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Alan Blinder, Princeton University professor and former vice chairman of the Federal Reserve, says the biggest reason for the growing deficit in the years out to 2040 is because of increases in health care spending. Its not that there is runaway spending in other areas. He cites CBO projections that show other costs stable relative to GDP from 2015 to 2035 and declining. This is why healthcare spending is at the heart of the problem. And why tackling the deficit has a lot to do with reducing healthcare cost increases.

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Are high prices for pharmaceutical products and healthcare services putting a severe burden on U.S. finances and defunding education, infrastructure, R&D in new technologies, which provide the underpinnings for future U.S. competitiveness? Yes say experts. In 2009 Americans per person cost of healthcare was $7,960. By comparison Canada was $4,808, Germany $4,218, and France $3,978. And without necessary efforts for educating people about caring for health and preventive care, the health conditions of Americans are no better than these countries, and poorer in some dimensions. Klein says deficits would not be a problem for the U.S. if prices for pharmaceutical products and healthcare services in the U.S. were similiar to that of the largest developing countries. Experts say the Obama healthcare law simply postponed the addressing of this problem.

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Steep drops in economic activity and loss of so many jobs is the reason why total lockdowns are not the best solution as seen from the experience gained by August. Selective lockdowns are now being applied across France, Germany and Britain in specific areas. About 400 million jobs have been lost, 13 million in the U.S.  Hospitals overwhelmed in northern Italy by March is what made the total lockdowns necessary.  These steps for total lockdown were made with very little known about the pandemic and the need to protect hospital and health systems. These decisions at that time are not questioned today. It is that now  with some treatments found, a vaccine close to being introduced, hospital system protocols established, health ministries and departments organized to respond quickly, and the public awareness at high levels,  it is now possible to impose these selective lockdowns effectively and quickly. As the WSJ now says the CDC had botched the initial development and distribution of tests in February- see WSJ analysis and our Lyrarc links of how 3 crucial weeks were lost in Feb with failure of the CDC and HHS in testing- making test and contact trace strategy window to be missed. China had not cooperated in letting a U.S. team quickly in the early days of February creating more uncertainty and risk. In that situation total lockdown suddenly became the reality to avoid a catastrophe. Today a carefully applied selective application of solutions can be done and is seen as the right way to protect jobs and livelihoods of people. ...

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The situation in nursing homes and eldercare is a huge black eye says this report from Canada. The situation is poor also in the U.S. and Britain. All the Anglo-Saxon countries appear to have the same problem of neglect of eldercare and homes for older citizens compared to say Japan, Germany or France with different healthcare systems and more invested in these areas of health and older citizens.Look at the numbers- in Canada 80% of deaths from coronavirus among older people in nursing homes. Next Ireland at 62%, and the U.S. at 40%. This report says these elder care facilities in Canada are run down, poorly equipped and understaffed. Canada's armed forces sent medics to the nursing homes in Quebec and Ontario and their reports are described as distruging and worrisome by prime minister Trudeau. In these countries lawmakers and policymakers have failed, and the culture of investing in areas other than health and public services and infrastructure, has failed the people. A poor scorecard for this generation of politicians, lawmakers, and leaders both in business and the government. ...

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Britain's National Institute for Health and Clinical Excellence (NICE) says Glaxo's drug Benlysta for lupus is not "good value for money." The drug is priced at 10,000 pounds a year in the U.K. ($15,600) and much higher at $35,000 a year in the U.S. Benlysta is covered by insurers in the U.S. and some European state run health systems according to Glaxo. NICE also rejected a new multiple sclerosis drug Gilenya, which costs 19,000 pounds a year in the U.K. ($29,700), and $48,000 a year in the U.S.

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An average of major opinion polls compiled by Real Clear Politics website shows 50.5% of Americans opposed to the Obama U.S. health care law.

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Krauthammer cites Congressional Budget Office numbers that show the Obama U.S. health care law continues the spiralling costs of health care with new government mandates at a time of severe budget cuts in education and other areas- for 2013-2022 the costs come to $1.76 trillion. The initial Obama administration figures of 10 year costs of $938 billion announced in 2010 reflected the fact that the new U.S. health care law would take 4 years to fully go into effect. Costs after 2021 are shown to be $250 billion each year in the CBO figures. The law is now before the Supreme Court in 2012, which has to decide on the basis of the limits of the Commerce Clause.

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Efforts to nurture democracy in West African nations- Benin, Guinea, Niger, and Ivory Coast.

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The Economist quotes experts saying that drug innovations would not be affected by price controls on drugs. Pricing reforms can accomplish the reverse, spur innovation by doing as Britain and Germany are doing- pioneering comparitive reviews of drugs effectiveness and cost-benefit analyses aimed at reimbursing firms for new drugs based on their performance. Sanford Bernstein, a financial advisory firm, says in its study that a 20% reduction in what Medicare pays for drugs would not kill off innovation, it would reduce earnings per share of big pharma firms by 3-8%. As drug research is now done in many countries, and its a globalized industry, innovation is not likely to be automatically affected by price reductions in one country like the USA, according to Alna Garber of Stanford University and Patricia Danzon of Wharton Business School.

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According to the General Accountability Office inquiry, 28 drug products had price increases over 100% in 2000, in 2008 71 drug products had such large increases. Medicines like Adderall for attention deficit disorder, Inderal for chest pain, Sumycin for infections were in the list of 416 brand name drug products where makers or distributors raised prices at least once by 100% or more for period 2000-2008. As large pharmaceutical companies sold their marginally profitable drug products or small selling products to smaller companies, these smaller companies would immediately increase prices to recover the money they paid to the large pharmaceutical companies. 26 of the brand name products saw prices raised 10 fold. A third of the drugs with large price increases treat depression and disorders of the central nervous system.

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The $350 billon in proposed cuts to Medicare and Medicaid in the 2011 deficit reduction talks will do little to reduce the rapid rise in medical costs. Instead it shifts the costs to seniors, state governments and public hospitals. Gail Wilensky, former head of Medicare under the first President Bush and now a senior fellow at Project Hope, says this should not be confused with real reform to Medicare which reduces the rapid increase in costs. It does little in the way of fundamental changes that would reduce the growth in costs. About $53 billion comes from reductions to senior's ability to buy extra Medicare supplemental insurance or Medigap. Another $14-26 billion would have the government reduce payments to hospitals for unpaid debt. The few items to curtail fraud in the use of CT scans or purchase of power wheelchairs would provide savings of $2-3 billion over 10 years. $4 billion comes from lowering Medicaid payments to hospitals treating a high percentage of low income patients, hospitals such as Cook County Hospital in Chicago, San Francisco General Hospital, and Parkland Hospital in Dallas....

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Lobbying by the American pharmaceutical industry and the Obama administration. Emails showing the negotiations between the administration and the pharmaceutical companies.

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A study by AARP of 514 brand name and generic drugs between 2005 and 2009, shows that generic drug prices went down an average of 31% during this period, and brand name drug prices went up by 41%. One of the authors of the report says that it is important to look at individual drug prices and not studies showing total spending on drugs, because this is a significant cost for people paying out-of-pocket, It drives up insurance premiums, and pushes retirees into coverage gaps in Medicare Part D drug program. Analysts indicate pharmaceutical companies are increasing prices on drugs before patent expiration to get as much profit before the patents expire.

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The new Dutch Health system that went into effect on Jan1, 2006, and is based on Stanford university prof Eindhoven's idea of "managed competition." What the Dutch experience holds for the USA as states like massachusetts look at mandatory universal health coverage on a private basis and for the US as a whole as the present system appears to be coming to a close.

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New ways to price drugs based on how well they work for patients.