic first hit to 100 million masks a month globally, and 35 million a month in the U.S. at plants in South Dakota and Nebraska. 3M says that it will import 10 million masks from its factory in China, which earlier this year was restricted from shipping it outside China as China needed masks for the pandemic. About 10 million more masks are made by two other manufacturers Alpha Pro and Louis Gerson Co.  U.S. Department of Health and Human Services ordered 600 million N95 masks from 5 companies to distribute to hospitals and build up the national medical supply stockpile. 190 million each of this is from 3M and Honeywell and 130 million Owens & Minor Inc.  3M says it will make 50 million a month in the U.S. by June. Honeywell which had moved production overseas, plans to bring back production to the U.S. by making 10 million masks by May at its Rhode Island and Phoenix plants. There is a company in Singapore that makes one million masks a day in China and other Asian countries, Pasture Pharma Pte, but most of it is committed to government agencies in China.   ...

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Are there costs or are there savings from the Obama health care bill? Does it affect jobs and how? The Congressional Budget Office says the health care law will save $230 billion in ten years based on a whole set of calculations and assumptions. Commonsense and basic math leads others to question how spending $930 billion on insuring 32 million Americans could end up with significant savings. The different view argues that the Budget Office erred in making some calculations, by counting $70 billion in premiums from long term care because they would be used to pay benefits later, omitted $115 billion in spending to adminster the law, and omitted $208 billion needed to prevent scheduled reductions in Medicare payments to doctors. The money needed on the Stimulus, on two wars in Iraq and Afghanistan, and the uncertain prospects of the US economy in the longer term till debt and other issues are resolved, injects the critical element of difficult choices and priorities. If state and local budgets are severely strained in 2011-2012 would that require federal help and will there be other needs that will have to be met by the federal government that are critical such as another unexpected downturn, or a resolution of unresolved bad debt at the large US banks There is also a sense that the health care law does not do enough to reduce the cost of health care that will be needed over the next decade so that other priorities are not neglected. Both parties are not up to the task in this respect for running the country's finances withot using the numbers to tell different stories....

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The influence of lobbyist on members of Congress just as the Obama administration, having studied the failure of the Clinton submitted healthcare plan try a different strategy of letting Congress come up with a healtcare plan. $133 million was spent in the second quarter alone by healthcare industry lobby interests creating headaches for reform efforts and the Obama administration.

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U.S. Senator Ben Sasse suggests an alternative approach of simply repealing the Affordable Care Act called Obamacare and replacing it at a later date. This is endorsed by president Trump. This is the new Republican strategy in July 2017. Forty nine senators voted in favor of this repeal in 2015, when president Obama vetoed this legislation. Two more senators are expected to support repeal according to Ben Sasse.

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A plan to postpone a 21% cut in payments to doctors for treating Medicare patients, and instead give a slight payment increase under a House proposal, at a total cost of $245 billion over 10 years, is raising questions about the the impact on the USA budget deficit in coming years. The Congressional Budget Ofice says the House health bill will increase the deficit by $239 billion by 2019. In past years the lawmakers in Congress have postponed the implementation of these cuts, and the administration would like to see this as a separate item and not showing increasing the deficit. The American Medical Association lobbied to have this provision in exchange for its support to the health care plan.

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Krugman talks about the misunderstandings and the whole lot of misinformation that comes from advertising and political commentary. With one man telling a Congressman at a town hall meeting: "keep your government hands off my Medicare." In apolitically charged atmosphere this makes rational decisions in acalm thoughful environment difficult or impossible- when the influence of lobbying by the health care industry and the influence of interests on behalf of patients and other interests have already created a difficult situation.

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The Venezuelan government provides gasoline to people in the country at a few cents a gallon- almost free. Even Saudi Arabia, the Emirates and Kuwait which have way better financial balances and dollar reserves do not provide gasoline at such prices. The result is chronic shortages of basic parts and other imports because the government does not have enough dollar reserves for imports. Venezuela devalued its currency by 32% recently, making imports more expensive and pushing inflation up even higher to 28%. The problems it creates are excessive and wasteful use of gasoline, and free gasoline that then provides consumers money to pay for surging cost of everyday imported products. Nullifying any real benefits when shortages, inflation, dilapidated infrastructure and lack of development and jobs, are taken into account. The lack of capital to invest in the oil industry has led to declining production making the situation unsustainable. Yet neither party of Maduro or Capriles in the upcoming April 14, 2013 election, following the death of Chavez, supports ending this subsidy. Efforts to end the subsidy by president Carlos Andres Perez in 1986 led to riots and about hundred deaths in police response, and a coup by Chavez, then a military officer, a few years later. Under Chavez the subsidy was extended to the level at which gasoline is about 4 cents a gallon. Compare this with the price in neighboring Colombia at $4.72 a gallon, and Brazil at $5.40 per gallon. Consumption per capita in Venezuela is excessively high, about seven times per capita than neighboring Columbia. The investment in infrastucture is hobbled by lack of capital, the capital Caracas dilapidated, and no major infrastructure projects taken up by the government. It costs Venezuela 8.6% of GDP or $27 billion to pay for the excessively high subsidy, compared to 3.2% of GDP going to healthcare spending and 5.1% for education. In comparison Indonesia, another developing country, uses 2.5% of GDP or 21 billion for its subsidy for a population of over 200 million. It is not that a fuel subsidy is provided, but the entitlement to free gasoline that makes Venezuela the lone exception. There is a reason why prices in Brazil and China, large developing countries, price gasoline to motorists at over $4 a gallon- to discourage excessive and wasteful use, and release scarce capital for infrastructure development, building dollar reserves for imports of machinery and equipment, and other uses in industrializing economies. Compare Venezuela with Bolivia under the socialist government of Evo Morales. In 2010 Bolivia increased its price of gasoline by 80%. The price in 2013 is about $2.00 per gallon. Morales cushioned the increase by increasing salaries in the health and education sectors, armed forces and police by 20%, and increasing prices of locally produced wheat, corn and rice by 10%. Morales said he did this to reduce state subsidies of $380 million for $660 million in gasoline imports, of which $150 million was siphoned off by smuggling gasoline to neigboring countries. Incentives were provided to oil companies to produce gasoline in Bolivia to reduce imports. ...