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Aizenman in this must-read describes the National Soda Summit and the presentation of one man Todd Putnam, a former executive from Coca-Cola that throws light on one of the truly important things that happened in the lives of Americans in the postwar period of development and growing prosperity. This is the development of marketing and advertising and its singular application in the case of Coca Cola to promoting sugary drinks. It is also related to what even business people describe as the single biggest problem in America. And it is happening at a time when the story is being repeated in developing countries such as China and India. Putnam describes the exhilaration, he and other Coca-Cola managers felt when the graphs at internal presentations showed Coke passing milk in consumption per capita in America. Several other facts stand out in Putnam's description of his experience- the ignorance on health issues among his marketing peers, the huge marketing prowess and dollars brought to bear once a goal such as increasing per capita consumption of sugary drinks was set- he was hired out of Purdue by P&G and worked at Disney before joining Coca-Cola- and the focus on the 12-24 demographic with 90% of all soft drink marketing targeted at this segment. What he regrets most is the focus on minorities who suffer some of the highest levels of obesity in America. No mention is made of the efforts underway in developing coutnries such as China and India which are seeing a surge in obesity rates and diseases such as diabetes. Coca-Cola says 41% of its sugary drinks are low calorie, but compared to milk, fruit juice and other healthier alternatives where does this rank? The cost to the nation's health care system alone would show that the performance of Coca-Cola's stock price over the postwar period came with a price tag that was never even thought about, when healthier alternatives as health drinks companies have found sell well when well marketed and formulated for different groups....

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A decade after the 2004 speech at the Democratic National Convention, Obama's message of change and hope as seen by American voters in 2014.

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Senator Mitch McConnell, the Republican Majority leader in the U.S. Senate has come up with a new health care bill that is aimed at winning over reluctant Republican Senators. Two taxes on high income people on 3.8% investment income and a payroll tax of 0.9% on incomes over $200,000 for individuals and $250,000 for couples are retained in this version of the bill, which adds $231 billion over a decade. Some of this is used to offset rising premiums in the new bill, and provide additional funds. The deep cuts to Medicaid are retained and Senator Collins of Maine says she is opposed to the new bill because this will hurt people in rural areas of Maine, and does nothing to change this. Senator Rand Paul of Kentucky is also opposed to the bill. Opposition comes from moderate Senators opposed to deep cuts to Medicaid in Republican health care alternatives to president Obama's Affordable Care Act, and from conservative Senators opposed for other reasons.  Senator Graham of South Carolina and Bill Cassidy of Louisiana introduced their own version just minutes before Mitch McConnell brought up his revised bill. All Democratic Senators are opposed to the Republican bill and call the deep cuts to Medicaid disastrous for lower income people.  ...

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According to recent Center for Disease Control numbers, about two-thirds of American women are obese or overweight. Retail stores like Target are trying to appeal to women in the 14 plus sizes where demand is growing.

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The BBC looks at some of the claims made by president Trump about India's rapid progress in delivering services to the people in electricity, sanitation, roads infrastructure, cooking gas, internet connections. BBC confirms that the economy size is now 6 times that in 2000, as Mr. Trump stated on his visit to Ahmedabad. It was in terms of the total value of all goods and services in the economy or GDP at $477 billion (IMF figures) in 2000. In 2019  it is $2,940 billion.  270 million fewer people were living in poverty in 2016, this is confirmed in a UN report. Here is the list for services as checked by The BBC. 1. Providing electricity to every one of the 600,000 villages in India. By 2014 most of the villages were electrified- at 96%. It is defined as having schools, health centres and 10% of households having electricity in each village. 2. About 600 million people having access to toilets under the Clean India mission launched in 2014. 100 million new toilets were built. 3. 70 million women were given access to cooking gas. 80 million new connections were built. 4.  320 million new internet subscribers. The figure is low about 600 million total internet subscribers. 5. It is true that infrastructure building is moving quickly says the BBC. About 10,000 kms were built in 2018-19 double that in 2013-2014 under a previous administration. The Mumbai Metro is mentioned in the WSJ as a project that has made remarkable progress. A bullet train project is moving ahead with Japanese financing and technological help from Mumbai to Ahmedabad.  Access to banking accounts and direct deposit of government transfer payments to all Indians is another project. Healthcare access through health care payments directly for health care costs incurred for low income families is another more recent project to reduce the uncertainty and improve finances of poorer citizens. ...

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About 400 million or one in 4 people people smoke in China. State ownership of the tobacco industry only makes this worse. Enforcement of bans on smoking is lax. Experts warn that this would become a major healthcare problem in China.

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Areas for growth for the Indian drug Industry include the large growing domestic market, the outsourcing by US drug manufacturers, and sales in other developing countries of Asia, Middle East, Latin America and Africa. Analyst estimates are that India will spend $30 billion a year on drugs to improve care for its people in the next 10 years up from $8 billion today. And the distribution network is being developed by drug companies insdie India to reach more people. Also companies like Pfizer plan to double outsourcing of manufacturing drugs from 10% today to 20%.

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Chris Cillizza of CNN shows here that back home in Maine Republican Senator Susan Collins hears from people saying again and again that they support her stand against the Republican health care bill. The rural and elderly are hurt most by this bill and Cillizza says Maine has a lot of these people.  He also cites the opposition of Republican Senator Rand Paul who doesn't like the other costly things tagged onto this bill, and wants a clean bill free of "billion dollar ornaments."

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CEO Shigetaka Komori of Fujifilm Holdings Corp. describes how Fuji responded to the technological changes that made photographic film obsolete. Kodak recently filed for bankruptcy protection. Fuji made the transition to other products to cope with the change. Komori became president in 2000. He says one of the responses was to reduce costs. In 2005 and 2006 Fujifilm reduced costs by $2.5 billion mostly in photographic film. Fuji's management asked the question what technologies the company possessed and how they could be applied in new business areas. This led to new businesses in making the films used for making LCD panels used on PC's, televisions and other devices. These materials generate 10% of sales. The other areas are in medical equipment, drugs and cosmetics. Fujifilm acquired health care companies Toyama Chemical for $1.4 billion in 2008 and agreed to buy SonoSite for $995 in Jan. 2012. Health care now makes up 12% of sales.

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The new Dutch Health system that went into effect on Jan1, 2006, and is based on Stanford university prof Eindhoven's idea of "managed competition." What the Dutch experience holds for the USA as states like massachusetts look at mandatory universal health coverage on a private basis and for the US as a whole as the present system appears to be coming to a close.

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The loss of state support in the 1980's resulted in the gradual withering of the health care system in China as individuals bore the brunt of health care costs. Hospitals and clinics shifted to pay as you go system, with the emphasis on prescribing treatment that would boost income including costly tests.

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Reports from the Sixth China North-South Lung Cancer Summit meeting of 300 experts focusses on controlling tobacco use and promoting early detection and treatment of lung cancer. Lung cancer is now the leading form of cancer in China, with 22.7% of cancer deaths each year. Currently about 1 million die in China from smoking related illness each year. CCTV reports this is increasing by 26.9% a year. Causes cited are aging population, air pollution, and widespread smoking. About one in three of China's people smoke, or about 350 million. Awareness of the dangers of tobacco use is not high outside two or three major cities. China manufactures about 1.7 trillion cigarettes a year, according to CCTV, and tobacco contributes 7-10 percent of state revenues.

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Both Ranbaxy and Dr.Reddy's, two of India's largest pharmaceutical companies, are bidding for Betapharm, Germany's fourth largest generic drugs maker. Ranbaxy's bid at 500 million euros was 50 million euros higher than Dr. Reddy's. Betapharm based in Augsburg, Germany, has sales of 161 million euros, and a workforce of 350. For Dr. Reddy's this is a way to get a foothold in a branded generic market in a developed country, says Dr. Reddy. This will be the largest foreign acquisition for an Indian pharmaceutical company.

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Jessica Todd, a USDA economist, says in a report that about 20% of the improvement in the diets of people surveyed comes from Americans eating out less at fast food places or restaurants. And this particular improvement she says is from an increased awareness on nutrition in picking out food, more choices available, and more nutritional information available to buyers. About one third of U.S. adults or 36% were obese in 2009-2010, according to the Centers for Disease Control and Prevention. This is a large increase from 15% in 1980. Studies show this is now declining gradually with increased public awareness of the risks of poor eating habits, including risks of diabetes.

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Achieving a right balance between the needs for public health in developing countries- and the need for cost reduction in developed countries- with the need to keep innovation, is the challenge facing the Indian Supreme Court as it hears the Novartis case on its leukemia drug Gleevec. The efforts by Novartis and other western pharmaceutical companies to restrict the flow of low cost generic drugs from India. India stopped granting patents on drugs in 1970. It only resumed giving patents under a WTO agreement on patents. The Indian government denied the patent on Gleevec and the case is now coming up before the Supreme Court.

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Only 23% of meals in America include a vegetable. The number of dinners made at home with a salad dropped to 17% in 2010 compared to 22% in 1994. Salads ordered at restaurants dropped to 5% in 2010 from 10% in 1989, according to NPD research company in its 25th edition of "Eating Patterns in America." The U.S. is going backwards in good eating habits and no enough attention is being paid to this in the debate about cost of health care. Their is a clear connection between good eating habits and health, and while invention and use of the latest research and innovations in health care are lauded, the decline in patterns of healthy living and food habits are receiving less attention.

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The private sector ignores health insurance. And state coverage in China is inadequate. More than two thirds of China's 1.3 billion people have no health insurance at all. If you have insurance you still pay up front in cash, if you do not have the cash up front you cannot get a surgery, treatment of any kind or any drugs, even if the insurance will later reimburse you. The Chinese health care system is dysfunctional and in a crisis because of the way it is structured, and the faulty policy incentives. It caps prices for basic drugs and procedures at below market rates, yet it lets hospitals profit from everything else from advanced drugs to sophisticated diagnostic tests. So hospitals invest heavily in technology and expensive testing. and drug sales account for 45% of revenues. And enforcement is lax. Doctors in Shanghai make monthly incomes of about $400, about what a taxi driver makes, so they supplement their income with bonuses earned by prescribing more expensive tests and drugs. There is no utilization review so the state reimburses for whatever the hospitals charge regardless of whether the test was needed or not. So the system is dysfunctional and lurching towards a crisis. In fact heavily burdening the middle class. The private outlays and burden of total health care spending has increased from 20% to 60% of total health care spending from 1978 to 2003, as the the health care system got the same dose of unfetterred capitalism as the rest of the system. The Government's share of total health care spending has dropped sharply. In addition there are design flaws that push expensive care and build in incentives for expensive care at the expense of good medical care. The government recognizes this problem and sees it as athreat to social stability. It has committed to increase spending on healthcare. ...