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Former Senator Jim DeMint lays out his reasoning for the Republican fight to defund ObamaCare, as the healthcare legislation is now called by Republicans. He points to problems with the legislation with issues about how much the added entitlements will cost in the future( more than the $250 billion by 2023 estimate of CBO insists DeMint based on the general lowballing of projections), and higher premiums for the young and elderly on exchanges. He says the 2012 elections were fought on economic issues not ObamaCare, and that the public he has met in visits to different states as president of the Heritage Foundation continues to be skeptical about ObamaCare. He sees the correct role of the Opposition party to point out the deficiencies in the law and call for corrections in the path for healthcare.

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Interview with Levinson of Genentech and answers to a wide range of questions about ther drug discovery process at Genentech, the cost of Avastin to treat cancer, the long years taken to develop the drug, the development and pricing of Lucentis for macular degeneration from the basic process of blocking the VEGF protein that helps the macular degeneration develop. The reasons for the pricing of Avastin- $55,000 for one year. And of Lucentis $2000 for one shot and the possible equivalence of Avastin and Lucentis so that doctors can take a small fractional dose of Avastin and use it in a tiny opthalmic syringe for cost of $50. The research budget of $1.86 billion. And the philosophy of Levinson about attracting the best scientists to Genentech by giving them opportunities as he puts it for "doing great science." And his emphasis on making Genentech a great place to work. Genentech was on Fortune's top twenty list 4 years in a row and No 1 in 2007 and No 2 in 2008 behind Google. Can Roche keep this up without Levinson and his team and the culture they have fostered, and the way they have created a great place to work ? ...

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India is piuoneering and innovating in the field of lowcost health care. The Indians say state of the art is not what they aspire to but world class, which means coming up with solutions in tech and health care that are affordable in a poor country.

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The drug industry which faces the prospect of losing billions of dollars in sales of epilepsy drugs if pharmacists substitute cheaper generics is using the Epilepsy Foundations state affiliates to lobby for legislatio which would make it harder for pharmacists to substitute generics for epilepsy. The FDA does not think generics are any different from the epilepsy drugs that will lose patent protection between 2008-2010.

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Leonhardt points out a couple of problems with Paul Ryan's budget proposal for Medicare. He says Medicare recipients, with the exception of the very affluent, currently haven't paid enough for the benefits they receive. He cites a study that shows Medicare pays out several hundreds of thousands of dollars for the average retiree more than they ever paid in. Medicare funds go for hospital expenses, the rest for doctors bills come from general government revenues. Government borrowing increasing the national debt to unsustainable levels so that current retirees do not have to pay higher taxes, is simply shifting the burden to the next generation. He says the Ryan plan shields those who will retire in the next 10 years because they are a powerful voting bloc, making this more of a political calculation than a bold reform step, as this means younger people will have to bear a disproportionate share of the burden. The other part of Ryan's calculus is that it has proven extremely difficult to reduce the volume of medical care that is consumed in terms of tests, lack of preventive care leading to graver problems, and surgeries. Simply by shifting a larger share of the cost to future retirees this will have an effect on the volume of medical care consumed and put a lid on costs. This is something that needs to happen says Leonhardt, but at the same time all Americans need to share in the higher taxes that are necessary to fund Medicare, exempting 75 million Americans only creates an imbalance in contributions. The other problem with this is that the costs of this exempted group will postpone serious deficit reduction for ten years....

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Researchers Rauh and Novy-Marx, estimate that states in the U.S. have pension shortfall of as much as $3.4 trillion, and the municipalities have pension shortfall of $574 billion. Seven states are expected to exhaust their pension assets by 2010, and half will run out of money by 2027. Several states have promised annual payments of 30% of tax revenues after their pension funds are exhausted.

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Athenahealth, a provider of software for physicians, is intervewed by Jon Kamp about the efforts to promote digitization in physician's offices.

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Analysis of 126 public pension plans by the National Association of State Retirement Administrators shows an average target rate of 7.68%. New York State Common Retirement Fund, third largest by assets, says it plans to drop the assumed rate of return to 7% from 7.5%. A drop of 1% boosts pension liabilities by about 12%, accoridng to the Centre for Retirement Research at Boston College. It means workers are required to contribute more to the pension funds for the same level of benefits, especially as lifespans grow and more Americans retire in an aging population. Other options are for states to cut payrolls and expenses. This is a positive step as it makes the assumptions realistic and improves the fiscal stability of the funds. The largest pension fund, California Public Employees Retirement System is considering dropping its assumption to below the current level of 7.5%. The lower assumed rates of return are not enough say critics, who cite the 3- 3.5% returns assumed in the 1960's for cash and bond based portfolios. The Laura and Arnold Foundation's Josh McGee says it is still not realistic. Retirement systems median actual return was 3.4% for 12 months ending June 30, 2015. Expert panel of actuaries and pension specialists says the right level for assumed returns is about 6.4%. Companies in the Fortune 1000 have already dropped the figure to 7.1%, from 9.2% in 2000, according to Towers Watson survey....

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After heated debate Governor Christie and leaders of the democratic party in the legislature agree on changes to New Jersey's public employee retirement and health benefits and pension system. New Jersey's pension system has unfunded liabilities of $54 billon and some estimates forecast that it will run out of money to pay pensions by 2018. The retirement age for new workers is now set at 65 not 62, pension contributions go up to 7.5% from 5.5% for state workers and to 10% from 8.5% for public safety officers. A major change is to delay annual cost of living adjustments till the pension fund returns to a stable financial footing. The absence of this change would have meant reducing retirees pension value by 30% in the next ten years. After the plan is 80% funded a new employee-employer pension governing board will modify the contribution rates and pension rules based on advice from actuaries. On health benefits the changes are for workers earning more to pay a larger share of premiums- so that a worker earning $60,000 would pay 27%, and a worker earning $95,000 would pay 35%. This particular change is phased in over 4 years and saves $300 million....

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Senator Mitch McConnell, the Republican Majority leader in the U.S. Senate has come up with a new health care bill that is aimed at winning over reluctant Republican Senators. Two taxes on high income people on 3.8% investment income and a payroll tax of 0.9% on incomes over $200,000 for individuals and $250,000 for couples are retained in this version of the bill, which adds $231 billion over a decade. Some of this is used to offset rising premiums in the new bill, and provide additional funds. The deep cuts to Medicaid are retained and Senator Collins of Maine says she is opposed to the new bill because this will hurt people in rural areas of Maine, and does nothing to change this. Senator Rand Paul of Kentucky is also opposed to the bill. Opposition comes from moderate Senators opposed to deep cuts to Medicaid in Republican health care alternatives to president Obama's Affordable Care Act, and from conservative Senators opposed for other reasons.  Senator Graham of South Carolina and Bill Cassidy of Louisiana introduced their own version just minutes before Mitch McConnell brought up his revised bill. All Democratic Senators are opposed to the Republican bill and call the deep cuts to Medicaid disastrous for lower income people.  ...

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FDA questions quality of life improvement claims for drugs known as ESA's or erythropoiesis-stimulating agents, which are the drugs Epogen and Aranesp of Amgen and procrit by J&J.

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New rules by the Government Accounting Standards Board (GASB) and Moody's would show U.S. public pension funds as about 57% funded instead of 75% funded under earlier rules. This will open up an even wider gap in how much they have in the funds and their promises to retirees to about an estimated $2.2 trillion. This puts pressure on state and local governments to either reduce benefits for new hires, have workers increase contributions, or set aside more money from the budget. Local governments face the risk of credit downgrades and higher borrowing costs if no action is taken and finances are worsening. An example is Illinois retired teachers who earn annual pensions of about $46,000 on average, and do not participate in Social Security under state opt-out. Even under old accounting rules this pension fund had $37 billion of assets and $81 in future liabilities. Under the new rules the unfunded liabilities could jump to 83% by one estimate, from over 50%.