LyrArc Article Gist
Alice Rivlin's efforts to break the deadlock in the bipartisan Obama administration commission. The commission was setup to recommend ways to control the US budget deficit. This group is paralyzed by politics as Democrats have tried to safeguard Social Security, and the Republicans are dead set against tax increases. Rivlin is working through a shadow commission on the deficit headed by former Senator Pete Domenici. This shadow commission is supported by the Bipartisan Policy Center, a think tank setup by former Republican and Democratic majority leaders. The idea is to get the process started through leaders of both parties, as happened in 1983, when Senators Monynihan and Dole initiated the process after a similiar deadlock. The agreement reached then led to a change in the Social Security law, which increased the cap on payroll taxes and raised the retirement age.

LyrArc Article Gist
How companies like United Health are lobbying aggressively to shape the new helathcare legislation to their benefit. BW says the health insurers like United Health, Aetna and Wellpoint are already winning through clever and effective lobbying of Congress. Former Senator Tom Daschle works as aconsultant for United Health. Senator Conrad who has led aeffort to replace the public plan with nonprofit medical cooperatives, which would be a weaker competitive threat to insurers, is also influened by the insurers. United Health's CEO Helmsley and its person working with Congress on healthcare Simon Stevens met with Conrad on June 4. When lawmakers in Congress cite consulting group Lewin Group, that 88 million or 56% of those with employer provided coverage would desert private insurance for a government run program, they are quoting acompany owned by United Health. The Congressional Budget Ofice says these numbers are too high. United Health has used savy presentations on how to cut costs, and help Blue Dog and other Democrats articulate their positions, to gain influence in shaping the plan to their interests. United Health thus counts a lot with Matheson, and Mike Ross of Arkansas, who are prominent with the 52 Blue Dog Democrats. and with Senator Mark Warner of Virginia. And United Health put together an effective lobbbying group, even hiring the chief of staff of House Democratic leader Steny Hoyer. ...

LyrArc Article Gist
The basic problems facing American health care. Douglas Elmendorf , head of the Congressional Budget Office, says none of the bills he has seen make the fundamental changes needed in how medical care is delivered and paid for. The big issue is the unwilingness of different interests to accept serious changes. THe NYT says the long run solution to the problem of rising costs is to move away from the fee-for-service system that pays hospitals and doctors for each additional service they provide and into anew system that is organized around ways that encourage low-cost and high quality healthcare. The difficulty is that the long run may be too far, considering the seriousness of the crisis. Elmendor also suggests taxing employer provided health benefits, as this will discourage the excessive use of medical care. As the NYT says this is politically risky, even though it believes this may be a way to the new system which has to discourage the use of health care in the manner it is conducted now, with too many tests being conducted. A new system requires an enlightened approach on the part of each interest group in the face of a crisis, and the failure to do that may only end up retaining some of the worst aspects of the old system just mentioned that drive up costs and make universal health care unaffordable....

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
Alan Blinder, Princeton University professor and former vice chairman of the Federal Reserve, says the biggest reason for the growing deficit in the years out to 2040 is because of increases in health care spending. Its not that there is runaway spending in other areas. He cites CBO projections that show other costs stable relative to GDP from 2015 to 2035 and declining. This is why healthcare spending is at the heart of the problem. And why tackling the deficit has a lot to do with reducing healthcare cost increases.

LyrArc Article Gist
Krugman talks about the misunderstandings and the whole lot of misinformation that comes from advertising and political commentary. With one man telling a Congressman at a town hall meeting: "keep your government hands off my Medicare." In apolitically charged atmosphere this makes rational decisions in acalm thoughful environment difficult or impossible- when the influence of lobbying by the health care industry and the influence of interests on behalf of patients and other interests have already created a difficult situation.

LyrArc Article Gist
The influence of lobbyist on members of Congress just as the Obama administration, having studied the failure of the Clinton submitted healthcare plan try a different strategy of letting Congress come up with a healtcare plan. $133 million was spent in the second quarter alone by healthcare industry lobby interests creating headaches for reform efforts and the Obama administration.

LyrArc Article Gist
The mortgage interest deduction mostly benefits wealthier people with larger mortgages who need it least, and who are likely to buy homes regardless of the deduction, say experts. Both the Brookings Institution and other experts such as Moody's chief economist, Mark Zandi, see the deduction as part of the negotiations for deficit reduction. The Brooking Institution's Ted Gayer, says the deduction subsidizes acitvity such as borrowing large amounts of money to buy larger homes which the U.S. should not want to subsidize in the current state of the country's finances. The Simpson-Bowles plan and the Feldstein-Romney plan sought to put unnecessary tax expenditures and deductions on the table for negotiation. The deduction was not part of the last tax reform in 1986 under president Reagan. Zandi says any changes should be phased in over a number of years so that housing sales ar not affected in the current recovery. David Stephens, CEO of the Mortgage Bankers Association says any changes should be implemented gradually. ...

LyrArc Article Gist
Copies with slight changes to extend drug life with new brand names- Clarinex for Claritin, Nexium for Prilosec, Paliperidone for Risperdal being the latest in this new marketing strategy of drug companies to extend the life and sales of a successful drug. The drug companies try to market the copy drug as a significant improvement, which is what J&J is doing with Paliperidone. Experts are skeptical. Pricing of the generic versions of Risperdal or its copy will be much less expensive. Cost is a sensitive issue. About 15% of Risperdal's $1.35 billion sales were from Medicaid, generic substitutions offer potentially large savings. Meantime J&J did not do clinical tests between Risperdal and Paliperidone, the tests with 1600 patients compared Risperdal with a sugar pill. A psychiatry Professor at Duke and another professor at NYU are skeptical of J&J claims for Paliperidone. United Health shows savings of $150 million by using generics instead of Nexium, so managed care payors will tread carefully....

LyrArc Article Gist
The National Childhood Vaccine Injury Compensation Program protects vaccine makers from much of the litigation risk faced by pharmaceutical manufacturers. It limits compensation for death to $250,000. This special vaccines court is called Office of Special Masters at the U.S. Court of Federal Claims. This may be one reason for Pfizer's willingness to pay $68 billion for Wyeth which is amaker of childhood vaccines. Vaccines will generate $21.5 billion in sales by 2012, according to Sanofi-Aventis. Vaccines are biologic products that can't be copied. Wyeth's Prevnar is designed to protect children against 7 strains of pneumococcal disease. It has sales of $2.7 billion projected to grow to $5.5 billion in 2015 according to Sanford C. Bernstein & Co. Vaccines have driven huge reductions in childhood diseases, and the Act is designed to potect makers of vaccines, who suffered from excessive litigation in the 1980's.

LyrArc Article Gist
Greg Ip tells India's story, piped water for hundreds of millions of Indians, massive increases in road and rail, rapid development of infrastructure, aviation, ports logistics. WSJ graph shows country growth of economies for Japan, China, India, Germany in 2000 and 2020. By 2000 Japan had grown its economy to become about half the size of the US economy with two decades of rapid growth since 1980. China repeated this process with two decades of hyper growth since 2000 to become about 75% of the US economy by 2020. The graphs also show Japanese growth tailing off so rapidly after 2000 in relation to the US economy that it is now only about 25% of the US economy. China is likely to follow the same path as growth slows and with an aging population to become about 35-40% of the US economy by 2040 from 75%. India following the process that happened in Japan and in China is likely to become close to 35-40% of the US economy by 2040 from about 18% today, with the fastest growth over the next two decades for the most populous country in the world. Greg Ip points out what has been achieved since 2014 with the Modi government. Good governance without leakages of public funds dedicated to infrastructure, ease of living, GST one India one tax so that growing pool of funds from taxes fund rapid development with no leakages to corrupt officials,  Swacch Bharat or Clean India, clean water from taps, electricity and cooking gas for the whole population of India with dates for completion. All this Ip calls removal of the shackles that existed for far too long even past 2000 and 2010 when China had vastly surpassed India from its low point in 1980 after Mao and the Great Proletarian Cultural Revolution. India today is in as much a pace of development as China in the 1990's and Japan in the 1960's, except that it now has the benefit of grasping how development can be done in a way that does not affect climate and health in adverse ways as happened with China's hyper growth -which also led to the tragic loss of manufacturing for workers and communities in the US and Europe due to the economic theories of laissez faire of the Reagan era. Reagan theory for governments not working with industry that were applied indiscriminately during the Clinton, Bush, Obama and Trump presidencies for three decades led to shipping manufacturing overseas with no regard for the risks and dangers. What Greg Ip fails to mention is the uniqueness of India that is united by Vedanta, Hinduism and Buddhism for thousands of years, and which keeps the fabric of society together when it is divided by 13 language groups. These 13 language groups are: Hindi 43% of the population, Bengali 8%, Marathi 7%, Telugu 7%, Tamil 6%, Gujarati 5%, Urdu 4%, Kannada 4%, Odia 3%, Malayalam 3%, Punjabi 3%, Assamese 1%, English 1%. It was the vision of the early leaders Vivekananda, Gokhale, Mohandas Gandhi, Nehru, Sardar Patel, that united a diverse country with many languages and cultural variation. And it is this vision of Vivekananda that is creating the Good Governance under Sab ka Vikas, Sab ka Viswas, Sab ke Saath, Sab ka Prayas of today- development for all, with the confidence of all, with the support of all, the efforts of all. Without a disciplined direction based on hard work India could not make it this far or fulfill the aspirations of its youthful population by 2040. ...

LyrArc Article Gist
The party congress of the Communist party does not look like its going to lead to any changes in the system, only to make sure it runs better by getting public input through pollsters on public officials, and on web sites on new legislation. The pollster, including a firm, Horizon Group, describes his role as working out a mechanism for people to express themselves as there is very real frustration in society. Websites airing public opinion helped introduce nondiscriminatory clauses in the new employment legislation. But otherwise there is actually a tightening of the control of dissent, as the party is worried that once it starts it will get out of control and jeopardize the economic progress However this leaves the future quite uncertain as there is still not enough room for airing the very real frustrations and concerns such as for the environment, health and services, the prevailing corruption, and the problems in the countryside of the poorer regions in the interior of the country. These concerns are being pushed into the future. For instance without a free press its hard to air corruption cases, as in India. Only two of the several thousand petitions under the system of letters and complaints xinfang are resolved. About 12 million are received each year by the government. Because of the obsession with tight control many activists end up in prison even though the causes such as the environment are popular. Like the activist who called attention to the Lake Tai pollution, and the rural blind activist mentioned who argued on behalf of women that were forced into late term abortions. Here the government actually stepped in to announce plans to cleanup Lake Tai, but the system continues its inexorable push to drive out any dissent even if it does not relate to political issues. This may be one of the severe distortions of the present system. ...

LyrArc Article Gist
Bowles and Simpson call for deficit savings along the lines they suggested as co-chairmen of the President's Deficit Commission- reducing the cost increases in Medicare, changes to Social Security, and cutting tax expenditures.

LyrArc Article Gist
U.S. presidential candidate Romney's plan to limit deductions to $25,000 leaves the taxes deductions of middle and lower income earners intact and hits high income earners with large deductions hardest.

LyrArc Article Gist
The feud between New Jersey Governor, Chris Christie, and the head of the state teacher's union, Ms. Keshishian. Governor Christie called the state legislature into an emergency session and pushed through a 2% cap on annual increases in property taxes, which have risen 70% over the last decade in New Jersey. The issue is whether the extent of spending on education is sustainable in New Jersey. New Jersey's median property tax is the highest in the nation, at $6,579. By comparison New York is $3,755 and Illinois $3,507. New Jersey residents pay an average of 11.8% for property taxes. Both sides have engaged in strong rhetoric and the teachers union has attacked the Governor in television ads. Governor Christie refused to discuss issues with Keshishian, and ended a meeting in his office, with "Not with you. I don't." The teachers argues that New Jersey schools provides some of the best schooling in the nation- the state's high school graduation is 82%, and it ranks among the top 5 states in key subject areas, according to the Education Law Center in Newark. Its graduation center for black males is 69%. New Jersey also has a heavily unionized public sector with relatively high wages for public workers of all kinds, including teachers. This and a state supreme court decision mandating increased funding for schools in poor communities raises the cost per pupil to $17,794, the highest in the nation, after Washington D.C. New York is at $16,981. California, and Illinois spend $11,000. The average New Jersey teacher makes $61,277 a year, well above the U.S. average of $52,800, according to the National Education Association. Medical and other benefits add $19,140 according to the teacher's union. And the unsustainability goes back to issues such as unfunded liabilities for benefits and pensions in New Jersey. New Jersey's Treasurer estimates the unfunded liabilities relating to lifetime health benefits for current and retired teachers at $36.32 billion....

LyrArc Article Gist
The publisher of the Wall Street Journal, Dow Jones & Co., is working to overturn a court injunction that prevents the public from seeing the Medicare billing records of individual doctors. Dow Jones & Co., filed court papers in January 2011, to overturn the court injunction. The American Medical Association has fought to keep secret the amounts of money individual doctors get paid by Medicare. The AMA filed a lawsuit against the government to keep secret these Medicare records, on the grounds of privacy rights, and won a court ruling in 1979. This court ruling still stands. The position of Dow Jones in its efforts to change this situation, is that giving the public access to the records is essential to the monitoring of so large a public expense as Medicare. These records would then be available to state medical boards, nonprofit organizations, universities and newspapers who can act as watchdogs over the $500 billion Medicare program. Such transparency and monitoring is an essential feature for the proper functioning of such programs and to prevent misuse of public money. For a program like Medicare, fraud and waste has enormous implications, as it adds to the spiralling cost of healthcare and to the unsustainable budget deficits. In one of the largest cases so far, the FBI, Justice Department, 700 state, federal and local agents, worked together to charge 114 defendents nationwide with Medicare fraud in February 2011. A senior law enforcemet official says Medicare fraud is so rampant, "there's no way in hell you can prosecute your way out of this problem, no way." He says the the answer is more effective monitoring of the money that goes out. And a key part of that is transparency and public access to how the money in Medicare is spent, what individual doctors and healthcare providers are getting paid by Medicare. The lack of this transparency for a program the size of Medicare can only lead to a lack of monitoring as the Dow Jones suit asserts, and make it difficult for the government to check abuses in the way money goes out. At a time when teachers and public workers and seniors are expected to make their share of the sacrifices to fix the budget deficits, it is incomprehensible that money should then be allowed to go out of the Medicare system through fraud and waste, because of a lack of transparency....

LyrArc Article Gist
Posturing and negotiating between Republicans and Democrats on deficit reduction before the "fiscal cliff" of automatic spending cuts and tax increases on Jan. 1, 2013.

LyrArc Article Gist
How diagnostic tests in portable toolskits, that patients can use themselves, are being developed at low cost in developing countries like China. This creates the kind of care appropriate for poor countries, where patients need something they can afford, and something that does not require repeat visits to doctors offices or clinics. Ustar Biotechnologies is a Chinese startup, that says it has the technology, costs that the founder says "no one can compete with," and affordable prices for poor countries. The sales of such diagnostic test portable devices or kits is expected to soar in coming years. Quimin You, the inventor and founder of Ustar, graduated in North America and worked with multinationals. His proposals for cheap diagnostic technologies were turned down by multinationals, who in their narrow focus saw these thechnologies undermining their existing products. Now Qimin is back in China with a startup that will do this.

LyrArc Article Gist
The EU's competition commissioner to crackdown on pharmaceutical companies that are delaying the entry of generics drugs with various tactics that are anticompetitive. EU has raided the offices of several marge drug companies and retrieved documents that show this activity was going on. About 5% of medical bills or 3 billion euros coud have been saved from 2000 to 2007, if companies had allowed generics to enter the market earlier and not resorted to these antitcompeitive strategies. Like paying off generics companies or having so many patents on the ingredients of the drug, in one case 1300 patents on one single drug, and then suing the generics companies to tie up the case in the courts.

LyrArc Article Gist
As Indian pharmaceutical industry sees drug testing in India as an opportunity, conditions for obtaining the best results are being established by taking necessary steps. With ashortage of experienced people to run drug trials, Indian government has stepped up training, setting up partnerships with the U.S. FDA, Health Canada, the World Health Organization, and other similiar organizations, The emphasis should be on credible dat and the safety of subjects says A.K. Pradhan, India's Assistant Drug Controller. After the death of an infant in a Wyeth Pharmaceuticals drug testing effort, the Drug Controller of India though supportive of Wyeth has raised certain issues that Wyeth is addressing.

LyrArc Article Gist
Romney says in the first presidential debate he will not increase taxes on the middle class: "I will not reduce taxes paid by high income Americans. And I will not, under any circumstances, raise taxes on middle-income families. I will lower taxes on middle income families." How he would do this is through limiting or eliminating deductions and loopholes among several measures, with work done on this by his advisor Martin Feldstein, Reagan's economic advisor and a professor at Harvard University- Romney's Tax Plan can raise revenue, WSJ, 8/28/2012. Where the Democrats and Republicans differ is that economic growth generated by creating incentives for business to invest and hire also plays a part in generating the additional revenues as it did under Reagan's economic plan. Behavioural factors play a large part of this as much as the incentives and other steps, to create a climate of business confidence- search in Janvoo for the Group "Reagan memo of 1980 by Shultz, Friedman," for more on this....

LyrArc Article Gist
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.  ...

LyrArc Article Gist
The House bill on health care cleared the House Committee on Energy and Commerce with a vote of 31 to 28. Five Democrats joined all 23 Republicans. Compromises were reached with Blue Dog Democrats, centrist Democrats who had concerns about the cost of the health care overhaul. The bill will be taken up again in September after the August recess, when Congress will be faced with the task of recociling the House and Senate versions and reaching common ground on a number of proposals. Some common ground has already been achieved between centris and Blue Dog Democrats and Democratic members who support Obama's proposals. Among the changes on which consensus was reached in the House version: 1. Access Insurers will have to accept all applicants and will not be able to charge higher premiums because of medical history or current illness. All insurers will have to offer a minimum package of benefits, to be defined by the federal government, and nearly all Americans will be required to have insurance. Insurers will have to get prior approval from the government before increasing premiums over a certain amount. About 95% of Americans will be covered this time. The cost will still be approaching $ 1trillion over 10 years. Federal subsidies will be given to those who cannot afford health insurance and Medicaid coverage will be expanded. And the insurance will be made more affordable for the uninsured. Democrats also reached a consensus on creating some sort of government insurance plan or nonprofit cooperative to compete with private insurers. 2. Mobility And under this new plan it will be easier to change jobs as one would retains one's health insurance. This should actually help the job market, and help promote the mobility that is needed, now that jobs are shifting out of sectors like autos to sectors like energy. 3. Cost The Energy and Commerce Committee voted 47 to 11 to set aprocedure for the government to give federal approval of generic versions of expensive biotechnology drugs. By one estimate this saves $9 billion over 10 years. The Democratic proposals from the Energy and Commerce Committee would authorize the Health and Human Services Secretary to negotiate prescription drug prices for Medicare benificiaries. The agreement and consensus among the conservative, liberal and centrist Democrats, and Democrats with ties and connections to the health care industry was reached after intensive negotiations, and adoption of a package of amendments that helped bridge the differences they had. ...