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Sabrina Tavernise writes about vaccine skeptics in the US. She sees it as a problem about gut beliefs. It is prevalent among people of different political views, not just conservatives. The misinformation on vaccines has made people who normally would be open to getting vaccinated a bit leery. Because of the flood of information spread in today's hyper sensitive news environment, including misinformation. Tavernise describes how different people in the US tackle the decision to get vaccinated or not and how this leads some to simply postpone getting vaccinated. Britain tackled this problem of spreading misinformation on vaccine effectiveness or risks early. It also helped that in Britain there is a very high regard for the National Health Service, the NHS. In Germany and also in France there was increasing skepticism in the beginning, yet this is reversible as there is growing recognition of the benefit of taking the vaccine in Germany and France. Much can and needs to be done to create public confidence and limit the spread of misinformation that leads to postponement of vaccination at a time when variants are becoming more contagious. ...

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People in Japan are living longer healthier lives. So much so that people are working well into their 70's. In Nagano, Japan, people say that those in their 40's and 50's are like a child with a runny nose, and people in their 60's and 70's are in the prime of their careers. In this WSJ report, 38 years old Norohiro Aizawa is a part time farmer, who says he plans to work into his 70's like many farmers in Japan. Today his father in his early 70's is active and in charge. Sachiko Kobayashi runs a crafts business, has a job making box lunches, and a garden full of pumpkins and radishes. She is 65 and gets up at 3 am. In Nagano she is called by the term pre-elderly, not elderly. For elderly she has a long way to go. Japan has 29% of the population in under over 65 years group, Europe 21% and US 17%. Yet something else is happening. People are just taking better care of themselves and their health, and living, working longer. A 70 year old today in Nagano is in health status like a 60 year old one or two generations ago. Perceptions of what is elderly have changed.    Japan's White Paper on the Elderly in 2021 shows studies suggesting that many in the 65-74 year group do not share traits associated with the term elderly.  Only 6% require care by others. Half of 65-69 year olds hold jobs, and a third of those in their early 70's also hold jobs. Life expectancy in Japan stretches into the late 80's for women, and early 80's for men. This is almost 5-8 years more than countries like the UK with a strong national health service. In April 2021 a revised Employment Law took effect, telling big employers to offer work to workers until age 70, up from previously government sanctioned retirement age of 65 years. Government says it is meant to protect the right of people to work longer. There is even a term called late-elderly.  Oshima 82 of Nagano, leads a volunteer group that shoots video of community festivals and works late into the night, and is cited in this WSJ story as saying that even if people called him late elderly, his response is oh yeah? I don't care. It is all about living a full life, terms don't matter at all when one stays healthy.   ...

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With fewer and fewer good startup companies and massive amounts of capital wasted on startups that did not produce either jobs or lasting value questions are being raised about the startup culture and role of startups in a growing economy. The coronavirus has speeded up the process- already underway was a lack of quality in startup companies, now these companies that were wasting capital are facing a completely different environment. Reasons given for their situation are the lack of job creation over last two decades from startups. The startup founders being many just out of college or with a few years of experience, lack of accumulated experience in industry of founders, the glamour that had nothing behind it except the search for quick results. Primarily though the reason is that it takes time to build good companies that also create good jobs and add to the country's GDP, and this means additions to technology, bringing experience and building up of experience of founders, that patience and persistence is lacking in today's startup culture and startup companies. There is a bigger problem and this is a problem for all of society and the whole nation in every country. This is the misallocation of capital, the erratic shift away from infrastructure, public services, health services and education, and employment in the national interest, that form the backbone of the economy of any country. It is in this sense that the shift in capital allocation, away from misallocation on a massive scale, has to be made in the national interest, interest of society, interest of the people.  ...

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What were the stories in the Economist magazine that were the most read stories of 2019? Not on president Trump. On Malaysia, China under Jinping, and exodus from San Francisco and Silicon Valley. The most read article was on the newly elected president of Brazil, Jair Bolsonaro. The mismanagement of the economy particularly extravagant state spending on the Olympics and soccer stadiums for the World Cup at the expense of basic sanitation services, bus and transport services, health services, led to the result of a majority of Brazilians rejecting the Workers Party and its leader former president Lula. Unfortunately most of the media including the Economist did not draw attention to this gap. During a period in which income from mining with export of iron ore, and soyabeans to China, enabled Brazil to live beyond its means, there was no effort to draw attention to glaring gaps in development of public services such as sanitation, bus services and transport, lack of building infrastructure other than to support mining. Glaring gaps in education and health services made the situation worse. The second most read piece in the Economist  was on March 10th- Malaysia's PM is about to steal an election. Here the Economist magazine joined the Wall Street Journal which originally broke the story on the 1MDB fund and irregularities in Malaysia where a development fund was misused by the government. Najib actually lost that election and the WSJ covered the story of the developments that followed in which Malaysia's new governemnt led by a returning former prime minister in his nineties Mahathir Mohammed, ousted his own protege Mr. Najib.  The third most read piece in the Economist magazine was - How the West got China Wrong.  Unfortunately the Economist magazine and most of the media covered China in the two decade long boom years without covering the other emerging story as well in which Mr. Lighthizer (now president Trump's top trade adviser) and others questioned the huge unsustainable trade surpluses in U.S. trade with China. With the economy facing huge downside risks and rising trade tensions with the U.S. Chinese president Jinping's move to remove the limit on terms in office in the Constitution was considered a shift from the notion that China was likely to turn into a democracy. Mr. Jinping had already completed his first term in office and the anti-corruption campaign, managing the economic boom for a soft landing, was carried out with the central leadership of the party, after the destabilization evident in the early part of Xi Jinping's first term. Much of China's path was predictable and rational behaviour in its national interest, what was not clearly defined or defended was the way the U.S. could sustain the trade deficits that had reached a billion dollars a day. Leading to Mr. Trump seizing on this as an election issue to form a bloc of voters separate from the two main parties, the Republicans and the Democrats. The fifth most read piece was on Oct 11, 2018- the next recession. It pointed out that with low interest rates central banks in the U.S. and Europe and America could not cope effectively with a recession. The sixth most read piece was on June 29, 2018- Bullshit jobs and the yoke of managerial feudalism. It cited Prof. David Graeber of the London School of Economics, who wrote a short essay that went viral on the prevalence of work that had no social or economic reason to exist, work he called "bullshit jobs". Graeber said people want to feel they are transforming the world around them in a way that is leading to a positive difference. No. 7, 8, 9, were on Bitcoin, Netflix and programming language Python. No. 10 most read was on Aug. 30, 2018- Why startups are leaving Silicon Valley. It showed that in 2017 more people left the county of San Francisco than entered. The main reason the cost of living was burdensome and out of control. As Amazon shifts attention to India and Brazil, and Apple pulls back from India, social media companies coming under fire for disinformation, this period of Tech is making way for a shift in a new direction. A direction that focuses on people's lives, wages, spending on much needed infrastructure and services. ...

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The WSJ looks at Elizabeth Warren's Medicare for All plan that marks a major shift for the U.S. economy.  Households would see their costs go down by $11 trillion, boosting their ability to spend on other goods and services. Because income and wealth was highly skewed in the past three decades in one direction, the spending capacity of lower and middle income households was pushed down. This and other similar plans would help restore a higher level of spending and with it an essential element of inflation of 2-3% to the U.S. economy which was missing in the last decade. This sets the tone for the kind of broad based recovery that happened after 1950 that strengthened America's middle class and made it the core of the economy, the core of the post World War II recovery in America and Europe. The plan would be paid for by higher taxes on corporations, tax rate of 21% for corporations going back up to 35%, and reverse depreciation schedules in the 2017 Republican tax law. The argument that this would reduce business investment does not hold that much says the WSJ because amid new trade tensions business investment has declined over the last 2 quarters, and has been sluggish overall. The other source for the estimated $13 to $20 trillion cost of Medicare for All plan of Elizabeth Warren is a 6% annual wealth tax on billionaires, in an attempt to have all pay their fair share and reduce wide disparities in wealth. Mark Zandl, chief economist of Moody's Analytics, says his sense is at the end of the day from a macroeconomic view- because $11 trillion in the hands of 80% of households who could boost spending after lagging behind in the last decade- the negative effect on business investment will be cancelled out by the higher consumer spending. The overall effect and today's context is infused in this analysis. Private insurance, premiums for insurance, and out of pocket cost that the public pays would disappear in this new system where all health payments pass through the government. Health insurance premiums paid by employers would convert into a new employer Medicare contribution to the government starting at an amount employers pay now and adjusting gradually toward national averages over time. Smallest businesses are exempted. Mr. Zandl says the most important aspect of this now is that Mrs Warren has shown that her plan's revenue sources match the cost so that the plan would not lead to deficits increasing and pushing interest rates higher, leading to negative effects on the economy. Republicans under Mr. Trump have paid little attention to expanded deficits caused by their tax law, and economists across the landscape have also shown less concern. Still attacks are made if the plans don't add up. For this reason a sound assessment in today's context of depressed consumers and an overall impact becomes essential. The WSJ quotes from a pre- assessment of Warren's plan by Simon Johnson, a Massachusetts Institute of Technology economist who co-wrote it with Mr. Zandl and Betsey Stevenson of the University of Michigan. What they point out is that putting cash in the pockets of the lower and middle class for spending makes a lot of sense today, and taking money out of the pockets at the way upper wealthy end,  does not contract the economy at all. Other effects they say are constructive by letting all workers get health coverage from the government instead of employers, this makes it easier to change jobs increasing labor mobility and productivity. A worker getting a better job and better utilization of skills could then shift without looking at the employer health care plan. Warren says there would be a five year transition so that workers in health care insurance industry can work in other insurance fields and in Medicare, no one would be left behind. The important thing being to build America's middle class again. ...

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Arrests were made in a UK police inquiry including the Treasurer of the SNP, into handling of over 600,000 pounds in donations for a second independence referendum used for running costs instead, say this report in The Guardian. This Guardian report by Libby Brooks shows outwardly successful the Scottish National Party was behind the scenes chaotic, according to members who are frustrated at what has happened since 2014. A big influx of Yes voting members changed the party after 2014, and unable to cope it simply continued to function without modernizing its mechanisms for the last decade. Another problem appeared to be that power was concentrated in the husband and wife couple of Murrell the party's former chief executive who helped the party's electoral prospects, and Sturgeon as deputy leader. For much of the time party insiders say loyalty to Sturgeon after she headed the government, meant there was no effort to modernize the party with the growth in membership, and no serious discussion about this. Stuff got steamrollered. One insider says party leaders were inexperienced in handling a party of this size and did not realize that these problems would build up. It also reflects the support given to challenger Kate Forbes for the leadership election. What it means for Britain is that Labour and the Conservatives can count on Scotland, formerly a base for Labour, to give the leading British parties a decent chance in the next election on cost of living and public services issues. Issues that are uppermost in the minds of people in Scotland, to gain an overall parliamentary majority to tackle the issues of health, education, public services and climate change after the pandemic. ...

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Reports suggest voter turnout of young people 18-24 was close to 70%. With most of the new voters, about 2 million 19-34 year olds registered to vote in the weeks before the election according to the Electoral Commission, drawn into politics by the simplicity and style of Labor leader Corbyn. One voter says young people voted because Labor did not sneer at them, recalling the negative tactics employed in the campaign and the likability of Labor leader Corbyn because he refused to respond. The National Union of Students and organizations such as UpRising, Hope Not Hate, Bite the Ballot, pushed young people into involvement. The election for students was more about the impact of Tory cuts to education, health, and other services, and about the future for generations to come. Students were deeply upset about the results of the EU referendum. The result is that in places where students were predominant such as Newcastle East and Central, Manchester Withington and Central, Cambridge and Canterbury, the turnout jumped  to give Labor wins in the north of England, and in London. ...

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Britain's National Health Service has setup a medical review of gender treatment of young people. It's conclusion after 4 years of research- "The reality is that we have no good evidence on the long-term outcomes of interventions to manage gender-related distress.” This NHS review found no clear proof that  gender dysphoria in children or teenagers was resolved or alleviated by what is called gender-affirming care, where a child's declared “gender identity” is affirmed and supported with social transition, puberty blockers and/or cross-sex hormones. After Cass the British government issued an emergency ban on puberty blockers for children under age 18. A similar approach is being taken in the Scandinavian countries, and in Netherlands, France, Germany, Belgium, Switzerland, the move is away from medical treatment of gender issues. American medicine, Cass says is “out of date,” and has put politics ahead of science.Not one American medical association or governmental official has reached out to discuss Britian's Cass report. Says Cass- “I think that’s where you’re misleading the public. You need to be honest about the strength of the evidence and say what you’re going to do to improve it.”   ...

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German chancellor Merkel imposes a partial lockdown in Germany starting November 2. This is followed by an announcement of a lockdown across France by president Macron. On October 28 German daily cases went above 14,000. Only 25% of intensive care beds are now available, creating a very serious situation. Meetings in public will be restricted to just two households of up to 10 people total. No crowds at sports events. Restaurants and bars will close except for take away. Schools and kindergartens will remain open. Church services and protests will be allowed to continue. Shops will remain open with one customer for every 10 square meters or 108 square feet. Merkel called it a "very serious situation," and said "we must act now to avoid an acute national health emergency." She told Germans the number of people in intensive care units has doubled in last 10 days, and in many areas it was no longer possible to track and trace infection chains. In 75% of the cases the source of infection is unknown. People are encouraged to work from home and companies encouraged to make this happen. Companies with less than 50 employees and self-employed will get support from the government with  about 75%% of the income. Companies, institutions and clubs will also get federal aid. About $10 billion euros are set aside for this aid. ...

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The failed June 2007 bombings planed and executed outside of the theater district in London and at the Glasgow airport terminal do not get as much media attention now but could have done a lot of damage and caused many deaths and injuries as well as panic in London and Glasgow. The terrorists were from Iraq and Jordan London and highly educated being doctors and part of the National Health Service. In the light of the Mumbai attacks it shows that the vulnerability of the UK from disaffected muslims.

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Having an adequate supply of N95 masks is critical for each hospital tackling the coronavirus pandemic. The lack of enough masks leaves health care personnel without the basic protection and is a grave emergency. Hospitals are resorting to reuse of the masks in this crisis and this is not a good practice as it increases the chances of infection. President Trump has invoked the Defense Production Act on April 2 against 3M. This gives the federal government more control over 3M's operations to ensure that it goes all out to make the healthcare N95 masks that the hospitals need in this grave emergency. This report in the WSJ covers the situation as of April 3 on the supply of M95 masks for health workers and others. N95 masks block 95% of very small particles. Supply in the U.S. is for 50 million N95 masks. Demand in the U.S. is for 300 million N95 masks as estimated by the Department of Health and Human Services. in March- this is how many are needed by health care workers to fight this pandemic in the U.S. The principal manufacturer is 3M. 3M company has doubled its production since January 2020. The trend before this pandemic was to send production over to China and other countries. This is changing now with the pandemic and the U.S. policy shifting to be self sufficient in medical supplies in the event of an emergency. A policy Peter Navarro, who heads the agency in charge of getting medical supplies, says President Trump is insisting be implemented. Hospital buyers supported the earlier trend to keep costs down, but this appears to be a costly mistake, putting health care workers in hospitals across the U.S. without the basic protection they need. Minnesota based 3M invented the first modern disposable masks in the 1960's. Interestingly 3M continued to make millions of masks in the U.S. even though competitors moved manufacturing overseas. The 50 million disposable masks 3M made globally went to workers in industries where it provided extra safety from metal shavings or other substances, and medical workers. Now 90% of masks go to medical workers. 3M ramped up production globally since January 11 when the pandemic first hit to 100 million masks a month globally, and 35 million a month in the U.S. at plants in South Dakota and Nebraska. 3M says that it will import 10 million masks from its factory in China, which earlier this year was restricted from shipping it outside China as China needed masks for the pandemic. About 10 million more masks are made by two other manufacturers Alpha Pro and Louis Gerson Co.  U.S. Department of Health and Human Services ordered 600 million N95 masks from 5 companies to distribute to hospitals and build up the national medical supply stockpile. 190 million each of this is from 3M and Honeywell and 130 million Owens & Minor Inc.  3M says it will make 50 million a month in the U.S. by June. Honeywell which had moved production overseas, plans to bring back production to the U.S. by making 10 million masks by May at its Rhode Island and Phoenix plants. There is a company in Singapore that makes one million masks a day in China and other Asian countries, Pasture Pharma Pte, but most of it is committed to government agencies in China.   ...

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First disrupt the young people's attention and create effects on mental health of long hours spent on social media such as Tik Tok. This results in a loss of literacy on basic knowledge of civics and American history to lower and lower levels. Then let these young people decide who should run the country and its government for the next 4-8 years. The founders never intended this and never anticipated this threat. Congressmen Republican Gallagher of Wisconsin and Democrat Krisnamoorthi of Illinois introduced a bipartisan bill to ban TikTok in the US considering that it was foreign adversary application when its literacy effects are even more a concern. Byte Dance has appealed the law that goes into effect Jan 19, 2025. The appeal is now before a 3 person panel of the Columbia Circuit Court of Appeals of Sri Srinivasan, Neomi Rao, and Douglas Ginsburg. Does Byte Dance have recourse to the First Amendment rights in the US Constitution when the US sees Byte Dance as a foreign adversary controlled internet social media service, is the question before the Appeals Court and next before the US Supreme Court. The US government has shown the judges confidential classified data that shows why it thinks there is foreign adversary influence of some sort.  It is interesting to note that national literacy standards and the ability of average American young people to know enough about American history and civics that is in a dire state today and a key vulnerability for US democracy. This is gravely harmed by social media influence. Only negative effects on mental health of children and young girls has been put forward. Too many hours spent on social media is a negative influence which is why China and now Australia and UK have put restrictions on is use. US has none. India has banned Tik Tok for security reasons. In all situations there are negatives here yet it is an appalling thing that literacy is not the biggest one put forward when it should be for this Nation. ...

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India's Ministry of Finance predicts GDP growth of between 7 and 7.5% for 2018-2019, after faltering GDP growth in 2017-2018 following action on demonetization and introduction of a national Goods and Service Tax. The IMF predicts growth of 7.4% for India in 2018 compared to 6.8% in China in 2018, with growth of 7.8% predicted for India in 2019.  Chief Economic Advisor Arvind Subramanian says there are "robust and broad based signs of revival," though risks remain in rising oil prices and inflation. The level is below what it could be, yet robust considering the policy actions taken by the government for the long term such as the nationwide GST implementation, which was taken up by previous administrations of both parties in government but never implemented till 2017. In addition the government faces the tasks of recapitalization of banks, the issues of job creation as manufacturing in India in the global context is only beginning to take shape, and agrarian distress.  The new Budget takes up the issues facing rural areas of the country by compensating farmers to the extent of 150% of agricultural cost and introducing the largest health care security scheme in the world for poor families. This comes a year before new national elections. The Modi administrations's focus appears to be for taking steps that will generate growth over the long term and learning from errors, yet being bold enough to take the necessary action based on experience.   ...

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When so much of infrastructure healthcare and education still needs more funding, and when St Paul's Cathderal lacks essential funds for basic maintenance and is in danger of closing, the Greensill scandal shows how much reallocation of funds to infrastructure, health, and education to help workers, students and families is needed. How much the existing culture distorts allocation of capital in ways that are vital to the future of families, students and workers, and lobbying acts in ways that are against the national interest. Here the WSJ says the lobbying of David Cameron, former UK prime minister extended to getting access to funds for Greensill, a  company that operated in  supply chain finance, lobbying for funds from the emergency financing facility provided by the Bank of England. Treasury rejected 56 messages sent by Cameron to top British politicians over several months to have rules changed. Greensill went into bankruptcy in March 2021, stranding investors who had put in $10 billion. A parliamentary committee is now looking into this case of Greensill. The company was founded by an Australian Lex Greensill, and does little more than provide companies a cash advance to stretch out the time to pay bills. One question no parliamentary committee will ask is why when the needs for infrastructure, health and education are so great $10 billion in funds, public or private even go into something like supply finance that does so little for the country. This is an example of the kind of distortion in the uses of capital that has become commonplace today, creating societies and countries with poorly  funded infrastructure and essential services in the advanced countries of Europe and the US. ...

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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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Tech is not going to fix this, say software experts from tech companies. Google and Apple's efforts in coming up with an app have fizzled out, says this report in thee WSJ. Has the U.S. lost precious time in waiting for an app by tech companies to be developed, instead of doing what India and Britain have done. India introduced its own app Aarogya Setu app from the Indian government. Britain had the National Health Service develop its app. India acted quickly. Is an app needed or essential? Germany decided that contact tracing based on Asian country experience was mainly about human contact tracers with skills to make the phone calls. All they needed was a centralized database on a computer and a phone. Germany set up teams at offices in each district in Germany and quickly plodded ahead even if all the offices were not fully staffed. In fact a third of the offices needed more people and resources. Yet the speed of action is something like 80 to 90% of the contact tracing effort when the team has the skill set to call. This is because clusters of infections do not wait - they spread. There is simply no time to waste. The German effort has produced the best results so far of any country of this size- Germany has 85 million people. The reproduction ratio is at 1.13 and Germany remains vigilant. It is the first country to reopen in Europe, and is methodically doing the right actions, much that the world can and should learn from. Contact tracing teams worked round the clock in the early days, they are still hard at work today, using their human skills to talk to people and find out who they were in contact with, calling the contacts in turn, at each step working to isolate where needed with followup calls from the state health departments. ...

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The Dean of Harvard Medical School says the Health Reform bill gets an "F" grade. He say its disingenuous to call this reform, and Congressmen and the White House are deceiving the public if they attempt to pass this off as reform. What it will do is accelerate health care spending in the US, and the bill has simply postponed most of the major health care problems, especially the ones that drive cost including the fee for service system and delivery of health care.There are no substantial efforts to control the growth in health care costs or improve the quality of care, which makes this effort unacceptable as reform. In his discussions with other health care leaders and economists, Dean Jeffrey Flier, says he has found the opinion unanimous on this point, that whatever the final legislation looks like in Congress, it will only serve to accelerate health care spending rather than contain it. On the present system's failings he is explicit- the current system he says promotes fragmented care making it difficult to assess outcomes, the true costs of care are disguised, and competition based on price and quality is made impossible. The new legislation while expanding access to coverage makes a terrible tradeoff of an accelerated crisis of health care costs and merely continues the current dysfunctional system. The experience of Massachusetts, where access to care was expanded but spending went up, is that this won't work. He points to the Special Commission on Health Care Payment System in Massachusetts recommendation, that the health care system there must be changed from a fee for service system to one with "capitated" payments. So what is really disingenuous about this whole affair? Congressmen making it look as if reform has happened and congratulating themselves on increasing access to health care, when many of the serious problems of funding health care, skyrocketing costs, and a dysfunctional system, have only been kicked further down the road for some future legislators to tackle. With the national debt about 12 trillon dollars when this plan is factored in, this is cause for serious concern. ...

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A good account of the history and weaknesses of the Amtrak based system of rail service in the USA. Questions abound about the queer situation where you find rail popular in Europe and so not prevalent and scarce in the USA. How efficient is Amtrak's rail service in conserving energy? Amtrak uses electricity made from coal, it uses 17% less fuel than a passenger car and 32% less than a airline airplane according to the Oak Ridge National Laboratory. Is this based on new fuel efficient locomotives? No the locomotives are old and Amtrak equipment is aging, so much more fuel efficiency gains could probably be made with new technology and investment. Rail service is coming out of a 40 year period of neglect, and Amtrak itself was probably created to put in one place and hold together a dwindling service, as the passenger services of freight railroads were consolidated to create Amtrak in 1970 by the federal government after the interstate highway system built during the postwar Eishenhower years led to a boom in car travel and the spread of housing to spread out suburbs. At the time private operation was not a consideration as Amtrak itself was a rescue operation to preserve some semblence of rail service before it died out. Now with fresh incentive to do mass transit the whole question being posed is whether private operators should be brought in and would do a better job than Amtrak. Today Amtrak has in all 632 usable rail cars an astonishingly small number, its Amfleet cars are 30 years old, and the Acela trains are 8 years old. In all it carried 25 million passengers last year and in 2008 probably will get to 27 million. Many of these are on long haul routes and where passengers can get to small towns where there is no plane service. Its labor contracts require it to keep these routes. So its a peculiar Amtrak that exists today as a result of historical events and shift to road travel, and it may not be the best vehicle to move the USA towards greater use of mass transit to conserve energy, as its slow to change and takes years to introduce new technology and is not spread out evenly over short and long haul routes. The customer service suffered all these years with no competiton and competition may be healthy for better technology, better service and service on new routes. The UK rail service from London to different parts of the country has been privatised for instance. Better technology and fast service are essential to attract new customers and this is an area in which Europe has made significant progress. At this point even with federal money Amtrak would take years to get new technology from the current manner of writing specification for bids, picking a vendor and waiting for delivery especially as vendors have dwindled because of the lack of demand in prior years....

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Department of Education invites controversy because of diversity programs and "transgender" as culture ignoring health risks. Established by president Jimmy Carter in 1979. Education in the US is run at the state level by each American state administration compared to UK where it is done at the national government level. It has one of the smallest budgets of any agency at 4%, Transportation is 1.7%, Agriculture 3.0%. Most of its work is overseeing $120 billion of federal grants and programs for public education through high school. It supports districts with low income students with $18 billion aid. Head Start program supporting 883,000 low income pre school children in 2022 gets federal aid from Department of Health and Human Services. National School Lunch Act of 1946 by Harry Truman is not affected as it is run by states,  federal aid comes from Department of Agriculture to 20+ million children. Republicans oppose spending about $1 billion to support Diversity program DEI initiatives and support for "cirtical race theory." There is opposition to "transgender." Britain's NHS had a commission look into transgender and says it poses health risks to children and young people. It also adds to anxiety of parents. Republicans are 53 -47 in majority in Senate- to scrap the agency Republicans need 60 votes in the Senate. The likely option is that they will pass a bill putting many of the functions in other agencies reducing its impact- between HHS, Treasury and Interior agencies. ...

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Labour will introduce 40 bills in parliament to make changes in renewable energy, the environment, transport railways, and for cost of living action. Great Britain Railways and Great Britain Energy are two public companies to be set up to reach goals in public transport modernization and in getting a five fold increase in solar needed to meet 68% cut in emissions by 2030 (Paris Accords commitment). Great Britain Energy will be capitalized with 8.3 billon pounds. (Labour scaled down its 28 billion pounds Green Energy Plan because of Tory mismanagement of finances but will continue to invest in vital projects). The answer is to take a creative approach. More money will be released through the Crown estate bill that will have the crown estate use its auctions of offshore land for wind energy and make investments in green energy. National Wealth Fund will invest in low carbon projects.  Fro water Labour will hold the water bosses to account and put companies such as Thames Water in special measures. Renationalisation was considered but was considered costly at this time, other action is being taken.  Nine bills are part of the 40– the planning and infrastructure bill; the better buses bill; the three rail bills, which are the passenger railway services (public ownership) bill, rail reform bill and high speed rail (Crewe to Manchester) bill; the Great British Energy bill and crown estate bill; the sustainable aviation fuels bill; and the water (special measures bill) – that all focus on protecting the environment. ...

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PFASs class of chemicals used in pizza boxes, carpet treatments and other consumer products. Experts describe the increased risk of cancer, asthma and other diseases from products that are everywhere in today's world. The NYT's Lipton and Abrams provide useful insights into the use of harmful chemicals in everyday life in 2015. Ms. Birnbaum, the head of the national toxicology program of the Department of Health and Human Services in the U.S. questions this widespread use in consumer products of PFASs and the need for alternatives in commentary in Environmental Health Perspectives, a NIH publication. 200 international scientists signed a statement urging countries to restrict use of PFASs. More public awareness is needed for the extensive use of chemicals in consumer products, so that consumers ask questions about which chemicals are in products and look for safer choices.

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Warnings to governments and leaders in industry and pharmaceutical research about epidemic preparedness by Bill Gates were ignored. He spent hundreds of millions of dollars to develop new vaccines and create disease tracking systems. But only governments could tackle this problem. He tells the WSJ in an interview that he feels terrible and that he wishes he had done more. His fear that a once in a century pandemic has come true. Governments did respond to the public health preparation needs as reported in France 24 to both SARS and the H1N1, both in Britain and France. It was the disbanding of this effort in the period of the global financial crisis and the eurozone financial crisis that led to the level of unpreparedness that Western Europe finds itself in today. This was caused by irresponsible banking practices. The response was austerity measures in Britain, France, Germany and Spain that led to leaving public health system investment being neglected, without fixing the original source of the problem. Misallocation of capital and lopsided priorities continued through most of the period leading up to the pandemic. There is a lot that Gates and other public spirited leaders could do now do in the new reordering of priorities and shifting the allocation of capital to public services and investments in infrastructure, and supply chain renewal to safeguard national interests. Today he is working with pharmaceutical executives and governments to produce billions of doses of vaccines while they are being tested. His foundation has reserved space in a manufacturing plant so that production can begin quickly once an effective vaccine is found. He says nobody has made 7 billion vaccines so that it will need all the help that it can get and international cooperation.  In an earlier interview with WSJ he told the interviewer in November 2014 that the world as a whole did not have preparedness. France and Britain prepared and then abandoned the effort for epidemic response by 2012 following the global financial and eurozone financial crises. Gates repeated the warning to 2016 presidential candidates in the U.S.  In 2017 at the Munich Security Conference he reminded people- "getting ready for a global pandemic is every bit as important as nuclear deterrence and avoiding a climate catastrophe." One focus of Gates was to come up with faster ways to a vaccine by using ready made components and then customizing it. This is an approach being adopted today by Oxford scientists and by Quidel Corp. in the U.S.   ...

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Sunderland in the northeast of England voted 69% for Leave in the Brexit referendum. It is one of the most deprived cities in the UK and after years of neglect by leaders and political elites it voted Leave to express its resentment of its treatment. Following the collapse of the shipbuilding industry the northeast of England has suffered from high unemployment with a third of the children living in poverty. Yet today there is a marked shift and cooling of the sentiment for Leave, as many of the promises made by the Leave campaign that more money would go to National Health Service, the economy would improve, and contributions to the EU would be diverted to England, appear to be broken. About $445 million was sent to the northeast of England from 2014 and helped the local economy. Benefit cuts, and austerity measures were continued by the May government in the northeast causing people to have doubts about the Brexit Leave campaign's promises. The EU's requirement that people of EU origin could work in the UK had riled residents in the northestern England deprived areas. Now a more realistic assessment of withdrawing from the EU is now taking place. About 60% of the exports of the northeast of England go to the European Union. The effect of this will be felt in this part of England and the costs of Leave are finally sinking in  for Sunderland residents. A Nissan factory in the area is a major employer and the government has stepped in to protect jobs. ...