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US health care is not working. In UK and Canada the sytem is regulated in a way doctors and hospitals work togerhter to keep costs down. This is not happening in the US. insurers and doctors are pitted against each other and patients are in the middle. Insurers are also running about 70% of self funded employer plans that pay insurers a fee and are the responsibility of employers. Insurers then cut costs and do this for employers. Sel funded means employers pay cost of claims insurers merely get a fee. Patients are caught in the middle between Insurers and doctors/hospitals. The insurers cutting costs overbilling Medicare and skimping on payments, doctors trying to overcharge. Christopher Whaley, an associate professor at Brown University’s School of Public Health says- “We have a system of whack-a-mole, with providers trying to get paid and insurers trying to constrain costs—patients are caught in the middle,”  Obama exchanges to get people covered never thought through to come up with a better system and is a Band Aid. At some point the whole system ought to be scrapped and one built from scratch and designed to work so that hospitals and doctors provide best service at lower costs.   ...

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The Trump administration is taking aim at drug costs under Medicare inflated by deals pharmaceutical companies make with industry go-betweens.  These are the secret deals of pharmaceutical companies with pharmacy benefit managers who negotiate the price of drugs for insurers and employers.

Under the proposal pharmacy benefit managers lose the legal protections that let them take rebates from drug companies.

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With the hype around AI and the propagandizing by people like Altman, Microsoft, and others AI got to the point where it made up 34% of the S&P 500 capitalization, and all time high for 7 of the large companies since 1980. Nvidia who makes the chips for AI  making up about 6.8% of the S&P 500, contributing to a quarter of the total return on the S&P 500 index in 2024.

Till someone in China figured out a way to do it at 5.6% of what it costs in the US for the high flying AI companies in the US. 

 

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The good mix of rain and sunshine is leading to higher estimates for wheat production in US, Europe and Australia. Australian production is up by 3 million metric tons over last year. Russia is exporting more than it did last year by 80% in April and by about 25% in May through Black Sea ports. This is easing pressure on wheat prices which are down to $9 a bushel. Russia exports to countries in the Middle East. US production of wheat is expected to be 8% higher this year. 

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Japan's International Cooperation Agency plans to fill some of the gaps in western participation in accelerating African infrastructure building that have opened up in the last  two decades. Unneeded wars in Iraq and Afghanistan led to lack of attention and focus on much needed development in Africa by the US and Europe. This is changing and the JICA with its long history of participation in African development is also now taking on an important role to give Africa a new opportunity to accelerate economic progress after the pandemic.

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There was a time during the Apartheid days in South Africa when diplomats and other visitors took great risks to help South Africans. Haigh is one of the Australians who did his best to help those who were fighting Apartheid and its segregation of black people. He was a junior diplomat at the Australian mission in Pretoria when he arrived in 1976 with riots in Soweto, outside Johannesburg. He helped Steve Woods, the journalist in "Cry Freedom," a British dissident flee the country.

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The Supreme Court chastises the governor's role yet leaves the decision on qualification or disqualification of 16 MLA's who crossed over to the Opposition in Maharashtra to the Speaker of the legislative assembly of Maharashtra state in India. The speaker Mr. Rahul Navrekar is expected not to disqualify the 16 MLA's. With the support of these and other MLA's Mr. Shinde had formed a new government in Maharashtra in a 2 party coalition with pm Modi's BJP party in the state.

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Ormat, a geothermal energy company, faces resistance to a new geothermal plant in Nevada.  130 residents in the desert town of Gerlach fear it will affect spring water in the ground. Ormat has 15 plants in Nevada that produce 433 megawatts or electricity for 325,000 homes. NYT shows this as an example of how conservationists who favor green energy find themselves pitted against energy companies doing renewable energy for profit. The Burning Man festival held in the desert has a large carbon footprint every year. 

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With the surge in travel that might even exceed prepandemic levels in the US this summer, being better prepared helps. Some tips in the WSJ- morning flights have fewer delays than later in the day, TSA Precheck $78 for 5 years or Clear at $189 a year are a good way to avoid lines, the Delta or United App that lets you know how far your gate is and where to be dropped off at the airport, packing right,  the drop off, and food and drink.

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This WSJ report on Elon Musk of Tesla shows him neglecting a healthy lifestyle and not paying enough attention to needed sleep and nutrition. Since taking over Twitter the 51 year old Musk is working even longer hours from 80 hours to 120 hours a week, says this WSJ report. This type of hectic lifestyle is not productive in the quality of work and comes with a personal cost to health. Musk's acquisition of Twitter acts as a serious distraction from running electric car maker Tesla.

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The Willow oil project in Alaska by Conoco-Phillips which has leasing rights was allowed to go ahead by president Biden with some environmental protections. The leasing rights would have given Coonco-Phillips the right to challenge the government in court with potential damages awarded of about $5 billion, says this report in NYT. It also comes as Biden is faced with the issue of oil prices and supplies, and the impact on inflation with the cost of living crisis, as well as the impact of climate change.

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After rapid growth during 2021 home sales in the US are expected to decline by 10% in 2022, according to the National Association of Realtors. The rise of remote work and homebuyers seeking more space had pushed up sales in 2021 with low interest rates. Mortgage rates are now up to 5% in an higher interest rate environment having an impact on home sales. Higher median home prices with the median price of a home up 15% in March compared to the previous year, and 9.5% lower inventories are also having an impact.

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Fed vice chair Lael Brainard is president Biden's choice to replace Brian Deese as director National Economic Council. She would help Biden at a crucial period for the US economy with recession fears and inflation, and aggressive interest policy of the Fed's Jay Powell to slow inflation. Brainard is a daughter of a US diplomat who became interested in economics after living in Poland and Germany, and seeing how countries so close to each other divided by the Iron Curtain followed very different economic policies.

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David McCoullough, dies at 89 years. He is the author of two best selling biographies of American presidents at crucial points in the American experiment on Harry Truman (1992) and John Adams (2001), for which he won 2 Pulitzer Prizes. He also won the National Book Award for- Path Between the Seas- the Making of the Panama Canal. He saw writing as painting in words, and writing as an art form, did extensive research so that his Truman book took 10 years, the Adams book 7 years. 

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Most countries in Europe and North America are observing a locked down Easter. In France 160,000 police officers and gendarmes are on duty to make sure people respect the lockdown. Fear that people will gather in parks and transmit the virus leads to officials in Germany, France and Britain to keep tight restrictions. The virus transmission has not abated in these countries. Religious services in Germany will be held online. Police in London patrolled parks and green spaces to prevent people going outside on sunny Spring days. 

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At a time when family physicians in Britain are experiencing burnout a plan for patients to use text messages to rate family physicians by the new Health Secretary Sajid Javid arouses intense criticism. A former Health Secretary Jeremy Hunt and the British AMA say the Boris Johnson government's effort to increase in person appointnments by offering incentives of 250 million pounds was a bad idea. They say efforts should be made to attract 6000 more general practitioners rather than demoralize family physicians who are already burned out.

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This editorial in the Times of India says China's new border law that goes into effect on Jan 1, 2022, aims to tighten control over border areas, with strengthening of border defenses and integration of border populations. It says this means border relations will not be affected by improvements in bilateral relations. China is rejecting the Indian position for border standoffs to be settled through improvements in bilateral relations in other areas. The Times Editorial says that an "aggressive, inflexible, belligerent China" is what India now faces. 

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The first trips by the Secretary of State Blinken and Defense Secretary Austin show the Biden administration's priorities. Efforts to strengthen ties with Japan and South Korea giving the Indo-Pacific region top priority with the emergence of China as a challenge to US interests. Next stop is India. Even before the trips to Korea and Japan, a virtual summit was setup between the Quad countries, the democracies of Australia, US, Japan and India that are committed to an open and free Indo-Pacific region.

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At one time Spotify's headquarters in World Trade Center 4 took up 16 floors of space. Today Spotify employees can work from distant locations. Spotify told employees they can work remotely, even in another state. Company after company is vacating space or reducing the amount of space it uses in the high rise buildings in New York City. New York may never look the same. The sight of thousands of employees entering he high rise office buildings to go to work spaces may now be a thing of the past.

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The pandemic came to young German people at a time when the trend was for less opportunity, more inequality. These trends are now aggravated and the loss of opportunities, and the loss of hope is even worse now in 2021. Job searches are being conducted while experiencing intense social isolation, boredom and lack of physical acitivity. The job competition is described here as horrendously competitive, a few roles and so many job seekers jostling to get them as companies have been hammered during the pandemic. 

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EC Council president Michel apologizes for not responding when EC Commission president von der Leyen was left without a seat at a meeting with Erdogan, Turkey's president, in Ankara April 6, 2021. Michel could easily have offered his seat to Ms.  Ursula von der Leyen and taken a seat on the nearby sofa instead, as a form of courtesy. This would have prompted the Turkish side to arrange for another chair next to Erdogan for face to face discussions on improving ties with Turkey during the pandemic.

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Matt Dickinson says in The Times that Pep Guardiola goes at it with fascination for the game, and with a singular drive and curious search to find the best he can in his players. It is not just that he has players like Kevin Bruyne, Foden and Mahrez. It is not just the money that backs the team. There is he says an extraordinary amount of creativity that Guardiola brings to his coaching efforts. Manchester City are now in the finals of the Champions League ready to face either Chelsea or Real Madrid.

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Labour Party's strategy in the coming British election is to tie Boris Johnson to Trump. This resonates especially on the issue of the National Health Service, with Labour saying a trade deal with the U.S. planned by Johnson is likely to raise costs of NHS with costly U.S. priced drugs. Mr. Trump says he sees little chance of the Johnson negotiated trade deal with the European Union allowing for a trade deal with the U.S. negating Conservatives plan to make Brexit work by negotiating trade deals independently. 

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The situation in poor neighborhoods of Jakarta, Indonesia, where workers in the informal economy need to work to make a living selling out of food stalls, and in other ways. With the lockdowns making this difficult during the surge in coronavirus in Indonesia, poverty is increasing and families struggle to survive. The covid social aid is not working as efficiently as in India where the prime minister had introduced various schemes including direct bank deposits to every one of India's vast population of households.

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Without a final Brexit agreement Britain has the advantage of being able to use Northern Ireland, which would remain in the EU, as a way to send British goods into the European market including goods from companies subsidized by Britain. This and related reasons on Britain being able to set its own rules on the borders between the two Irelands, and on its trade and movement of goods, is why Boris Johnson says Britain does not absolutely need an agreement on Brexit with the EU.