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In India's southern coastline state of Kerala, PM Modi has pursued a strategy of working with the CPI led government on development projects, and at the same time contested elections to set up a BJP government in the state. The capital city of Trivandrum (Thiruvananthapuram) local election has led to a BJP municipal government in 2026. In an address to supporters in Trivandrum PM Modi said he was gratified by the results in elections for the capital city of Trivandrum (Thiruvananthapuram), and wanted to make it India's model city., It reminded him he said of the situation in Gujarat when the BJP party won elections in Ahmedabad for the first time in 1987 for city government. By showing good governance in Ahmedabad, BJP was able to win elections in the state and provide good government and industrialization for Gujarat for the decades since 2001 when Modi formed the state government. This bodes well for Kerala said the Indian PM. Many schemes for improving the welfare of farmers, for people in health, housing and small business loans are coordinated by the federal, state and city governments to get the best results and this speeds up industrialization and modernization in the Indian model to create the kind of results China and Japan achieved in their heyday. ...

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Questions about the true cost of the Obama health care legislation and the assumption that the legislation cuts the deficit by billions of dollars. This WSJ editorial says one has to look at this closely, and not merely look at CBO projections, which may be based in a certain context and not reflect the true costs, especially because many accounting gimmicks and use of numbers to present a particular picture is taking place. The information this editorial cites is that: it uses 10 years of taxes to fund six years of subsidies, Social Security and Medicare revenues are double-counted to the tune of $398 billion, a new program funding long-tem care frontloads taxes but backloads spending, and the assumption of an automatic 25% cut to physician payments that Congress is unwilling to authorize. Rep. Rand Paul has tried to present an alternative view which needs to be studied just as closely, because of the enormous impact of a jump in spending at a time when the public finances are fragile. WSJ also cites the work of Richard Foster, the chief Medicare actuary, as an alternate perspective of how things could turn out, Doug Holtz-Eakin, and Eugene Steuerle. It calls for common sense in evaluating programs, entitlements, defense or other government spending. They not only cost money, but costs escalate over time as history has shown over decades, till they eventually are discovered to be not affordable unless the middle class is willing to dig deeper into its finances to pay for them. Alternate perspectives from a range of informed opinion, Howard Dean, Martin Feldstein, and the head of Harvard's Medical School show that the issue needs to be looked at closely and carefully and cannot be something in which CBO numbers can be trusted to tell the whole story. Especially when common sense, history, and informed opinion across a spectrum of thought advises caution, and fragile public finances also suggest caution. Howard Dean, former Governor of Vermont, says the health care bill is not real reform, and may do more harm than good. He says in a Washington Post article, December 17, 2009, the Obama health care bill does not insert competition into insurance markets, does not significantly reduce costs, and does not improve the delivery and use of health services. It was he says done with a political calculus and crafted for votes not real reform. Jeffrey S. Flier, Dean of the Harvard Medical School, gave the Obama health reform bill an "F" grade, saying in a Nov 18, 2009, WSJ article, that it was disingenuous to call this reform, Congress and the White House were simply deceiving the public. He said the bill will accelerate US health care spending, postpone most of the major health care problems, expecially the ones that drive cost, including the "fee for service" system and delivery of health care. He says in his discussions with economists and other health care leaders the opinion was unanimous that the bill will accelerate health care spending. He cites Massachusetts as an example, where access to care was expanded under the same dysfunctional system, and spending went up, and it doesn't work. Feldstein, who in early 2008 suggested proactive solutions to the mortgage debt crisis which were never adopted, says that the Obama health care law means higher taxes in the long run to pay for the $1 trillion cost of health care for the uninsured group over 10 years. Feldstein says that the Obama plan is to cut Medicare to cut spending, and will reduce the amount of medical services, as reduced spending comes from fewer services, not reducing payments to providers. And he asks if the cost reductions are weighted too heavily towards reduced services and not reduced payments to providers ,would this result in large cuts to services to affect the quality of healthcare for the 85% of the American people who are accustomed to a different pattern of healthcare. ...

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This WSJ report looks at the toll on mental health of men during the pandemic.

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Rising costs in the French health care system.

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Questions may relate more to how these situations affected the role of Gates and similar individuals in protecting the interests of the US, Europe, India, Latin America and Africa in health organizations such as the World Health Organization. As globalization spread governments in the West surrendered some of the essential role they played in world health organizations to individuals and NGO's, and countries lacking experience needed for such an important task. The mishandling of the pandemic is partly a result of this retreat by western governments from the role that they have played during the nineteenth and twentieth century. In the US letter to the WHO by president Trump the role of Gro Harlem Brundtland of Norway was shown in handling an earlier virus epidemic that originated in Asia so that it would not spread and could be controlled. This is the H1N1 crisis in 2003 cited in Mr. Trump's letter to the World Health Organization. Brundtland took strong action that was missing during this pandemic after the US and western nations surrendered the essential role they have played for centuries based on role in medical science discovery for maintaining public health. Surrendering this role or seeing it erode is one of the biggest mistakes of our time and a mistaken form of globalized behaviour. It is only now being corrected as the realization dawns on major nations such as US, UK, France, Japan, Russia, India and other countries about the essential stability provided by western nations knowledge, experience and resources to this task of maintaining global health. Even a nation like India has to base its role on hundred or more years of work in medical science and commitment to public health that transcends political preferences or national interest to take on and be a worthy participant with the advanced nations that have played so great and beneficial role for the world in public health. What to speak of transient interest of nations in the developing world or countries where national interest or political preferences play a part in public health of the peoples of the world. This responsibility for world's public health can never be delegated to individuals, foundations or any one country, or small countries, or a combination of these, only to the collective experience of the last 300 years in medical science discovery and the role of Europe including Russia, and the US in leading the way.  The Biden administration has the same underlying concerns as the Trump administration about this mishandling of the pandemic and the disasters that followed bringing so much death and suffering This excerpt on Brundtland of Norway is from the letter the US sent to the World Health Organization- "In 2003, in response to the outbreak of the Severe Acute Respiratory Syndrome (SARS) in China, Director-General Harlem Brundtland boldly declared the World Health Organization’s first emergency travel advisory in 55 years, recommending against travel to and from the disease epicenter in southern China. She also did not hesitate to criticize China for endangering global health by attempting to cover up the outbreak through its usual playbook of arresting whistleblowers and censoring media. Many lives could have been saved had you followed Dr. Brundtland’s example." ...

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A survey published in the Journal of the American Medical Association shows mental health related ER visits from 2011 to 2020 rose from 4.8 million to 7.5 million. The proportion of ER visits for mental health issues rose from 7.7 percent to 13.1 percent. Insufficient treatment options and availability of preventative care is leading families to seek help in emergency rooms. The JAMA paper's conclusion: "A dedicated national commitment will be needed to address the gaps."

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Canada does better with only 28,000 cases of the virus compared to 3 million in the U.S. by early July 2020, 300 infections a day compared to 28,000 a day. Three things Canada got right are its health system that provides universal health care to all Canadians, not having culture wars about accepted practice such as face covering and social distancing, and Trudeau adopting an approach of bringing Canadian opinion around a common fight against the virus.

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The basic problems facing American health care. Douglas Elmendorf , head of the Congressional Budget Office, says none of the bills he has seen make the fundamental changes needed in how medical care is delivered and paid for. The big issue is the unwilingness of different interests to accept serious changes. THe NYT says the long run solution to the problem of rising costs is to move away from the fee-for-service system that pays hospitals and doctors for each additional service they provide and into anew system that is organized around ways that encourage low-cost and high quality healthcare. The difficulty is that the long run may be too far, considering the seriousness of the crisis. Elmendor also suggests taxing employer provided health benefits, as this will discourage the excessive use of medical care. As the NYT says this is politically risky, even though it believes this may be a way to the new system which has to discourage the use of health care in the manner it is conducted now, with too many tests being conducted. A new system requires an enlightened approach on the part of each interest group in the face of a crisis, and the failure to do that may only end up retaining some of the worst aspects of the old system just mentioned that drive up costs and make universal health care unaffordable....

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Figures on costs for the uninsured and total spending on health care by researches at George Mason University.

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The third or booster dose of vaccine is needed to take out the Omicron variant. The UK Health Security Agency analyzed data from 581 Omicron cases and thousands of Delta cases to calculate how effective vaccines such as Pfizer and Astra Zeneca were against the Omicron variant. This early analysis shows a third booster dose prevents around 75% of people from getting any coronavirus symptoms. The double dose of the vaccine however provides good protection against severe coronavirus that needed hospital treatment says the UK Health Security Agency. Of equal concern is the rate of spread of the Omicron variant. Here this BBC report shows graphs of UK National Health Security Agency which show the rate of spread is rapid with cases doubling every 2-3 days. For the UK which on December 10 had about 1265 cases this means says this BBC report that the number of Omicron cases could be well above 100,000 in the UK by the end of December. The BBC graph shows the curve for Omicron cases moving in a close to vertical direction upwards. Reports say the experience in South Africa where the Omicron variant was first detected is similar in pattern causing rapid spread. ...

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Effects on mental health of the lockdowns in China for covid and personal stories of despair and helplessness.

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All Americans can agree on one thing- that vigorous exercise will be good for their health and JFK Jr is right about reviving his uncle John F Kennedy JFK's fitness challenge. JFK reminded Americans of the challenge put by Teddy Roosevelt to Americans to get fit. The "Make America Healthy Again" campaign of RFK Jr. is proposing a number of actions in this direction as shown in his September 5, 2024 Op-Ed in WSJ shown here alongside.

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In his speech at the Labour party conference Keir Starmer wll put mental health as Labour's key pitch to voters. Starmer will say that a Labour government will take note of the mental health crisis after Covid and make mental health treatment available to anyone who needs it within a month, and create drop-in mental health hubs for children and young people. This is Starmer's first in person address to Labour's party conference.

Labour believes the mounting fuel crisis with most petrol stations out of gasoline is creating concerns about Boris Johnson's ability to tackle Britain's problems after Covid pandemic. Referring to Boris Johnson's plea for motorists not to fill cars unless necessary, Starmer will try to contrast the challenges facing Britain after the pandemic with the chaotic approach of Boris Johnson. 

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The runup to Intenational Yoga Day on June 21, 2021.  Pictures of Yoga Practice in wonderful outdoor settings in places all over the world from the Ministry of External Affairs, India. India Post issues a cancellation stamp for Yoga Day. The United Nations supports yoga practice as a way to promote physical health and mental health during the pandemic. Much remains to be done to bring yoga practice to people in India and around the world. The tremendous neglect of physical and mental health during the last three decades, in nutrition, eating habits, in exercize, has led to rising obesity and resulting diseases. The benfits of modern medicine and technological advances in medicine have largely been lost due to  poor habits of nutrition and exercize. Yoga and other forms of exercize including walking and cycling are an excellent way to get back to living in the proper way.

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Aging does not happen gradually but happens in waves at early 40's and early 60's and at 78 years, say Stanford scientists. This means we should be proactive and act by having a regimen of exercises that we take extra care to do when we are at these ages so that we compensate for rapid muscle loss or other aging related issues including balance, posture, skin health, cardiovascular, and other health issues. Nutrition can also be geared to specific foods that will strengthen us.