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The private sector ignores health insurance. And state coverage in China is inadequate. More than two thirds of China's 1.3 billion people have no health insurance at all. If you have insurance you still pay up front in cash, if you do not have the cash up front you cannot get a surgery, treatment of any kind or any drugs, even if the insurance will later reimburse you. The Chinese health care system is dysfunctional and in a crisis because of the way it is structured, and the faulty policy incentives. It caps prices for basic drugs and procedures at below market rates, yet it lets hospitals profit from everything else from advanced drugs to sophisticated diagnostic tests. So hospitals invest heavily in technology and expensive testing. and drug sales account for 45% of revenues. And enforcement is lax. Doctors in Shanghai make monthly incomes of about $400, about what a taxi driver makes, so they supplement their income with bonuses earned by prescribing more expensive tests and drugs. There is no utilization review so the state reimburses for whatever the hospitals charge regardless of whether the test was needed or not. So the system is dysfunctional and lurching towards a crisis. In fact heavily burdening the middle class. The private outlays and burden of total health care spending has increased from 20% to 60% of total health care spending from 1978 to 2003, as the the health care system got the same dose of unfetterred capitalism as the rest of the system. The Government's share of total health care spending has dropped sharply. In addition there are design flaws that push expensive care and build in incentives for expensive care at the expense of good medical care. The government recognizes this problem and sees it as athreat to social stability. It has committed to increase spending on healthcare. ...

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"Ram Rajya" is a concept of a just society that serves the needs of the people based on the ancient history and ancient paths of Bharat or India. It is easily understood among the farmers and ordinary people of India. During the long period of colonialism it meant to Gandhi and hundreds of millions in the villages of India a sense of society free of colonialism and colonial rule that did not invest in the country or its people, no matter their religion or caste or language group. In this sense Ram Rajya is all about a just society of governance that meets the needs of all the people, that makes investment in the resources of the country to the benefit of the people. In the modern period in the transformation of rural societies such as China or India or other parts of Asia, Ram Rajya or Buddha Rajya as an extension of the same concept, and about what Abraham Lincoln called society for the people, of the people, by the people, in his call to America for a Just Society. In this sense it has connotations for the world as it struggles to build a style of governance in society that builds the infrastructure, invests in the education and minds of the people, in their health and wellbeing along all dimensions. In this way it is a social concept that is embodied in the best of human society throughout history. It embodies the aspirations of the people of Asia to modernity inspired by ancient tradition, aspirations to science and technology and building modern societies. Of India with Ram and the Buddha, China in its connections to the Buddha, to the people of Indonesia with the connection to Hanuman, and the people in South East Asia and Japan through their connections to the Buddha which were embedded in the ancient society of Ram and the Upanishads in the land south of the Himalayas. No one is too small, no effort is ordinary or small- "I am very small, I am very ordinary, if someone thinks so one must remember the contribution of the squirrel. Remmbering the ocntribution of the squirrel will dispel our hesitation, and teach us that every effort big or small, has its strength and contribution. The foundation of Sabka Prayas (everyone's efforts) will be the foundation of a divine, and capable, just and good Bharat or India for all its 1400 million people."   ...

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Wholesale inflation calculated weekly is at 7% in India. And the country's Finance Minister Chidambaram says he is more concerned about inflation than a growth that slows a bit. Experts forecast growth slowing down from 9% to 7% in the next 2 years as the global slowdown affects India. For the US India has been a good export market with sales growing at the rate of 75% a year according to the USA Commerce Department. But a look at the charts shows that China also had periods of a couple of years when growth slowed to 7% in recent years before it gradually went back up to over 10%. And China's growth will also be affected by the global slowdown and fall weel below 10%. And this may be a health y thing for China as it decides what kind of growth it wants to see that is better than the haphazard growth of the last few years with its huge environmental costs and lax regulation and the imbalances in growth between urban and rural as well as wages and benefits without labor law protections to create domestic consumption by a middle class. ...

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The worst flaw in the health care bill says the Economist is that "fee for service" and doctors billing for each test done continues as before.The whole idea of medical services based on medical necessity and value for money has been left out of the billsin Congress. Alan Meltzer also pointed this out in his discussion of the deficits and debt over the next decade; that the 25% reduction in medical expenditures does not look anywhere closer to reality, worsening the deficits. This is also the view expressed in the discussion of health care reform in the November 2, 2009, issue of Business Week. Never mind said BW that the doctors and hospitals account for one third of medical expenditures and there is waste in Medicare spending. Congress said BW has made no changes in the "fee-for-service" system of medical care that has inflated medical costs, by paying doctors for the volume of services delivered and not the quality of services delivered.

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Krauthammer says there is reason for optimism that the super committee of the August 2 Debt Ceiling and Deficit bill can achieve major results. The reason he says is that much of the work in key areas has already been worked out by the Simpson-Bowles Commission. This has also received extensive public scrutiny and discussion. Its now upto the committe to make some choices for tax reform. For the sake of efficiency and fairness this needs to be done. Efficiency is gained by closing the loopholes and the tax exemptions for mortgage interest deductions, health-care exclusion, and subsidies such as the one for ethanol. And in its place moving to lower tax rates, the 23% envisaged by Simpson-Bowles, or the 28% from the Reagan days, down from the 35% today. Fairness is gained by removing tax breaks for special interest groups that do much of the lobbying. The mortgage interest deduction can be phased out starting at $500,000 in the inital phase or using the plan for tax expenditures proposed by Martin Feldstein. Feldstein's proposal outlined in the New York Times on May 4, 2011, (see group for Feldstein) was to limit the reduction in taxes from deductions and exclusions to 2% of the person's AGI or adjusted gross income. The other part of the Committee's focus would be the structural changes to Social Security and Medicare- raising the Social Security and Medicare ages and changing the inflation formula, and means testing Social Security. Obama has already considered the raising of the age for Social Security and changing the cost of living formula....

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A report by the Longevity Science Panel for the UK says the life expectancy gap between the richest and poorest neighborhoods in England has increased since 2001. In 2001 this was 7.2 years, by 2015 this increased to 8.4 years. The government points to cancer rates, the Longevity Science Panel report authors say income inequality was the main factor. To do this report LSP looked at data from the Office for National Statistics for 2015, which divided England into 33,000 residential areas and rated them on factors ranging from income levels, health, education and crime. This report points out that men and women from the bottom fifth were 80% more likely than the top fifth to die in any given year. 

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Wal-Mart has fallen behind competitors CVS and Walgreen in its drive to open medical clinics in its stores. Walgreens now has 350 in-store clinics, CVS 600, Target 44, and Kroger 80. Wal-mart has 149 in-store clincs in the U.S.

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This beautiful DW.com video shows the use of face masks in vibrant colors and styles is in the hope that it will become popular. It is of great importance in the fight to stop the spread of coronavirus. A large part of people who have coronavirus are asymptomatic and are a big problem as spreaders of the virus, say health experts. The Robert Koch Institute in Germany recommends use of face masks. Jena is the first city in Germany making them mandatory. Other cities will follow, only not soon enough,

Face masks to prevent spreading the virus are a way of life in China, South Korea. Then why is it so difficult for Europe and the U.S.? Czech Republic and Slovakia have made face masks mandatory. The Center for Disease Control in the U.S. are now revising their guidelines to require people to wear face masks to avoid the spread of the virus, cloth masks or scarfs could be used also.

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The differences in the Democratic party between conservatives and liberals that make it difficult to get things done in healthcare, energy and other areas. The lack of White House leadership in a number of areas, and in anumber of instances. The lack of Senate leadership on these issues with the Senate not having done much in energy and healthcare legislation. Add to this the influence of the $133 million that lobbyists spent in the 2nd quarter 2009 alone. The failure of Republicans and Democrats in Congress to push vigorously for cost control in the health care industry adds to these problems.

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Public opinion in the district of Steve King, a Republican in the House of Representatives favoring defunding of Obamacare healthcare law.

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All sides joined the President at the White House, as part of his consensus building efforts, and to get aseat at the table in restructuring health care. The insurers and health care providers, including technology providers, all committed to cutting the cost of health care. New social insurance programs to cover 45 million uninsured Americans, and to make health care affordable for businesses and individuals, will be unworkable at currently projected rate of increase in health care costs of 6.2% a year for the next decade. The industry promised to reduce that by 1.5% through voluntary efforts, even though there is skepticism about whether they will deliver. The insurers are against a government sponsored health plan fearing it will drive them out of business. Insurers and health care providers are lobbying against the cuts in their Medicare payments, and insurers are fighting Obama's cuts to their private Medicare Advantage plans by a total of $176 billion over 10 years. Doctors are fighting a 21% cut in their Medicare fees scheduled to take place in January 2010. Pharmacuetical companies and makers of medical devices are concerned that new products will have to pass a cost-benefit test before being approved for coverage under Medicare. Its just that they all see the continued rise in costs as somehow unsustainable, especially in the current economic crisis, and share the feeling with business and the rest of the country that the system is broken. At the same time like the banks and bank executives, health care companies and their executives go on lobbying aggressively and doing things the old way, which raises questions about how well these systems that are broken can be put on the right path....

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Providing health insurance to the roughly 50 million people that are uninsured costs some $120 billion ayear. This will hae to be paid for through limiting the tax deduction on employer provided health insurance (something Obama campaigned against), or cost reduction in the bloated cost structure for health care in the country. But the same health care providers who committed to cost reduction in arecent conference at the White House are lobbying against some measures that reduce cost.

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Questions being addressed to get health care to the uninsured and to all Americans at an affordable level.

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David Stockman, director of the Office of Management and Budget under Reagan, is interviewed by Tom Keene. Stockman says the US has $52 trillion of debt on a $14.5 trillion economy, a ratio of 3.6 times GDP. Historically, before 1980, it has been around 1.6. This debtification of the US, he says, is the major problem facing the US today. Stockman sees little or no economic growth in the next 5 to 10 years, as debt reduction progresses.

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As president Jinping begins a second five year term his focus is on the small communities like Chashan, only a 6 hour drive from Beijing, that were neglected in the rush to industrialization. He has vowed to get rid of poverty in China by 2020. About 43 million people live in rural communities that have mostly older people and live on 95 cents a day. There is another challenge say experts which is the much larger popuation that lives in rural and urban areas- including urban migrants without property and residence rights- who live on less than $5.50 per day, $165 a month, according to the World Bank. This is about 1070 yuan per month, or in Indian rupees for a comparison with India- which was at a similar stage of development in 1990- of Rs 10,000 per month. About 40% of China's population or 560 million people are in this group. With a rapidly aging society as a result of the earlier one child policy, China faces the risk of not advancing from the level of a middle income country, in the way that South Korea and Japan have moved to levels similar to Western Europe and the U.S. As China's growth level slows and with an aging society this remains a major challenge. As this report shows there is great pressure on local officials to eliminate the poverty level of people living below $30 or about 200 yuan a month, as targets are set at local levels and corruption weakens the effort. There is concern at the lack of an effort to improve the living conditions of the 200 million rural migrants living in cities, who under China's "hukou" system are not considered residents and are not getting education and health benefits. ...