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Wal-Mart is expected to announce a five year plan to meet specific targets for lowering sodium, trans fats and aded sugars in a whole range of foods- including rice, soups, canned beans, salad dressings and snacks foods- in packaged foods sold under its house brand, Great Value. Other moves towards healthy foods are to move to eliminate the extra cost to consumers for healthy foods made with whole grains. It will also lower prices on fresh fruits and vegetables. This plan is similiar to other plans announced by companies such as Con Agra Foods which set a target of reducing sodium content in foods by 20% by 2015. New York City also has a public health initiative for healthy foods. another move by Wal-Mart is to get major food suppliers like Kraft, to follow the example set by Wal-Mart. Kraft sells 16% of its global sales through Wal-Mart. The move will be gradually introduced over five years which makes for slow progress, and the targets set for sugar reductions are much less than they should be, says Michael Jacobson, executive director of Center for Science in the Public Interest. Another serious drawback is that Wal-mart has not proposed to tackle the major cause of childhood obesity, which is the added sugars in soft drinks....

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The Washington Post survey of 1200 readers on how the Republican healthcare plan of Speaker Ryan and the House of Representatives looks to them, how it affects them in their lives. Here Somasekhar of the Post gives the stories of 5 Americans. Some see the prospect of losing their insurance under the Republican plan even as they reach an older age, others a smaller segment says the Post, whose premiums jumped under the Affordable Care Act say they faced high premiums and high deductibles. The Post says the large majority of opinions have expressed anxiety over the proposed Republican Ryan House plan for healthcare. One of them is an uninsured poor farmer, Mr. Woosley,  income about $18000 who gained benefit from expanded Medicaid under the Affordable Care Act,  one Mr. Smith, 32 years, a personal injury attorney who faces paying $10,000 if he did not take insurance and $10,000 if he took insurance because of high premiums so a wash either way deciding to do without it, one a tech worker Mrs. Powers, 62 years, income $22,000 on year and $4000 the next, from middle class during the tech boom but facing fewer opportunities and uncertain income from part time work, hit by the deep recession facing fewer opportunities as she gets older and now the prospect of losing insurance without government subsidies, one who is from the middle class who sees little benefit from the Affordable Care Act and is forgoing insurance because of the high premiums yet faces a penalty for not being insured under the ACA, another Mr. Blanchard, 52 years, is from the middle class, a computer programmer who lost his job in downsizing, earns $100,000 as a consultant self-employed, pays $767 in premium a month and relies on the Affordable Care Act which helps him gain freedom from working at a company that could downsize,  another is a middle class programmer Mr Riffle,age 44, and his wife, who does not qualify for a subsidy with a $71,000 family salary from working 4 jobs between himself and his wife- this person finds it too expensive for his salary to buy insurance $900 a month and $14,000 deductible under the Affordable Care Act. His views are worth listening to as they go to the crux of the problem- he says he may not be any better with the Republican plan. He sees the real problem as the high cost of health care in the U.S. and the only way this can be fixed is for members of Congress to be asked to use the insurance exchanges they create. If this sample is representative it shows that there are real problems with both the Affordable Care Act and the Republican plan, that the high cost of health care the problem lurking behind every plan that does not squarely address this, and till that happens and members of Congress experience what ordinary people face, this problem can never by fully solved.   Woosley, Smith, Powers, Blanchard, Riffle, and their personal experience is at the crux of what is right and wrong  with the Affordable Care Act, and also with the new Republican plan of Speaker Ryan and the House of Representatives. For every Woosley, Powers and Blanchard who benefit, there is a Smith and a Riffle who are indifferent or are affected by the high cost under Affordable Care Act and the current system of medical care with its high cost. The Affordable Care Act does not  tackle high cost, for that to happen the culture in America that makes it possible and acceptable to charge high prices must change. Another problem apart from bringing health care costs is that any solution needs to have the whole country behind it. If the notion that all people are entitled to basic health care is to stand, the whole country needs to believe it as they do in countries like France, Britain, Germany and Japan. If this has to be made a workable proposition health care has to be offered at a price that makes this possible to achieve, and that idea also needs the deep and broad sense of support from the culture in America similar to that in these other countries. Until that happens politicians in America will get elected and turned out of office in turns on issues such as health care, based on which side they take and which problems they choose not to face squarely and responsibly. ...

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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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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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A study done at the University of Wisconsin's Population Health Institute by health sciences professor, David Kindig and PhD candidate Erika Cheng, shows the impact of smoking, graduation rates, poor choices and availability of food, and incomes, in declining life spans of women in some parts of the U.S.

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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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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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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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The startling truth about health "reforms," - they won't control spending, and without that the whole system of health care will rapidly become unaffordable and unsustainable. Obama's Council of Economic Advisors points out in new report that since 1975 annual health spending per person, adjusted for inflation has grown 2.1 percentage points faster than overall economic growth per person. At this rate health spending which was 5% of the GDP in 1960, and is 18% of GDP today, would grow to 40% of GDP in 2040. Medicare and Medicaid would increase from 6% of GDP now to 15% in 2040, or equal to three fourths of federal spending. Employer paid insurance premiums for families which grew 85% in inflation adjusted terms from 1996 to $11,941 in 2006, would increase to $25,200 by 2025 and $45,000 in 2040. This would force employers to reduce take home pay. Samuelson says the uncontrolled health spending is singlehandedly determining national priorities, reducing discretionary income, raising taxes, widening budget deficits and squeezing other government programs, while it is producing large amount of waste in medical spending. See the link to Prof. Tyler Cowen of George Mason University in NYT, 6/14/ 2009, who cites the habit of doctors to write many expensive tests as one of the prime culprits in the wasteful spending. And in the process it delivers higher cost for lower overall quality of health for the American people. This at a time when many European countries provide live examples of doing it in a better way- lower cost, better health. The serious problem with the Obama health reforms says Samuelson is that it talks about restraining spending but may end up increasing spending. Its talk about controlling spending he says is good intentions, but based more on hopeful thinking, public realtions and risks becoming cosmetic reform. Because to really control spending will require coming to grips with its fundamental cause- hospitals and doctors are paid mostly on a fee-for-service basis and reimbursed by insurance, private or governmental. Such a system encourages doctors and hospitals to provide more services, expensive tests, favors heavy use of expensive medical technologies to increase profits, and for patients to expect them. Samuelson puts his finger on the root of the problem - there is no incentive and every disincentive for all the players in this game , doctors, hospitals and patients to seek reform of this system. For doctors and hospitals the hope would be that this cosmetic "reform" would leave the system basically unchanged, and patients to continue with a lifestyle and expectations that do not not acknowledge the fact that a lot of healthcare does not come from spending but from preventative care, education, good eating and exercize habits, and healthy lifestyles. And the uninsured are no exception, they would simply start consuming the expensive care for lower quality of overall health like everyone else. With this kind of situation confronting us, the views of Samuelson, and Professor Tyler Cowen of George Mason University, as welll as a growing chorus of informed public opinion on this subject, is that insuring the uninsured is a good idea, but doing it within the bounds of the present system, can only increase the costs. And too much is at risk, to rely on what Samuelson calls a scattershot of measures to control costs made up by Congress such as "evidence -based guidelines," "electronic record-keeping," "bundled payments to hospitals, to give the illusion of progress that won't make a serious difference. A sweeping restructuring of health care is needed, that would overhaul "fee-for-service" payment and reduce the fragmentation of care. It will also need what has not even be touched on adequately in the debate. This is the massive need for education in the schools about nutrition, eating, exercize, healthy lifestyles. It would also require opinion leaders in each field from sports and other fields to lead by example and with constant public presence, the media, and companies to form a partnership with private institutions to change existing eating habits and lifestyles that encourage obesity, smoking, fast food eating habits, large portions in restaurants....

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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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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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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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President Obama's program for education includes promoting charter schools, closing failed schools, making teacher pay reflect the quality of education they can provide, and providing financing to support better education and better classrooms. Here he outlined his plans in a major speech on education to an Hispanic group.

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A number of issues came up at the Women20 Summit in Berlin. Annette Niederfranke, Director of the International Labor Organization, brought up the issue of family reconciliation as "one of the toughest challenges for working women worldwide," that in order to meet obligations women tended to work in "non standard forms of employment and in part time work linked to lower wages, lower social security, lower benefits, and fewer training possibilities." Childcare was also an issue that was prominent considering the lack of adequate childcare in many countries including in the European Union. With responsibilities for the elderly, babies, and small children women tend to be in the workforce for shorter periods leading to men taking up many of the higher positions. Angela Merkel pointed out that Gemany tended to take a narrow view of professions available to girls, saying- "So it is very very important that we take a broader view of things while girls are still at school." Merkel also supports a Africa compact that would help women set up small and middle size businesses in poor countries. The "Digital" aspects of this and other efforts for women were a major topic being discussed. One idea that came up was that more cooperation from men was needed to make things happen. This is the third Women20 Summit after ones in Turkey and China, and a sense of momentum was felt by women. ...

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Prof. Peterson of Harvard and Hanushek of the Hoover Institution, authors with Woessmann of the book "Endangering Prosperity: A Global View of the American School," offer some startling reminders about the importance of education to economic growth and incomes in countries. Simply by raising the math standards in the U.S. to the higher standards in Canada would raise GDP by three fourths of one percentage point. One advantage that the U.S. enjoys comes from its good university systems, open markets, rule of law, tax rates, and open immigration policies, which give it about two thirds of a percentage point in higher GDP growth per year. The estimates are from the authors calculations. For the period 1960-2009, a period of rapid growth in Asian countries Korea, Taiwan, Singapore and Hong Kong, higher test scores in math and reading compared to the wrold average as measured by NAEP test and PISA, have led to 2% higher GDP growth. NAEP shows only 32% of U.S. high school students proficient in math compared to 45% in Germany and 49% in Canada and 63% in Singapore. By contrast to Korea and Taiwan, Peru, Argentina, the Philippines and S. Africa have about 2% less in GDP growth because of lower scores compared to the world average....

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How will countries like India generate jobs when technology enables manufacturing and other activity to do work with fewer and fewer people. Even Hon Hai in China is shifting work to robots. Technological progress is leaving more people unemployed and widening income gaps with the benefits going to a few people, says the Economist in this research based essay. It will require carefully managed governance to invest in infrastructure, raise skills of less skilled workers through education, and wage subsidies for those left behind to ensure our current system works in the future.