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Ann Matthews describes how the U.S. Supreme Court ruling on the Obama health care law affects 4 managers in the health care industry and U.S. businesses.

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A report from the U.S. Federal Reserve on the impact of the financial crisis of 2008-2009 on the wealth of American households. Between 2007 and 2010 says the report the median net worth of American families went down by 39%, from $126,400 in 2007 to $77,300 in 2010. This had the result of putting Americans back to the level of net worth in 1992. Much of the loss in net worth was from asset value reductions. The median value of stock market based retirement accounts decreased by 7% to $44,000. The biggest drop was in housing values- falling by 42% to $55,000 in the three years. Americans are working down their debt- a quarter of families are debt free, credit card balances declined 16% to $2600 from $3100 from the period 2007 to 2010 of the report. Yet the median level of family debt remains the same as more families support their kids education by taking out college loans. Median income fell about 8% to $45,800 in 2010, with income losses especially large in the manufacturing industries as the U.S. manufacturing sector worked to improve competitiveness. Other factors supplement this picture. The burden of college loans increased to over $1 trillion for middle and working class families. With the burden of college debt young people were more likely to delay buying first homes, indefinitely dealying recovery in the housing market. Seniors on retirement see interest income from savings negligible with low interest rates and higher risk in a volatile stock market. ...

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Jacobs and Richtel of the NYT give this exceptional story of how Mexico changed between 1980 and 2016. Following the joining of NAFTA free trade zone the Mexican diet and food ecosystem began to more closely resemble the food diet system in the U.S. bringing with it severe health consequences. Soda and coke are now more entrenched in Mexico, as are fast food outlets. In 1980 only 7% of Mexicans were obese, compared to 20% in 2016, according to Institute for Health Metrics at the University of Washington. And diabetes kills 80,000 people a year, becoming the top killer according to the World Health Organization. A trade expert at Tufts University, Timothy Wise, says Mexico took on the worst aspects of a first world country like the U.S., with few protections. A similar problem is taking place in India and China as obesity grows, according to the T.H. Chan School of Public Health at Harvard, as low nutrient highly processed foods of large food companies with huge advertising budgets take a prominent place in diets. This is a growing problem for countries from Colombia to Ghana and Nigeria. ...

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How to have many interests, add nature walks and hikes to maintain health balance and avoid burnout from work.

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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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The UK NHS is urgently tracking down parents of 35,000 children in London who are not fully vaccinated against polio, says this report in The Times. Health officials have detected the first outbreak since 1984. They are trying to trace it back to a "single household or street." London has lower rates of polio vaccination than the rest of England, dropping to levels that are seen as risky for the health of children. Vaccination rates are low in north and east London says this report in The Times. In London as a whole the vaccination rate for one year olds in 2021 is at 87%,  5 percentage points lower than that of the UK as a whole of 92%.  

Lack of investment in public health and services has weakened the public health system even as hundreds of billions of dollars were misallocated by capital markets gone astray. The pandemic exacerbated a bad situation in public health lowering vaccination rates even further.

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In launching the Ayushman Bharat Digital Mission prime minister Modi says it "has th potential of bringing a revolutionary change in India's health facilities."  Following the launch of Arogya Setu app and the 900 million vaccine doses given under Co-Win for the free vaccine campaign this is the next step.  To take healthcare facilities to a new level and integrate it with technology prime minister Modi noted the 1.25 billion remote consultations under telemedicine that have taken place since March 2021 under e-Sanjeevani. Using this people in all parts of India are able to connect with doctors of large hospitals in cities. Ayushman Digital will connect digital solutions of hospitals across India to each other. This would make process simplified and enhance ease of living. Under this plan every citizen would now get a digital health ID and health records digitally protected. The overall model is for preventive healthcare and in event of disease easy, affordable, accessible healthcare.  Part of the plan is to build the facilities and resources to be able to handle needs. For doctors and para medical manpower a comprehensive network of AIIMS and modern health institutions is being setup, and one medical college is being setup for every 3 Lok Sabha parliamentary constituencies. In villages and rural areas primary health care network is being strengthened. Over 80,000 centers of this type have been operationalized.    ...

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US president Biden's multi-trillion dollar spending plans for infrastructure, climate change plans, education and healthcare, are based on a changing perception about the effectiveness of the public sector spending initiatives. The Reagan period idea that the public sector is not as efficient as the private sector that lingered through the Clinton, Bush and Obama, Trump administrations is no longer accepted. After the pandemic another perception is taking root that when it comes to health infrastructure the government has a leading and indispensable role to play. Gone are the doubts about this that hung like a cloud over the nation's plans for infrastructure in health, education and supply channels. Following the global competition with China a new factor is also playing its part. The need for government to play an active role in trade, in protecting technological resources, and in supporting US technological firms in competition with other countries. There is a new perception that the government should be determined to play this role. In the effort to be self-reliant after the pandemic the government is expected to play a role in redesigning the supply channels and providing the direction and incentives for supply channels worldwide that give America a competitive advantage and less dependence on other nations. ...

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Melania Trump and her documentary "20 Days to History" with Amazon support in production and marketing. Melania says at the premier that she wanted to show what it was like to be in her role, to "show other people what it takes to go from being a private citizen to first lady again." Melania has been underestimated and has shown leadership in mental health issues, on how internet and social media affects children, on housing in disaster relief, and on a range of issues that affect women and children. She also brings originality in her thinking about issues. For someone from Slovenia to come to the US as an immigrant and to be thrust into roles that she never would have anticipated she has shown exceptional composure and ability to learn and absorb from events happening so quickly around her. TR would have recognized her abilities and her softspoken and effective ways to assert herself on issues relating to the social media and how it affects children, one of the key issues facing the US for the next generation. ...

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Breaking the norm of jobs requiring sitting down in one place for long hours that is killing us with health problems is desperately needed today. 20,000 NPR listeners joined this study by the Columbia University Medical Center to see if they could break the habit and set a new model for work behaviours. Participants were asked to take a break of 5 minutes every hour. 70% took the break showing that given the right encouragement people are willing to try something new that improves job performance, mental health, and physical health.

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Questions raised about the government's committment to serious health care reform. New leaders of China who took power in 2002 and 2003 with concern for the poor, did not put discuss reform till 2006 and during this crisis there isn't the urgency that is needed. Recent documents, says the Economist, that were circulated secretly within the bureaucracy for 3 weeks before being made public, provide no clear target about how much people would be reimbursed for medical treatment. The other concern is that the central government provides only 40% of the 850 billion yuan allocated for additional spending on health care in the years 2009-2011. This is about $125 billion. Burt local governments may not be keen on spending on health care as officials are still judged by how much they can boost employment and GDP growth. Over three years the central government's annual share of the additional spending on health care of 850 billion yuan is 111 billion yuan, according to Caijing, a business magazine.But the 2009 budget on health care is 118 billion yuan, so its not clear that things add up. The central government's additional spending in each of the 3 years is only $16 billion. How this can provide help to the 200 million uninsured, the insured who still pay a large amount for health care, and pay for essential pharmaceuticals on a list prepared by the government, and pay a portion of the expensive diagnostic tests that hospitals like to make money from, is not clear. The whole system will have to be overhauled so that hospitals do not have the incentive to prescribe these expensive tests and pills that cost more. The government says it will be 2020 when 90% of Chinese are covered by agovernment financed health insurance system- 11 years away. This only means that domestic consumption may remain depressed for a decade or so. With export markets collapsing, this leaves China dependent on infrastructure spending for growth for a long time, and lower growth rates with higher unemployment. ...

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The $500 million jury award to two persons getting hepatitic C as a result of "unsafe practices" at the Endoscopy Center of Southern Nevada. The jury decision for punitive damages was made against Health Plan of Nevada for $270 million, and Sierra Health Services for $230 millon in Clark County District Court in Las Vegas. The plaintiffs argument was that the insurers paying the health care provider had a responsibility to monitor the quality assurance of providers in its network.

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Under a plan called "premium support" Paul Ryan's U.S. budget proposal would have seniors choose a private insurance plan from a federally operated exchange. Each year the government would pay private insurers a specific amount to cover the cost of premiums with the rest borne by seniors. The total amount paid by the government would go up only at the rate of overall inflation, it would not go up at the higher rate of health care inflation. By doing this the government would take off the trillions of dollars of projected spending on health care that are largely the result of the higher inflation rate in health care costs. This higher inflation rate on health care costs is something that both parties have failed to control, and remains a major weakness in all health care proposals to date, including the Obama health care legislation. Allowed to continue growing at this rate when U.S. debt to GDP is nearing 100%, health care inflation costs pose major risks to the nation's finances.