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Walmart is going to require employees to use certain hospitals for costly spine surgeries, an effort to weed out unnecessary procedures and lower healthcare costs. The retailer earlier used a voluntary scheme to get employees to use the hospitals offering lower cost quality care, but found that half of the people needing spine surgery who volunteered to travel decided not to undergo expensive spine surgery. A spinal fusion surgery costs $77,000 at Mayo Clinic which tries to first see if other options of physical therapy can do the job. Walmart has insurance coverage for 1 million people.

Costs are going up and up. The average cost of family health plans from employers is up 5% this year to $20,000, with workers paying one third of cost, a survey by Kaiser Family Foundation shows. 

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The Biden administration has limited the conflict in the Middle East through maintaining relations with the government in Tehran. Now more than ever there is a need for the kind of stable well thought out policy in the long term interests of all nations including the US, Europe, China and India for a peaceful solution to conflicts- this is being pursued by the Biden administration. It is possible because president Biden has focused on economic growth for all and extracted America from the entanglements in the Middle East in Iraq and Afghanistan that have undone previous presidents and US development.

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Boris Johnson wins an 80 seat majority for the Conservatives in parliament in the 2019 election. He gets a mandate for a quick exit from the European Union by the end of January 2020, and billions of dollars in public spending on infrastructure, the NHS, and public services. He gets an unexpected 364 seats in parliament after winning the support of working class voters hurt by the financial crisis and by industrial decline. Working class voters in the north of England and the Midlands decided to trust Mr. Johnson. The Labour party won 203 seats, its lowest total since 1935.  The British pound surged to its highest level since May 2018, and domestic stocks surged with their best day since 2010. Part of the optimism stems from the size of the win that gives Johnson more flexibility at home and more leverage with the European Union to negotiate Brexit that works best for Britain. Working class areas that suffered for decades with loss of heavy industry, decaying infrastructure and poorer public services put their trust in Johnson's pledge to spend more to revive these areas. Johnson called his government "The People's Government" in his victory speech and promised to spend $131 billion on infrastructure, the National Health Service, schools, and public services. Johnson said in the speech that working class families may- "only have lent us your vote. I am humbled that you have put your trust in me, and that you have put your trust in us. And I and we will never take your support for granted." The other big event in this election is the election win in Scotland of the Scottish National party winning 80% of the seats and seeking a referendum on independence. Mr. Johnson has stated that he clearly opposes this. In Northern Ireland a majority of legislators were elected who favor unity with Ireland. This sets up a constitutional struggle that Mr. Johnson faces in his first elected term in office.   ...

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King points out that trade agreements are not what they used to be as most tariff barriers are whittled down. He says more than 70% of imports come into the U.S. duty free, and the average tariff is about 1.5% declining significantly in the last 2 decades. If all import restraints are lifted it would increase U.S. economic output by less than 0.05% by 2017, according to the International Trade Commission. This figure is also cited by Krugman in the NYT with a column saying the Trans Pacific Partnership(TPP) trade agreement pushed by the Obama administration is no big deal. King also points out that the U.S. already has free trade agreements with Australia, Peru, Chile, Singapore and other TPP countries. Some experts see China's success with setting up the Asian Infrastructure Investment Bank (AIIB) attracting India, UK, Germany, France and other countries, is creating pressure on the U.S. to come up with its own response in the form of TPP with Japan, Vietnam, Malaysia, Peru, Chile and other countries....

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Fears that India may be falling behind China, Mexico and Brazil in healthcare for the people. A planned budget increase was never implemented. Today the Indian government spends only $20 billion on healthcare for a population of over 1 billion people. Annual spending on healthcare is about 1.4% of GDP. Now the Indian government is planning to increase this to 2.5% of GDP. One senior health official Amarjeet Sinha, says other emerging economies such as Brazil, Mexico, Malaysia, now have better public health indicators than India. In 1990 India's public health indicators were similiar to those countries. Another serious problem in India is malnutrition with an estimated 4 of 10 children malnourished. Underinvestment in healthcare is a significant problem as needs grow but there is a shortage of resources and trained healthcare personnel. Arvind Singhal, chairman of consutancy Technopak, says India needs an additional 1 million doctors and 2.5 million nurses to meet the needs of the current level of the Indian population. To do this 600 new medical colleges and 1,500 nursing colleges are needed. The child care advocacy group Save the Children UK, points out that just to meet India's committment to reduce the infant mortality rate by two thirds of the current level by 2015- to meet India's commitment to the UN Millenium Development Goals- India will need 2.6 million additional trained health workers. This shortage is most acutely felt in rural areas, especially in the large states of Uttar Pradesh and Bihar....

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Frederick Harris of Columbia University says there is a price to be paid for a black president and it may just be too much for the average black person. There is a difference betwen symbols and substance, betwen a role model and accountability in a representative democracy, which is sadly lacking when the black elites, clergy and politicians fail to debate the issues about the problems facing the black community. Problems related to the increasing poverty among black Americans, and the 14% unemployment for black people. There is he says a strange reticience among the black elite to hold the president accountable on these issues just as they would have done for any Democratic president, even one who was as popular with blacks as Mr. Clinton. He says the experience with Obama is not even remotely comparable to the transformative nature of the work of Rev. Martin Luther King in the black community. It may stem from Obama's multiracial background, growing up in many countries, his elite education and being part of a liberal elite more than of the black community. The price is too high in economic and social terms for the poor or average black person and it has created a divide between the average black person and the black elite, with different concerns and different priorities. Harris points out that poor and poverty are words not mentioned often by Obama. Related to this is the foreclosure crisis in which ordinary black people were hardest hit with no effective help from the president to homeowners badly needing relief. Sheila Bair of the FDIC and Martin Feldstein advocated aggressive help for homeowners under water which did not come from the president. Showing not just the limits of a black presidency, but false hopes, inexperience and lack of leadership in issues that mattered to all Americans in the housing and foreclosure crisis. A populist from Kansas, as Sheila Bair describes herself, had the right instincts and courage of convictions which the president lacked and the entire country needed....

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As airlines charge for food they are getting more feedback from customers and they are collecting this feedback to learn what customers want and what kinds of food to carry. Delta and Midwest and US Airways are lloking at different food options that are healthier and liked by customers. Delta and Midwest have hired Chefs from restaurants to come up with better nutritional and flavorful dishes that will appeal to customers. Customers who take longer flights or who change planes with very little time to get food in the stopover time are dependent on getting something good from the airline food or staying hungry. These travellers are willing to pay more for better food. The whole shift to having customers pay for food may result in better food choice and menus which are healthier and flavorful. Certain kinds of foods don not hold up in an airplane environment and chefs are experimenting with menus and choices that will be best suited for this. One traveller faulted American for serving a huge cookie thats like a half pound size. It shows how little thinking goes on in airline offices about the food thats served. Already US airlines are falling behind in getting newer planes and some airlines are usoing really old planes that aren't fun to travel in now add the discomfort from badly thought out or not thought out at all food and imagine the onboard experience. see th link to how US airlines are falling behind in getting new planes and the links to all the flight delay especially into New York....

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President Biden visits the Polish town of Rzeszow close to the Polish border with Ukraine. It serves as the headquarters of the 82nd Airborne Division and Us operations to supply weapons and humanitarian aid to Ukraine. The Russian offensive met with stiff resistance and incurred high casualties in Ukraine with this WSJ report showing 40,000 casualties in the 150,000 Russian invasion force, making it less effective. 
Russia appears to have scaled down its objectives to focus on the separatist Donbass region in the east. The offensive on Kviv, Odessa and Kharkiv is stalled with stiff resistance. About 10 million people have been uprooted.  3.7 million people fled Ukraine, with 2.2 million crossing into Poland.

The US has warned that it would respond if Russia attempted to use chemical weapons. 

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Scientist Kim Mishra at the Swiss Federal Institute of Technology has come up with a method to make chocolate not just from the cocoa seeds discarding the pulp, husk and juice as is done today. This is wasteful. The new method uses the cocoa pulp, the husk and the juice as a way to make chocolate without sugar and use the whole fruit. This will reduce the impact on the climate with more chocolate production and less deforestation for new cocoa planted in South American countries as an addition to production in African countries like Ghana. It will also benefit cocoa farmers in Africa and Guatemala by increasing their income. This report looks at the colonial past of chocolate production by companies such as Lindt as Swiss producers worked with French and British colonies to expand production in the late 19th century.

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Amitabh Kant reflects on his 6 years at Niti Ayog planning for development in India. He says energy transition is an important part of development for India. The integration of India as a major part of a new supply chain for the free world is a critical part of India's development. Kant talks about the aspirational districts program that covers transformation of the lives of 80% of India's people living in 112 districts. Moving India up by 79 positions on the World Bank Ease of Doing Business rankings is also one of the tasks he looks back at with a sense of achievement. Parmeswaran Iyer who headed the Swachh Bharat and Jal Jeevan Missions will now be new head of NIti Aayog, the organization that is driving India's development to 2030 and 2040. Niti Ayog stands for National Institute for Transforming India. Its pillars are- 1. Pro-people  2. Pro-Activity  3.Participation 4. Empowering 5. Inclusion of All 6. Equality 7. Transparency It has a maximum of 4 members. Suman Bery is vice chairperson appointed in March 2022. The members are appointed by the prime minister. It is different from the earlier Planning Commissions under Nehru in that it does the work of being a think tank yet the allocation of funds and decisions come under the prime minister and the finance ministry. ...

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Krugman says the kind of spending on helping the US economy never happened. That is relative to the size of the US economy, not much happened uder the Obama administration. As evidence, he cites the figures that total government payrolls have declined by 350,000 since January 2009. And he says government purchases of goods and services increased only by 3% in the last 2 years.

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Guardiam Oped by Keir Starmer for Britain and Mette Frederiksen of Denmark  December 9, 2025. Both leaders of socialist parties in Northern Europe, and Starmer now keen on following the example of fighting illegal migration set by Mette Frederiksen in Denmark. "When trust in government to confront the challenges of today falters, our sense of shared belonging can begin to crack. As the prime ministers of two great European nations, we will not let this happen." "That’s why we are both taking practical action to fix the asylum system. Denmark has led the way here, with tough but fair reforms which have delivered results. Last year, the number of people being granted asylum in Denmark was the lowest in 40 years, excluding the Covid year of 2020. The UK has taken similar steps. After years of gimmicks and failed policies, we are going further than ever before with action at home – surging removals of those with no right to be here and making settlement reliant on integration and contribution, while pushing for coordinated international action too." This addresses the problem of illegal migration to Britain that is threatening to create further divisions in Britain as if Austerity, Brexit divisions, followed by Covid have not rocked Britain enough already. Starmer says he will protect Britain's borders to protects its democracy, and that responsible progressive governments can and will deliver on the change people are crying out for- Britain will follow Denmark's example. They will join Italy, Germany, Austria and other nations that are moving in this direction. ...

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Overseas business locations of US companies offer a way to avoid American government oversight where the business practices have severe adverse effects on the finances and well being of the American public. What responsibility must the US take for ensuring that the deliberate use of such locations to operate independently of government oversight with practices that hurt ordinary Americans savings, is the subject of this report in WSJ. Cryptocurrency firm FTX operated from the Bahamas before being charged with fraud by the US government. 

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China's campaign against corruption and the popular programs that the Chinese government of Jinping encourages on television. This includes the 52 part series on television called "In the Name of the People." The programs show how the Communist party's upright officials stand up against the corrupt ones. The idea is to build up the reputation of the Communist Party, as it sagged under the previous administrations during the period of rapid growth when such behaviour was tolerated to in some ways.

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A Smithsonian Museum exhibit on the slave trade and 36,000 voyages, 12 million people on the ships to Brazil and the US. It tries to tell the story in a way that will be constructive to bring people together, and also tells stories of free black men and whites who did not enslave or opposed it.

It tells a transnational story instead of a regional one- how it affected the whole world. The exhibits will travel to the Iziko Museums in Cape Town, South Africa and to the Museum of Black Civilizations in Dakar, Senegal.

Of the 12 million it is less well known that 500,000 made it to the US, 5 million made it to Brazil.

Individual stories of a woman Diarra in Mali walking hundreds of miles to a free colony in Senagal where slavery was abolished. Of a man Tahro in the Kongo kingdom brought in 1858 to the US in the Carolinas even though slave trade was banned by the US Congress in 1808.

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Zelensky calls PM Modi on Dec 26 as India takes on the G20 presidency in 2023, and the presidency of the UN Security Council as an elected member for the month of December 2022. He asks PM Modi to pursue a peace formula for a settlement on the war in Ukraine

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Hagel did exactly what the White House expected him to do, say experts, including not coming up with any large ideas on the defense forces, tackling the budget cuts, working with the rank and file in the military, and implementing the administration's policy of reducing involvement in foreign military conflicts. Hagel's role was limited by micromanagement by NSC officials and Hagel was seen as deferential to the military chiefs and generals who had different views of the conflicts in Syria and Afghanistan- some generals seeing the administration's response as hamstrung by keeping resource committment to the minimum in Syria and others saying not enough resources were there to extend involvement to places such as Aleppo in Syria. Hagel resigned after pressure from White House officials who realized the inadequate nature of the very things that the White House expected of Hagel- following what the public sees as failures in the Middle East.

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A quick look at the graph in this Times Report shows the carbon dioxide CO2 emissions for the US, European Union, China and the Rest of the World in 2020. For the EU it is about 3.0 billion tons of CO2 emissions, for US it is 5 billon tons, for China 10 billion tons and the Rest of the World 16.0 billion tons. What this tells us is that a lot will depend on not just China, but India and other countries such as Brazil, Mexico, Indonesia in the developing world for how much CO2 emissions can be reduced to tackle climate change and other environmental problems.  For that 16 billion tons in the rest of the world reduction will depend on renewable supply and technologies to do it, rapid growth of economies in India and other countries to generate the resources and technology initiatives to get a shift from coal. Meanwhile it is a choice between having electricity for homes in rural areas in India or not. This is where bright spots such as solar technology in India that are giving quantum leaps for renewable solar energy with new technology cutting cost in successive waves of development can play a part.  ...

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The mistakes  and the right action done in Italy that the world can learn from as Italy tackles the coronavirus. The coronavirus is a dangerous pandemic yet there is one part of it that can be used to take the right action. The timeline of countries affected early in January and February and early March with information from these countries on what worked very effectively and what did not work with bad results is available. The mistakes were made in Bergamo, a town in Lombardy region of northern Italy with the highest number of infections and deaths in Italy. Bergamo had limited testing, no rigorous attitude for quarantining those who had come in contact with people testing positive, and lack of contact tracing. In Vo another town in northern Italy the situation is a complete contrast with resort to mass testing and isolation of clusters which has reduced infections to zero and made it a safe place. Vo is a small rural town 85 miles east of Bergamo in the Veneto region. This was the method used in South Korea, China, Taiwan and other Asian countries that have overcome the virus. Bergamo is an example of what failed in Italy with the worst number of fatalities. The health crisis worldwide has shown this  method of first general quarantine to buy time to build capabilities for testing  and preventing things spiralling out of control,  then mass testing, contact tracing and isolating the people who test positive, and repeating this process again and again till infections are way down,  is the only way to control this crisis. In the early days massive quarantine or stay at home strictly enforced is the best solution till production of tests accelerates to permit mass testing and isolating the clusters of infections. This mass quarantine buys time for accelerated production of tests and building up the capabilities of labs to process these tests, including use of a central national lab centre with national data on computers for microbiologists to monitor the entire country. This was done in South Korea reports in WSJ show. This is vital for everyone involved in the effort to control the virus to understand based on the experience of  countries that have successfully overcome coronavirus. It is the experience in South Korea and Italy that the U.S. White House response coordinator Dr. Brx is looking at and learning from as she and the White House team in the U.S., governors of all 51 states, health officials including CDC, are looking at as they execute their action plan in phases.  ...

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Medicare Supplemental insurance (also called Medigap) covers out of pocket cost that are not covered by Medicare Advantage. Over long period of retirement thes plans offer the best protection from unanticipated costs. The Plans use alphabetical leters A B C D F G K L M N with F discontinued. And are standardized, meaning regardless of insurer or state you are in they are the same being set by the US federal government. These plans are sold by private insurers the largest being AARP plan by United Healthcare. One can join when enrolling for Medicare Part B when premiums are usually better yet one can also join afterwards. About 36% of Medicare holders have Medicare Supplemental or Medigap policies for health insurance.

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Exxon is looking for a big oil dealer in the shale patch in the US. It is considering the acquisition of shale company Pioneer Natural Resources with a market cap of $49 billion. Exxon wants to make use of its windfall profits of the last year to good use. An acquisition of Dallas based Pioneer would give Exxon a dominant position in the West Permian basin of Texas and New Mexico. Exxon made windfall profits of $56 billion in 2022 after the jump in oil prices following the Russian invasion of Ukraine. Based in Irving, Texas, it is heavily invested in fossil fuel assets and its thinking is that fossil fuels are here for a long time as it has not made a significant shift to renewable energy. During the cutoff of Russian oil supplies Europe has depended on LNG supplies from the US and Qatar, and on Norway for increased oil and gas supplies. President Biden included drilling concessions in some of the legislation passed in Congress and Conoco plans to drill in Alaska. The transitional period has gained support in places like the US and Norway following the need to support the European Union and Germany in the crisis. This gives oil companies some time to sort out their future plans for renewable investments. ...

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By failing to show a grasp of the problems of rural poverty and lack of upward mobility, of health and education, in the rural parts of the US, Paul Krugman ignores the spirit that for so long kept the lights on for rural America in the time of FDR and Truman. The NYT's Thomas Edsall has done a great service to America by showing where the Democratic party under Clinton and Obama lost the spirit of FDR and Truman of standing by the common man, of "The People, Yes" that Carl Sandburg wrote so eloquently about not so long ago.

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The NYT's Kristof gives this exceptional report on the use of cancer causing chemicals all around us in many consumer products. With the increased use of chemicals has come the tripling of asthma rates in the last 25 years, leukemia up by 1% a year, increasing obesity, and breast cancer rates increasing from 1% in 1975 to 12% today with only some of it from better detection. Doctors at the Mt. Sinai School of Medicine in New York, say American girls who had puberty at the age of 17 in 1800, now have puberty at the age of 14, even 12. Earlier menstrual cycles increase the risk of breast cancer because of increased exposure to estrogen. Studies show exposure to pesticides, PCB's and other cancer causing chemicals increase the risk of cancer, and a link to early puberty. Asian women moving to the U.S. are also experiencing higher rates of breast cancer as they move to societies with higher use of chemicals in daily life, say experts at Mt. Sinai. Poor eating habits and lifestyles with less exercize are also to blame, but chemicals also play a role. Americans are moving towards shunning packaged processed foods for fresh food in their diet, and more are learning the benefits of regular exercize, but the same degree of public awareness is lacking for the extensive use of chemicals in our consumer society. In other societies around the world that are copying us such as in China, India and Brazil, the situation is even worse, with the spread of a reckless idea that modernization requires jettisoning health safety concerns. Even a simple pizza box has PFAC's chemicals made to make the box resistant to grease. In 2015 where products are labeled environmentally friendly by large companies to attract buyers and build the right image in the minds of consumers, consumers asking questions and making better choices make a difference by offering a seal of approval. Carpets have chemicals, and most disposable plastic containers contain chemicals that could seep into the food if heated. The use of plastic containers and microwaves is common practice in todays society, where less cooking is done on the stove than in the period before 1960. The sheer size of the chemicals developed since 1950 is staggering- more than 80,000 chemicals according to the Children's Environmental Health Center at Mt. Sinai. And this Center says less than 20% have been tested for toxicity. ...

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All sectors of the U.S. economy see an increase in hiring, including retail, transportation, healthcare and manufacturing, as the economy adds 288,000 jobs in June, according to the Labor Department. Manufacturing added 16,000 jobs, transportation 17,000 and the public sector increased jobs by 26,000. Hiring also picked up for high school graduates compared to the poor record in 2013. In 2013 one Barclays economist says the jobs for high school graduates at this point were declining by 16,000 a month on yearly basis. He says employers are now adding 29,000 jobs for high school graduates a month in 2014. The unemployment for high school graduates declined to 5.8% in June 2014, for persons with some college education or an associate degree 5.0%, for college graduates 3.3%. Barclay's estimate is that the U.S. added an average of 231,000 jobs a month for the first half of 2014. The inflation rate remains at about 2%, giving the U.S. Fed more flexibility in setting rates to support jobs growth. The lower unemployment rate of 6.1% understates the underemployment, as a more accurate measure of employment which includes people working part time because they cannot find jobs is at 12.1%. The proportion of Americans in the labor force is also at a 36 year low of 62.8%. These two indicators for unemployment, unemployment including people working parttime, and the proportion of Americans in the labor force, combined with inflation, are the main indicators Fed chairmam Yellen is looking at....

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The Labor department reported that unemployment surged to 10.2 % in October 2009. 190,000 jobs were lost in October 2009. Ther breakdown lokks like this. Construction lost 62,000 jobs, manufacturing lost 61,000 jobs forming the bulk of the job losses. Its interesting to note that only 16,000 jobs were gained in the federal government and 16,000 jobs were lost at the local government level making the net gain zero at the government level. And what was gained in the health care sector 28,700 jobs and in educational services 10,700 jobs for a total of 39,400 jobs was completely offset by 39,800 jobs lost in retail sector. The useful point here is that local governments are hurting and retail sector is hurting and little is going to change this as long as job losses continue and the gains at the government level and healthcare and educational services are simply offset by losses inretail and local government. This situation will likely ocntinue into 2010. The losses in manufacturing are likely to continue. A sample of companies like Eaton, Boeing and John Deere shows that 2010 will not generate many jobs. Eaton has decided to have its 55,000 employees take aweek of each quarter, so there is one twelfth work capacity unused which is where Eaton will turn to before hiring. At Boeing there are layoffs of 10,000 planned but its also hiring 3800 workers for anew factory in South Carolina, and at John Deere 452 workers will be recalled in November but in December there is aplanned shutdown. A September Survey by Business Roundtable found that 13% of firms planned to increase employment in the next 6 months, but 40% planned to cut payrolls. So manufacturing looks to go on like this in 2010 with slowing but continued job losses. The numbers show that in October the median number of weeks it takes to find ajob up to 18.7 weeks which is the highest number since the sixties. What gets ignored by the small print you find it in the Wall Street Journal is the broader unemployment rate which is 17.5% when you include those who have stopped looking, those who work part time but need full time work and the marginally unemployed. The rates jump for younger workers here and in Europe also. ...