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Delayed elective procedures and surgeries are a serious problem during the pandemic. To get some idea of the magnitude of the problem- Britain had 6 million on the waiting list for elective procedures at the end of October 2021. This is up 41% over March 2020 when the coronavirus was first detected, according to data collected from Britain's National Health Service. The same data show 300,000 were waiting for over 1 year compared to 3000 in March 2020.

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Common sense comes to the German Border with Merz and the national emergency rule at the border, just as has happened under DJT at the US Border. May 8-25 turned back at Germany's borders with 9 European countries about 100 persons- success of national emergency rule at the German Border. This relieves not only pressure on public services in German towns and cities, it also removes a source of anxiety in the people who experienced political divisions and random attacks in public spaces from migrants. It also removes the threats of extreme factions in politics that have used the migrant crisis for exacerbating political divisions. Merkel's policy was not workable from the beginning and based on assumptions that were not correct as Germany and the EU could do more to improve the modernization and improving health and education, industry and agriculture inside Asia, North Africa to help the people in these regions than by taking in migrants. Who has ever suggested migration to Europe or the US  as a solution to the problems of China and India in the 1930's and 1940's, from wars and even famines. The right solutions of decolonization turning back invasions into the 1940's, and providing technology and capital for modernization after 1950 and accelerating this after 2000 have created two modernized nations of 2 billion people. ...

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Connecting the National Health Service in UK (NHS) to Nature would take NHS to a new level by bringing mental health through nature walks to many people who need it during the pandemic. Damian Carrington of The Guardian looks at social prescribing where people are referred to nature projects, a trend that is growing in the UK and adding a highly valuable component of health to NHS. This is called Green Social Prescribing. 

There is significant support for the idea of Nature walks adding to wellbeing. A 2019 study cited here shows weekly 2 hour dose of nature improved health and wellbeing.

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The advice to reduce cancer risk is not surprisingly the same from D. Michael Sekeres of the University of Miami- stay away from sugar, alcohol and tobacco products and take in more fruits, vegetables and whole grains, ancient grains and exercise regularly. The magnitude of what this would achieve on a a national scale when food habits have gone downhill for decades is what is also at stake. It would do what nothing else could do for the nation's health on a massive scale which is why it is the right thing to put much of our focus on, to create a culture that put much importance on the quality and kinds of food, on artificial vs natural, on food grown in good environments, on local vs shipped long distances, on processing vs not processing, all the time thinking of one's own health and what it will do for the quality of life we live. Just a fraction of the savings in medical care would pay for education and parks, green areas in neighborhoods, public health services, high levels of sanitation, leading to better well being that leads to more productive and intelligent citizens. It would lower the levels of multiple diseases and create a healthy society. ...

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Queen Elizabeth leads tributes to the National Health Service for "the grief and loss felt by so many," as Britain pauses for a minute's silence, on the first anniversary of the lockdown of March 23, 2020. She offers flowers to St. Bart's hospital, after the recovery of Prince Phillip who was in hospital for one month for heart surgery and recovery. Pictures of a canon preparing for a outdoor garden service at Durham Cathedral, and lighting of candles at other cathedrals, offer glimpses of a solemn moment of silence, and the nurturing of hope for the recovery.

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It is only appropriate to bring up Aneurin Bevan in 2024 after the pandemic and as ordinary Britons seek to improve health and living standards, and their compatriots in the US also seek a better form of universal health coverage that works to provide better health  for less cost similar to Europe. In 1948 the National Health Services Act was passed into law with Aneurin Bevan having seen it through parliament as a member of the Labour party from Wales. The NHS was operational in July 1948. Clement Attlee summoned Bevan after winning in a landslide in 1948 and asked him to take the Housing and Health Ministry. Bevan was a coal miner's son who then used his skills in parliament to get passage of laws that created one of the most enduring  institutions of modern times. A docudrama by Prince about a visionary Welshman Aneurin Bevan as Health Minister who founded the NHS National Health Service of Britain. Michael Sheen plays Bevan.

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This report in WSJ takes a detailed look at how the shift to digital payments, and digital badges for covid free designation on smartphones are affecting a part of the population of 60+ years that is notinternet or smartphone savy.  60+ years make up only 10% of the users of internet on age based graph, even though they are a large part of China's rapidly aging population, estimated to be closer to 20% of the population or about 250 million. Elderly people in China are having a hard time with scanning of health codes to access transport and other services. To tackle the covid pandemic China has health codes assigned to citizens which link user national ID and Covid status. These need to be scanned in for access to train and transport facilities and other services, color coded digital badges on smartphones that show one is covid free.  Most elderly cannot handle these smartphone tasks because they lack the skills of young people with smartphones or lack the digital payments having used cash all their life. Other problems are poor eyesight, health problems, but the most severe is a big skills handicap in downloading apps, in typing quickly, and in navigating the internet. The government is taking steps to provide relief for the elderly by prohibiting places of services from refusing to accept cash, and finding ways to make the health codes system work for seniors. ...

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The National Health Service in Britain is struggling under the effects of budget cuts, covid delays, and an aging population, says the WSJ. With the cost of living crisis and the Tory resistance to wage increases when nurses are found turning to food banks there is now a strike by healthcare workers. A former head of the NHS says the UK healthcare system is facing a crisis like nothing he has seen in his career. The UK has mistaken cheapness for efficiency in its approach to health, and it is now coming to roost. It is coming apart- people with heart attacks have to wait average one and half hours for an ambulance. Hospital beds are scarce tuning patients away. One in ten are on waiting lists for non emergency surgeries. 

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Elections in December in Britain are rare, with this election in 2019 in Britain being the first in one hundred years. It also poses big risks. There is the flu season, the National Health Service being stretched to provide services, the weather, and voter turnout.  It poses risks for Tories and Labour, and Boris Johnson's bid for Leave seats held by Labour is a bold one that could turn out either way. Labour plans to run on a positive program of change and not just the Brexit issue. Johnson will campaign without being able to have Brexit behind him. The close association with Mr. Trump and Mr. Cummings brash style could also play a part in the election creating another level of uncertainty. Mr. Hammond, a leading Tory rebel says he is not sure if he wants to see the Tories win, adding another level of uncertainty. The SNP in Scotland hope to take Tory seats in this election and the Lib Democrats are campaigning on canceling Brexit altogether to get Tory Remain seats. ...

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Boris Johnson wins an 80 seat majority for the Conservatives in parliament in the 2019 election. He gets a mandate for a quick exit from the European Union by the end of January 2020, and billions of dollars in public spending on infrastructure, the NHS, and public services. He gets an unexpected 364 seats in parliament after winning the support of working class voters hurt by the financial crisis and by industrial decline. Working class voters in the north of England and the Midlands decided to trust Mr. Johnson. The Labour party won 203 seats, its lowest total since 1935.  The British pound surged to its highest level since May 2018, and domestic stocks surged with their best day since 2010. Part of the optimism stems from the size of the win that gives Johnson more flexibility at home and more leverage with the European Union to negotiate Brexit that works best for Britain. Working class areas that suffered for decades with loss of heavy industry, decaying infrastructure and poorer public services put their trust in Johnson's pledge to spend more to revive these areas. Johnson called his government "The People's Government" in his victory speech and promised to spend $131 billion on infrastructure, the National Health Service, schools, and public services. Johnson said in the speech that working class families may- "only have lent us your vote. I am humbled that you have put your trust in me, and that you have put your trust in us. And I and we will never take your support for granted." The other big event in this election is the election win in Scotland of the Scottish National party winning 80% of the seats and seeking a referendum on independence. Mr. Johnson has stated that he clearly opposes this. In Northern Ireland a majority of legislators were elected who favor unity with Ireland. This sets up a constitutional struggle that Mr. Johnson faces in his first elected term in office.   ...

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Captain Sir Tom Moore a 100 year old veteran who served in the Wellington regiment in World War II was knighted for his walks in his garden in Bedfordshire raising $3 million for the NHS.

His positive spirit is reflected in his words that he doe not feel very old inside, maintaining a youthful spirit in older age. He cooks his own dinner and walked for miles in his garden to raise money for the National Health Service.

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Labour Party's strategy in the coming British election is to tie Boris Johnson to Trump. This resonates especially on the issue of the National Health Service, with Labour saying a trade deal with the U.S. planned by Johnson is likely to raise costs of NHS with costly U.S. priced drugs. Mr. Trump says he sees little chance of the Johnson negotiated trade deal with the European Union allowing for a trade deal with the U.S. negating Conservatives plan to make Brexit work by negotiating trade deals independently. 

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The Cass Commission for Britain's NHS on how transgender affects children has concluded that there are dangers in the gender affirming care for minors.

Cass Commission's 4 year research for Britain's National Health Service concludes that gender affirming approach is mistaken. The American Medical Association, the American Academy of Pediatrics and the Department of Health and Human Services, are not a taking a science based approach to this important issue for parents of children, and the serious unease this is causing across the Nation in 2024, is shown in a report in the NYT by Pamela Paul.

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Captain Tom Moore a soldier from the Second World War II who marks his 100th birthday and has become a national hero in Britain. He decided to take 100 laps in his garden before he turned 100 to thank the Nation Health Service for a surgery of his hip. The activity created a fund raising drive for NHS raising 30 million pounds.

See the Royal Mail mailbox painted blue in his honor for the 100th birthday in this story, and the Spitfire and Hurricane planes flown  by the RAF in his honor. Tom showed humor in adversity, and a mature wisdom, no-nonsense attitude, to be an inspiration for young and old, says Britain's army chief.

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The Times correspondent in Beijing says he sees two Chinas one that is showing technological advancement in 5G, in space technologies, in information technologies, infrastructure building in big cities. The other China is in rural areas away from the big cities, in smaller towns in regions away from Beijing and Shanghai. These areas have suffered neglect and have changed little over decades, with the focus during industrialization on larger cities and the coastal areas. This is evident in the manner health services infrastructure and development of medical personnel and doctors were neglected in the rush towards building manufacturing and infrastructure of road and rail. There is a shortage of doctors and hospitals, health services are costly, and waiting lists for beds at hospitals is huge. Doctors are also not held in high esteem because the focus is on profit in the market economy that has taken over the health sector.  Education of citizenry on respecting the common welfare which is expected and normal in Europe and America has also suffered during the rush to industrialization. Efforts to ban and eliminate use of certain wild animal foods not being respected by fellow citizens can be seen in this context. This caused the SARS virus epidemic and the epidemic today from the coronavirus. Seen from this angle a slowdown in construction, infrastructure building, and a slowdown in the economy, can even be healthy, so that focus can be shifted to better health, better sanitation, and better medical infrastructure including medical human resource capabilities. Investment in public education on health and self enforcement of rules by citizenry for a better society is indispensable for progress. It is in these conditions that the challenge of the national and international emergency of the coronavirus can be seen today. It also provides an opportunity to reflect on progress so far and the needs of the future. These challenges are even tougher than repeating what one has done before such as building more and more infrastructure, as they involve building a better society through public discipline along with investment in health and education services. This provides a lesson for many Asian, Latin American and African countries in the rush to industrialization. Turning over the health sector to a market economy making services costly and distributed unevenly in the population has not worked in the U.S. for the betterment of all citizens and a healthy society. Carrying this over from U.S. to China and not learning from Europe in what Europe has done well in the less costly and broad distribution of health services for the people, is one of the poorer lessons learned. This is also true for India and South Asia, South East Asian countries in their rush towards industrialization.  ...

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A Commission in Britain has raised serious concerns about transgender medicine and its impact on the health of young people. Parents across the US and in European countries are very seriously worried about the impact on their children creating a great deal of stress, coming so soon after the pandemic when elder care caused much distress.

Cass Commission's 4 year research for Britain's National Health Service concludes that gender affirming approach is mistaken. The American Medical Association, the American Academy of Pediatrics and the Department of Health and Human Services, are not a taking a science based approach to this important issue for parents of children, and the serious unease this is causing across the Nation in 2024, is shown in a report in the NYT by Pamela Paul.

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This election is seen as a turning point for Britain. The Liberal-Conservative coalition has come up with a radical plan to cut spending and decentralize services in the areas of education, policing and health care. The plan is to cut the deficit quickly from 11% of GDP in 2009-10, to 2.1% in 2014-15. By comparison the outgoing Labor government's plan was to balance the budget by 2016-17. And the fiscal impact of Labor's budgets would have been 4% by 2014-15, compared to the Cameron government's looking at 6.3%, with larger and accelerated cuts in spending. It is something of a gamble by the Tory-Liberal government. If the severity of the cuts in spending stifle growth, then Plan B will be needed. The size of the cuts are not seen as feasible. With growing interest payments with the large borrowing by the government, and no real cuts in healthcare spending, departments delivering public services in Britain face cuts of 25% by 2014-15. With defense and schools limited to cuts of 10%- other departments would face cuts of 33%. According to the Institute of Fiscal Studies one way to reduce the severity of these cuts in department budgets, would be to find additional savings in the welfare budget. In June, Mr Osborne, the Chancellor of the Exchequer, announced 11 billion pounds in savings in this area (with half coming from using a different measure for inflation in calculating benefits). Additional savings of 14 billion pounds in welfare budgets, can reduce the size of the cuts needed in departmental budgets to 20%. One example cited is means-testing payments that go to the affluent as well as to poor people, such as child benefits, and cutting winter-fuel payments. Tories and Liberals agree on the need to decentralize government and services in the areas of schools, policing and the NHS. In schooling the idea is to give more choices to parents and children. Current schools can apply for academy status and new "free schools" will be run be non-profits, charities, churches, and parents. These schools will have freedom to set pay, select curriculum, and still receive state funding. In policing, the idea is to have directly elected police and crime commissioners for every constabulary in England and Wales. The elected commissioners would appoint constables and determine budgets and priorities. For the National Health Service the move is to give groups of general practitioners a significant role in the delivery of health care. ...

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Germany faces serious problems in its vaccination drive and efforts to control the pandemic in November 2021. The rate at which people are getting vaccinated has slowed to 150,000 a day and the percentage of the population that is vaccinated is stuck at 67%. This percentage of 67% fully vaccinated in Germany as of November 3 is much lower than that in Spain, France and Italy.  Spain is at 78%, France at 69% and Italy at 72%. (Data from NYT) This report in the Guardian points out that most of the remaining one third of the population is not eager to get vaccinated as surveys show that the those who have refused to get a jab are unlikely to change their minds.There is also the problem of booster shots. Germany's 16 regions conduct the vaccination drives and with many of the vaccination centers not active since September staff has to be retrained or rehired. This makes it harder to give booster shots to everyone that was vaccinated early by the start of winter. Why is it that Germany lags behind Spain in vaccination? There is a great deal of trust in Spain and Portugal in the health service and people are 100% behind their health system. The other countries that have a low rate of fully vaccinated are the US at 58%, Brazil 57%, Russia at 33%. Even the UK with its well respected National Health Service remains at 68% fully vaccinated. Today the US, Russia, Brazil, European Union countries and India have many of the 5 million deaths from coronavirus. India's vaccination drive is approaching 1100 million vaccinated, yet there is along way to go in getting most of the population fully vaccinated because of the large population of 1.3 billion. This is why the Indian prime minister on the first day of returning from the COP26 climate summit devoted his time to meeting with leaders of different states and heads of districts with low vaccination rates to press home the idea that the effort had to be taken up vigorously in the coming months. ...

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Now that finance ministries around the world are trying to save their economies with trillions of dollars in aid packages their finances are stretched to the limit. The so called digital tax is not really a digital tax. And efforts to recover lost tax revenues in Europe are being opposed by the U.S. because tax levies by France go only to France, not the U.S. The U.S. Treasury or U.S. government or the American people would not turn down tax revenues that it normally gets when its finances are stretched to the limit with trillions of dollars for cornavirus leaving little for crumbling infrastructure and essential public health services, other services that determine quality of life in America.  This Washington Post report shows that there is greater awareness that the right approach is to pay taxes based on where revenues are located and by the number of users in each country. But the problem goes deeper than that. The coronavirus changes the entire perspective and take this back to roots. Companies pay taxes because it is the right thing to do. In Japan Panasonic's founder Matsushita felt that it was a national duty to pay its share of taxes as it too was sharing in the benefits provided by society- in the health, sanitation, education and transportation, parks, and hundreds of services provided by government. Once this is seen as dispensable or somebody else's problem, then these very services and infrastructure can be starved of capital. Coronavirus changes this perspective. People crave for outdoor spaces- who is going to maintain them and set up new spaces. People crave for not moving around on crumbling bridges, roads, subway systems. Who is going to provide them? People crave for good schools, community colleges. Who is going to provide them? People crave for good sanitation systems? Who is going to provide them? People crave for good public health systems. Who is going to provide them? Its just good common sense. Is it possible for common sense to be missing? It is- just ask people today, and it is good common sense to have good critical infrastructure such as sanitation, medicine, public health, and local manufacturing of medicine, yet economic experts and economic theories thought it made sense not to do this.  ...

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Laura Marshall-Andrews is a GP, a General Practitioner doctor, in Brighton, England, with a different approach to patients and health care. She takes into account the whole patient, the patient's mental condition, putting back some of the things that reduce isolation, increasing feelings of self-worth, bringing more community and nature interactions of a positive nature that can affect the patient's health. In some situations having a doctor who listens and is willing to take the time to talk to and know the patient, and being aware of the patient's whole condition as opposed to fragmented areas based on fields of medicine can make a huge difference. Don't look for a diagnosis, treat the whole person,  says Laura Marshall Andrews in her new book- What Seems To Be The Problem? She believes social prescribing takes a whole load off the National Health Service in Britain. This includes art, photography classes, dance classes, singing classes. A study by the University of Westminster shows the GP visits go down by 30% and emergency A&E visits by 25% with social activity prescribing. Yoga, meditation, gardening, nature walks, are also part of the same activities that can help people improve how they feel and think and bring the sense of peace in their lives that brings better health with it. In the loneliness and isolation, community dislocations and pressures of life in today's cities, all these activities are immensely important to the idea of whole health of the whole person. Dr Andrews says that if you keep a community happy and creative, then you are not going to need a lot of expensive hospital treatments." "Cum Scientia Caritas" the motto of the Royal College of General Practitioners means Science with Caring. ...

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Jeremy Hunt, head of the Health Select Committee and Health Secretary 2012-2018, says Britain needs to take up mass contact tracing as its next national mission. Britain he says has passed 20,000 tests a day for coronavirus. America has passed 150,000 tests a day. Both more than South Korea. What is missing when compared to South Korea and Taiwan is mass contact tracing.  The app TraceTogether is not enough, as it was used by only 20% of Singapore's population. Only South Korea and Taiwan are able to open up the economy, have workplaces and life function close to normal through extensive testing and mass contact tracing, with feet on the ground. This is the only path that has worked with South Korea successfully out of the lockdown. This means "feet on the street." Making these calls requires skills, getting information, getting cooperation, offering guidance, and ensuring people isolate themselves after contact with an infected person. Sometimes it is by phone and sometimes in person wearing full PPE. They need to be sensitive enough in talking to someone feeling ill and to see how home isolation can be achieved, who else the coronavirus infected person or someone in the chain of contacts has been in contact with. Mr. Hunt says no effort should be spared in doing this as the millions of jobs in Britain, of people without work, the economy, and the need for light at the end of the tunnel of lockdowns, requires a way out. A huge task but a lot of impossible tasks are being tackled in the health services. The resources of Britain, every spare civil servant, every administrator not working, every one who can do this, needs to be enlisted to do this. The same task needs to be tackled in America, and in other countries as a national mission. ...

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Pearlstein quotes Dickens in "Oliver Twist," about the law being an ass, and the constitutional law exercize in the Supreme Court of the U.S. giving a sense of a failure of the so-called best and brightest in reasoning out the issues. He points out that a serious problem is that American business which is burdened with high health care costs for employees is seriously missing in this debate after years of complaining about high costs. The National Federation of Independent Businesses is actually one of the plaintiffs questioning the constitutionality of the Obama health care law. Pearlstein says business wanted an end to the fee-for-service medicine that increases consumption of medical services and pushes up cost relentlessly, and that Obama's health care law does this. This is not the case as both Democrats and Republican administrations have failed to resolve this side of the cost issue, and this is the hidden reason for the loss of credibility for both sides in this debate, leaving health care problems to be resolved in future administrations. ...

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It is only 10 days from the Thursday July 4 election night and Keir Starmer went to work immediately Here is what he said today: "My new cabinet hit the ground running. We’ve lifted the ban on onshore wind. We’ve created a national wealth fund to invest in and grow our economy. We’ve met NHS bosses to get the 40,000 extra NHS appointments we need each week and 700,000 urgent dental appointments up and running as quickly as possible. The Department for Education is resuming and expanding its recruitment campaign to kickstart our promise to hire 6,500 new teachers. We’re taking emergency measures to pull the justice system back from the brink of collapse. And, on day one, we scrapped the Rwanda gimmick and began setting up a new Border Security Command to smash the people-smuggling gangs for good. Now is the time for politics as public service. A government committed not to its self-preservation but to uniting the country in the shared mission of national renewal. The start of the road back to restoring people’s hope and faith that politics can be a force for good. No more gimmicks, lies and self-serving self-obsession – this government knows we have a duty to the people we are elected to serve." ...

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President Trump on a three day visit to the UK promised a free trade deal with Britain if it made a decisive break with the European Union. Such a free trade deal could take years, offer small benefits compared to the loss of the much larger trading relationship with the European Union. It would face hurdles in passage through Congress because Democrats controlling the House of Representatives see a decisive break with the European Union including the customs union arrangement as affecting the open border in Ireland risking the hard won peace in Northern Ireland.  Prime Minister Theresa May proposed a withdrawal arrangement that would keep the customs union arrangement but has failed to secure the support of a faction within her Conservative party that favors a decisive break from the EU. Such a break that Mr. Trump and Boris Johnson the leader of this faction -and a favored candidate to succeed prime minister May after her resignation- would reduce Britain's GDP over the next 15 years at the higher end of the range of 0.1% to 9% a year. A decisive break called a no deal Brexit with no arrangements or agreement for withdrawal with the EU, would lead to a loss closer to the 9% estimate. British experts to the EU are about $275 billion or 44% of its total exports compared to about $44 billion to the U.S., according to HMS Customs source, showing how important it is for Britain to maintain a close trading relationship with the European Union. British farmers would also face competition through agricultural imports from the U.S. in a free trade deal. During his visit Mr. Trump also stated the National Health Service, everything would be on the table in a free trade deal with the U.S.  Theresa May responded by saying that the NHS would not be open for negotiation to American corporate involvement. Public sensitivity is high on any change to the National Health Service. The trip of president Trump to London in which he supported Boris Johnson as candidate to succeed Theresa May, with discussions between Trump and Johnson for 20 minutes, and a visit by Nigel Farage to the U.S. embassy, and no meeting with Labour party leader Corbyn, only shows the widening of differences on the issue of British withdrawal from the EU making any deal for withdrawal even less likely. Labour party leader Jeremy Corbyn now favors a second referendum on whether Britain should leave the EU.  ...