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Shigeru Ishiba was reappointed LDP party secretary-general in Japan. Ishiba served three terms as defence minister, is popular with the rank and file and the public. He has a good grasp of security issues. He will be the No. 2 person in the cabinet after prime minister Shinzo Abe. Ishiba was the first LDP official to give a specific trading range for the yen by publicly calling for a range of 85 to 90 yen to the dollar. The yen closed at about 85 yen to the dollar on Dec. 25, 2012. Two women join Ishiba and Abe in the leadership positions. Seiko Noda is now chairwoman of the party general council. And six term parliamentarian Sanae Takaichi is policy chief for the LDP.

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George Fisher is the presiding outside member of the Board of Directors. He does not appear at all affected by the magnitude of things going on around General Motors when he answers questions about GM having stayed with trucks for way too long and not invested early in cars and fuel efficiency in a manner which says almost boldly, "so what?" He makes statements one does not expect like the one that "we are absolutely convinced that we have the right team under Rick Wagoner" " and the "Board agrees to a person that" and so on. Can one be absolutely convinced about anything if one is careful and does one say it out loudly, especially in these uncertain and very risky times.

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WSJ looks at the changes in the way medicine should be practiced in the light of what we have learned from the pandemic.  Medicine practiced before the pandemic and still today relies mainly on a visit to the doctor or specialist who is short of time. There is a shortage of doctors. Patients have many illnesses as a result of decades of neglect of proper nutrition, and exercize habits. Obesity is at about 40% in the U.S. about 30% in the UK and 17% in France, and high also in other parts of the world. These high rates were unknown throughout history and result in many illnesses and increase by four times the vulnerability to the coronavirus. One authority in medicine calls obesity pouring gasoline on a fire for effects of the virus.  A doctor's appointment with doctors short of time with no coordination around a whole range of factors related to obesity, illnesses, health checkups, mental health, is now seen as a heavily handicapped way to practice medicine or for patient healthcare and wellbeing. The alternative is discussed here as the way forward. A  team will be responsible for a patient's care not just an individual doctor. The team would care for general health after a patient's checkup, cover individual illnesses, weight issues, mental health, exercize nutritional needs and other good healthcare habits. Instead of relying on doctors at a time of shortages of doctors the team would be led by nurse practitioners.  A nurse practitioner is someone with a bachelors degree and a masters degree or doctoral degree in nursing with 1000 hours of clinical training. Studies have shown that they are effective and even more effective than individual doctors. Today particularly with the problem of doctors with limited time compounded by the built up problems of decades of bad habits in nutrition and exercize and poor "cultural" habits getting entrenched, there has never been a greater need for a better way to practice real healthcare for a person's wellbeing. Particularly in rural areas with an even larger shortage of doctors the health practitioner led team will play a big role. Patients will under this setting receive more care virtually and get more followup care by phone and video messaging. The numbers tell the story- there are shortages of doctors in USA, Europe, Africa, Latin America and Asia. In the U.S. shortage of doctors is 55,000 projected to 2033 by Association of American Medical Colleges. There are 290,000 nurse practitioners licensed in the U.S. and 131,0000 physician assistants. The goal will be to get an adequate number of nurse practitioners licensed in this decade to take care of these teams. The pandemic has made virtual visits to doctors and nurse practitioners popular. Medicine reimbursement should and would be practiced on the basis of how well a patient is doing not on a fee for each micro service that is delivered. For this to happen the teams led by the nurse practitioner have to commit to patient education of the benefits from good practices and good habits for nutrition, exercize, caring for oneself. A doctor short of time is hardly the person to carry on this patient education which is where the major opportunities for a new system arise. The virtual care also provides a new medium for patient education and awareness of the risks of getting illnesses, preventive actions to be taken in advance. One approach being tested in California and Texas is for a monthly fee for patients more payments by health plans to doctors or healthcare teams if the patient is healthier. Additional health professionals are added to the team including health coaches, dietitians and medical assistants to increase its effectiveness in counseling and education and monitoring.  The nurse practitioner team approach is already being practiced in parts of the U.S. including the example of New Hampshire shown here, and is predicted to be the approach for primary care in the next decade. ...

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The inspiring story of Joan Poh, only the second rower to compete for Singapore in an Olympics. She rises at 5 am to workout as she also works as a nurse in a 10 hour shift at Tan Tock Seng Hospital. She has missed meals as she does her training in the midst of work as a nurse. She returned to working in nursing after a call from Singapore government for frontline medical workers in April of 2020. She sees sport as a dream, a luxury that one has to work for. Puts in 100% as a nurse and when rowing 100% as a rower.  At 5 foot 5 inches, 30 years old,  she is much smaller than other rowers, and uses her technique and training to compete. She is the oldest of 3 children who grew up in a 1 room apartment in Singapore. Without resources she learned to row on a long boat by joining a dragon boat rowing team when she was 17, then learned to scull in 2015 at age 25. In 2019 she took extended leave from her hospital to train for the Olympics in Australia. A Canadian who won Olympic Bronze in 1996 and 2000 coaches her free from Vancouver Island in Canada, using videos and workout programs, and went to Singapore when Poh qualified for the Olympics to train her in person. She looks at competing not just as medal winning, and sees this as one step in building a team in the right direction. She sees creating opportunities for others, and overcoming her childhood situation growing up struggling for resources. She says early on it was for her not wanting her lack of resources to decide what she could do. As she puts it - to always aim for a strong start even though one started with not such a good start. ...

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It may come as a surprise that even a conservative Republican Senator Lindsay Graham of South Carolina, talked recently on CSPAN television about the US needing immigration in an organized manner to meet the growing shortage of workers in the coming years in the US. This report by Alicia Caldwell in the WSJ looks at the city of Topeka, Kansas, home to University of Kansas in nearby Lawrence, which is trying to attract immigrants who are allowed to work to meet 6600 worker positions that remain unfilled. Mayor Michael Padilla of Topeka is a cross between a liberal Republican and a conservative Democrat as are many immigrants from countries in South America. The Greater Topeka Partnership is looking to attract Spanish speaking people to fill these jobs, because of stagnant population and a lower unemployment rate than the US average. This effort in Spanish language has resulted in 10,000 resumes submitted. Another effort for Uniting with Ukraine has brought 160 Ukrainians to Topeka. These efforts are happening since 2019 and in some cases the city has offered $15000 a person for relocation costs. Citywide the effort is being welcomed including the business community. Topeka, a town of 126,000 is home to 17% Spanish speaking residents. Molly Howey who heads Go Topeka and the Greater Topeka Partnership is shown here, and says Topeka had already had success with its Spanish speaking population when it started welcoming new immigrants.  The rapid recovery of the US after the pandemic and its resilience for growth over the next decade is creating a recognition among Republicans as well as Democrats, among economic planners and business of the need to fill shortages of workers as the US invests trillions of dollars in its economy in coming years in infrastructure, manufacturing and and new technologies. It is an effort that is unprecedented since the post war effort to build a modern economy in the 1950's. ...

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The Opinion given by the US Supreme Court shows the thinking behind its decision to call Affirmative Action or race based admissions by colleges unconstitutional, as violating the Fourteenth Amendment Equal Protection Clause. Because the respondents (Harvard College) use of race involves stereotyping and negative criteria the Court declared it invalidated. "It unduly harms non-minority interests," not permissible when all citizens are equal regardless of race or color. Proposed by Congress and ratified by the States the Fourteenth Amendment provides that no State shall "deny to any person.... the equal protection of the laws." Proponents of that law describing as the "foundational principle" as "not permitting any distinctions of law based on race or color." As WSJ shows today there are three times as many White as Black or Hispanic families in California making below $50,000 a year.  "That the law shall be the same for the black as well as the white, that all persons shall stand equal before the laws of the States." It was a blot on the face of America that this allowed racially segregated schools till this was changed, says the Supreme Court. It calls the Bakke decision to allow race based admissions as a deeply splintered decision and Judge Powell writing for himself allowed it only to allow the educational benefits that flow from a diverse student body. The decisions in Grutter stated that in 25 years this race based admissions should end and in no way can it be used for stereotyping or as a negative- to discriminate against those racial groups that were not the beneficiaries of the preference. A university's use of race could not be used to "unduly harm non-minority interests." It also means engaging in stereotyping- "a demeaning assumption that students of a particular race think alike."  ...

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The first rally for Harris in Milwaukee, Wisconsin. The road to the presidency goes through Wisconsin and Harris received enthusiastic support with Governor Tony Evers putting it this way-On the Tony Evers excitement scale that goes from ‘holy mackerel’ and maxes out at ‘heck yes,’ I am jazzed as hell to be welcoming our next presidential nominee to Wisconsin: Vice President Kamala Harris.” Harris used the same lines she used in Wilmington at her first rally in Milwaukee, Wisconsin. In her legal career, Harris said, she “took on perpetrators of all kinds. Predators who abused women, fraudsters who ripped off consumers, cheaters who broke the rules for their own gain.” “So hear me when I say I know Donald Trump’s type”  On project 2025, the blueprint for the first 100 days in office of a Trump second term, the action items are ones that would jeopardize the safety of American institutions that were set up with so much care by Thomas Jefferson, John Adams, and nurtured by the first president George Washington with little attention to himself, and protected by president after president through civil war under Abraham Lincoln, through 2 World Wars and The Great Depression under Woodrow Wilson and Franklin Roosevelt, through recovery under Harry Truman and Ike, only to falter under a series of mediocre presidents Reagan, Clinton, Bush, Obama and be endangered by a NBC television show and construction business person with support from new social media networks that were unknown throughout America history till 2010 and television networks that had degenerated into recklessly divisive behaviours to win silo audiences. ...

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The BBC looks at the conflicting agendas when it comes to China of Rubio at State and Tulsi Gabbard at Intelligence. Lighthizer is the positive in correcting the trade imbalance with China because he served as US Trade Representative in the first DJT term and has experience going back to negotiating with Japan under Reagan as Deputy Trade Representative.  Controversial are the appointment of a Fox news person Hegeth as Defense Secretary, as he has no experience running an agency, and this one employs 3 million people. Gaetz as Attorney General is being questioned by many Republicans, and in the Senate by Cornyn (R). On spending the Office of Government Efficiency is not a department and Vivek Ramaswamy age 39 years lacks experience in administration, cost cutting. Elon Musk has cut costs at Tesla and Twitter but has no experience handling budgets of agencies. Trump has promised more spending. The cost cuts would be the opposite of what he promised if it cuts essential programs not for efficiency but for viewpoint.   ...

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Jeannie Rice, originally from Seoul, South Korea, is a 71 year old marathon runner who runs the marathon in 3 hours 27 minutes and 50 seconds. She holds the world record for her age, after 3 failed attempts. Average pace is 7:25 per mile for 13.1 miles, which is something people aspire for at 30 years age. She runs 4 to 6 marathons a year. Her routine is to run 10 miles a day on average for 7 days a week with long runs on the weekend. She lives in Ohio and runs in the winter in Florida. The way she does it- take a day off before the race, keep several pairs of sneakers and change them every 3 months. She doesn't crosstrain much, preferring golf. She eats a lot of carbs, rice even white rice, pasta. She starts with a pre-run snack of a small banana and half tablespoon of natural peanut butter, coffee. Post run it is a bagel with avocado. Lunch is green salad with avocado. Dinner may be rice with shrimp and vegetables. Experts say training programs are highly individualistic. A fit person takes about 3 months to be ready for marathon running. Long runs are crucial. A 12-18 hour rest period after a marathon is suggested to allow tissue healing. Proper footwear and several pairs of sneakers are critical to avoid injury. ...

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The Southern Nevada Water Authority has cut water consumption coming from the Colorado River by 25% over 2 decades even as population has grown by 50%. It has done this by fining people for excessive use and paying landowners to remove turf grass. One television ad shows a person being scolded for excessive water use and the line "Vegas is enforcing water waste big time."  As a result of water conservation, water pricing, and replacing turf grass, the seven states fed by the Colorado River and the reservoir Lake Mead have seen much improvement in water usage. Lake Mead hit by a drought in the years 2000-2015 is now risen by 25 feet to 1096 feet in 2020 making it 44% full, the highest level in 6 years. The water conservation efforts in Southern California have yielded results. Metropolitan Water District of Southern California gave out $350 million in rebates for replacing turf grass. Irvine Ranch Water District cut drinking water use by 20% with higher pricing for inefficient use beyond a set limit. Building codes are amended preventing turf grass in front of homes. Lawns and golf courses replaced turf grass, with some golf courses using desert landscapes. In this area of 10 million people 200 million square feet of turf grass was taken out. ...

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Senator Lamar Alexander is a kind of misssionary for electric cars and for a major push with government assistance in this area. A bill sponsored by Alexander and Senator Byron Dorgan plans to designate 5 to15 urban areas as model locations for electric car use. These areas would get money for infrastructure such as recharging stations, and people in the areas would get an additional tax credit to take the tax credit from $7,500 to $10,000. The bill has important provisions for promoting research at companies and universities to improve electric car batteries. $1.5 billion would be allocated for research in electric car batteries, and a $10 million prize for the person or company able to build a battery with a 500 mile range. The total cost- $10 billion.

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Dr Kevin Lee, a British neuroscientist, heads EpiNova, a 60 person unit within Glaxo's R&D department. Lee founded two biotech startups before joining Glaxo. The smaller units called Discovery Performance Units are Glaxo's way of creating biotech startup like units which it is hoped will produce better results. The 36 DPU's in Glaxo R&D are given 3 year budgets and flexibility to make their own decisions for drug research. The large bureaucracy, scientists not working across fields and an older mindset are seen as obstacles in the search for new drugs. EpiNova with its own logo operates in a a Glaxo facility, an hour north of London. Decisions are made faster, says EpiNova chemist Dr. Wilson, and the atmosphere is that of a startup willing to try new approaches quickly.

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Are high prices for pharmaceutical products and healthcare services putting a severe burden on U.S. finances and defunding education, infrastructure, R&D in new technologies, which provide the underpinnings for future U.S. competitiveness? Yes say experts. In 2009 Americans per person cost of healthcare was $7,960. By comparison Canada was $4,808, Germany $4,218, and France $3,978. And without necessary efforts for educating people about caring for health and preventive care, the health conditions of Americans are no better than these countries, and poorer in some dimensions. Klein says deficits would not be a problem for the U.S. if prices for pharmaceutical products and healthcare services in the U.S. were similiar to that of the largest developing countries. Experts say the Obama healthcare law simply postponed the addressing of this problem.

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Akerson's last day at GM. He talks about saving GM and the selection of Mary Barra as the new CEO. In a talk with employees at the Detroit Rennaissance Center Akerson says about saving GM: " You had to feel you were doing something for the country. To let the industry go by the wayside... it could be fixed and I love an underdog. Although I am a Republican I knew the bailout was the right thing to do." He says about Barra that when she took the product development job things were in chaos, and Barra was a decisive person who did a miraculous job in an uncomfortable situation. About Barra's personal characteristics Akerson says- "she is humble, confident and decisive and she will move the needle- also a very balanced individual and well centred."

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The percentage of Americans snacking more than 3 times a day increased to 56% by 2010, according to government data. This was at 20% in the 1990's and 10% in the 1970's. And with this comes higher rates of obesity, as this has made for unhealthy eating and reduced the number of healthy meals. 48% of Americans skip meals 3 times a week and 53% decide what to eat for a meal less than an hour before eating, according to a Hartman Group survey. Not all snacks are unhealthy as food companies are introducing healthier snacks than before. The discipline of earlier generations for having a healthy meal at meal times has eroded with single person households, two career families, and the generally hectic pace of life.

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The GM restructuring plan of the Obama administration, as GM enters bankruptcy, was designed so that the UAW plays a constructive role in building the new GM. There is a wage freeze, and a no-strike clause until 2015. The union gets a 17.5% ownership of GM, which helps to align the union's interests in improving the share price. At the same time the unions health fund's shares are novoting, so that the union does not make decisions for the company. At Chrysler even though the union has 55% ownership shares, it has only one person on the Board. In the same way the union has a limited role in running GM. The idea is to get the union out of the us vs. they habits of the last 50 years.

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Comments about Edward Whitacre, who put AT&T together after becomng CEO of Southwestern Bell, and built the new business around cellular, wireless and internet services once the long distance market collapsed. Says board member and leader Kent Kresa, of Henderson and Whitacre, "they are both open to the ideas and opinions of others. I think there will be a good dialogue." Says a colleague Haskell Monroe, on the AT&T board, " he faces the facts, he looks for the truth and he is a person who takes responsibility for his decisions." Says Gerald Myers, a University of Michigan professor and former chairman of American Motors Corp, "he is'nt a loveableguy. He's not going to be your friend. He is blunt, but he is so often right that you accept the abuse."

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After meeting with Rishi Sunak, the Finance Minister and the Business Secretary Alok Sharma prime minister Johnson is keen on getting things to as normal as possible in the summer to save jobs. About 3 million jobs could be lost, some permanently if businesses cannot open by summer, especially in the hospitality industry. This could push unemployment up from 1.3 million  to 2 million. The Times reports that at one point in the meeting Johnson said "Christ!" In mid March after he had the virus and Britain saw a surge in cases Johnson made health a priority even quoting Cicero in Latin that the health of the nation was the priority. Now this is changing with the jobs situation becoming a major risk. Much of the loss of jobs is likely say experts in the red wall districts that Johnson took from the Labour party in the election, and the prime minister feels a special responsibility to these districts. Johnson also said at one point about youth unemployment 18 to 24 years that is bleak, that he wanted to have an apprenticeship for every young person. The critical R rate is higher in the northwest and the southwest of England, compared to London. In England overall it is between 0.7 and 0.9. It needs to be around 1 to avoid spreading the virus.  As part of the social distancing guidelines ministers are also discussing changing the distancing on public transport so that it is 1 metre instead of 2 metres, so that reopening to get back to close to normal can be done sooner.     ...

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U.S. healthcare spending of about $3 trillion comes with poor results. The cost per person is about three times that of countries such as France, Britain, yet the results show U.S. doing extremely poorly. The author points out that less spending on healthcare and more on social services in areas such as education, nutrition, housing and other services would improve the outcomes and results. It is this missing factor that is helping other countries in Europe, Japan and China achieve better outcomes and returns per dollar spent.  Social spending can affect such things as nutrition, exercize levels, lifestyles, housing and result in dramatic improvements in obesity levels for instance, or inflammation levels in the population that play a role in many diseases. The idea is prevention. This is not happening because higher health dollar spending has lobbies to support it. Social spending also is a dollar expense that shows up immediately whereas results are spread out into the future as a longer term benefit with healthier populations that need to consume less healthcare and treatment. Elizabeth Bradley, president of Vassar College is an expert on this subject. She says social services spending gives more bang for buck  in health outcomes.  The point is relevant also for countries in South Asia and Africa that have taken some on some aspects of the U.S. health system resulting in health care spending that does not deliver the most for the dollar spent, and ignores the critical role of prevention.  The solution lies in moving these health care dollars out of the health care spending and into education for health outcomes, lifestyles, exercize habits education, and into social services that enable prevention and better health. ...

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Tips from executives for designing home offices which inspire, promote creativity, are energizing, and have the technology to get things done. Here Joann Lublin provides examples of two fulltime commuters, a TV producer and a private equity executive who get a lot of work done from home offices, and a executive who uses the home office for creative work. The space uses the right colors, decor and pieces that bring out good memories, are energizing, and recreate the kind of natural environment the person feels most comfortable in.

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The situation today of the London and the Thames Valey region's economy and the economy of the areas surrounding it in the south. Its history,downturns in periods after the dotcom crash in 2000-2005 and the current expected downturn after the US subprime crisis, and the expected deterioration in the housing market here. As well as problems for the financial institutions in a tightening credit market with London's position as a key centre of international finance impacting the economy the most. Regional diffeernces in the current upturn London's output per person grew to 136 vs decline in output per person in Scotland Wales and the North, a 36% improvement in London vs deterioration elsehwere in the north and in Wales. With Newcastle in the north hit by the Northern Rock mortgage lender's collapse adding to the difficulties from a general decline in manufacturing. A general decline in industry in the north and the rest of the country outside the Thames valley region shows up in the numbers. From 2000 to 2004 according to official estimates, manufacturing declined from 17.9% to 14.1% and financial services around London expanded from 5.5% to 8.3%, and by 2006 to 9.4%. With a contribution of one tenth of the economy financial services account for 30% of overall GDP growth in the last 3 years and 30% of all corporation tax revenues which helped the Labor government finance its public sector improvements and infrastructure improvements. The current downturn will also lead to a sharp drop in immigration to Britain. Growth is expected to slow to 1.4% in London and in the rest of the country in 2008 which is lower than the 2% growth in London region in the period 2000-2005 when the last downturn in London occurred. The financial services industry spills out benefits to other regions and the rest of the country which is how the British economy has done well even with the lack of strong manufacturing, weak exports and strong currency. ...

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Putin's mother barely survived the siege of Leningrad in 1941. A plaque at the Piskaryovskoye Cemetry in St. Petersburg says 641,803 people died of starvation in the city from 1941 to 1944. She lost one child during the siege. Putin was born in 1952 and is the only surviving child.

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Fake news ads on Google Search are a couple of the hard to believe results Hiroko Tabuchi finds in one of his searches using the words "climate change." One ad says "Global Warming Hoax." More alarming is the way the Google algorithm and a person's search history is used by Google to send that person what he likes or approves. So that a NYT reporter's account may show a different ad on Search for "climate change" - mostly positive ones from Environmental Defense Fund. Tabuchi says some of the ads calling climate change false are still appearing on Google even after the New York Times alerted Google about the problem.  A perceptive observer would find that that this is exactly how Search can end up reinforcing people and dividing them into different camps hostile to each other. More significantly it might make people resistant to even hear another person with different ideas, a problem we face today in American democracy. ...

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The Italian cabinet of prime minister Mario Monti, includes Corrado Passera, CEO of Italy's largest retail bank, as minister of economic development and transport. In selecting his cabinet Monti brought in respected members from academia, banking, business and the higher levels of the civil service. Monti's agenda includes cutting public spending, increasing revenues, changing the pension system, reintroducing a property tax on first homes, and making it possible for business to hire and fire workers by changing Italy's rigid labor laws. Emma Marcegaglia, president of Confindustria, Italy's business association, says he is the right person to restore credibility and to put Italy back on the road to economic recovery. She had a high regard for the selections in the cabinet. The big challenge in her view was now to get the Italian parliament to approve the changes.