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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. ...

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Milbank describes Romney's problem as similiar to that of Al Gore- the feeling one gets that he is just not authentic. He tries to be a regular guy but he is not. He campaigns on his business experience, giving little attention to his record and experience as governor of Massachusetts.

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William Cohan describes the "bait and switch" techniques used by Bain Capital that he experienced in his personal dealings as a deal maker for 17 years on Wall Street. By this he means that Bain would make attractive offers in the early rounds of an auction for firms as the only way to get selected as a prospective buyer for a final bid. This was necessary for Bain to visit the company facilities and examine its books on-site. At that point Bain would finds all sorts of problems with the company and lowball its bid. Cohan says of all the private equity companies Bain Capital was the one most noted for using these methods during the period Romney headed the firm, and questions the credibility of Bain's word and Romney's word.

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The Journal says Santorum needs to fit his economic point about helping manufacturing into a broader economic policy, and broaden his support base beyond the social conservative base. It says about Romney that he needs to find an authentic message that appeals to conservatives beyond catchphrases about repealing Obamacare. The problem it says is both candidates do not appeal to the whole Republican party. One candidate Romney lacks the fervor and firm convictions and the other Santorum has fervor and firm convictions about social issues, but can't do the same for economic issues and the other concerns of Republican voters.

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Kodak Labs in Eastman Kodak Park, Rochester, New York, in 2015, as the struggle to come up with new applications to reinvent the company continues.

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A study done by the Hudson Institute shows an increase in sales of 5.5% on average in same store sales of restaurants which increased lower calorie items on the menu. The reverse is taking place for restaurants that have neglected to do this, with these restaurants experiencing a decline in sales. This was based on research firm NPD and restaurant data at 21 fast-food and sit-down restaurant chains between 2006 and 2011. Chains that include lower calorie counts on menus include Panera, McDonalds, Denny's and Au Bon Pain chain. Federal regulations will require restaurants with 20 or more outlets to post the calorie counts in early 2014. The process of moving Americans away from eating habits that lead to obesity is moving at a slow pace. Margo Wootan, director of nutrition policy at the Center of Science in the Public Interest, says large serving sizes at restaurants lead to overeating and obesity. Frequency of eating at restaurants is another problem, with studies showing women who eat out more than 5 times a week take in about 290 calories each day compared to women who do not eat out that often. The healthy options at restaurants are still restricted to a small portion of menus and healthy choices are limited....

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This story by Emmarie Huetteman describes the effort of three Republican women in the U.S. Senate who had the courage to listen to the different voices in their home state and use their informed judgement in deciding how to vote on a Republican healthcare bill or Affordable Care Act repeal effort. Especially when they heard that it would hurt people in their state, the elderly, low income and other vulnerable people without offering alternatives. Even when this meant resisting pressure from fellow Republicans. The senators are Capito of West Virginia, Collins of Maine, and Murkowski of Alaska. This is particularly significant at a time when too much polarization has led to paralysis in coming up with informed discussion and good solutions to problems. It is also significant that senators from the midwestern states such as Iowa- Mr Grassley, and Kansas- Mr. Moran, also joined the effort to listen first to people back home in their districts before making up their mind. 

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The Bureau of Labor Statiistics puts out a statistic each month, called the JOLTS for Job Openings and Labor Turnover Survey, which shows how many job openings there are in the US. This statistic stood at 2.2% for February 2009, down from 3% in Feb 2008, and this is 2.2% of all the jobs in the USA, which comes to about 3 million. The Conference Board's report shows 3.2 million online advertised vacancies as of March 2009. The odd thing is that there are so many advertised vacancies when the unemployment rate has shot up in the same year from 4.8% to 8.1%. The implications are serious. First there is a mismatch in qualifications. As jobs are lost in construction and the financial industry and in retail, new jobs are appearing in health care, education, government and accounting. This structural shift is happening quicker than the market can respond, or faster than labor retraining has time to respond. And compounding this the severe housing market leaves people unable to sell their homes and move. This makes for a less mobile labor market than the US has had in the past. With the government stepping in to ease the burden of unemployment there may be even less incentive to move. And those that move will have to accept the lower pay in new careers , and employers will have to settle for imperfect fits in filling vacancies. To reduce the mismatch in qualifications governments will have to ramp up their job retraining programs. ...

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China bans smoking in public places in June 2015. The authorites say unlike previous bans before the Olympics this one will be enforced. The damage to public health is immense, with about one third of smokers in the world in China. Public spaces include restaurants, offices, bars, nightclubs, airports and trains. Included also are areas around schools and hospitals. There are 301 million smokers in China, according to the World Health Organization. About 53% of men and 2.4% of women smoke regularly, and this contributes to 1 million deaths from heart disease, cancer and other diseases. WHO estimates about 100,000 deaths from second hand smoke. About 28.1% of the population are smokers, based on the 2010 survey. The survey was organized by the WHO and China's Center for Disease Prevention and Control. The figure of 2.4% shows women are less affected than men by the damage done to public health. Women also are leading the way to fight smoking and effects of second hand smoke. People in Beijing already have to deal with the effects of pollution in the air they breathe, and are keen on eliminating the additional harmful effects of secondhand smoke added to this....

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Coral Davenport of the NYT provides some of the basics of the Paris climate change agreement. This includes an effort to cut greenhouse gas emissions by half to avoid a situation in which atmospheric temperatures rise by 2 degrees Celsius or 3.6 degree Fahrenheit.  The earlier effort to negotiate an accord failed in 2009 in Copenhagen. This time all 186 countries were asked to signup with the USA and China, the No. 1 and No. 2 polluters and India leading the way. Germany is well on its way to self sufficiency through development of solar and wind energy with the German government leading the way, and France leads in the use of nuclear energy. How did this happen now? As Davenport points out there are scientific studies. But this is not the primary reason China is shifting.Davenport fails to emphasize the health concerns and pollution concerns that motivated China to shift away from coal. China's industrial revolution of the last 3 decades has come at a huge cost in pollution of air and water, and president Xi Jinping has decided to make the shift away from coal a top priority. It is estimated that mortality rates for areas of high coal use north of the Yangzte river have higher mortality rates than areas of lower use of coal south of the Yangzte river. The other big polluter India is shifting because it is learning from China's experience. Davenport mentions the resistance to the scientific evidence in the Republican party. As a result it is already clear that it lacks support in Congress and under a future Republican administration. In a fashion similar to healthcare, president Obama failed to create a consensus before proceeding in the hope that this would be better than waiting. However American industry is already moving away from coal as documented in Links- "The Trump executive order on coal and the continuing shift to natural gas." Utilities in the U.S. are making the shift away from coal because of the economics and planning ahead as governments can change every four years. ...

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A study by the National Employment Law Project shows most of the job creation in the economic recovery to 2014 in the U.S. is replacing the better paying jobs with lower paying jobs in fast food retail and similiar low paying industries.

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Washington Post editorial on the Obama Georgetown speech of April 13, 2009. It questions whether President Obama has the candour and courage to tackle the tough issues of deficit reduction and entitlement reform. New healthcare spending for coverage itself will add to entitlement, and it says some of the savings mentioned by the President are phony or already needed for new spending for the economic recovery and health care. At the same time the paper gives Obama good marks for his clarity and grasp of the crisis and steps for recovery, and the policy agenda in the areas of health care, energy and education. The questions about courage and candor also raise all the questions about facing upto the facts about insolvent banks that Krugman, Rosenfeld, the Economist and others have raised. Is Obama dodging the hard choices, is he dithering? On the toughest issues like foreclosures, insolvent banks, global regulation pushed by the Europeans, will he end up making inadequate or faulty choices, and when he comes around to making the tough choices, will he have lost so much valuable time as to prolong the crisis and stretch it out to many years....

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Unemployment in Fort Wayne, Indiana, is 6.8%, and 14,600 workers are looking for a job. Peters and Wessel talk to employers in this midwestern U.S. city and find that employers are looking for people in manufacturing with just the right set of skills, in other cases the benefits and parttime local school system jobs paying $8-$12 per hour with no benefits go unfilled because of the lower wage.

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The Human Needs Index pioneered by 2015 Nobel Prize Winner Angus Deaton looks at consumption of services such as healthcare, housing and of food, to determine how people in each region are doing and poverty levels. Using this index Minnesota and North Carolina at about 1.15 are doing much better than Nevada and Michigan.

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Wessel describes the changes in American manufacturing as it goes through some of the same changes that happened in Germany in the years after reunification. With high unemployment German manufacturing companies worked with unions and the government for wage restraint over the last decade, resulting in wages barely keeping up with inflation. The increase in productivity and wage restraint helped Germany become more competitive with factories in Asia and Eastern Europe. Wages are now increasing with larger wage increase negotiated by the unions in Germany, as skilled labor is becoming scarce. In the U.S. Labor Department figures show an increase in output per hour in American manufacturing of 13% in the last 5 years and 21% in the five years before that. Typical of the wage changes in manufacturing- American Axle & Manufacturing plant in Three Rivers, Michigan hires assembly workers at $10 per hour, with older "legacy workers" making $18 per hour. General Electric brought back manufacturing work from Mexico paying workers $13 per hour for new hires, compared to to $21- $23 in prior years. At GM, Ford and Chrysler workers make $16-$19 per hour in base pay compared to older workers with legacy rates of $29-$33. The Bureau of Labor Statistics shows earnings for production workers in manufacturing averaging $19.15 per hour in April, which is where they were in 2000 adjusted for inflation. The impact of this large increase in productivity with new machinery and production methods, and the wage reductions in manufacturing, is a return of offshored jobs. Wages increased in China and Mexico in the last decade. After a 35% decrease in the number of manufacturing jobs in the U.S. from 1998-2010, the number of jobs has increased by 4.3% to 11.9 million in April 2012, according to the Labor Department....