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Estimates show the 50 million Americans enrolled in Medicare today will increase to 80 million by 2030, according to the program's actuaries. Simple demographics as the baby boom generation ages is making controlling the deficit without controlling increase in health care costs as both sides in the fiscal cliff negotiations are attempting to do can only lead to defunding critical areas such as education, R&D and infrastructure, and breaching the safety net for lower income Americans. Health care spending took up 7% of GDP in 1960, increasing to 17.9% of GDP in 2010. Federal spending on healthcare has grown to about 25% in 2012 from 10% in 1960, and is projected to increase to about 33% in ten years by the Congressional Budget Office.

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Beer made from locally grown cassava and other ingredients and government tax incentives is making it possible for SABMiller and other large beer companies to make low priced beers for the African market. African governments such as Kenya have eliminated excise taxes on low priced beer, and the production of locally made Senator beer by Diageo's East Africa Breweries is increasing rapidly in East Africa. SABMiller makes low priced beer brands in Ghana, Uganda and other countries. The government sees this as a way to reduce the consumption of locally brewed beers of poor quality, and a source of revenues. Health workers expect an increase in health problems as a result of increasing consumption of low priced beer. Obesity is amajor problem in S. Africa and in other African countries. This will have effects in the higher rate of diabetes and other diseases related to obesity. Alcohol consumption in Africa per person is about 10 liters of alcoholic beverages a year, with consumption at 70 liters in S. Africa, the country with the highest rate of obesity. The figures globally are 35 liters, and 91 liters in the U.S., another country with high rates of obesity and diabetes, according to 2011 figures from Euromonitor. ...

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The health care system is designed to encourage procedure based specialist practices and discourages the patient understanding education and monitoring that occurs with a well designed preventive family physician practice. As a result a patient only spends 30 minutes ayear on average with family physician compared to one hour in other developed nations. In the USA there has been a steady decline in the level and quality and extent of family care and the close one on one rapport with well trained family physicians who enjoyed their work and understood their patients and kept up with their health conditions and provided good and regular advice on these conditions. There is no money in this care as a result first you provide an environment where a whole range of medical conditions can flourish and expand, and then you hit them with a whole series of tests to rule out specific medical conditions. It is a perfect way to expand the testing and let testing flourish, so it would appear that if someone had wanted to start with a goal of letting testing proliferate unhindered then this would be the perfect way to design it. ...

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As the related article in The Washington Post points out the narrative inside India relates more to the the sense that terrorism has been a persistent problem for India and the public's sense that action was needed. Most of the issues in South Asia relate to development, roads, dams, bridges, airports and housing that need to be built, healthcare, sanitation and education on a massive scale. This is an area where India can show the way forward for South Asia, and be the real test for Mr. Modi after the many projects that he has initiated in India in the first term. It is only ordinary Indians, Pakistanis, Bangladeshis, Sri Lankans, and other people in South Asia that are paying the price for neglect of development and infrastructure as China, South Korea and other nations have forged ahead. A focus on development is the right sphere for competition both for Mr. Modi and for people in the region.

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An average of major opinion polls compiled by Real Clear Politics website shows 50.5% of Americans opposed to the Obama U.S. health care law.

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In France MEDEF the employers union is calling for relocating strategic industries back to France. In its plan of reopening of May 28 it calls for "targeted relocating of strategic sectors, to France, and Europe, with healthcare a priority." The French government of president Macron and people support this. To get an idea of how people feel consider that surveys recently taken show 89% of French people wanting to relocate industries back to France, and 47% want to do this completely, even if this means higher prices for consumers.  French carmaker Renault announced 4600 job losses in France as demand has dropped, even after the 5 billion euros of state help it has received for the pandemic losses. France has a 15% stake in Renault and Renault has given a commitment to bring value added manufacturing back to France after state aid. President Macron has called for economic sovereignty. His call as the pandemic leads to rethinking of old supply chains is - "We must build more in France, on our soil. And rebuild our national and European sovereignty." It is a rethinking that is now getting overwhelming support of the French people. ...

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The increase in the Nasdaq Composite Index to 4000 by November 2013. In contrast to the period in 1999 the Nasdaq Index now has companies in the Index in a broader number of tech fields including medical technology, pharmaceuticals and consumer. Tech companies in the Index now have reliable tested products and generate significant revenues and profits. Apple has 8.02% representation in the Nasdaq Composite Index. Other companies are Microsoft with 5.15%, Google 4.80%, Amazon 2.88%, Intel 1.95%, Qualcomm 2.09%, Gilead, 1.88%, Amgen 1.42%. The Index is more diversified in 2013. B/E Aerospace and First Solar are part of the Index. About 13.5% are in Health Care technologies, including Celgene and Myriad Genetics. And 7.1% in Telecom, including SBA Communications. Priceline, Amazon are part of consumer internet companies in the Index. Tech based companies make up only 45% on the Index Composite compared to 66% in 1999, with these companies on stronger revenue and profit footing and not bid up speculatively as they were in 1999....

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U.S. health insurance company WellPoint Inc. will offer higher payments to primary care physicians. This is part of new strategy to reduce emergency room visits and costs after deterioration in a patients condition by relying on primary care physicians for better care at the outset. Payments to primary care physicians will be increased by 10%, with higher payments when the results show better quality and preventive care. WellPoint has a network of 100,000 primary care doctors. Physicians who meet certain goals such as lowering the overall cost of a patient's health care costs will be given an incentive of 20-30% of the savings realized. The new effort will add 1-2 percentage points to the 6-8% of the $100 billion that Wellpoint pays for claims processed each year. WellPoint's management sees a reduction in medical costs of about 20% by 2015 as a result of such efforts.

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A 41 year old doctor, Vasant Narasimhan, is the new CEO of Novartis in Feb. 2018. Under Narasimhan R&D is expected to get prominence. His predecesor Mr. Jimenez's focus was on developing new prescription drugs. Dr. Narasimhan sees a shift to new technology, improving data science and digital capabilities to discover new medicines. This shift raises the possibility of a spinoff of the Alcon eyecare business and the Sandoz generics business.   Narasimhan joined Novartis in 2005 from consultancy Mckinsey & Co. and becoming head of R&D. He is expected to push a series of tech based initiatives including artificial intelligence to be used for new biomarkers showing effectiveness of treatment, new sensor technologies developed with Microsoft. This shift is a result of the earlier effort under previous CEO's to make up for the loss of patent protection on profitable drugs by diversifying into consumer healthcare. During the period under Jimenez Novartis share price performance was mediocre, rising 41% over 8 years. Its business is stagnant with a 1% increase in 2017 for revenues, the first increase in 3 years.   ...

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How the French health care system works. France comes in first and the USA 37th in aWHO health care ranking. THe difference in deaths from respiratory disease is half that in the USA, and lower rates of death from heart disease and diabetes. IT has more hospital beds and doctors per capita than the USA. 65% of French people are satisfied with their health system compared to 40% in the USA, and yet France spends 10.7% of GDP on health care and the USA spends 16% for poorer results. THe French system is more generous to its seniors. Unlike Medicare there are no deductibles, just modest co-payments that are often dismissed for chronically ill. And diabetes and critical surgeries are covered 100%. French also buy supplemental insurance like Medigap for extra expenses like dental and eyglasses. Cancer patients are treated free of charge. Avastin treatments costing $48,000 a year are provided at no charge. France's PMI or Protection Maternelle et Infantile, is rated highly. It is anetwork of thousands of healthcare facilities, that ensure that every mother and child in the country receives basic preventive care. Mothers even receive afinancial incentive for attending their pre and post natal visits. France makes this care affordable by reibursing doctors at a much lower rate. The average yearly net income for doctors is around $55,000, about athird of what doctors in the USA make. But French doctors don't have to pay back huge student loans as medical school is paid for by the state and malpractice insurance premiums are only a tiny fraction of that in the USA. And again the French government pays two thirds of the social security tax for most French physicians- which is typically 40% of income. So the $55,000, is more like $92,000 taking that into account and more like $110,000 when student loans and malpractice is taken into account at US levels. Specialists who have 4 or more years experience can charge what they want, but as one gastroenterologist says, there in an unspoken and undefined limit to what you can cahrge or what is socially acceptable. Yet even in France there is inflation in health care costs that the government deals with through price controls and more spending. The French national insurance system is running increased deficits each year and this is now $13.5 billion, and it has led to higher taxes for employers and workers. ...

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Apple iWatch sales are about 11 million -15 million units in last 4 quarters. The iWatch sales are a small fraction of sales overall. Apple quarterly profit declines by 22.5%, as revenue declines and iPhone sales decline. Half of the quarterly revenue decline comes from China. This has hurt the share price by May 2016.

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Signs of a permanent shift in property and housing markets in China in 2014 as the new administration of premier Li Keqiang shifts policy to focus on employment and indicators of wellbeing such as pollution, education, and healthcare.

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Abbott's decision to raise the price of AIDS drug Norvir 5 fold in 2003, and how it undercut Glaxo's drug Lexiva which is used in combination with Norvir. Abbott included Norvir ingredients in a new drug Kaletra and this was priced cheaper than other AIDS drugs when it increased the price of Norvir. Glaxio is now suing Abbott for this pricing practice.

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The Economist quotes experts saying that drug innovations would not be affected by price controls on drugs. Pricing reforms can accomplish the reverse, spur innovation by doing as Britain and Germany are doing- pioneering comparitive reviews of drugs effectiveness and cost-benefit analyses aimed at reimbursing firms for new drugs based on their performance. Sanford Bernstein, a financial advisory firm, says in its study that a 20% reduction in what Medicare pays for drugs would not kill off innovation, it would reduce earnings per share of big pharma firms by 3-8%. As drug research is now done in many countries, and its a globalized industry, innovation is not likely to be automatically affected by price reductions in one country like the USA, according to Alna Garber of Stanford University and Patricia Danzon of Wharton Business School.

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Pearlstein quotes Dickens in "Oliver Twist," about the law being an ass, and the constitutional law exercize in the Supreme Court of the U.S. giving a sense of a failure of the so-called best and brightest in reasoning out the issues. He points out that a serious problem is that American business which is burdened with high health care costs for employees is seriously missing in this debate after years of complaining about high costs. The National Federation of Independent Businesses is actually one of the plaintiffs questioning the constitutionality of the Obama health care law. Pearlstein says business wanted an end to the fee-for-service medicine that increases consumption of medical services and pushes up cost relentlessly, and that Obama's health care law does this. This is not the case as both Democrats and Republican administrations have failed to resolve this side of the cost issue, and this is the hidden reason for the loss of credibility for both sides in this debate, leaving health care problems to be resolved in future administrations. ...