LyrArc Article Gist
Interview with Gerard Kleisterlee, retiring CEO of Philips Electronics. Kleisterlee led the effort to focus on emerging markets where sales of health care, lighting and consumer products are accelerating. Second quarter sales in emerging markets went up 29% for 2010 over the prior year, and now are 34% of total Philips sales. As part of this strategy Philips is increasing its staff and research divisions in China, to capture part of the $125 billion that China plans to spend on healthcare in the next 3 years. Kleisterlee talks about local competitors in emerging markets who are trying to get a regional or global presence. How Philips is increasing local responsibility, and how it is designing, engineering and manufacturing products specifically aimed at local markets in emerging market countries- as away to compete effectively in these markets. He also points out that it is no longer sufficient to be in the major cities, Philips has to move into smaller cities and into the rural areas to increase sales. He sees consolidation opportunities in Asia where the lighting manufacturing is still fragmented. Responding to a question about Philips still being too old, too male, and too Dutch, Kleisterlee agrees that it is too male and too Dutch for his comfort. Women are a bigger part of his health-care team, but not that much progress in other areas of the company. And he would like to see more local leaders in emerging markets. He sees consumer behaviour changing in one respect- there is an increasing consciousness among buyers for value, and not just for low price points, but at all price points....

LyrArc Article Gist
Brooks says no to the current health reform bill as most experts say it does little to control the bulging healthcare cost curve which will take it from 17% of GDP to 22% and beyond. He goes over the pros and cons. Passing this gets little done for health care reform in a fundamental way that is so badly needed today. Says Brooks the system today is rotten to the bone with opaque pricing and insane incentives, with consumers insulated from the costs of their decisions, this won't change with the current health care bill. In fact he says according to the chief actuary for Medicare it will cause health care spending to grow faster. At this rate we will be giving more money to insurance companies and programs that have great social value like expanded preschool and other needs that America has will be shoved aside. In coming years as the population of America ages there will be growing needs for health care. With no increase in supply, and the perverse incentives still in place, prices will continue to grow rapidly without the focus on efficiencies that is badly needed. Brooks points out that its not the politics is the chief obstacle to reform as most people say, but the reverse is the truth, unless one gets the fundamental incentives right politics will be terrible forever. ...

LyrArc Article Gist
The US government shutdown ends with Republicans + 8 Democrats in Senate voting to end shutdown on November 10, 2025. This keeps the filibuster voting rule which requires 60 votes to pass. Support of some Democrats was essential to make this happen. After bipartisan negotiations 7 Democratic Senators and Angus King Independent from Maine split with their party leaders Schumer and Jeffries of New York who called for a 1 year extension of Obama ACA healthcare subsidies which the Republicans opposed.  Democrats ensured the funding for SNAP benefits continues to Sept 2026 and the 4000 federal layoffs would be reversed and prevent future layoffs in the federal workforce. Democratic Senators voting with Republicans were Cortez Masto and Jacky Rosen of Nevada, Jeanne Shaheen and Maggie Hassan of New Hampshire. Tim Kaine of Virginia and Dick Durbin of Illinois joined the Senators from New Hampshire and Nevada. John Fetterman who has voted independently of the Democrat party to meet views of Pennsylvania constituents supported the move. This splits New Hampshire, Maine, Nevada, Illinois and Pennsylvania from the Schumer-Jeffries leadership from New York. Tim Kaine voted with Republicans by getting them to agree to reverse federal workforce layoffs, get back pay and stop layoffs. King, Hassan and Shaheen formed the core of Democrats who believed there was no chance Obama ACA subsidies would be extended for another year as long as shutdown continued whereas there was some chance after it ended. Both Senators from Nevada Rosen and Masto were following the needs of their constituents, and so was Fetterman of Pennsylvania. ...

LyrArc Article Gist
The second wave of the coronavirus is bigger than the first with the U.S. exceeding 100,000 cases a day for many days in November and hospitalizations doubling to 93,000 from the beginning to the end of November. There is also the fatigue with the virus for healthcare workers and the people, and loss of income for workers leading to income and food insecurity. In this situation a second stimulus to help people and businesses is a urgent priority for Congress. A group of bipartisan senators have put together  $908 billion stimulus plan to get through the Congress by December 11. This is a compromise between the two parties. Supporting the bill are Cassidy, Romney, and Collins for Republicans and Manchin, Warner, Cassidy for Democrats. It would provide- 1. $300 a week in federal unemployment benefits for 4 months. 2. $160 billion for state and local governments. 3. Temporary moratorium on coronavirus related lawsutis. 4. Additional funding for small business, schools, health care, transit, student loans. There is growing agitation among influential senators against the leadership in both parties of McConnell and Schumer, with the sense that the leadership has failed to recognize how critical the issue of emergency relief is for tens of millions of Americans. This is its only hope for passage with the bickering of the leadership on both sides. ...

LyrArc Article Gist
US House Republicans are pursuing cuts in spending of as much as 50% in many programs that are considered essential, such as a 50% cut in foreign aid at a time of global food insecurity, deep cuts in the FBI's counter intelligence budget, deep cuts in healthcare services and housing to low income Americans following the pandemic and high inflation, and other cuts to services benefiting workers and families. Democrats in Congress and president Biden oppose such cuts and hope to eliminate the deficit with cuts that do not place an unfair burden- taxes on the wealthiest with over $100 million and on stock buybacks would generate about $2 trillion to cover the whole deficit which is in the range of $1.4 trillion in 2023 moving to $2 trillion a year. Much of the Republican plan is being shaped by Mr. Trump's former Budget Director, Russell Vought, says this report in the NYT. Mr. Vought calls it an attack on the bureaucracy and woke spending. Other Republicans see this as an ideological approach that does not address today's problems. Chuck Schumer, Democrats Senate Majority Leader asks Republicans to spell out their plan. ...

LyrArc Article Gist
GST revenue increase is important because it finances healthcare, education, infrastructure building, jal ghar and cooking gas, Digital India initiatives, housing programs in a way that has never happened before and is needed for modernizing the Indian economy. The same approach is being taken by president Biden in the US to finance his climate and tax bill of $369 billion. It is the biggest climate action bill in history and revenues to finance renewable energy transition are coming from a 15% minimum corporate tax that is being agreed to by all countries in the world including US, Britain, European Union and India. Just today the WSJ the largest biotech company Amgen in the US paid 3.5% effective tax rate on revenues for 2013 when tax rate under federal law was 35%, and the IRS is working on getting $10.7 billion back in payments due over a decade. Much of Amgen's profits of $24 billion had been shifted to a location in Puerto Rico says a report in WSJ. The development work of the free world countries including US, EU, and India cannot happen without this. Without this the US, EU and India cannot even remain competitive with China or tackle national security threats. ...

LyrArc Article Gist
Looking back Mohandas Gandhi's effort to prevent separate electorates was an important contribution to today's rapid industrial development and modernization of India. Delivery of infrastructure, education, healthcare and other improvements could not have been delivered as they are today with weak governments. Gandhi understood clearly the effects of divide and rule and how this had led to over one hundred years of disinvestment in India by 1900. Even after 1950 it took another 70 years for governments to follow the experience of Japan and China and rapidly modernize. Separate electorates as suggested by Ambedkar for lower castes would only further weaken India, as would communal representation of that type. Not integrating the one third of India that was under princely states would have had the same effect. Sardar Patel grasped clearly the effects of not integrating these princely states would continue the effects of divide and rule. In this way the foresight and wisdom of Gandhi and Patel have given a new generation of leaders the sound fundamentals on which to build a modernized nation, the largest democracy, and a nation with a young population that is fulfilling the aspirations of its young people. ...

LyrArc Article Gist
The point at which pensions begin and retirement begins is thought of normally as 65 years. This is changing. Experts on ageing at Britain's ONS, Office of National Statistics say 70 years is replacing 65 years as the age at which people can work and contribute to society, working later in their careers and doing voluntary work. This would help ease pressure on pension system financing and cost of social service to elders. Because of rising longevity and improvements in healthcare, diet and lifestyles people age 70 had characteristics of people age 65 in 1997, say ONS experts. ONS looks at a new way to measure ageing. Do not use chronological years from birth, work backwards from remaining life expectancy and operate on the basis of 15 years as the marker for old age. Under this method start of old age is 70 for men and 72 for women. As people over 65 years is approaching a fourth of the population this fresh thinking gives more room for pension system sustainability, and helping engage people at work for longer more productive lives. Both for the economy and personally for the individual. ...

LyrArc Article Gist
WSJ interview with Narendra Modi before he meets Joe Biden at the White House. This interview talks about India seeking larger role in world affairs, about Indian democracy. Seen from inside India the perspective is different. India is at the same stage where China was in 1990-2000 with the rising aspirations of a billion people, Japan in the Meiji period in 1900. It is all about jobs, investment, technologies and manufacturing on a scale that surpasses China in that period with newer technologies to meet the rising aspirations of 1.4 billion people. China's trade with the US was three times higher than the Indian trade with the US in 2022, India desperately wants to catch up and fast. The Danish ambassador to India was asked what he saw in India today and he said it was the rising confidence of people that struck him most. The digitalization that has changed the way government benefits are provided to 1.4 billion people and opened bank accounts for all, provided delivery of services to all parts of the population. The infrastructure that is being built at breakneck pace, and new colleges and universities expanding access to quality education, healthcare.   ...

LyrArc Article Gist
Compare the presidential election spending in France and US one sees a huge, really huge difference. In France by law the first round it is limited to 16 million euros and second round to 22 million euros. Companies cannot donate and maximum donation is euros 4600 per year. All candidates must be given equal time by networks after official campaigns start usually March 28. If you get 5% of the presidential vote you get about 48% of the $22 million ceiling and if not only about 5%. Its a fairer system considering about $5 billion will be spent in US presidential election 2024. It keeps out lobbyists and donors looking for silent favors as the pharma industry and the tech industry in the US that has prevented any legislation on fair drug pricing or oversight of the monopolies of Apple, Google, Microsoft, Amazon, Meta and others, taxation of profits of tech and fossil fuel companies, or passage of healthcare for all. Indian elections cost of 1.35 lakh crores or $13 billion in 2024 are also similar to the US with parties spending leading to much corruption in the democratic process and defeating its best character.  ...

LyrArc Article Gist
One perspective of what Silicon Valley is focused on is shown by Reid Hoffman. It does not mention climate change, not one word on climate change, no words on cost of living action, little is said about factories and jobs for reviving American manufacturing, helping workers and families and redesigning the world's supply chains. It is critical of addressing monopolies and regulatory action by the FTC even where it is needed. It calls for huge investments in AI that would leave little for investments in science, education, healthcare and infrastructure, and says "trust us to do the right thing." It calls for pro-innovation direction when pro-innovation has been the thrust of policy for three decades with the results that we have seen leading to widening gas between the upper and lower classes and shrinking of the middle, a pharma industry out of control in pricing, and negligible investments in education by so called "tech" companies who like Apple have outsourced manufacturing to China. A return to tech and Silicon Valley is not needed as embedding it in the nation's policy making priorities is the Nation's problem. ...

LyrArc Article Gist
The author of the study Youth in Germany Kilian Hampel says, German youth after the pandemic have increasing stress about soaring housing costs, inflation, war in Ukraine, and fears about old age poverty. This is similar to what is happening in the US. This will be a factor in the European elections. Though a lot is written about far right parties. Much of the work that remains is about ensuring fairness, and equity, tackling inflation and building housing. This needs greater investment than Germany is today undertaking. Much of the Greens and Socialist party plans to invest in the last federal election were stalled when they did not get a majority and had to depend on the FDP which is too conservative for making the investments needed in the economy. In the US Biden forged abipartisan effort and invested heavily in Republican areas in the south and west. A similar task is needed in Germany including investing in the East and in education, healthcare and building new infrastructure. Rail, road, airport and bridge infrastructure in Germany is dilapidated and only by investing in it can the economy gain strength to meet the aspirations of young people. ...

LyrArc Article Gist
$700 million loss on a clean beauty brand during the pandemic by Carlyle taking money from investors. During the pandemic Carlyle private equity invested $700 million of investor's money in Beauty Counter, a direct seller of a clean beauty brand started by Mrs Renfrew. The product and concept failed. This is $700 million that could have been invested in much needed nation's infrastructure projects, in climate change action, in renewable energy, in healthcare, in education, with reasonable returns. Capital market misallocation is a huge problem for the last 2 decades, with hundreds of billions of dollars lost or wasted in dubious products such as $100 million for a new golf ball with hundreds of such projects and products that are not vital needs for the American people. Tax benefits for such dubious projects and ideas lead to more revenue that is diverted away from the essential needs of the Nation and the American people. Over two decades this adds up to huge losses which would mean a lot of the Nation's infrastructure could have been replaced by now using this money. The capital allocation system needs to be rebuilt from the ground up to meet the vital needs of the Nation and the American people. ...

LyrArc Article Gist
African continent debt reached $1.1 trillion in 2024. About 900 million people live in African countries where interest payments on debt exceed money spent on healthcare and education. In Nigeria external debt is $40 billion, in Kenya $35 billion and Uganda $12 billion.  Take Nigeria with 220 million people. 40% of the revenue collected goes to meet interest payments on debt. For many African countries there is zero per capita income growth for a decade. During the 2010 crisis as interest rates reached new lows US and European Reagan era intellectuals including Democrats encouraged African countries to borrow at low rates and banks loosened restrictions putting more African countries into debt buildup borrowings. As interest rates went up the cost of paying the debt accumulated required more loans at higher interest rates. Nigeria paid a premium over that of 10% for a loan of $2 billion just for interest payments. The debt crisis means African currencies depreciate reducing purchasing power.  With war in Ukraine and Covid prices of food and energy rose. Only the strong and disciplined leadership and rapid industrialization provided breathing room as with Modi in India, Jinping in China, the African continent and Latin America lacked this and are feeling the pain. ...

LyrArc Article Gist
A live interview by BBC Hindi with Arvind Kejriwal, chief minister of Delhi. In the interview Kejriwal says there are 55 deaths from the demonentisation by removal of 500 and 1000 rupee notes in India. When questioned about this and proof, Kejriwal says BBC is biased. The effort by the the Modi government to  remove these rupee notes is an effort to get people in the informal economy,  the deals in real estate, and people in other parts of the economy which pay little or no taxes to bring the cash to banks and pay the taxes due. This is intended to increase government revenue for investments in infrastructure and education, healthcare. services. The large scale of the shift has caused difficulties for ordinary people, and the upper classes, and the government is working to work through these problems. In India the black money as it is called is estimated to run to about 1 trillion dollars. It is also the result of corruption and has deprived the economy of needed investments and modernization. ...

LyrArc Article Gist
The Affordable Care Act or Obamacare gave families of 4 with incomes of less than 125,000 or single income less than $60,000 a chance to buy insurance with federal subsidies. When these subsidies were increased under the IRA Act of president Biden the enrolment has doubled in the last 5 years to $24 million. These subsidies expire in 2025. Under the One Big Beautiful Act the policy of subsidies for ACA is not being renewed when it expires in 2025. This shows the band aid approach of Obama to healthcare and the lack of a comprehensive approach. The policy on migrants during the Obama and Biden administration also stretched public funding resources. Insurance companies now plant to make up for the los of subsidies from the government by raising prices for this subpopulation in a broken healthcare system in the US by 15-20%. This report in WSJ shows a young woman on ACA insurance in Illinois with a payment of $590 a month to Blue Cross of Illinois facing a new payment of $678, almost the size of a mortgage. ...

LyrArc Article Gist
Epic Systems of Verona, Wisconsin, is one of the companies engaged in digitizing health records. It has helped develop records for 40 million patients in hospital systems such as Cedars-Sinai Medical Center in Los Angeles, Kaiser Permanente, the Cleveland Clinic, and John Hopkins Medicine in Baltimore and the Weill Cornell Physicians Organization of New York. Epic provides the software, the IT systems, the training and support. Epic is one of the pioneers in this, having been in the business for 30 years. About 40% of primary care doctors in the U.S. and 25% of hospitals use electronic patient records. The Federal government has provided $2.7 billion in funding from $27 billion of Stimulus funds assigned for the purpose of conversion to electronic medical records. This is likely to speed up the conversion. Other providers are Cerner, Allscripts, Meditech, Siemens Healthcare, G.E. Healthcare, and IBM. Epic Systems is considered the defacto standard in the industry for medical schools and some of the major hospital systems in the country. New contracts are leading to a major expansion of Epic Systems which employs 5100 people. Epic plans to hire an additional 1000 people. Revenue for the privately owned company are estimated at $1.2 billion, a 45% increase over the prior year. Epic is expected to have 127 million patients under medical records by mid 2013. To get the feedback essential for such a large conversion, CEO Faulkner relies on feedback from 250,000 doctors who use the Epic systems software, and on nurses and doctors from Epic who visit customer's sites to see first hand how it works and what needs improvement. Judith Faulkner started Epic more than 30 years ago. A project for the Psychiatry department led to other projects after she graduated in computer science from the University of Wisconsin. Epic continues to attract programmers to Wisconsin by making the Epic campus a fun environment and a great place to work. ...

LyrArc Article Gist
Germany, the UK and Canada offer additional models for health care insurance that vastly improve results for dollar spent over the dysfunctional U.S. model. Here Jamie Daw take a look at the German social health insurance system which dates back to hte period of Bismarck in 1884. The German system is funded through progressive taxation which charges for healthcare based on incomes not on health needs.

About 100 nonprofit health insurers provide insurance and all Germans are required to have health insurance. Contributions to sickness funds are centrally pooled and allocated using a formula to insurers. Insurers can only charge small out of pocket fees limited to 2% of income annually. Sickness funds combine market power to negotiate lower prices.

Administrative and governance costs are 3% in Canadian system and 5% in the German system. 

LyrArc Article Gist
Abbott Labs acquisition of Piramal Healthcare for $3.7 billion gives it 7% of the Indian market. Acccording to IMS Health emerging markets drug sales for 17 countries went up from $42 billion in 2000 to 126 billion in 2009. Anlysts expect 70% of global growth to come from these areas in next 5 years.

LyrArc Article Gist
Republican governors hold governorships in 30 states in the U.S. They have a different perspective on the expansion of Medicaid envisaged in the healthcare law, as long term funding for the expansion is uncertain. With the deficit reduction planned in negotiations between president Obama and the Republican controlled House the outlook for money going to state funding is precarious.

LyrArc Article Gist
Is G.M. pushing too early for an I.P.O. offering in the fourth quarter. Would a year or more of good results improve the chances of making an I.P. O. on attractive terms. By then the proceeds could be used to invest in growth, fund healthcare and pension liabilities, instead of just offering an exit for the government.

LyrArc Article Gist
With unemployment at 27% millions of Greeks and the elderly like Nikos Solomos, 60, cannot afford premiums and have joined the ranks of the uninsured. Greece's budget cuts have hit the health care sector hard because of mismanagement and corruption with prescription drugs costing about three times the cost in other EU countries. Cuts in heathcare are over 25% since 2009 and more cuts planned. Anthony Faiola with contribution from Elinda Labropoulou provides an exceptional account of the state of health care through the stories of ordinary Greeks like Nikos Solomos with intestinal cancer and the shortage of staff, equipment and supplies at Metropolitan Community Center in South Athens and Gennimatas General Hospital. Problems now include a resurgence of tuberculosis. Some of this pain is being felt in other EU countries with sharp cuts in public health spending, including Spain and Ireland.

LyrArc Article Gist
The Economist cites the Dartmouth Atlas Project which shows differences in cost across the country for health outcomes and spending involving Medicare. It cost $5000 per person in Salem, Oregon in 2006, $8000 in San Francisco, and more than $16,000 in Miami, with outcomes for health tending to be better in places where the costs were lower. This is one of the statistics that Peter Orszag of the Congressional Budget Office uses to come up with his estimate of 30% waste in health care spending in the United States. Prof. Skinner at Dartmouth and Prof. Garber at Stanford point out that of most health systems around the world the American system is "uniquely inefficient" and wasteful. The Economist cites information that the American system is twice as costly per person for healthcare than the Swedish system, and that it costs twice as much in Minnesota as in Miami. A poll done for the Economist shows 52% of the people in the UA are dissatified with the quality of care, 40% think the system needs fundamental change, and 29% think that it should be fundamentally rebuilt. The lack of uniform coverage is also causing turmoil in the system. About 49 million are uninsured, and a quarter or more are able to buy insurance and do not buy it because it is so costly, has exclusions and coverage is inadequate. But these people also end up in the emergency rooms along with the indigent costing the whole system tens of billion of dollars for costly late interventions that could have been avoided with preventive care early on. With the economic crisis and rise in joblessness, the dire condition of state and local budgets, the situation has probably drastically worsened, and the system near breakdown. ...

LyrArc Article Gist
How the French health care system works. France comes in first and the USA 37th in aWHO health care ranking. THe difference in deaths from respiratory disease is half that in the USA, and lower rates of death from heart disease and diabetes. IT has more hospital beds and doctors per capita than the USA. 65% of French people are satisfied with their health system compared to 40% in the USA, and yet France spends 10.7% of GDP on health care and the USA spends 16% for poorer results. THe French system is more generous to its seniors. Unlike Medicare there are no deductibles, just modest co-payments that are often dismissed for chronically ill. And diabetes and critical surgeries are covered 100%. French also buy supplemental insurance like Medigap for extra expenses like dental and eyglasses. Cancer patients are treated free of charge. Avastin treatments costing $48,000 a year are provided at no charge. France's PMI or Protection Maternelle et Infantile, is rated highly. It is anetwork of thousands of healthcare facilities, that ensure that every mother and child in the country receives basic preventive care. Mothers even receive afinancial incentive for attending their pre and post natal visits. France makes this care affordable by reibursing doctors at a much lower rate. The average yearly net income for doctors is around $55,000, about athird of what doctors in the USA make. But French doctors don't have to pay back huge student loans as medical school is paid for by the state and malpractice insurance premiums are only a tiny fraction of that in the USA. And again the French government pays two thirds of the social security tax for most French physicians- which is typically 40% of income. So the $55,000, is more like $92,000 taking that into account and more like $110,000 when student loans and malpractice is taken into account at US levels. Specialists who have 4 or more years experience can charge what they want, but as one gastroenterologist says, there in an unspoken and undefined limit to what you can cahrge or what is socially acceptable. Yet even in France there is inflation in health care costs that the government deals with through price controls and more spending. The French national insurance system is running increased deficits each year and this is now $13.5 billion, and it has led to higher taxes for employers and workers. ...

LyrArc Article Gist
California's governor Jerry Brown has put forward his budget plan for fiscal 2013 showing a budget surplus of $851 million. Brown was able to get Proposition 30 passed in the November 2008 elections. Higher income earners pay more in taxes for several years and the sales tax is increased. An improved economy with unemployment down from 11.3% in 2011 to 9.8% in Nov. 2012 is helping with higher tax revenues. General fund revenues are expected to increase 3.3% to $98.5 billion in the 2013 fiscal year from $95.4 billion the prior year. Brown has accomplished a remarkable feat of balancing the budget for 2013 and still continuing to invest in education and healthcare. Spending will increase 5% to $97.7 billion in fiscal 2013 from $93 billion in fiscal 2012 with higher spending on education and health care and lower spending in other areas. Brown's path to achieving this was eased after Democrats won control of both houses in the the state legislature. Says Brown: "Right now, for the next 4 years, we'll be talking about a balanced budget, we're talking about living within our means... This is new." Even Republicans praise this effort from a veteran of California politics- his father was governor in the Kennedy years, and he was governor in the 1980's....