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General Electric, GE, experienced a steep decline in the last decade. The worst news came in 2018 with the loss of half its share price and market value. One story tells about an employee who was forced out of retirement back to work seeing the loss of value in GE shares in 2018. Rarely has a company of this size seen a fall in stock price this steep, for a stock that was once seen as safe for widows. About 60% of GE business comes from jet engines, electric power generators and wind turbines. GE now plans to sell its health care business and other business that do not relate to core infrastructure in energy, aerospace, and other markets. Under Jack Welch a faulty model of adding diverse businesses that had nothing to do with its core business and expertise in infrastructure were added. A home mortgage lending business was added and GE Capital expanded. NBC Universal was added with little justification in a period when CEO's acted without much consultation. The home mortgage lending unit collapsed with large losses during the 2008 financial crisis and GE's share price dropped drastically to $6.00. Under Welch's successor Mr. Immelt the GE Capital unit was shrunk in size, but losses continued to mount. An oil field service unit was added which also sustained losses.  Immelt's successor Flannery faced a loss of $15 billion from the financial lending unit. Sale of some businesses was not sufficient to meet the loss. Flannery is now taking GE out of all the businesses which were not core business. The NBC Universal television business was sold to Comcast in 2013. GE Healthcare is next. This closes a bad chapter in GE's story under Welch and Immelt. GE's dividend was cut for the second time since the Great Depression. The story of GE is also the story of American business during the last two decades, with icons such as GM, Ford and GE suffering decline, businesses that operated like little fiefdoms of old nobility in Europe, with CEO's operating in a CEO centric culture, not tolerating contrary opinion for informed debate on issues facing the business. Alfred Sloan founder of Genral Motors called constructive debate central to good management. Later Intel CEO Andy Grove coined the phrase constructive confrontation as a way of constructive debate, and the CEO was shown as the first of equals. The CEO centric management ignored these warnings and admonitions in running their fiefdoms.   ...

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State based exchanges in New Mexico, Oregon and other states have experienced difficulties setting up and running the exchanges. Many states have turned to the federal government to operate the exchanges.

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S. Jaishankar is one of India's most experienced diplomats. The Indian Express shows work he did in Sri Lanka during another crisis. He called the Indian High Commission in Sri Lanka when he learned about hospitals in Sri Lanka that had shortage of supplies and could not conduct surgeries for this reason. He asked that arrangements be made for these healthcare supplies.

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This is an exceptionally humorous operating room story of Dr. Trump and Dr. McConnell by Kristof of the NYT. Sometimes humor tells the story- and Kristof does this using a story of a surgeon president Trump in the operating Room trying to address the concerns of the patient Janet, as he keeps telling her she needs a new heart with great benefits, great benefits, before she implodes or goes down failing. Flat out take the old heart out even if a replacement hasn't been found, believe me great benefits the surgeon tells her, just that the patient just isn't getting convinced as its happening to her. The analogy is with replacing a health care plan, not just the Obama plan, any plan without something to take its place. For a few days before this article by Kristof, the Republican effort to repeal the Affordable Care Act without having a replacement was presented as a good idea. Janet is like the three Republican women- Collins of Maine, Capito of West Virginia, and Murkowski of Alaska who wanted to keep the heart they had till a replacement was found, against the surgeon Trump's advice. In a way it is about politicians in the last decade who never had any discussions as they rushed through with their own agendas, as the Republican and Democratic health care plans were rushed through Congress with relatively little participation and debate to hear all viewpoints. ...

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This NYT report says US president Biden is different from past presidents in two ways. He is pushing for infrastructure spending on a big scale from the very beginning of his administration. He is also not interested in shrinking his plans for multi-trillion dollar infrastructure spending to win support from Republicans. A big reason is that he sees the opportunity to go ahead because the perceptions of the American people have changed in the last five years, and have changed even more in the last year with the pandemic. Health, education,  infrastructure, and competitive technology leadership resource development spending with government playing a leading role is seen as indispensable for the US as a nation if it is to play the leading role that it has played over much of the last 100 years. Government leadership is seen as indispensable including in redesigning the existing global supply chain so that the US is no longer dependent on other nations and taking on risks. ...

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G-7 nations reach agreement for a global minimum tax of 15% a floor for taxes that the Biden administration finds acceptable. This agreement was reached at a meeting of the Treasury chiefs of the 7 G-7 countries in London on June 5, 2021. The G-7 countries are Canada, France, Germany, Italy, Japan, UK, and US. Next agreement from Russia, China, India and Brazil in the G-20 nations would establish new ground rules for the major economies. The G-20 meeting is in Venice July 9-10. The OECD is steering the international efforts to achieve that goal. For the agreement to be effective a number of small nations that use tax rates of below 15% to attract business have to be part of the new rules. One of these countries is Ireland with a tax rate of 12.5%. For the Biden administration in the US the goal is a significant one as president Biden seeks business to pay its fair share so that long neglected priorities for education, healthcare, infrastructure, post pandemic improvements can be met. France and other nations in the EU face similar needs in the post pandemic environment. By setting a floor the Biden administration is both creating a new cultural concept of fairness in taxation and making it possible to finance the $2 trillion spending programs for these priorities of president Biden. Behind this are important facts that have left the large tech businesses paying little or no tax depriving governments of the very revenues that are needed for infrastructure and services for a modern well run state. The Biden administration seeks to include the tech businesses as well as all businesses in the new tax rules so that a uniform idea of fair taxation applies across the whole economy for the first time in two decades. In this way it makes up for the missed opportunities in the OBC administrations of Obama, Bush, Clinton that have led to loss of faith in the state and institutions in the US. A similar situation prevails in the UK,  France and Germany where previous administrations failed to address this important issue of fair taxation and financing infrastructure and priorities in health, education, and critical needs of the people.   ...

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Senators Mike Lee of Utah and Jerry Moran of Kansas declare their opposition to the Republican Health Care bill proposed by Senator McConnell. This decision by the two senators makes it impossible to begin debate on the bill. Earlier two other senators, Susan Collins of Maine and Rand Paul of Kentucky announced their opposition. This means the Republican health care bill has no chance in the Senate even after changes to the bill passed by the House of Representatives. Republicans have a thin majority in the Senate make it difficult to pass legislation. Collins met with residents in Maine and Moran with people in his home state of Kansas, and both senators heard a lot about the negative effects of the Republican bill on people in their state. The bill is seen as hurting people in rural areas, elderly, and not likely to do enough to bring down premiums. Its plan to slash Medicaid spending has drawn strong opposition from all Democrats.

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Hillary Clinton narrowly loses the Michigan primary to Bernie Sanders in March 2016, as the Sanders campaign focusses on Clinton's support for trade agreements that hurt American workers and lead to loss of manufacturing jobs. About three fifths of voters in the Michigan primary considered this a major issue. Many less educated younger workers see their job prospects diminish and wages drop with free trade that hurts American manufacturing jobs. Bill Clinton signed the NAFTA agreement with Mexico, and as a member of the Obama administration Clinton supported the Trans Pacific Trade Agreement, later opposing TPP when she left the cabinet. Sentiment against trade that hurts manufacturing jobs in the U.S. is strongest in midwestern states such as Michigan, Ohio and Illinois. This was also a major issue benefitting the Liberals under Justin Trudeau who won in Canada's industrial Ontario province which has suffered hollowing out and loss of manufacturing jobs under the Conservative Harper administration. In the U.S. the issue goes back to the Clinton Administration for two decades. New jobs created by Apple, Google, and other tech companies pale in comparison with the industrial jobs created in another era that benefitted working class families. This issue and high unemployment or under employment, lower wages for working class families, was a major issue in the 2016 U.S. presidential election campaign. Widening wealth disparities, and lack of upward mobility, high tution and healthcare costs for ordinary families, dominated the campaign in the U.S....

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Susan Jaccoby brings up a major issue facing healthcare in America from personal experience. A third of the Medicare budget, she says, goes to the last year of life, and a third of this goes to the care in the last month. At the same time public opinion polls show Americans see the problem being too much medical intervention rather than too little. Especially when there is no hope except to prolong life for the patient with an highly deteriorated qulaity of life for a few months or a year, doing no service to the patient or future generations who may see their basic services cut when they most need it as a result of the unaffordable spiralling cost of Medicare. A Pew Research Center poll in 2006, shows 22 percent say a doctor should not always make efforts to save a sick person's life, and 70 percent believe that patients should be allowed to die in some situations, when it only prolongs life for a few months for instance and patients live in pain. The problem only gets worse in future years as an estimated 8.5 million Americans are expected to be over 85 years in 2030 with these same choices facing patients, their families, Medicare and the country....

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U.S. president Obama's passive response in the handling of the NSA spying on the phones of world leaders including the president of Brazil and the chancellor of Germany comes under criticism in the U.S. The failure to provide adequate assurance- and take immediate action since the summer of 2013 when the first revelations of NSA spying were out- to regain trust of European and other leaders is seen as a weakness in leadership. With German presidential elections approaching German chancellor Merkel actually tried to tone down the initial uproar over NSA spying revelations in the summer of 2013. It was only after it was revealed in October 2013 that NSA had monitored Merkel's mobile phone did the chancellor make an issue of this and Obama could not respond to why no action had been taken since the summer and a complete review of NSA spy activities made by the President and advisors. Because world leaders are involved, and not just of allies but large emerging market nations such as Brazil, this becomes the personal responsibility of the U.S. president. Obama also comes under criticism for not responding to the failure of the healthcare website. This matter is of a different nature and could be handled by the President's Health and Human Services Secretary, Ms. Sibelius....

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Zardari is described as "very, very weak" by the administration, and his popularity is only in the double digits compared to 83% says the NYT. From the standpoint of democratically elected government it is important to note that Zardari himself was never directly elected, and is highly unpopular and weak, and known for corruption. If anew election was held today its highly unlikely that he would be elected. Even Benazir Bhutto's popularity may be aresult of years of military rule, and the efforts by General Musharraf to suppress freedoms and prolong his rule. Her party came to power in addition from a sympathy vote after the Musharraf government did little to provide the securtiy that could have prevented her from being shot at an election rally. With the lack of good alternatives -not the military which has provoked wars with India, not the Bhutto parties which have lasted for only short periods marked by corruption, and its not clear if the Sharif governments have done much better- its hard to say how the people of Pakistan can register their voice for responsibile democratic government which works diligently to bring services in healthcare, education, and build infrastructure, for Pakistan to keep up with the region's development....

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In Brazil's 2018 elections most candidates talk about shoring up crumbling infrastructure, and law and order. Yet no one talks about the budget crisis as there is no money left for doing this.  Shocking as this may sound after years of overspending and a recession, Brazil now uses borrowed money to pay pensions and salaries, and keep schools and hospitals open. Brazil's public spending exceeds revenue by about 7% of annual economic output. Taxes are already 40% of economic output, according to CIA's World Factbook website, making it hard to raise taxes.  This WSJ analysis says you cannot overstate the problem in Brazil as about two thirds of the budget goes to paying old age pensions, payroll of public sector and public healthcare. By 2020 these liablilities will grow to the point there is nothing left for discretionary spending such as roads, infrastructure, new hospitals, police equipment. Trimming pensions and freezing wages are likely options to tackle the problem. Still this leaves Brazil with the prospect of a lost decade.   Neighboring Argentina is experiencing a contracting economy and had to turn to the IMF for assistance.  The decline in GDP comes as a new conservative administration took over promising an improvement in the economy. The peso declined by 18% in 2018 so far leaving Argentina's public and private debt of $166 billion which is 80% denominated in U.S. dollars much harder to pay off. The stronger dollar has hurt Argentina leading to a $50 billion support agreement with the IMF.  Much of Latin America is now in an economic crisis. ...

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Detailed account from visits to the Chinese rural countryside to see how Premier Wen's heralthcare and education reforms are faring.

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Jill Biden teaches at Northern Virginia Community College. She wants to continue her job teaching community college students helping them prepare for 4 year colleges, even after Mr. Joe Biden becomes the new president of the U.S.  This story of Jill Biden in The Times is exceptional in giving a vivid picture of the person closest to the new U.S. president. Both the Bidens, Joe and Jill, come from working class families in the northeastern U.S. Mr. Biden's life is marked by a single event that has affected his whole life the death in a car accident of his first wife Naomi in December 1972 when he was running for U.S. Senator in Delaware. He won that election becoming the youngest senator in U.S. history. The family retained high ambitions for Joe, hoping that he would become president. Jill met Joe Biden during this campaign and she married Joe in 1975. Jill had spent 13 years of her career teaching English in secondary schools, and the past 27 years teaching in community colleges, including the eight years when Biden was Vice President. Along the way she studied for 2 Masters degrees and a doctoral degree. Her dissertation for the doctoral degree was on the topic- Student Retention at Community Colleges: Meeting Student Needs. Student dropout rates are high about one in three in community colleges dropout.  It is a sign of the misplaced priorities of today that Dr. Biden takes pride in her degree and many do not think this is important enough a topic for a dissertation. Not only her education and hard work studying for advanced education makes her a unique asset, there are other parts of her character that make her exceptional and right for the times. Jill Biden entered a family that in some ways after Naomi's death was broken. The were two children surviving the fatal car accident in 1972, Beau and Hunter. This story shows how she handled this in a way that required extraordinary serenity and composure. There was the ambition of the family. There was the memory of the accident and Naomi. There was the cynicism about her passion for education in fashionable Democratic party circles out of touch with the roots of the national character in education and in libraries starting with Ben Franklin and Jefferson. With president Biden entering office at a time when the U.S. as a country is broken by the very neglect of education, healthcare and working class Americans, Jill Biden at 69 years has the experience, vigor of spirit and character needed today.   ...

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Where do you place a winner of the Democratic primary in Maine, Graham Plattner, an oyster farmer who dropped out of college at George Washington University, served briefly in the Middle East wars of Bush and Obama, and had PTSD. Is he working class, middle working class or is he from a downwardly mobile professional class considering he has parents who are well educated and father a prominent lawyer in Maine? Plattner easily defeated a 3 term governor of Maine with his average working class demeanor and language. He is for universal health care, (Medicare for All) universal child care, affordable housing, affordable college. Politics in the US has been moving away from the simple divisions before 1950 created by the Industrial Revolution- the workers in factories and the owners of capital allied with the professional middle class. The few owners of capital mostly college educated allied with people from the non college educated workers in factories who are conservative in their values and beliefs and on the other side the college educated professional middle class now downwardly mobile because of the many recessions and high unemployment from frequent financial crises, with college costing $80,000 a year putting them in deep debt. There is today in the WSJ a story of a professional worker who at $194,000 a year salary is not able to payoff $15000 debt which owners of capital have set at 26% interest and is in downward spiral. Some of this comes from large college and other debt. There is says WSJ Analysis $1.25 trillion in credit card debt alone with highest delinquency rates in decades in 2026. Cost of living has only made things worse and some of this happened as Biden poured money into the economy to help people hurt by the pandemic, yet with some short run consequences with demand strong businesses including hotels, restaurants and grocery stores, auto dealers, jacking up their prices by over 20% in 1 year and Biden failing to respond, getting overwhelmed by open borders migrants under Mayorkas and Harris (also hit by a sudden Venezuelan migrant influx). This is the America one has today- a confusing mix. This in reality means Democrats may take issue with Democrats, Republicans take issue with Republicans, and Democrats join with Republicans on issue by issue basis. It might actually be rational than irrational. On cultural issues if the country has gone over its head and moved too fast on some issues that are not for the general public good, people of different backgrounds can come together to get the best path. On economic issues things are never so straightforward, there are unpredictable consequences and the rules of economics are really not so straightforward either.  Providing relief can mean the government shouldering the burden as during the pandemic which it should, yet with caution as businesses can use the excess demand to raise prices and one is back to square one with everybody worse off as happened with Biden. Migrant flows and fears of insecurity in public spaces can lead to a severe public "discomfort that can waylay the best intentions of a Harris or Biden, leading to public "backlash." In fact the title of a recent book is "Whiplash." Current books include Floridan Marco Rubio's "Decade's of Decadence- How our Spoiled Elites Blew America's Inheritance of Liberty, Security and Prosperity." Rubio means it. Its authentic because as Rubio says repeatedly, his parents could make a living in the 1960's working in a factory with decent wages, low cost of living and low cost of college, the arithmetic between salaries and what you needed for decent home in suburbs and sending children to good public schools, then to college, all adding up. The result is that Rubio could go to college and serve in the Florida legislature. Rubio says in 2026, after the elites under Bush and Obama and faulty economic theory shipped all of our factories to China, that the story of his parents and his education would simply be impossible. This is what he told people in India on his first visit last week. His parents were Cuban immigrants, yet he identifies with Spain and with western civilization, a devout Roman Catholic. Rubio is a Republican, and is in large contrast with Alejandro Mayorkas, also from Cuba, and Biden's Head of Homeland Security. This is the mix of people and representatives in Congress,  business people, small business owners, professionals, that we have today in 2026 in the US. Plattner and Rubio, one a Democrat and one a Republican- both have something in common. Plattner also has general disdain for "the corporate interests, the billionaires, the Washington DC elites, and the establishment politicians."  The winds are blowing in the direction of getting things right- remembering that Eisenhower continued the work of the Kennedy and LBJ administrations (Eisenhower built the Interstate Highway System for instance, and LBJ gave America Social Security and Medicare). Before that Franklin Roosevelt a Democrat built on the work of his uncle Republican Theodore Roosevelt (TR gave America the idea of good governance and built the US Navy, FDR fought the Depression and stabilized a faltering economy after mistakes made by Republican Herbert Hoover could have happened even if Hoover was a Democrat. FDR was himself from a wealthy New York family and when he first met fellow New Yorker Frances Perkins before his struggle with polio, a haughty New York gentleman. That was before Frances Perkins as FDR's Labor Secretary joined forces with Roosevelt to give New York a modernized administration governance structure by 1940 that was applied to all 51 states after 1950. It allied labor with capital with fairness for all, and was the first such modern structure of this size the world had ever seen, which was the fundamental strength of the United States of America. It was imitated in Asia, first in the Shanghai region then China, and first in the Ahmedabad region and now India. The US is faced with the challenge of recreating and rebuilding this today, as first China, then India remind America of its roots which they have followed in their own style and culture.  First good governance, then good institutional structures, alligning labor and capital with fairness for all, strong affordable + accessible educational and healthcare systems, and investments of capital and labor for infrastructure + industrial development. ...

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This editorial in the HIndu newspaper says more than the Rs. 2000 crore allocated for Ayushman- for covering 10.74 crore families with Rs 5 lakh health  coverage- is needed. This should have been setup earlier and it is now time to upgrade the public health infrastructure so that it can handle the much needed care of 40% of the population given free coverage upto Rs 5 lakh under PMJAY.

Not all states have joined. The challenge of tight cost control has to be met through defined treatment packages for which rates are prescribed so that the challenge of standardization of facilities and reasonable rates for procedures is met.

Prevention is also of great importance and here the 150,000 health and wellness centres across India of the National Health Protection Mission have a special role to play.