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Jan Ruckert-John, Professor of Sociology of Food  at the University of Applied Sciences, Fulda, Germany is interviewed by DW.com on theissues involving gender preference for vegetarian food, the issues with meat. Particularly at this time of coronavirus and climate change the issue of overemphasis on meat in diets around the world is a topic that comes up. Men trend more towards meat. The role of cows and meat in climate change is not adequately understood.

There is less understanding about the benefits of more vegetables, fruits, whole grains, and nuts in our food, with less meat and the need for public education, a role for health departments in many countries to create public education campaigns. Even less understood is the role of herbs such as used in Asian countries from turmeric and ginger to cinnamon in promoting health. 

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How Integrative Medicine, changes in lifestyle and diet, yoga and exercize, meditation, no smoking habits, can add up to changes in the nation's health that work more effectively than new drugs to prevent or delay the onset and progression of chronic diseases like diabetes, asthma, heart disease and of obesity, etc that consume 75% of the costs in the $2.1 trillion spent on medical care in the USA. Shockingly 95% of these costs are incurred after the onset of the disease, proving that prevention is simply not an important part of the equation.

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The $1.2 trillion spending bill to cover the budget for 2024 for defense, health and human services, education and other parts of the US government passed the Senate 74-24 with Republicans joining Democrats to pass the bill. It came in the wee hours of the morning just after the midnight deadline for funding the US government. Disagreements on funding programs between the 2 parties led to this situation of delay till the last minute as each side sought to improve its position. 

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Medical insurance choices are complicated for a reason. This WSJ report says a PhD. is not sufficient to figure it out. They were designed this way to maximize profits from a government program by private insurers and capture as large of the market for the Medicare Advantage plans they offer. Heavy lobbying in Congress makes it possible to write legislation that keeps selecting coverage complicated.  The only way to clean up this mess is through universal health insurance, that is UN's SDG 3.8,  that is fair for all, which everyone can understand, and the US as an advanced technological nation can support. Reducing transparency works with heavy advertising for private insurers with Medicare Advantage Plans to capture the largest chunk of what the government spends. Medicare Advantage insurers capture $943 billion of spending on Part A & B Benefits compared to $693 for traditional Medicare. 

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The Great Pacific Garbage Patch of 1.6 million square kilometres near the coast of California, shown in this video from the US Oceanic and Atmospheric Administration, is one of many garbage patches in the world's oceans. It is like a peppery soup of microplastic with larger items mixed in and the peppery soup part is the hardest to cleanup. Cleanup is no easy task- cleanup of just 1% of the Pacific ocean would take 67 ships one year according to one estimate. The best way to tackle this is to tackle it at the source prevent it from getting into the ocean in the first place. Imagine 10 million metric tons of this stuff that end up in the worlds oceans each year because of a lack of public awareness of the risks and dangers of this kind of pollution that over time could pose health risks that are not properly understood today through contamination.

 

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The UK government's chief scientific adviser, Sir Patrick Vallance, says coronavirus testing has not been scaled quickly enough. Public health experts warn that Downing Street is in the position to face "an unforgiving reckoning." The UK has done 5400 tests per million population, the U.S. 8894 tests per million, and Germany 15,700 per million, according to data from Worldometer website. UK got off to a slow start.  Experts at Imperial College, London, say a major problem is the lack of contact trace, test, isolate. Contact tracing having fallen behind. The government is relying too much they say on an app from Google and Apple to do the tracing because for this kind of work humans are needed, "boots on the ground" are needed. South Korea and Taiwan have successfully used people to do the contact tracing by using access to cellphone carrier data that was made possible from protocols established in earlier MERS crisis. ...

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What is the right retirement age for health is an important question. Dana Smith points out that the number 65 that started with the system of social security started in US  by Bismarck in Germany in 1889 and Social Security in the US in 1935 by president Franklin Roosevelt has no basis on the grounds of health of the population and longevity. Since that time people live much longer to about 74 years and for 45% of the people in the US who are in the knowledge based work the ability to work continues past 65 or 67 years.  For the remaining people who are in professions involving physical work such as construction or in the restaurant industry the situation is quite different, requiring a category based retirement age that takes this into account. For these people health outcomes would deteriorate if they continued to work in stressful work for longer. Another factor to be considered is to ask what this means as a national goal. Would a nation aspire to give its citizens an opportunity to travel, broaden their minds and engage in other activities they would like to do which they could not do while working full time. In this situation these years after retirement could give people a chance to live happier lives. It is not to be taken lightly as the current protests in France show. Age discrimination in France also plays a part as there may be fewer years of work opportunity if employers stay away from people over 50 years or discriminate against women. With childcare and care for elderly, part time jobs, women work longer for smaller pensions than men, leading to a sense of unfairness. French protests show that the outcomes need to be weighed carefully from a health and national goal standpoint and the retirement age set accordingly with flexibility for harder work.  Following the pandemic years and the cost of living crisis the protests in France show the need to develop a national consensus on the issue of retirement age, and rules plus culture change in industry that ban age discrimination for workers. Special provisions for women and people in construction so that the system is seen as fair to all parts of the workforce. ...

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US president Biden ends a conflict that hurt America's middle and working class by distorting priorities for domestic goals, hurting families from middle and working class, and abandoning priorities for infrastructure, health and education. US president says he feels he has made the right decision on behalf of all Americans and America's friends in the world.

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More men than women died in the first year of the pandemic 2020 in the US. Experts say this is startling, and say that men were less informed on vaccination than women in 2021 and 2022. This leads experts to believe that men suffered more than women in the years following that first year. The report comes from the Center for National Health Statistics, part of the CDC.

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A reminder that the old Republican party of Eisenhower and Teddy Roosevelt still exists, simply waiting to be revived from its slumber with a new platform that brings in a different attitude and culture to the problems facing the US of infrastructure, manufacturing at home, public services, health and education access for all Americans and holding on to the bedrock of principles and courage of Ike and TR.

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The full text of the letter is given here. In this letter the U.S. sets out some important facts about events that happened during the coronavirus crisis during the crucial 4 month period from December 2019 to March 2020. Every week lost in this time due to reasons of a lack of transparency, openness meant hundreds of thousands of people more infected and tens of thousands of deaths worldwide. There are questions of transparency, of openness and this raises questions about the manner in which the World Health Assembly operates with hundreds of small countries in Africa and Asia having votes equal to that of the U.S., India, Brazil, Mexico with votes taken of over 200 countries. The entire election process can now be seen as questionable, when over a billion people in one country alone such as India or hundreds of millions in Brazil and Mexico would have to bear the consequences of poor decisions made by small countries that can be swayed in one direction or another based on political bias and other considerations that have nothing to do with global health.  At the conclusion of the letter by the U.S. to the current WHO shaped by a controversial election in 2017 the following is stated about the standards set by Gro Harlem Brundtland and which helped the world prevent the SARS crisis which originated in China in 2003 from spreading to the large countries of the world India, Brazil, Mexico, and other such countries in Asia and Africa, Latin America, and the U.S. European Union. "In 2003, in response to the outbreak of the Severe Acute Respiratory Syndrome (SARS) in China, Director-General Harlem Brundtland boldly declared the World Health Organization’s first emergency travel advisory in 55 years, recommending against travel to and from the disease epicenter in southern China. She also did not hesitate to criticize China for endangering global health by attempting to cover up the outbreak through its usual playbook of arresting whistleblowers and censoring media. Many lives could have been saved had you followed Dr. Brundtland’s example." Even this does not come to grips with the flawed way in which the election of WHO head is done. It can no longer be relied on when there is the danger that lack of transparency can emerge in the WHO leadership itself because of a flawed process. It risks endangering the lives and livelihoods of hundreds of millions in countries such as India, Brazil, Mexico, as well as in the relatively small countries of Africa and Latin America where even basic water supplies are at risk but which could tilt elections at the World Health Assembly. Consider that a cyclone just hit the Indian state of West Bengal and Bangladesh on May 20 just as the coronavirus pandemic is spreading. That this region of 1.5 billion people had just 2 votes out of over 200 cast at the World Health Assembly in 2017 shocking. And even these votes cast based on old geopolitical considerations not how good the candidate is, and how good the country he is coming from is in terms of its record  on public health. The irony here is that private foundations in the advanced countries in the U.S. and Europe some of whom are major donors to WHO did not think that more experienced candidates in their own countries with a better record of public health such as in France or Germany are better qualified, in a flawed NGO support mentality left from the Clinton years. Basically the people in these large countries such as India, Brazil, Mexico were disenfranchised, when the austerity policies were consuming the European Union, and the U.S. had just elected a new administration itself groping for ways to reverse years of neglect of public services and infrastructure priorities. They would trust good leaders no matter where they come from, who have a record of transparency, leadership, and all the values we cherish together no matter where we come from. ...

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Indian health minister Mandaviya goes house to house in Palitana, Gujarat, to start India's Har Ghar Dastak, house to house vaccination drive. Indian government has identified 50 districts with vaccination rates below 50% for first shot, for efforts at house to house vaccination by visiting homes of the unvaccinated. PM Modi returning from Glasgow held a meeting with chief ministers of the worst affected states such as Maharastra,Tamilnadu, Karnataka and other states with officers at the district level also present, to start Har Ghar Dastak campaign. Modi told the chief ministers and district officials that his talks with leaders of developed countries had increased his awareness of the great risks in letting any slackness or loss of vigorous effort take place in the vaccination effort. Germany is today facing a pandemic of the unvaccinated with fully vaccinated stuck at 67% and facing resistance from unvaccinated and closing of vaccination centers. The US is also facing the same problem and the winter looks increasingly fraught with dangers for both US and Europe, when people go indoors. India seeks to avoid having to face the same problem by taking action in advance to get unvaccinated to enlist in the national effort. Only Spain and Portugal have rates of vaccination close to or over 80% for fully vaccinated, and this is because of the huge trust people in these two countries place in the health system, seeing vaccination as a gift of modernity, and seeing that it is important to not risk health of older family members with whom most young people live with in these countries. ...

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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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A critical part of the Affordable Care Act is the setup of marketplaces or exchanges to let people without insurance buy individual health plans. Some states setup their own exchanges, and some states let the federal government step in and run them. To help the lower middle class and poor the Act provides health subsidies to buy insurance in the exchanges, and 85% of customers in the exchanges qualify for this benefit. The U.S. Supreme Court voted 6-3 in 2015, compared to a tight vote in 2012 on the Affordable Care Act, to maintain the health subsidies. Justice Roberts wrote the majority opinion, saying "Congress passed the Affordable Care Act to improve health insurance markets, not destroy them." Justice Scalia dissented calling it "interpretive jiggery-pokery." Justices Clarence Thomas and Samuel Alito Jr. dissented. Voting in favor were Justices Anthony Kennedy, Ruth Bader Ginsburg, Stephen Breyer, Sonia Sotomayor, Elena Kagan, Justice Kennedy dissented in the 2000 case. The challengers petition to the courts was based on a reading of phrases in the Affordable Act which had not occurred to the writers of the law. The reading suggests only people enrolled in state setup exchanges are eligible for subsidies. If the Supreme Court ruled in favor of the plaintiffs the 6.4 million Americans who are enrolled in the federal exchanges would lose the subsidies provided under the law and lose health insurance. And the economic foundations of the Affordable Act would be undermined with insurance companies required to provide insurance to all regardless of pre-existing conditions and subsidies removed, leaving the companies with sicker pool of customers resulting in destabilizing the exchanges and higher premiums. The court ruled in favor of an interpretation that is compatible with the whole law and the intentions of the statute to help the middle class and the poor buy health insurance. The chaos in the insurance markets that would result in going with the plaintiffs because of a careless writing of a phrase, was uppermost in the majority's mind. Chief Justice Roberts emphasized this, saying- "The statutory scheme compels us to reject petitioners' interpretation, because it would destabilize the individual insurance market in any state with a federal exchange and likely create the very 'death spirals' that Congress designed the act to avoid." This case originated with 4 plaintiffs from Virginia who challenged the IRS regulation that said subsidies were allowed regardless of whether the exchanges were run by the state or the federal government, arguing that this was at odds with the particular phrase in the law that was ambiguous about federal exchanges eligibility for health subsidies. Judge Roger Gregory of the Fourth Circuit Court of Appeals in Richmond, Virgina, ruled that the phrase was indeed ambiguous, but the IRS was owed deference in its opinion. Chief Justice Roberts made it clear that this was not a case for the IRS, saying "it is instead our task to determine the correct reading." ...

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The tough job President Obama faces as he faces opposition from politicians who have interests to protect, and healthcare businesses with interests to protect. The President has to come up with a plan that is deficit neutral, because financial markets could see a healthcare bill that further widens the deficit as a signal for higher interest rates that would deepen the recession. At the same time each of the three sources of revenue puts him at loggerheads with political leaders in Congress or groups with interests to protect. Limiting income tax deductions for high earners could raise $267 billion in 10 years. It would require taxpayers in the top tax brackets deduct their mortgage interest, state and local taxes, and charitable donations, at the 28% tax rate instead of the 33% and 35% tax rates. The opposition is with democratic leaders that it would hurt charities, universities that depend on tax deductible donations, and taxpayers in high tax cities like New York city that are the home base of Democratic leaders. Yet only 1.4% of households would be affected says the nonpartisan Tax Policy Center. The Center on Philanthropy at Indiana University, says charitable giving would decrease by 2%. The other opposition on this comes from the preference of Senators Baucus and Grassley, who head the Senate Finance Committee, for tax increases or cost savings to come from the health sector. Specifically they want to see the value of workers' employer provided health benefits subject to income taxes. It is a situation in which every sensible person admits the need for healthcare reform and would see the current pace of healthcare costs as unsustainable and dangerous; and after that will just go back to his group and try to preserve as much of the status quo as possible, so as not to disturb by much the benefits or compensation they have secured from the system over the years. Then there are political leaders in Congress with their own preferences, and Congressmen who are the subject of heavy lobbying by these interests. The administration and the Presidents job is to navigate this stream with a workable deficit neutral plan, without any requirement for any group to make sacrifices, and in some situations even small sacrifices for the public interest. Would charitable institutions be hurt that much, what if charitable institutions were exempted, why would other interests the try to obtain the same exemption. Its like the unions trying to keep the old unsustainable goldplated healthcare and other benefits at GM even as the ship was going down. Taxing employer provided employee health benefits as income would raise $2.5 trillion over a decade. The opposition here is from unions which are a force in the Democratic party and which count tax free health benefits as a legacy of the labor movement. Employer provided health insurance covers 160 million American employed and their dependents under the age of 65, so it has a wide impact. Yet most economists favor ending the tax break. They say it mainly goes to upper income taxpayers, and discourages cost consciousness among consumers of health care, thus encouraging excessive spending and surging health care costs. Senior Obama advisors, Peter Orszag, the budget director, and economist Jason Furman favor this approach. So do Republicans in Congress. Senators Baucus and Grassley are not asking for the complete removal of the tax break, what they want to see is capping the value of benefits that go untaxed. If the tax-free limit is $13,000, a policy worth $15,000 would pay income taxes on $2000. A third spource is to spend less on Medicare. About two thirds of the $948 billion in savings Mr Obama has proposed over 10 years comes from a number of reductions in Medicare spending. $177 billion comes from insurance companies bidding for government reimbursements for offering private plans to seniors. $106 billion comes from cutting the subsidies to hospitals serving the uninsured as universal coverage should remove this need. And $110 billion in reduced payments to hospitals and doctors because of productivity gains. A range of industries insurance companies, hospitals, doctors drugmakers, nursing homes, home health care companies and medical device makers, all stand to lose from reduced payments from Medicare and Medicaid. And these groups with interests to protect are another factor in this process of working out a healthcare plan. ...

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For the regions hardest hit by the coronavirus and its variants- the US, Brazil, India, Europe, Russia, China and Africa, the researchers and the frontline workers in South Africa are doing an incredible job. This report by Stephanie Nolan in the NYT shows the work of researchers at KRISPS advanced medical research center and the frontline workers in South Africa, who are making a difference. Shown are researchers and scientists at KwaZulu Natal Research Innovation and Sequencing Platform in Durban, South Africa on whom the world depends for stepping up the fight against the coronavirus- Dr Tulio de Oliveira, principal investigator of the national genetic monitoring network, and Saleem Abdul Karim, epidemiologist. On the frontline workers who visit patients homes to make sure immune compromised patients have access to their medications is Sizakele Mathe, community health worker. Stephanie Nolan has provided a much needed account of what work is being done on the frontlines to keep us all safe. ...

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This WSJ Exclusive report shows 1.89 million breakthrough infection cases in the US and at least 72,000 hospitalizations, 20,000 deaths among fully vaccinated people in the US this year. The WSJ reviewed medical record data for 21 million fully vaccinated people, and an array of state reports to put together this analysis. It shows people with weaker immune systems and elderly are more susceptible for breakthrough infection and hospitalization. It also shows that vigilance is necessary in following covid protocols for social distancing, masks, hand washing, as the figures show smaller but yet significant percentage of people at ages younger than the elderly are getting breakthrough infections and getting hospitalized. 3.35% of people 35-49 years who were fully vaccinated but with waning immunity from taking the shots early on and lacking booster shots to build immunity back up again, and who are breakthrough infections, are hospitalized in this WSJ analysis of EPIC's Health data. For people 50-64 years this is 7.45%. The importance of getting the booster shots has never been greater. ...

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The rule requiring health pass showing one is fully vaccinated goes into effect in France starting July 28 at restaurants, coffee shops, trains, and other public places. For the first week restaurants will not be fined. After this they can be fined 1500 euros for a single violation. The passe sanitaire in France is now required  for all public places where more than 50 people gather, such as events and museums including the Louvre in Paris. It will be extended to restaurants, cafes and shopping centres in August.

French premier Castex says 97% of the 18000  daily average new cases in France, up by 150% since the prior week, are from the unvaccinated. This has made health authorites and the government concerned about the delta variant high transmission rates and the high proportion of people still not vaccinated. For France this poses risk of a new kind of fourth wave, causing the government to take strong action to accelerate vaccinations.

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European Union countries, Britain and the US face the risk of a resurgence of coronavirus through the Delta variant and other variants. The Delta variant detected in India is 40% to 80% more transmissible than the Alpha variant detected in the UK, with the Alpha variant 50% more transmissible than the original coronavirus that originated in Wuhan.    Virologists in Italy feel they are flying blind at this time because of the lack of genetic sequencing in Italy, Spain, France and across most European Union countries. The UK has done genetic sequencing on 27% of recent covid positive tests. The figure drops to 1% for Italy and is tiny for most of the EU countries including Spain and France. Without genetic sequencing it is hard to predict and take steps. Another problem in the EU is that the southern economies Spain, Portugal, Greece, Italy, Croatia are dependent on summer tourism for the economy. The UK economy can handle a delay to a full opening for 6 weeks without serious impact to the economy, says WSJ. Southern European economies can afford only short delays to full reopening. Croatia acted as a door to spread of coronavirus into central Europe when Germans and Austrians went to vacation spots in Croatia in summer 2020. This situation could be happening again in 2020 with British and other tourists visiting vacation areas in Portugal, and Germans visiting Greece and other summer tourism spots. Portugal's national health institute says the Delta variant represents 60% of new cases in the area around Lisbon based on early data. The government of Portugal is facing criticism for letting a Champions League soccer final to take place in Porto, Portugal between two English teams. Thousands of English fans watched the game at the stadium. Other problems are in relaxing of mask rules in France and Italy, last week in France and in the coming week in Italy. French nightclubs open July 9 without mask requirement. Germany is maintaining some social distancing measures and this includes mandating medical masks in closed public spaces and on public transport. Half of French, Italians, Germans are vaccinated and quarter fully vaccinated. Yet the gaps of unvaccinated people is large enough to cause serious concern of another wave. The relaxation of mask rules- the entire stadium in Budapest was packed for a recent game between Hungary and Italy for a soccer Euro 2021 game with no masks to be seen. Stadiums played a key role for the spread of the original coronavirus in Italy with a game in Bergamo, Italy, in the area near Milan. All this makes health officials concerned about the risks of still another wave of the coronavirus.   ...

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A ban on TikTok in 270 days is plausible, with credit going to Republican senators in Congress, as they insisted on it being incuded in the Ukraine aid bill package. Not only because of security and democratic process concerns- then one asks why what other real even larger concerns?  A ban on TikTok by restricting its use that does not affect education is already in place in China, yet such a ban is easier implemented in state power centralized government for the benefit of China's young generation and not in the US system of government. Excessive time spent on social media apps in the US including TikTok as the largest are a serious problem in America today -for young people's educational activity such as reading, studies, and for mental health. Taking a large part of the young generation in a direction that is not beneficial for the US, for democratic process to function with young people taking time to be better informed and for the health of the younger generation.  People assume that TikTok audiences will shift to other social media apps such as Facebook, but a large part of the TikTok population may engage in other activities that promote health as the consciousness for food and its preparation increases, for the value of exercise, engagement in sports and viewing sports or music, engagement in Nature and hobbies, and in time spent on travel, all happening as the Nation shifts its attention and consciousness after these troubled decades from financial crisis of 2009 to the pandemic, a period of dismal failure to deliver public services with funding diverted and misallocation in capital markets collapsing or near collapsing infrastructure around us sapping the Nation's spirit and its energies.  A new spirit is emerging in the Nation and a shift in the attention of the younger generation as it feels the fatigue that is now felt for music idols such as Taylor Swift is entirely plausible so that TikTok would have risen and faded away both in the US, India, and even in China as it shifts its attention in a different world. ...

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India registers an amazing comeback feat of 75% vaccinated with two doses on January 30, 2022, without the resistance to vaccination seen in US and Europe. For over a billion people this is nothing short of extraordinary. India's experience is similar to that in other parts of Asia and Latin America where people trust health authorites, after years of dealing with many diseases requiring vaccination in the last 50 years.

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California is now the first state in the US to make vaccination mandatory for teachers. Teachers who turn down vaccination will need to undergo regular testing. This goes into effect Oct 15, 2021. California is also considering mandating eligible students to be vaccinated to attend school. Different states in the US are setting different rules for mask mandates for schools. California and Illinois require them, while 4 states have banned mask mandates in schools. 

The mandates and other action have pushed the fully vaccinated rate in California up to 64% for residents over 12 years, compared to 59% nationwide in US according to health data cited in the WSJ. Teachers unions in California support the rules. The largest union California Teachers Association, with 310,0000 educators, says 90% of its membership is vaccinated.

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This report in the WSJ  shows that president Xi is pulling back from his signature economic policy to reduce wide gaps in wealth and opportunities in China. In 2021 this was a policy that Xi pushed to reduce inequalities that have built up over decades of hypergrowth. One tenth of the population owns 68% of the wealth in China creating an highly unequal society. Concerned about the future of the Communist party as disparities kept widening and 40% of the population was left behind, Xi early on in his first and second terms made tackling corruption and inequality part of his policy.  Yet the way China's economy is structured, its dependence on the construction industry for growth, and on local governments for investment, it is easier to tackle infrastructure projects than address widening gaps in society. Xi's efforts have led to slowdown in growth to 5% or less. With the US and Europe moving to shorter supply chains and moving supply chains to less integration with China, slowing growth to less than 4-5% presents a major challenge for China. Leading to a pull back from the Common Prosperity policies that Xi initiated and which are part of Communist party policy in its early period after 1949. A major problem for China says WSJ is that social security contributions revenue is 6.5% of GDP compared to 9% for advanced countries in the OECD, the Organization for Economic Cooperation and Development. Personal income taxes are 1.2% of GDP compared to 10% in UK and US. This prevents the better funding of programs for maintaining a better safety net and social support for the less well off in society. The pandemic followed by Ukraine war have added new urgency to the acceleration of the effort to build new supply chains, leading to new manufacturing innovation and manufacturing leadership in the US and European Union, and in countries such as Japan, India, and other parts of Asia. This too has made the goals of reducing inequalities and addressing the wide disparities in Chinese society more difficult with sharply slowing growth in China. This was also the experience of Japan and South Korea with decades of fast growth followed by sharp slowdown with unanticipated problems. ...