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Th cost of cancer drugs Avastin and Erbitux and the need for putting life savings at risk for a few months of treatment create tension among families, doctors and treatment providers. A course of Avastin could run $56,000 and take 90 days for reimbursement by meicare or pricate insurance, and a 20% co-pay comes to $11,200.

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Making some territorial concessions appears to be the only way for peace talks to succeed. For a long time there was insistence on territorial sovereignty of Ukraine by EU and NATO leaders. This appears to have prolonged the war- with needless loss of life on both sides, and costly damage to Ukraine infrastructure, a population that had to face additional winters and hardship in war ravaged areas. NATO's Stoltenberg from Norway, leaders of northern Nordic and Baltic countries, the UK, could take that position without having to face the hardship of the war. NATO had to be re-formed under a new name and new structure  following the collapse of the Soviet Union, with wariness about the possibility of centuries old since 1700 UK and Nordic historical adversarial relationship with Russia casting a shadow over that organization, and embroiling the US in conflicts not of its own choice or of wise leadership. This is the root cause of the Ukraine war. It would have been best to completely restructure NATO and give it a new name without Northern European nations leading it. Principles matter once soviet communism was no longer there NATO formed for its expansionism in 1950's had served it's purpose. Rasmussen from Denmark and Stoltenberg from Norway led the organization for the last decade and half from 2009-2014 and 2014 to 2025, with backing from Obama/Merkel for most of the period of the war in Ukraine. Also most of the period NATO expanded to Russian borders happened under Northern European leaders from Spain, Britain and Nordics (Solana, Robertson, Scheffer, Rasmussen and Stoltenberg) and the organization NATO getting the northern European slant based on historical adversarial relationship of Britain and Russia since 1700- for no other reason than the British wanting to protect its large Empire and commerce in India which in the 18th and 19th century included most of Asia. Under Robertson the UK Defense Secretary much of this transformation into turning NATO into something anti-Russian happened which was primarily because of British and Nordic perceptions of Russia as an adversary. Robertson added the following countries at the Prague Summit in 2002 to NATO- the Baltics, Romania, Slovakia and Slovenia. Russia faced internal upheaval in those years and Yeltsin in resigned in 1999, Putin was elected in 2000. It is clear that Russia had suffered severe economic hardship in that period and Putin's first goal in 2002 was to stabilize the economy.  It could be said that this turning NATO over to UK and Nordics was a huge mistake considering that Russia was still the largest nuclear power after the US, and British policy was now determining US policy. And Britain's Robertson/NATO should not have involved itself in the Afghanistan war using Article 5, as the US could have handled this alone and limited that engagement. It got US involved in another conflict, conflict with Russia that was to come in Ukraine on the side of the Baltics and Ukraine, without US clearly understanding what the roots of that war was about and implied confrontation with Russia 20 years after the Prague Summit in 2002 under George Bush junior. The incompetence of Bush and Obama/Merkel laid the seeds of the Ukraine war in 2022 following Robertson, Rasmussen, Stoltenberg, small Nordic nations and Britain creating a conflict that did not need to happen, with loss of hundreds of thousands of lives of Russian speaking fraternal peoples of both Russia and Ukraine. The Republican sentiment under DJT of the tragedy of such huge losses of young people, and desire to end this loss of life, can nowhere be seen in bellicose talk in northern European nations, that take the US for granted to fight their wars.  The wisdom of Washington, Lincoln and TR/FDR clearly caution in getting involved in European centuries old animosities. For the US it meant in practical terms that it could no longer carry out the Monroe Doctrine essential for peace and good governance in the western hemisphere as only a Russia desperate to make its views known about NATO would interfere in the western hemisphere against US assertion of the Monroe Doctrine with the US Navy. Instead drug trafficking gangs took over Latin American countries and created a flow of fentanyl and millions of people through migrant traffickers across the US southern border. As America has expressed its concern for loss of Russian and Ukrainian men in the war for the first time under DJT Russia has distanced itself from Venezuela, Mexico and Latin America. The loss of hundreds of thousands of young Americans to fentanyl is a shared tragedy with the loss of hundreds of thousands of young Russians and Ukrainians in the last decade. How reliable are Northern European countries when it comes to protecting the eastern seaboard of the US with the acquisition of Greenland? It is a policy pursued by presidents since the Alaska Acquisition from Russia. By Seward, Teddy Roosevelt, Harry Truman and DJT. Denmark the land where NATO secretary general Rasmussen was from followed by Stoltenberg from Norway  (for 15 of the years of the war in Ukraine 2010-2025) the US efforts to protect its eastern seaboard are rebuffed by both Denmark and Norway, and the US presented in a negative light as an imperialist power in the face of Danish East India Company's  colonial attitude since 1700 clearly imitating the colonial British East India company.  It shows Northern European nations looking out for themselves not for the US, and embroiling the US in their wars at the cost of the entire western hemisphere being destabilized. The population of UK, Denmark and Norway, Baltics is far less than the Mumbai, Shanghai, Sao Paulo , Berlin and Tokyo regions. Should the views of a small population in northern Europe of 2% of the total determine the future of US, Europe, China, India, Brazil, and other parts of the world with 5 billion people the 98%, when issues of war and nuclear conflict, nuclear buildup, the western hemisphere destabilized with drug trafficking gangs running rampant in countries, divide the world in opposing blocs, when the wellbeing of most of the world's people in Asia and Latin America, Africa is at stake by establishing a essential degree of cooperation by all sides. The US under DJT has chosen a wise policy of cooperation over conflict -with China, with Russia, with all the major powers, and with smaller powers. Reading the wisdom contained in the writings of Washington, Lincoln, TR/FDR confirms it is clearly the wise choice. ...

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This editorial in the Wall Street Journal says faster approvals at the Food and Drug Administration have helped bring more generic drugs to market lowering prices for the public. In 20 months the Trump administration approved 1617 generic drugs, 81 a month on average or a 17% increase over the preceding 20 months. Council of Economic Advisers in October said this was a saving of $26 billion for the public.

President Trump is looking at price controls as a way to bring down drug prices. With increasing outcry about high drug prices in the U.S. the Trump administration and Democrats in Congress are looking for new approaches to bring down prices.

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His full statement, which he posted on X, is below: "My Fellow Americans, over the past three-and-a-half years, we have made great progress as a nation. "Today, America has the strongest economy in the world. We've made historic investments in rebuilding our nation, in lowering prescription drug costs for seniors, and in expanding affordable health care to a record number of Americans. "We've provided critically needed care to a million veterans exposed to toxic substances. Passed the first gun safety law in 30 years. Appointed the first African American woman to the Supreme Court. And passed the most significant climate legislation in the history of the world. America has never been better positioned to lead than we are today. "I know none of this could have been done without you, the American people. Together, we overcame a once in a century pandemic and the worst economic crisis since the Great Depression. We've protected and preserved our democracy. And we've revitalised and strengthened our alliances around the world. "It has been the greatest honour of my life to serve as your President. And while it has been my intention to seek re-election, I believe it is in the best interest of my party and the country for me to stand down and to focus solely on fulfilling my duties as President for the remainder of my term. "I will speak to the nation later this week in more detail about my decision. ...

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The Indian pharmaceutical industry is expected to grow by 13% to $24 billion in 2010. R&D is a special focus, as new drugs can be developed at much lower cost in India. Mr. Piramal, for instance, kept the R&D operation of Piramal when he sold the rest of the company to Abbott Labs of the USA. The Piramal lab in Mumbai has 300 researchers and scientists, and Mr Piramal says he can develop new drugs at a tenth of the $1.5- $2 billon cost it takes for this in the USA and Europe.

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The shift to finding new drugs for cancer. Pfizer has a development team of 10000 researchers in one location near San Diego, California, to develop new drugs for cancer even though some experts say the search for cancer drugs is devilishly complicated. The causes of cancer at the molecular level are complicated and vary even from person to person for the same cancer. Says one expert this also raises questions about the benefit to people as a large amount of resources are shifted to areas like cancer that affect fewer people than other diseases, and where the existing drugs have only prolonged life marginally, in some cases even as low as a few months at a huge cost of thousands of dollars. Tarceva for pancreatic cancer for example only prolongs life by 12 days at a cost of $3500 per month. 860 cancer drugs are being tested in clinical trials according to the trade group of the pharmaceutical industry. This is more than twice the number for heart disease and stroke, and nearly twice the number for AIDS and all other infdectious diseases combined, and nearly twice the number for Alzheimier's and all neurological dieases combined....

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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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Pfizer shares fell by 2.5% as the deficit deal of August 2 was announced. The deal envisages cuts to Medicare. Pfizer CEO Ian Read says the pharmaceutical industry is not immune to the macroeconomic trends. Another trend he described in an interview is the shift in buying drugs- with high unemployment people either going without prescription drugs or switching to low cost generics.

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Treatment costs with Praluent for cholesterol control are extremely high at $14,600 a year.

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Governor Newsom of California is joining Republican Governors of Montana and Alabama to allow cities to act to limit encampments of the homeless in American cities, taking the case to the US Supreme Court. The Biden Administration is walking a delicate path by supporting rights of the homeless that lower courts support  yet not wanting to see the spread of homeless encampments affect the overall safety and health of cities where homeless encampments affect quality of life in neighborhoods. Homelessness of 600,000 people in the US, with more than half sleeping outside in open spaces and parks is now before the US Supreme Court. The pandemic, the large increase in housing costs in the western states, and the cost of living have pushed many people over the edge, at an alarming rate for four years. Justices ask city attorneys of Grants Pass, and in effect other cities in the US, where are people supposed to go if no other shelter is offered by the city, that they have a right to sleep, and breathe. "Sleeping is a biological necessity- Justice Elena Kagan. "Are they supposed to kill themselves, not sleeping," Justice Sotomayor.  Justices Kavanaugh and Roberts questioned whether judges should be making decision that should be made by policymakers. US Supreme Court is reviewing a lower court ruling upholding rights of homeless people in the US  under the 8th Amendment that is opposed by the city of Grants Pass, Oregon. A small western town of 40,000 people facing a problem of a significant portion of its population, about 8%, having to sleep in parks and in open public spaces because they have nowhere to go. It has only 138 beds from the Gospel Rescue Mission for homeless situations with strict rules. It faces in today's America rising homelessness- affordability of housing affecting people in many states. In 2022 an three judge panel of the 9th Circuit Court of Appeals which covers western states Oregon, California, and Washington upheld a lower court decision barring the city of Grants Pass from enforcing a citywide ban on sleeping in parks at night if no other shelter was available with fines ranging $75 -$295. As a result of this decision encampments of the homeless are increasing in the western states because restrictions on public camping no longer play a deterring role. Cities say this increases crime and drug use, disease, and hazardous waste.  ...

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A report by pharmacy benefits managing company Express Scripts shows a 13% increase in the price of branded drugs in the U.S. from Sept 2011 to Sept 2012. Generic drug prices declined by 22% in this period. The report also shows that growing spending on specialty drugs for cancer, MS and other diseases is a big reason for the increase in prices of branded drugs. This report is from a random sample of six millon Express Scripts members using prescription drug coverage. Prof. Schondelmeyer of the University of Minnesota, who manages the drug benefits program at the university and conducts a similiar price report for AARP, says the potential benefits for these specialty drugs are not that good to justify the high prices.

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Under a new program to increased spending on healthcare from 1.3% of GDP to 2.5% the Indian government plans to provide free pharmaceuticals at state run hospitals. This is expected to cost $5 billion over 5 years. Initially 350 drugs would be on a list of essential medicines and would be purchased from generics manufacturers in India. Dr. K. Srinath Reddy, heads the committee advising the Indian government on healthcare. He says this will help improve access to medicines for the vast majority of the people. Estimates show 70% of out of pocket medical costs for Indians come from spending on drugs. About 40 million people are pushed into poverty each year because of the high cost of medicines, says Dr. Reddy. He said that in 1984 31% of the medicines at government run hospitals were provided free to admitted patients, dropping to 9% in 2004. For outpatients this dropped from 18% to 5%. The free medicine program would be part of a larger universal health care program to be introduced over the next decade. India's large generics pharmaceutical industry makes the provision of free medicines on a large scale a feasible option in India because of the lower prices, with additional pricing advantages when purchased in larger volumes by the government. This would also have a major impact on the quality of healthcare in the country of 1.2 billion people for a relatively small investment. It also promotes a sense of fairness and equal access because the benefits of decades of modernization have been unevenly distributed and because of widespread poverty....

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With unemployment at 27% millions of Greeks and the elderly like Nikos Solomos, 60, cannot afford premiums and have joined the ranks of the uninsured. Greece's budget cuts have hit the health care sector hard because of mismanagement and corruption with prescription drugs costing about three times the cost in other EU countries. Cuts in heathcare are over 25% since 2009 and more cuts planned. Anthony Faiola with contribution from Elinda Labropoulou provides an exceptional account of the state of health care through the stories of ordinary Greeks like Nikos Solomos with intestinal cancer and the shortage of staff, equipment and supplies at Metropolitan Community Center in South Athens and Gennimatas General Hospital. Problems now include a resurgence of tuberculosis. Some of this pain is being felt in other EU countries with sharp cuts in public health spending, including Spain and Ireland.

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Vanguard economists using the work of Stanford Unversity economists Bloom and Baker and University of Chicago economist Davis have developed their own estimates of the cost of overall uncertainty to the U.S. economy. Bloom, Baker and Davis show the level of overall uncertainty in 2011-2013 is about 50% higher than the level seen since 1985. Vanguard's estimates are for a drag on the U.S. economy of about $261 billion in deadweight losses from this uncertainty- uncertainty in monetary policy, uncertainty in deficit reduction, uncertainty in business investment. Their estimates show 1 million jobs not created, job growth per month lower by 45,000 in the last 2 years, and gdp growth of about 3% per year in 2011 and 2012 in place of the 2% average recorded, in the absence of these uncertainty shocks experienced by the U.S. economy. McNabb points out that the market gains of the S&P 500 are based on an unstable foundation as long as this overall uncertainty is not lifted and create a serious disconnect....

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This report in the WSj looks at the Silicon valley approach of pursuing rapid torrential growth at any cost. It shows the victims as investors looking for outsize returns to the point of turning their attention from the facts showing the products as highly hyped improperly as tech for WeWork or having health risks in alternative smoking products in the case of Juul Labs Inc. Both company CEO's were asked to resign. This discussion is on the the limited number of new ideas as the tech really creative stuff  peters out and the tens of billions of dollars pursuing a few ideas even if they as in the case of WeWork basically a real estate company subleasing space were not really tech. The neglect of top priorities in infrastructure, in priorities for health, education and other pressing needs are a result of the misallocation of capital by capital markets structures of funds, banks and investors. Juul started at Stanford University and quickly raised $14 billion. Soon three million high schoolers in the U.S. were using the vaping product as e-cigarettes causing alarmed parents to bring up the issue and the Food and Drug Administration to look into it. As the tech boom results in fewer new ideas practices fail to change in the allocation of capital and wasted capital, resulting in gross neglect of priorities for infrastructure, health and education, wide gaps in income.   ...

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Allan Blakeney was health minister of the Canadian province of Saskatchewan, and later premier of the province. Blakeney, as health minister in premier Woodrow Lloyd's government expanded a program in 1962 to cover the costs of doctor provided medical care. Earlier in 1946, the Saskatchewan government of Tommy Douglas setup a program of universal insurance coverage for hospitalization. This program of universal healthcare was extended to all of Canada in 1966. He later headed the provincial New Democratic Party and was premier of Saskatchewan from 1971-1982. During this period he introduced a New Deal for People, which included a dental program for children, prescription drug program, subsidized housing and a guaranteed income supplement for the elderly poor.

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Mexico's economy grew at 1.34% in the third quarter of 2011, according to the national statistics institute. Annual growth is estimated at 4% for 2011. The war against organized drug trafficking in Mexico cost the economy one percentage point of economic growth, according to estimates by BBVA Bancomer, Mexico's largest bank. Mexico received $20 billion in foreign investment in 2011, about the same as in 2010. Cars and aerospace have drawn large foreign investment. Mazda will invest $500 million on a new plant in central Mexico. Honda says it will spend $800 million on a second Mexican plant. In recent years with higher costs in China, higher transport costs, and a weaker peso with a stronger yuan, Mexico is becoming more competitive with China as a manufacturing investment location. The younger workforce, low inflation and technical education schooling, offer Mexico additional advantages. Mexico is the second largest manufacturer of flat screen television sets, and is now the fourth largest location for outsourced IT such as call centers. Axa CEO, Henri Castries, and Siemens CEO, Louise Goeser, have very favorable views of doing business in Mexico. Siemens sees sales increasing by double digits through 2015, and has located one of three global R&D centers in the state of Queretaro. Goeser says many parts of Mexico are safer than parts of the U.S. A large part of the violence is concentrated in a few states, and in border cities like Juarez, and affects smaller businesses more than the large manufacturing enterprises of overseas companies. As a result it is as if there were several economies in Mexico, with foreign enterprises largely insulated from the violence. ...

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Following Brexit on January 31, 2020, Britain's government led by Boris Johnson prepares to negotiate new trade deals with the U.S. and other countries. The freedom to negotiate these trade deals was a key part of the plan of Brexit supporters and Mr. Johnson. The Times, Britain's leading newspaper, looks at the prospects of trade deals with each country- the U.S., Australia, New Zealand, Japan. Facing re-election Mr. Trump is seen as favorably inclined to work out a trade deal that he can show during the campaign. Trade discussions have taken place between the UK and Australia, Japan. Mr. Morrison in Australia and Mr. Shinzo Abe want to see strong trading ties and investment with Britain. Japan or Australia could be the first countries that work out a trade deal with Britain as discussions are at an advanced stage.  Britain has a small deficit with Japan in trade. It has a small dollar surplus in trade with the Australia and New Zealand. With the U.S Britain has a large surplus, it exports 121 billion pounds and imports 76 billion pounds. The prospects of trade deals are enhanced by the similarity in outlook of the governments of the U.S., Australia, and Japan, which share views on jobs expansion, economic growth and are centre right in economic philosophy. They also share a strong connection with working class voters under Johnson,Trump and Morrison. Mr. Trump is seen as a strong deal maker so that any deal would involve some concessions from Britain that increase U.S exports, including farm exports. Difficult issues with the U.S. are -pharmaceutical drug imports that could increase Britain's NHS cost for drugs, the digital services tax from Britain on U.S.  companies such as Google and the Trump retaliatory threat to impose tariffs beyond the current 2.5% on car imports of $11 billion from Britain. On agricultural imports Britain's natural foods preference conflicts with imports of genetically modified (GMO) foods from the U.S. Experts say this could lead to a partial or Phase 1 deal that does not need approval from the U.S. Congress, similar to the Phase 1 trade deal with China which sidestepped the thorny issues on trade. This is something both sides can show their support base as a win. ...

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President Trump plans to give "a very, very positive message" in his third State of the Union message on February 4, 2020. This comes one day after the chaos of the Democratic Iowa caucuses and a day before the president's certain acquittal in the Senate for impeachment charges of obstruction of justice and abuse of power. The president is likely to avoid partisan jabs to focus on his economic record. The theme is "the Great American Comeback." Mr. Trump will emphasize what he has called "the blue collar boom," the ways his policies are helping the middle class, aides say. The president will point out his administration's efforts for working families, for paid family leave, affordable child care, lowering cost of prescription drugs and health care.White House speechwriters writ much of the text, with policy suggestions from key government agencies taken in. Mr. Trump makes edits with a marker, and thinks about the best way to get points across till the last minute, something that comes easily to him with his colloquial style. ...

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Walgreens is changing its growth model to add the business of Health and Wellness buying two companies I-trax Inc. and Whole Health Management which run 350 health centres at corporate offices. Pharmacies will be added to these centres. Its targeting 7600 office sites with 1000 or more employees that could use a health-care center. Its competitors CVS and Walmart are going into managing employer drug benefit programs, with Walmart's selling point being reducing costs of paying for prescriptions for employers.

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About $106 million comes to the Taliban from individuals in Saudi Arabia, Iran, Pakistan and oter Arab countries. A Taliban fighter receives $200 a month and the cost of financing the war for the Taliban is somethig it can do indefinitely from local souces, as it is not costing much. Opium is one source but even if this is cutoff the Taliban can continue fighting indefinitely using other sources, according to experts. The drug trad provides in the range of $70 million to $400 million ayear. And efforts to cut the flow of financing have not been successful.

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Novartis CEO, Joseph Jimenez, is interviewed by the WSJ's Marta Falconi. Jimenez sees the need to focus on patient outcomes and giving payers incentive by reducing total hospitalization cost through better drugs. One area he sees the pharmaceutical industry needing to change is to invest more in R&D, and less in sales and marketing.