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Kerala state of 35 million people who speak the language Malayalam, is one of the rare places today that has only 4 deaths from coronavirus, 524 cases confirmed and no community transmission. Here the Guardian looks at the reasons why. The Health minister KK Shailaja started very early on January 23, with a meeting of her rapid response team when the virus was still in China.  She setup a control room and instructed Kerala's 14 districts to do this on Jan. 24. When the first case arrived on Jan. 27 on a plane from Wuhan, Kerala had already adopted the WHO  protocol of test, trace, isolate and support. These passengers were checked for temperature, tested and quarantined. With some at a nearby hospital and others in home isolation. This is all the more amazing considering that Kerala is a state in southern India on the west coast that has a large number of people living and working overseas. Many are in the Gulf countries and the arrival of these refugees could have triggered a second outbreak. This was prevented by careful testing, and contact tracing of clusters.  When one group was evasive and concealed information from an airport surveillance team -arriving from Venice, Italy,  in late Feb- a case was detected back to them.  Contact tracers tracked down all of the hundreds whom they had been in contact with and quarantined them.  By 23 March all flights to 4 Kerala airports from overseas were stopped, including Cochin and Trivandrum. On March 25 India went into lockdown.  Some of the achievements in Kerala include quarantining 170,000 people early. with strict surveillance, which is now down to 21,000. Accomodating and feeding 150,000 migrant workers from other states, before returning them on charter trains to their home areas. A big reason for the success is the high literacy rate in the state. A big emphasis on education and healthcare is a part of the Kerala model. Shailaja is a secondary school teacher, and Health minister. From the days since independence of India in 1947 the state has a strong socialist tradition of taking care of the basics- health, education and public services. It also generates a part of its GDP with income from workers who are overseas.  Another reason for the success in dealing with coronavirus is experience. The state had a virus epidemic called Nipah in 2018 which has become the story for a movie called Virus in Malayalam. There is decentralized public health system in the state and people value their health care facilities, understand and trust the health care authorites. There are hospitals at every level of administration and 10 medical colleges. But trust and education, experience tackling the virus before, are key. Kerala is showing that poor countries can deal effectively with the virus, and create a better life by adopting the right model of creating good societies that value education, healthcare services, better economic structures and distribution of wealth, and  a degree of trust and responsibility found in a state that values public spiritedness. ...

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Hillary Clinton narrowly loses the Michigan primary to Bernie Sanders in March 2016, as the Sanders campaign focusses on Clinton's support for trade agreements that hurt American workers and lead to loss of manufacturing jobs. About three fifths of voters in the Michigan primary considered this a major issue. Many less educated younger workers see their job prospects diminish and wages drop with free trade that hurts American manufacturing jobs. Bill Clinton signed the NAFTA agreement with Mexico, and as a member of the Obama administration Clinton supported the Trans Pacific Trade Agreement, later opposing TPP when she left the cabinet. Sentiment against trade that hurts manufacturing jobs in the U.S. is strongest in midwestern states such as Michigan, Ohio and Illinois. This was also a major issue benefitting the Liberals under Justin Trudeau who won in Canada's industrial Ontario province which has suffered hollowing out and loss of manufacturing jobs under the Conservative Harper administration. In the U.S. the issue goes back to the Clinton Administration for two decades. New jobs created by Apple, Google, and other tech companies pale in comparison with the industrial jobs created in another era that benefitted working class families. This issue and high unemployment or under employment, lower wages for working class families, was a major issue in the 2016 U.S. presidential election campaign. Widening wealth disparities, and lack of upward mobility, high tution and healthcare costs for ordinary families, dominated the campaign in the U.S....

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Enabling access to broadband to millions of people in developing countries that lack this access is the next goal for Facebook. Facebook embraced open source software and it is relying on open source technology, including its own as open source, as a way to reduce the cost of building and operating the world's telecommunication networks- an operation that costs $150 billion a year. This will put pressure on telecommunications providers such as Ericsson to cut costs. Nokia has joined Facebook in the Telecom Infra Project or TIP, a Facebook initiated group that has set as its goal cutting telecom costs. Some of this is to be seen at Facebook developers' conference with open source efforts such as urban wireless network that checks performance 125,000 times a second, and a long range wireless system that can send a gigabit of data a second, according to Facebook.

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Saudi Arabia which was seeing GDP growth of 4% a year is slowing and should see GDP growth at 2% in 2009. Overall Saudis are in much better shape than their cousins in the United Arab Emirates like Dubai and Abu Dhabi. THis is because the Saudi banking system followed conservative practices and parked its $500 billion in foreign assets in US and European government bonds. Saudis can use these funds to increase infrastructure, education and healthcare spending by an estimated 10% this year to about $150 billion. At the samt time the Saudis will have to pull back from the $600 billion of megaprojects that were planned and will have to put more government money in projects that do go ahead. There is likely to be a hold on the projects to build a number of new cities in remote parts of the country. Some like the King Abdullah Economic City planned for the Red Sea coast may get the go ahead.

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Indonesia is a country with a long history of Hindu and Buddhist culture before conversion to Islam through traders from Malaysia and Sufi saints in the sixteenth and seventeenth century. Hanuman and other deities from India are also part of the existing culture and traditions. Communist influence has been alien to this culture and tradition as in India. It was part of the Dutch empire in the east and a source of European trade in spices from the seventeenth century. It is also a extensive island chain of Java, Sumatra and other islands with a population of 280 million very closely linked to India culturally and with links to America since independence. Indonesia was given a great deal of importance during the Cold War with Robert Kennedy and other leaders visiting Indonesia during the period after Sukarno in the sixties. By 2000 the US engagement with China had evolved to the point that neglected India, Indonesia and the entire south east Asian region in a preference for links with China.  The British division of India led to the US links with India and Indonesia being shaped by that division and the Cold War with Russia. The confusion of the struggle against colonial rule of the British and Dutch led to leaders such as Nehru and Sukarno who compounded the difficulties of the Cold War and perpetuated with it the old British idea of a divided South Asia on a religious basis that had supported British rule and set the conditions that made it possible for a small group of English civil servants to run the country. This led to the Indian and Indonesian relationship with the US being stifled as the US struggled to rid itself of the British obsession with a divided India. Culturally India and Indonesia are part of an extended region in Asia with development aspirations and a youthful population that aspires to better infrastructure, better education, healthcare and ease of living, and the better opportunities in life. This is what migration did for Europeans who left for America for a new life on the east coast and on the prairies of America. It has little to do with the obsessions of the British and the Dutch that divided the region between the Indus and the Ganges and divided the Indonesian islands. That phase is now coming to an end as China reverts to its Communist period leadership under a new generation led by Mr. Jinping, a son of one of the veterans of the Communist Revolution of 1949. The US has to evolve its relations with India, Indonesia, Vietnam and other countries into new ties of trade, culture and technological exchange. This is needed as it winds down its close trade relations with China in its supply chain to rebuild a new supply chain after the trade wars and the pandemic revealed the deep flaws of that supply chain. What is needed is not the efforts of one changing adminstration after another, but an effort started by president Biden that will last through different administrations as the US engages with Asia in the way that it engaged with Europe after FDR and Truman for most of the twentieth century. And one that rids itself of the obsessions of divided regions from the colonial period of the Dutch and the British. The1.6 billion people in India and Indonesia share a  common aspiration of being a major part of the Free World with America. ...

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Chief Justice Roberts let the Obama healthcare law stand arguing that the individual mandate for everyone to carry health insurance acted as a tax, and was on these grounds constitutional. Justice Roberts found middle ground by first rejecting the Obama's administration's argument that asking every American to buy health insurance was legal under the commerce clause, and following this with the a non partisan approach that found the mandate legal under the tax clause. Roberts was guided by the writings of an eminent legal authority, Justice Oliver Wendell Holmes. Roberts referred to this in his opinion saying: "It is well established that if a statute has two possible meanings, one of which violates the constitution, courts should adopt the meaning that does not do so." Legal scholars speculate whether Roberts changed his vote later on or whether the Justice had used the questions in the hearings on the law to explore the idea that the law could be constitutional on different grounds. During the arguments in the hearings Roberts said: "The idea that the mandate is something separate from whether you want to call ita penalty or tax just doesn't seem to make much sense."...

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Pearlstein quotes Dickens in "Oliver Twist," about the law being an ass, and the constitutional law exercize in the Supreme Court of the U.S. giving a sense of a failure of the so-called best and brightest in reasoning out the issues. He points out that a serious problem is that American business which is burdened with high health care costs for employees is seriously missing in this debate after years of complaining about high costs. The National Federation of Independent Businesses is actually one of the plaintiffs questioning the constitutionality of the Obama health care law. Pearlstein says business wanted an end to the fee-for-service medicine that increases consumption of medical services and pushes up cost relentlessly, and that Obama's health care law does this. This is not the case as both Democrats and Republican administrations have failed to resolve this side of the cost issue, and this is the hidden reason for the loss of credibility for both sides in this debate, leaving health care problems to be resolved in future administrations. ...

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The NASDAQ index reached 5000 by April 2015, a level reached in the stock market boom in 2000. Yet investment strategists who were wary of the stock market in the period before the 2000-2002 collapse of the market see this market differently. The NASDAQ itself is not what it was in 2000, with the 2015 NASDAQ component stocks being different for the most part, and the healthcare and other sectors better represented in the index. Only three of the stocks in the top ten in 2000 are in the top ten today, including Microsoft. The S&P 500 trades in April 2015 at 18.5 times its company earnings for the past 12 months, compared to an historical average of 15.5, according to research firm Bespoke. A big part of the difference today is the investment climate of low inflation, which gives the U.S. Federal Reserve flexibility in raising rates. Low rates make bonds with lower yields less attractive, and increase the present value of future earnings. The yield of the 10 year U.S. Treasury was 1.917% on April 25, 2015. In April 2000 it was 6%, and in mid 2007 it was 5.3% before the financial crisis in the two periods. James Paulsen, chief investment strategist at Wells Capital Management oversees $347 billion in fund investments. He also was wary of the U.S. stock market in 1999, yet he does not see the similiar kind of risks today, and sees a long term bullish trend. The scenario he envisages is more of a pause or temporary decline. Paulsen has shifted money to European markets, as U.S. stocks are becoming more expensive relative to their European counterparts, a strategy that is being followed by other money managers since 2014. Higher price volatility is seen in the markets in 2015, with the S&P 500 up 2.9% for the first four months of 2015, and the Dow up 1.4%. ...

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The VW emissions scandal lingers on five years after the rigging of of millions of diesel vehicles to cheat emissions tests. Now former CEO Martin Winterkorn is ordered to face trial on charges of defrauding customers. It is interesting to note how it all started was a grandiose ambition set by Winterkorn according to this report in the WSJ, to make VW the largest auto company in the world ahead of Toyota and General Motors and push sales of diesel vehicles in the U.S. with "clean diesel vehicles." At this time of pandemic it is appropriate to note that the world has changed since 1946 when the wages of top managers were 2 times that of a Caterpillar company worker, and reached level of 400 times a worker for some executives of companies before the pandemic.  Even in supposedly egalitarian countries where worker representatives are on boards such as Germany, the wages had pushed way upwards to about 170 times the salary of the average worker at VW in 2015 when the emissions crisis erupted. This VW episode shows that the grandiose ambitions of executives were another part of the problem before the pandemic. Today the VW disaster has led to a completely opposite result. Diesel is not taking over the U.S. it is now the now the no go in Germany, as diesel vehicles are being phased out. Instead Germany's auto industry is now making large investments in the electric car industry. Significantly chancellor Merkel and the CDU no longer see the automobile industry in Germany as having some kind of special status and the shift to electric is being made with the planned loss of jobs and a restructuring to replace lost jobs with other jobs over 10 years. And the SPD has called for a legal ratio of the average ratio of a company's top managers  in relation to a workers wage at the same company. The pandemic has put things in perspective on a number of fronts, from wage relationships, health, healthcare and wellbeing, healthy lifestyles, mental health, making clear that health and a commonsense idea of fairness, good infrastructure, and sensible wage relations all go together in this world that the creator made. ...

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Bernie Sanders is reelected Senator from Vermont, as one of the oldest and most senior members of the US Congress in history. He will be 89 at the end of his fourth term in the US Senate. At 83 years he is the most resilient and active Senator in the US. Bernie Sanders support was key for president Biden's election in 2020. “It should come as no great surprise that a Democratic party which has abandoned working-class people would find that the working class has abandoned them,” Sanders said. “First, it was the white working class, and now it is Latino and Black workers as well. While the Democratic leadership defends the status quo, the American people are angry and want change. And they’re right. “Today, while the very rich are doing phenomenally well, 60% of Americans live paycheck to paycheck and we have more income and wealth inequality than ever before. Unbelievably, real, inflation-accounted-for weekly wages for the average American worker are actually lower now than they were 50 years ago. “Today, despite an explosion in technology and worker productivity, many young people will have a worse standard of living than their parents. And many of them worry that Artificial Intelligence and robotics will make a bad situation even worse. “Today, despite spending far more per capita than other countries, we remain the only wealthy nation not to guarantee healthcare to all as a human right and we pay, by far, the highest prices in the world for prescription drugs. We, alone among major countries, cannot even guarantee paid family and medical leave.” ...

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Maps of the region of Kashmir in the Himalayas shown here show how close Pakistan cities of Lahore and Islamabad are to Jammu and Kashmir and how close the Punjab is to Kashmir. It gives recent history of Kashmir since colonial rule of British ended in 1948, and no mention of the history of Kashmir from 100 BC to the 15th century when for 1500 years Vedic and Buddhist cultures, Shiva culture prevailed in the region. For only 200 years between 1500 and 1700 were Muslim invasions prevalent in the region after 1750 the British gradually took control of the region when Kashmir was a British protectorate under British law and non-religious rule.  Much of the present situation is a result of the abrupt end to British rule after World War II by 1948-1950 with Communist China, a new state of Punjab and Sind called Pakistan, and most of South Asia as India emerging from the conflicts and contesting control. India now leads an effort since 2016 for modernization of the region, to provide the education and healthcare levels of modern states of Europe and America to Himalayan region that is missing because of a lack of the technological resources, and resources India is now able to use to build infrastructure and invest.  ...

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The average U.S. light vehicle price was $30,303 in April 2012, up $1219 from the prior year. Incentives were also lower, down $146 to average of $2,446, according to TrueCar.com. This is happening even though cars account for a greater portion of sales of light vehicles. Used cars and trucks prices increased by 3.2% in March over the prior year, according to the Labor department data. Pent up demand is part of the reason. Another reason is the discipline exercized by auto manufacturers, especially the Big Three, in not letting supply exceed demand and therefore not having to offer higher incentives to get rid of inventory. These practices of oversupplying the market hurt the Detroit automakers in the period before bankruptcy, especially GM. Increases in used car prices and higher prices of new cars create a virtuous cycle for automakers to support higher margins. With the high retirement and healthcare costs reduced through bankruptcy and new agreements with the UAW, the Detroit automakers are now better positioned in the market to sustain margins by limiting production to demand. ...

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Tyler Cowen, Professor of Economics at George Mason University, points out some basic truths about health care as it is practiced today in the USA, and healthcare spending as it stands today. He questions whether starting out with extra spending plans to provide coverage to all will help solve the basic problems facing American health care. Too many tests and diagnostic procedures used by doctors is not aproblem that will be solved by spending more money to cover everyone. And government taking on more spending to cover all will not address all the other major shortcomings of the American way of practicing medicine, like prescribing a battery of tests, that tend to drive up costs, to just mention one of the problems. And it will not address any of the shortcomings in the way Americans take care of their health, diet, exercize and healthy lifestyles. THese are critical to get good health outcomes for the people, and which combined with careful spending of dollars where it will provide the greatest benefit, is the only way the health care solutions can be found....

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Health insurance premiums for family plans increased by 9% in 2011 according to a survey by Kaiser Family Foundation. A similiar survey by Mercer showed premium increases around 6%. Another change is that health insurance plans are becoming less comprehensive and deductibles are higher, with higher copays and employees contributing more to premiums.

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A study published in the British journal Lancet shows that the number of people suffering from diabetes went from 153 million in 1980 to 353 million in 2008. The study shows the U.S. having 24.7 millon diabetics in 2008, which is three times the number from 1980. About 70% of this is from population growth and aging, and the rest from obesity, lack of exercize, changing diet. The American Diabetes Association estimated the cost of treating diabetes in the U.S. at $174 billion for 2007. About 138 million diabetics live in China and India. In India there is an additional cause- malnutrition in early childhood years for the poorer segment of the population. European countries have done better than the U.S., Mexico, India and China. S. Korea and Thailand have done better than other Asian countries. And this is attributed to healthier lifestyles, diet and less obesity in these countries.

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Results at Midland Memorial Hospital in Texas, show that a low cost conversion to electronic medical records by using the VA system's open software and having computer software companies adapt it to Midland's needs. This cost Midland $7 million and has resulted in many benefits. Senator Rockefeller is introducing legislation to promote the use of this open software for conversion to electronic medical records. Medsphere chairman Kenneth Kizer, former undersecretary ohealth care at the VA oversaw the development of VIstA software. He says its enhanced version called Open Vist A, "can be installed in one third the timeand for about one thrid the cost of the big-name proprietary systems." There is alot to be said for open software as this would enable hospitals and clinics acoross the country talk to each other and pull up records and sen them electronically, wich is hard to do when different systems of differnt commerical vendors interact. If Midland Memorial is any guide there are huge savings in the conversion. By enabling access instantly of patient records, lab results and Xray images, there are a huge array of benefits. It helped Midland catch up with a$16.7 million coding and billing backlog for 4,500 patient records in 4 weeks instead of 5-6 months. In the 18 months since the system was made hospital wideinfection rates dropped 88%, because of guidelines in the record system that prompted nurses to follow infection control procedures, such as changing dressing or following procedures when inserting a new IV. That is huge. Bed sores were reduced from electronic prompting to nurses to turn patients.And Midland increased by 77%in staff compliancewith guidelinesfor care for patientson ventilators, which if not followed could lead to pheumonia....

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Laffer says there is a big gap between the cost of health care and what people actually pay, which keeps cost escalating as there are no pressures from users of services to economize or bring reductions in the prices. But Laffer offers no effective solutions either his patient centred approach to health care reform does not address the problem that employers are paying for health care for the large part and these are not taxed as benefits leaving the employee free to load up on services and ignore the cost, which works just fine for the health care providers who increase revenues and profits- also called cost escalation upto the point now reached where the nation can no longer afford it.