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Wal-Mart is expected to announce a five year plan to meet specific targets for lowering sodium, trans fats and aded sugars in a whole range of foods- including rice, soups, canned beans, salad dressings and snacks foods- in packaged foods sold under its house brand, Great Value. Other moves towards healthy foods are to move to eliminate the extra cost to consumers for healthy foods made with whole grains. It will also lower prices on fresh fruits and vegetables. This plan is similiar to other plans announced by companies such as Con Agra Foods which set a target of reducing sodium content in foods by 20% by 2015. New York City also has a public health initiative for healthy foods. another move by Wal-Mart is to get major food suppliers like Kraft, to follow the example set by Wal-Mart. Kraft sells 16% of its global sales through Wal-Mart. The move will be gradually introduced over five years which makes for slow progress, and the targets set for sugar reductions are much less than they should be, says Michael Jacobson, executive director of Center for Science in the Public Interest. Another serious drawback is that Wal-mart has not proposed to tackle the major cause of childhood obesity, which is the added sugars in soft drinks....

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The French system what works and what does not work compared to the Anglo-Saxon systems of Britain and the USA. Health care works, public transport and high speed rail works, nuclear energy and the energy industry works, education works for small elite universities but fails in the larger system. The large public projects are executed well, and France has done well with its long tradition of the state building infrastructure projects. But when it comes to individual initiative and starting up new companies such as in computers and high tech of that kind, France does not do so well. And the state collects a larger proportion of taxes than in other countries to finance these benefits. France is also good at rule making, which serves it well in controlling the kinds of bubbles that regularly hit the Anglo-Saxon countries. And with 21% of jobs of all workers in France in the public sector and government, with 49% when one includes related sectors protected from economic downturns, the French workers are much better protected than workers in Britain, USA and other countries from economic downturns. Unemployment stays high in upturns and at 8%, and in downturns does not go too far above 8%....

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Some of the concern about the economy comes from the economic damage done by the coronavirus. The longer the shutdowns continue the more the damage. About 17 million have filed claims for unemployment benefits. The WSJ consensus of 57 economists is that 14.4 million jobs will be lost in coming months, and the unemployment rate will rise to a record 13% in June, from a 50 year low of 3.5% in February. The earliest the economy could go back to the level in February 2020 is 27 months says the WSJ economist survey. The brighter side of this comes in two aspects of this pandemic recovery curve. By flattening the curve and strict testing, contact tracing and isolation till the vaccine is developed about half the jobs lost can be recovered by the end of summer, says Moody's Analytics. The vaccine a year from now or in 9 months by November 2020 would allow the economy to recover faster. A more optimistic view comes from Daiwa Capital Markets which predicts many of people laid off will be recalled quickly allowing the labor market to recover in 6 months by September or October 2020. Only finance and real estate might take longer but most of the industries where the vast majority of jobs are could be back on their feet. The credible evidence supporting this perspective of a rebound comes from Colorado and Washington which require large employers to specify whether layoffs are temporary or permanent, 70% this year are temporary. Compare this to the prior 2009 recession where this figure was less than 1%- as reported by WSJ. The big push in this direction will be the $2 trillion that the Trump administration and U.S. Congress have committed to this task. Even more so is the determination of president Trump to protect American workers at all costs, that every job counts, and that businesses without exception to get the money have to show that workers are retained. The very success of the aid is being judged by how quickly people are back to work. Now for a look at where the situation is today- Oxford Economics, a UK based forecasting and consulting firm, projects 27.9 million jobs lost with industries other than those ordered to close making up 8 to 10 million of that number. It projects April's report will will capture late March layoffs. It will show cuts to 3.4 million business services workers, including lawyers, software groups, architects and consultants, advertising professionals, in addition to 1.5 million non-essential healthcare workers, 100,000 information workers. One conclusion of this report is that the virus does not discriminate across business groups and business service workers are also affected. Many companies that were hiring will cancel that move and many will cut hours worked. Many of these business services are not a priority. Hospitals are affected too, as they cut elective surgical procedures and routine care that are major revenue sources. Some are now charging for telemedicine visits to maintain some revenue stream. State and local governments employ 20 million workers. As tax receipts decline these local governments will face choices of cutting payrolls and services without enough federal government relief. In a way laying off workers and having them take unemployment benefits shifts that burden to the federal government so that services for overtime to police and paramedics, retention and deployment of nurses in schools.    ...

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The discussion on whether it is feasible to achieve any significant cost savings as long as middle class consumers are not cost conscious about their employer provided health insurance. This would be so as long as their health insurance benefits are not taxed as income. America suffers from a particularly strong case of not minding the price increases imposed by the health care industry as long as its not out of pocket cost. But Obama seems stuck on his insistence that the middle class not take on any burden, that there be no middle class tax in the form of this tax on health care benefits. Critics say even FDR did this by having the middle class pay with payroll contributions for Medicare and Social Security. And even if the 5% of Americans who make more than $280,000 are taxed it will not generate by itself the money to pay for the $1 trillion cost of the plan, as the prospects of cost reduction are uncertain- especially when the basic nature of America's health care system are not changed, like the lack of cost consciousness of consumers of health care when its perceived to be free and employer provided....

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The House Energy and Commerce Committee passes ahealthcare plan with 31 to 28 vote. The Senate version takes adifferent approach. The Senate version has moved away from the employer requirements in the House bills. The Senate committee is moving towards aproposal to require employers to contribute if their workers are getting government assisted insurance coverage. It has also moved away from the surtax on the wealthy in the House bills which is expected to raise $500 billion. Instead the Senate version proposes an excise tax on insurers for health plans that offer generous benefits. Under the current bill being considered in the Senate such a insurance policy tax could raise $180 billion. The Senate Finance Committee is also different in that instead of the public insurance option it offers nonprofit health insurance cooperatives as an alternative. There is agreement between the two parties on anumber of things so the debate will center on the public insurance option, surtax on the wealthy to pay for the plan, and the requirement for an employer mandated coverage for all employees....

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The US House of Representatives voted 245-189 in favor of repealing the health care law. Only 3 Democrats joined the entire Republican caucus in voting for repeal, compared to 34 Democrats who voted in March 2010 against the health care law. This is a largely symbolic move as the Democrat controlled Senate will not consider the repeal, and even if it did the President would veto it. Republicans favor some aspects of the health care law which allow children to be on the parent's insurance till age 26, and a ban on insurers denying coverage due to pre-existing conditions. Opinion polls show 46% of respondents opposed repealing and eliminating the law, and 45% favored repealing it. The health care issue ranks third among the economic issues important to respondents, behind unemployment and reducing the federal budget deficit.

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Abbott's decision to raise the price of AIDS drug Norvir 5 fold in 2003, and how it undercut Glaxo's drug Lexiva which is used in combination with Norvir. Abbott included Norvir ingredients in a new drug Kaletra and this was priced cheaper than other AIDS drugs when it increased the price of Norvir. Glaxio is now suing Abbott for this pricing practice.

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Lipton, Austin and LaFraniere of the NYT tell the story of how the serious differences between the prime contractor for the federal healthcare website, CGI Federal, and the Obama administration officials handling the website, evolved into conflicts that could not be resolved. This led to the flawed website being rolled out on schedule ignoring serious problems with the website. The detailed report comes after interviews with Obama administration officials and specialists who worked on the project and looking into government and contractor documents. A month ago in October 2013 the healthcare website for the Obama healthcare law was up only 42% of the time with 10 hour failures happening frequently. Basic steps for the functioning of website backup systems in case there is a failure, testing to ensure negligible or no outages, were not secured. The government officials responsible for the rollout did not have the capabilities to handle such a project. Henry Chao, who worked in the Medicare agency for 19 years was left to oversee day to day questions for the website HealthCare.gov, but lacked a formal background in software engineering and no authority to make the decisions needed. The $630 million project was setup inside the Medicare Agency, instead of a separate agency specially setup for this project and staffed with the appropriate skills as originally proposed. Five different lower level government officials made decisions without the authority needed and no one person with the necessary skills was given overall responsibility and decisionmaking. A series of missteps were allowed to take place- settting many added requirements that made it difficult for contractors to focus on basic steps and get them right, use of the MarkLogic database system instead of systems from IBM or Oracle against the advice of contractors, multiple contractors without a way to control the overall project, shifting requirements from the government and bureaucratic delays for resolving basic issues such as use of social security numbers, all worked to create delays. With the delays came a deterioration of relations between Obama administration officials and the contractors. The government officials response was to stick to the deadline of Oct. 1 rollout, with Michelle Snyder, chief operating officer of Medicare agency telling people she would fire the contractor if possible. In the end no one took responsibility for a safe reliable rollout, even though the system failed a test of 500 users in late September and was down half the time in mid-October. President Obama or his advisors were either not kept fully informed, or did not grasp the significance of the collapse in relations between contractors and the government and a project out of control. His aloof distanced approach was not an asset in such matters- saying about the rollout and use of the website: "this is real simple" like using the Kayak website for travel bookings- and he saw no need to take action leading to the major failure for the administration that followed....

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While communities with high unemployment and depressed areas like Rocky Mount in N. Carolina, with 14% unemployment -and many customers skipping prescriptions because they can't afford them- are the worst off, the national picture shows many similiarities. Even with Medicare drug benefit, lowcost generics, and Walmart type low cost drugs, many Americans cannot afford prescription medications for life threatening illnesses. Nationally a third of respondents say they are not complying with prescriptions as they cannot afford them, compared to a fourth three years ago.

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The U.S. Senate passes a motion that allows the chamber to proceed with a debate on a health care bill. The motion passed 51-50 with Vice President Mike Pence casting the deciding vote. Republican Senators Collins and Murkowski voted against the motion. This report in the WSJ says this sets in motion a process in which debate will take place and amendments will be made. It is not clear what shape the bill will take. Under the process used only a simple majority is needed in the Senate, yet this allows for many amendments to be made.  Only hours after this motion passed by one vote, a bill replacing major parts of the Affordable Care Act failed to pass 57 votes against and 43 in favor. Senator John McCain who arrived in Washington from Arizona following brain tumor surgery, delivered strong criticism of the way the Republican healthcare bill was rushed through allowing very little debate. Experts have commented on the way the bill was rushed through with a thin majority for passage, with very little debate, first by Democrats in 2009 and now in the House by Republicans. With the same pattern now followed in the Senate by Mitch McConnell, the Republican leader in the Senate. A backup bill would remove just the individual and employer mandates and a tax on medical devices- the elements Republicans agree on, if no majority can be put together for the healthcare bill. ...

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This article details the manner in which pharmaceutical companies like Sanofi, Novartis and other western pharma companies are using EU patent laws to have customs offices in the Netherlands and other European transit points to detain pharma shipments by Indian companies to developing countries. Cipla and Ind-Swift shipments are mentioned. India's pharma exports of generics and other medicines is $4.9 billion in 2009 according to Global Trade Information Services. Indian pharma companies are having to divert these shipments through Singapore and other transit poits to avoid this detaining of shipments and this costs more. India plans to file a complaint with the World Trade Organization according to India's commerce secretary, which one expert says it has agood chance of winning.

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The House bill on health care cleared the House Committee on Energy and Commerce with a vote of 31 to 28. Five Democrats joined all 23 Republicans. Compromises were reached with Blue Dog Democrats, centrist Democrats who had concerns about the cost of the health care overhaul. The bill will be taken up again in September after the August recess, when Congress will be faced with the task of recociling the House and Senate versions and reaching common ground on a number of proposals. Some common ground has already been achieved between centris and Blue Dog Democrats and Democratic members who support Obama's proposals. Among the changes on which consensus was reached in the House version: 1. Access Insurers will have to accept all applicants and will not be able to charge higher premiums because of medical history or current illness. All insurers will have to offer a minimum package of benefits, to be defined by the federal government, and nearly all Americans will be required to have insurance. Insurers will have to get prior approval from the government before increasing premiums over a certain amount. About 95% of Americans will be covered this time. The cost will still be approaching $ 1trillion over 10 years. Federal subsidies will be given to those who cannot afford health insurance and Medicaid coverage will be expanded. And the insurance will be made more affordable for the uninsured. Democrats also reached a consensus on creating some sort of government insurance plan or nonprofit cooperative to compete with private insurers. 2. Mobility And under this new plan it will be easier to change jobs as one would retains one's health insurance. This should actually help the job market, and help promote the mobility that is needed, now that jobs are shifting out of sectors like autos to sectors like energy. 3. Cost The Energy and Commerce Committee voted 47 to 11 to set aprocedure for the government to give federal approval of generic versions of expensive biotechnology drugs. By one estimate this saves $9 billion over 10 years. The Democratic proposals from the Energy and Commerce Committee would authorize the Health and Human Services Secretary to negotiate prescription drug prices for Medicare benificiaries. The agreement and consensus among the conservative, liberal and centrist Democrats, and Democrats with ties and connections to the health care industry was reached after intensive negotiations, and adoption of a package of amendments that helped bridge the differences they had. ...

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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.