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The $350 billon in proposed cuts to Medicare and Medicaid in the 2011 deficit reduction talks will do little to reduce the rapid rise in medical costs. Instead it shifts the costs to seniors, state governments and public hospitals. Gail Wilensky, former head of Medicare under the first President Bush and now a senior fellow at Project Hope, says this should not be confused with real reform to Medicare which reduces the rapid increase in costs. It does little in the way of fundamental changes that would reduce the growth in costs. About $53 billion comes from reductions to senior's ability to buy extra Medicare supplemental insurance or Medigap. Another $14-26 billion would have the government reduce payments to hospitals for unpaid debt. The few items to curtail fraud in the use of CT scans or purchase of power wheelchairs would provide savings of $2-3 billion over 10 years. $4 billion comes from lowering Medicaid payments to hospitals treating a high percentage of low income patients, hospitals such as Cook County Hospital in Chicago, San Francisco General Hospital, and Parkland Hospital in Dallas....

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Hamdi Ulukaya on how he started the Chobani brand of yogurt and the company from an idea and a postcard about a Kraft yogurt plant put up for sale in Columbus, New York. Here Hamdi is interviewed by the WSJ's Sarah Needleman. He describes how he developed the recipe with a master yogurt maker from his home country of Turkey, knowing that he had only one shot to get it right. That included pricing because Greek yogurt is costlier to make. The idea came from the postcard which made Hamdi think about the fact that always astonished him- that there was no quality yogurt in the U.S. He hired five people in the plant, had the walls painted, and the master yogurt maker as the sixth employee. The yogurt was introduced in 2007. The pricing had to be right- costing betwen $1.00 and $1.30, not too high. He decided on giving out free samples to get people introduced to the product and had a sampling truck go around the country, similiar to what Ben & Jerry's did with their ice cream in the early days. To avoid costly ad campaigns Chobani was introduced using bloggers, Facebook and Twitter to reach consumers directly....

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Community Aging in Place: Advancing Better Living for Elders, has been here since 2009, it is offered in about 65 places across 26 states. in the US. It helps people 60 and up stay in their homes such as Chikao Tsubaki 87 years shown here in the Washington Post. It brings a repair worker into the home to figure out how to make it safer for falls, in addition to an occupational therapist and a nurse. Center for Disease Control and Prevention says these falls contribute to deaths of 41,000 older Americans each year and cost Medicare $50 billion. Yet this report in The Washington Post shows Medicare does not cover it, and most private insurance plans do not grasp the idea of keeping people healthy in good settings, paying only when people fall, doing little to prevent the falls. Sarah Szanton is a nurse practitioner who worked with older Americans in home settings in West Baltimore and started CAPABLE in 2009, and is now Dean of the John Hopkins University School of Nursing. In it the client and care team work together to do problem solving and brainstorming. One study shows $20,000 in savings a year for Medicare continuing for 2 years person after one CAPABLE intervention. ...

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Investing strategy that is in contrast to PIMCO's Gross and El-Erian view that we are entering aperiod which is the "new normal"- aperiod of diminished expectations with stocks playing a smaller role. This means that investors hold as little as 30% in stocks. Barry Ritholtz, CEO of Fusion IQ, a quantitative research firm says he sees this recession as similiar to the 1973-74 recession and sees growth picking up by 2013, or 5 years into this one. Ritholtz thinks its wise to have larger investmetns in fixed income and similar investments, but also to have exposure to stocks in growth areas of the world. Robert Arnott of Research Afiliates, aresearch and analytics firm, suggests a mix of five even baskets: Us stocks paying healthy dividends, stocks and bonds from mature foreign economies, stocks and bonds from emerging markets, stocks and bonds built around oil and commodities to hedge against inflation, and 20% in bonds. including Treasury inflation-protected securities. Such aweighting would increase stocks as apercentage of the portfolio to 50%....

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Consumer lending went down by 1.7% in October 2009 according to Federal Reserve data. A WSJ analysis of Fed data shows corporate and consumer credit markets have shrunk by 7% or $1.5 trillion in the 2 years through early November 2009. And ont he other hand the Treasury debt outstanding has gone up quickjly by 40% as the governmet tries to finance large deficits. The market for every type pf bond has recovered from the crisis, and money is going into the markets, but this does not mean more money is flowing into the economy. The tighter lending results in consumers and businesses more reluctant to hire and invest. Mohamed El-Erian, CEO of Pacific Inestment Management Company says this means the US econom will grow at 1.5% to 2% ayear compared to the 3% growth that is typical for healthy growth. Says Erian: "the idea that we have reset to where we came from is false. It is abumpy journeyto anew destination with significant long-term effects."

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Tyler Cowen, Professor of Economics at George Mason University, points out some basic truths about health care as it is practiced today in the USA, and healthcare spending as it stands today. He questions whether starting out with extra spending plans to provide coverage to all will help solve the basic problems facing American health care. Too many tests and diagnostic procedures used by doctors is not aproblem that will be solved by spending more money to cover everyone. And government taking on more spending to cover all will not address all the other major shortcomings of the American way of practicing medicine, like prescribing a battery of tests, that tend to drive up costs, to just mention one of the problems. And it will not address any of the shortcomings in the way Americans take care of their health, diet, exercize and healthy lifestyles. THese are critical to get good health outcomes for the people, and which combined with careful spending of dollars where it will provide the greatest benefit, is the only way the health care solutions can be found....

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Wal-Mart is expected to announce a five year plan to meet specific targets for lowering sodium, trans fats and aded sugars in a whole range of foods- including rice, soups, canned beans, salad dressings and snacks foods- in packaged foods sold under its house brand, Great Value. Other moves towards healthy foods are to move to eliminate the extra cost to consumers for healthy foods made with whole grains. It will also lower prices on fresh fruits and vegetables. This plan is similiar to other plans announced by companies such as Con Agra Foods which set a target of reducing sodium content in foods by 20% by 2015. New York City also has a public health initiative for healthy foods. another move by Wal-Mart is to get major food suppliers like Kraft, to follow the example set by Wal-Mart. Kraft sells 16% of its global sales through Wal-Mart. The move will be gradually introduced over five years which makes for slow progress, and the targets set for sugar reductions are much less than they should be, says Michael Jacobson, executive director of Center for Science in the Public Interest. Another serious drawback is that Wal-mart has not proposed to tackle the major cause of childhood obesity, which is the added sugars in soft drinks....

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The US sees no contradiction to India looking for bargain priced oil from Russia to meet the growing needs of its economy and is actually furthering the goals of the G-7 by lowering the price Russia gets for its oil. It helps the economy of 1.2 billion people that like the rest of the world has struggled to fight the pandemic and has incurred the kind of heath costs that even China is now struggling to pay for. President Biden clearly understands and supports this. Democracies an only succeed if they fulfill the aspirations of their people. On this point Biden made clear in his State of the Union that he will generate what it takes from large corporations that paid no tax, to invest in America. Rather than fuel the profits of large oil companies India has increasingly chosen to use Russian discounted oil to invest in India. The Biden and Modi policies are identical generate savings and invest big time in trillions of dollars over the next few years to put democracies ahead in meeting rising aspirations that have been unfulfilled for far too long, which is where the real battles are being fought and will be won, and rightly so. US Assistant Secretary of State for Energy Resources, Geoffrey Pyatt,  said during a visit to New Delhi on Feb. 16-17- "Our experts now assess that India right now is enjoying a discount of about USD 15 a barrel in the price that it is paying for its imports of Russian crude. So by acting in its own interest, by driving a hard bargain to get the lowest price possible, India is furthering the policy of our G7 coalition, our G7 plus partners in seeking to reduce Russian revenues."  Looking at the bigger picture the problem was created by Germany under Merkel who built Germany's over dependency on Russian oil to power a cheap fuel economy it thought was in Germany's interest. This is now being reversed by the hard work of Mr. Habeck of the Green party in the coalition government of Scholz in securing alternative supplies in record time for the EU to avoid a recession. In this sense the perception created early of India which has suffered itself from invasions in 1962 and incursions in the Himalayas more recently, it is not a problem India can solve by becoming energy short at a time when it has invested so much in fighting the pandemic. A similar problem was created by Republican and Democratic administrations of the past that concentrated the supply chain in one country. India lost much investment in the last 8 years as a result of the policies of Merkel's Germany and past Republican Democratic administrations in concentrating the supply chain in one country. ...

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The influence of the AMA convened Relative Value Scale Update Committee (RUC) on how the Medicare payments to doctors is shared, and on the growth of the Medicare budget. Concern that the interested party is driving the decision making process. Medicare costs went up by 9% in 2009. Fears that doctors have too much control over the dollars in the $500 billion Medicare program. The tendency to focus on more expensive procedures and short change preventive and less costly care. Medicare spends $60 billion on doctors fees. The older codes remain in place even when costs are reduced, leading to higher costs for the Medicare budget each year. And there is little incentive for doctors in RUC to revise overvalued codes.

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Nelson Schwartz of the NYT looks at the town of Neenah, Wisconsin, a year after the election in Wisconsin, Michigan, Pennsylvania with 80,000 votes swinging the other way from blue to red handing the election to Mr. Trump. The pressures are still there with cheaper imports, paper mills about to close, and workers still struggling to keep the same lifestyle as their parents. Even with low unemployment of about 3% in Wisconsin, with the slow increase in wages and corporate pressures for profits, trade wars, the sense is that the problems of the American middle class are still just as deep.

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Peter Baker of the New York Times takes a detailed look at Obama and the Presidency in October 2010. He has a long informal interview with President Obama, and uses his knowledge of prior Presidents, to provide a revealing look at Obama's first term in office upto this point. It provides an exceptionally insightful look at the man and his administration, in all its facets, facets that have create both hope and disillusionment. Obama comes across as the cerebral person even in his musings about popular disappointment with the administration, and does not seem connected with the gut-wrenching issues of jobs, foreclosures, the economy, and the economic future as a President needs to be. After all the inspirational rhetoric, Obama, says Baker, did not stay connected to the people who put him in office in the first place. And revealingly Baker shows that even today Obama talks only to a few insiders, compared to Clinton's wider circle, to understand what is happening in the country.