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The health care system is designed to encourage procedure based specialist practices and discourages the patient understanding education and monitoring that occurs with a well designed preventive family physician practice. As a result a patient only spends 30 minutes ayear on average with family physician compared to one hour in other developed nations. In the USA there has been a steady decline in the level and quality and extent of family care and the close one on one rapport with well trained family physicians who enjoyed their work and understood their patients and kept up with their health conditions and provided good and regular advice on these conditions. There is no money in this care as a result first you provide an environment where a whole range of medical conditions can flourish and expand, and then you hit them with a whole series of tests to rule out specific medical conditions. It is a perfect way to expand the testing and let testing flourish, so it would appear that if someone had wanted to start with a goal of letting testing proliferate unhindered then this would be the perfect way to design it. ...

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Sandhya Sharma of The Economic Times puts a spotlight on the dominant role of China in global shipping by 2005. In 1980 China had a tiny role in global shipping, with bicycles a dominant form of transportation in Beijing. By 2019 this role had expanded to dominant position in all the largest modern technology container ports with global shipping volume having more than doubled since 2005. Much of this was done by working with major providers of container port technology such as Maersk of Denmark and other European shipping companies, with imported technology playing a critical part. India is starting from basics in its effort to develop its shipping in the Indian Ocean region with its large coastline facing the Suez Canal and the eastern coastline facing Malaysia, Indonesia and Australia. This was evident during the recent "Atman Nirbhar" global shipping meeting in Vizag- the Maritime India Summit 2021. The goal is to make the next decade one of rapid development of the maritime sector to secure India's position in global shipping particularly in the Indian Ocean region. Collaboration with major European technology providers will play a key role in developing container ports to the levels required for India's future role in global shipping. Sharma discusses the visit of premier Boris Johnson in April 2021 to India to forge strong trade ties.  The Indian prime minister held virtual meetings with premiers of Sweden and the Netherlands, two major maritime nations in Northern Europe for stronger trade and technology ties. These ties are part of the broader effort by the US, UK, and European Union countries to forge strong trade and technology ties with India now that it is clear to them that new supply chain will be needed over the next decade as China disengages from that level of its trade ties with Europe, US and India. New global supply chain means new global shipping container ports and global shipping links of India, Vietnam, Malaysia, Indonesia, with the US and Europe. Looking at what happened between sometime in 1995 and 2005, and in 2005 to 2009 when the global financial crisis hit, when China went from a miniscule level of world trade to predominance. And the years of the Obama administration 2008-2016 when this simply continued without any understanding of its implications for both sides, to levels of China's predominance in world shipping that can only be considered as unbelievable. Growing at over 12% through continued use of  imported technology from Europe and the US. Looking back at what happened one sees that this made China over dependent, its economy too intertwined with Europe and the US. This also made the US and Europe over dependent on China in its supply chain. It took the pandemic and the one term Trump administration, the crisis in Hong Kong, the situation in Ladakh and India's norther border, the South China seas and Vietnam,  for both sides to realize this was not in the interest of any of the countries involved.   ...

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Hillary Clinton has received $21.4 million from Wall Street donors for her 2016 campaign fund, compared to $75,000 for rival Bernie Sanders, according to this report in the Washington Post. This was raised in questions by Anderson Cooper of CNN at a town hall in Derry, New Hampshire on Feb. 3, 2016.

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The U.S. House of Representatives passes the McConnell-Biden deal on raising the debt ceiling by 269 to 161. For its passage through the House 174 Republicans and 95 Democrats voted in favor, 66 Republicans and 95 Democrats voted against it. Republicans voted for it with a proportion of 3 in favor and 1 against, compared to Democrats where it was 1:1 and as many opposed it as supported it. It took much persuasion from Vice President Biden and Speaker Boehner to get the votes in favor of passage. Republicans who opposed it were concerned about the modest cuts in spending. Democrats who opposed it considered it a giveaway to Republicans with no tax increases or addressing of tax expenditures. The deal's trigger provision to require cuts in spending to be 50-50 for defence and entitlements was used by Biden to show Democrats that the next $1.2 trillion in cuts would take a more balanced approach. Democrats would have leverage to make their case for savings through tax increases or tax expenditures....

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Deborah Solomon interviews Abby Cohen of Goldman Sachs. Cohen is asked about bank bonuses and compensation, about the role of the banks in the financial meltdown, and whether she and Goldman Sachs felt any responsibility for the economic crisis.

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The Muslim Brotherhood and the democracy movement activists in Egypt reject any connection to Iran, Hezbollah or Islamic movements in other parts of the Middle East.

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The Egyptian military announced the names of a eight member Constitutional Committee. The committee will be given the task of rewriting six articles of the constitution. These articles relate to presidential term limits, judicial oversight of elections, and parts related to curbing the president's powers to amend the constitution and restrict civil liberties, including sending civilians to military tribunals. The committee is asked to come up with recommended rewriting of these articles in 10 days. Reports say the constitutional changes will then be put to a popular referendum. The committee will be led by Tareq al-Bishry, who is a retired judge and a prominent historian. Mr Bishry and a Cairo University law professor, Atef al-Bana, are thought to be followers of a modern Islamic school of thought. Other members are Sobhi Saleh, a popular member of the Muslim Brotherhood who represented Alexandria in parliament from 2005 to 2010. About the selection of the committee, Abdel Yousef, a senior official of ElBaradei's National Association for Change, says the names are a good sign from the military. See the heart rending account of Sobhi Saleh and a prison set on fire from which he makes his way out after his arrest during the protests. The account is by Nicholas Kulish in the New York Times, Feb 4, 2011....

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Israel outlined its own proposals for a nuclear agreement on April 6, 2014. Israel's Intelligence Minister Yuval Steinitz, says any deal must include Iran cease all nuclear research and development activity, remove its enriched uranium stockpile from the country, reduce the number of centrifuges to below what was agreed to in the outline that emerged from talks with Iran in April 2015, closing of the underground facility at Fordow that was built clandestinely in the early 2000's. Steinitz said- "The deal has to be made on the assumption that Iran might violate it."

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Colonel Stevenson's efforts to limit features on a new bomber for the U.S. Air Force to replace aging B-52's and B-1's. Contractors added a kitchenette in one design which was turned down by Stevenson and senior officers at the Air Force. Senior officers were mindful of how it might be seen by the public and aware of the need to keep costs down during a period of austerity budgets. Barnes describes the efforts of Colonel Stevenson as he led efforts to limit the new plane to essential features, turning down contractor proposals for a plane that could be converted into a drone, reconaissance and cyberdefense features, and other embellishments that would drive up the price tag per plane. In 2011 budget negotiations defense officials agreed to limit the cost to $550 million per bomber, a third of the cost of the B-2 which cost $1.8 billion per plane. Because new planes take a decade or more to design and build with cost overruns, it is also important not to venture too far into technological unknowns. This adds more time to build and proves costly. The Long-Range Bomber project started in 2011 with Secretary Gates signing off on the requirements for it to give the president the option to move quickly in a matter of hours to penetrate distant airspace. The cost is $600 million spent till Oct 2013 for research, and $8.7 billion budgeted to 2018. The Air Force is sticking to existing engine design, and Stevenson says if the technology has not been tested the Air Force is not interested in experimenting with it. In the process Stevenson finds himself trying to change the culture at the Air Force, where putting cost as the top priority is a new concept....