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This review of Acemoglu and Robinson in the MIT News is relevant to the situation faced today. The two professors at MIT and University of Chicago, have provided two books relevant to today's crises, the first "When Nations Fail" in 2012 about the need for inclusive nations, and the second "The Narrow Corridor" about the importance of the role of individual and society in sustaining democracy. Their point in the first book "When Nations Fail" in 2012 coming after the financial crisis caused by banking excesses stated that the nations fail when they are not inclusive.  In practice it is about " the system being rigged" to favor some groups as the Republican party and Mr. Trump say has happened. The banks and lobbyists, pharmaceutical industry and lobbyists, tech industry and lobbyists, leading to a system where individual and society are pushed into a corner. Social theorist and economists fail to look at things in practice such as profit seeking behaviours and unethical behaviour that goes unchecked, which continued after the financial crisis into the election of 2016, with charges of rigged systems.  This week Germany's DW.com oped pages covered New York with the statement that treatment in New York costs $15,000 for coronavirus infection illness yet many New York residents in the worst affected neighborhoods would find a $500 expense difficult to bear. Early closing of schools to control infection rate was resisted by Mayor De Blasio of New York because many parents depended on schools for lunches for their kids. The situation had been allowed to deteriorate to that level.  In their second book the MIT authors are saying that the role of the individual and society are important to check that of the state (for example if it is perceived as being rigged by the influence of lobbying of legislators and politicians as the Republican party and Mr. Trump have maintained). It is only when it is checked and there is some tension is there the possibility of democracy and democratic processes, say the two MIT authors. In the absence of this the states and elites of politicians and business interests supporting the leaders and their common behaviours, become a perpetual state, in effect a one party rule of two parties with similar behaviours and interests in the state. A situation that allowed the outshoring of American manufacturing and European manufacturing to China including critical infrastructure, essential infrastructure over 2 decades even over the protests of Mr. Lighthizer since 2010. As the twin crises evolved in Europe of austerity policies after banking excesses in Europe, and the migration crisis of migrants coming from North Africa and the wars in the Middle East, a similar situation began to develop in Europe as the political elites entrenched in Germany, France, and Spain faced new voices. The tensions that arose were constructive bringing in the role of society and individual that the MIT authors say are so necessary for the narrow corridor of democratic process to function. New parties emerged in France with Macron's La Republique En Marche, Podemos and Ciudadanos in Spain, and in Germany with the SPD and CDU shrinking till the revival of Merkel for her handling of the pandemic. Coming from an intuitive way born from experience in East Germany, Germany's recent president Joachim Gauck, civil rights activist  came up with the same ideas. He is a Lutheran pastor in former East Germany who struggled against the government of the German Democratic Republic (former communist East Germany) for a role for individual and society against the state. We profiled and quoted him in "The Way Forward"  column in Lyrarc.com. Gauck's point was that  having diverse groups in the conversation is important, not excluding others from outside in the conversation is important. Gauck called  debate "the oxygen of democracy,"  that needed to be maintained.  Genuine democratic process is hard to sustain, it happens only when the role of individual and society is given prominence, so that only a narrow corridor exists for democracy, a narrow space in which can be sustained only if the effort is there, the goodwill is there, and the grace of Divine Providence.  It is fragile and it is critical to sustain.   In this sense the sometimes heated debate in the U.S. and Europe, Asia and Latin America about words such as- austerity, community, solidarity, migration, New York Mayor De Blasio's choice between school lunches and infections, about infrastructure, pharmaceutical prices, infrastructure, outshoring, jobs sent overseas, manufacturing locally, made in USA or made in India or made in France, Atmannirbhar Bharat, misallocation of capital starving health and public services, are all relevant and essential for democracy. This includes the discussion to avoid use of the military in protests in American cities in the middle of a pandemic which just crossed the 2 million mark in cases in the U.S., that was taken up by Defense Secretary Esper. In it lies the hope for democracy and many voices. Der Spiegel recent look at the pandemic how it happened in China, closes with the line- you need more than one voice in society. A constant reminder that many voices be heard, counseling patience, but also that wise choices be made with divine providence.           ...

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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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Just as the drug industry is more getting more dependent on the government with the medicare drug benefit raising the retail drug purchases paid by government to 34% in 2006 from 28% in 2005, the industry is facing more governmental scrutiny, from the FDA, from Congress from the public, and during this election campaign. Rep .Rosa DeLauro, who heads the House appropriations subcommittee that has oversight over FDA funding compares the drug industry to the tobacco industry saying that it requires the same amount of scrutiny. At the same time the drug industry is aware of the changes in the public mood and the recent controversies over drug studies, such as the one on Vytorin and other controversy. It is initiating some voluntary changes, registering clinical trial results, submitting commercials to the FDA before they air, and under pressure from medical journals registering trials before they are performed. A new law will requires and its not clear whether the drug industry is dragging its feet and then making changes when there is increasing public pressure. This is the feeling of the medical journals like the Journal of the Medical Association and the New England Journal of Medicine. JAMA's editors will be keeping up this pressure as they have more articles showing how the drug industry manipulates data and the need for public skepticism of information that comes out of the drug industry. The New England Journal editors expressed the need to publish information that helps doctors get all the available information, and not just the information from the drug industry that makes the drug look better than it really is, such as the information and analysis it provided on antidepressant medications. The chairman of the energy and commerce investigations subcommittee Rep. Stupak, finds the advertising for drugs contains information that cannot be backed up and not true ethically, medically, or legally. As this reflects the public mood look for more investigations in Congress and investigative research by the journals. On the issue of importation of drugs from Canada there is bipartisan support as both Senator McCain and Senator Clinton support importation. Clinton supports legislation that allows the FDA to approve new generic versions of biotech drugs which would lower prices of biotech drugs. And with the US consumer budget facing strains in a recession there will be increasing pressure and demands for relief in the area of drug prices, especially for the elderly and uninsured and from corporate payors. ...

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The planned resubmission to the FDA for approval of diabetes drug Tresiba by Novo Nordisk with improved prospects. The Novo team has discussed its findings with regulators. If the resubmission is accepted Tresiba will be ready for launch in 2015 or early 2016. A once weeekly successor to Victoza, injectable treatment for diabetes, and an oral formulation for diabetes, are other new diabetes drugs Novo Nordisk plans to bring out. The oral formulation market is estimated at $13 billion by Citigroup.

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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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"It may be that this iron curtain is small, unimportant and justified, but it is a bad sign." Howard Buffett took a stand in the House of Representatives against the VOA broadcasts being used inside the US in 1947.  Warren Buffett is the son of Congressman Howard Buffett of Omaha, Nebraska, who was on the Board of Education of Omaha, started a small stock brokerage firm, and ran for US Congress in 1942, reelected twice and in 1950. He also ran Howard Taft's Republican presidential campaign in 1952. Looking at Buffett in the FDR-Truman years- one sees a young Buffett in contrast to Warren Buffet's silence on the 2008 financial crisis, raising serious issues- about the Truman doctrine in 1947 on the floor of Congress, was Acheson falling dominoes analogy a dangerous one?  It worked in Turkey-Greece with $400 million in aid in 1947 but was Acheson/Truman using a dangerous analogy of dominoes that would later hurt the US in French colonial Indochina wars, and in the reference to protecting oil resources in Middle east in Iran, Iraq and Saudi to lead to wars that exist to this day in 2024? Wars DJT and Biden have both opposed in contrast to Reagan, Bush, and Obama. There is a huge contrast between the father Howard Buffett, descendent of Huguenot ancestors from 1600 New York, and the finance professional Warren Buffett who went to Columbia University in 1951-52 as student of Prof. Graham with 70 years in finance during which financial crises destabilized the US with Buffett not taking a stand. One hedge fund manager say it is pure nepotism to pass on the company Berkshire to Warren's son Howie. But he is not surprised- who else would be sure to keep the company headquarters in Omaha, keep things simple invested in index funds and much of it in a few companies leaving the investing to managers chosen by Warren, with Howie's job to make sure his father's principles remain. Howie is Warren Buffett's 70 year old son, who Buffett 90 years is setting up as his successor as chairman who will not do investing leaving it to managers, yet be able to change CEO's. Howie worked for a few years at See Candy, a Berkshire owned company before becoming corporate VP at ADM food producer, followed by working on his own farm in Decatur, Illinois which he enjoyed doing. At ADM Howie left after an anti trust investigation began, in which the company was charged with $100 antitrust fines for price fixing says the WSJ. What is Berkshire Hathaway? It is a trillion dollars of investment funds invested in a few companies under name Berkshire Hathaway, using some of the basic ideas of Benjamin Graham, a pioneer in careful investing, adopted by Warren. Where has Buffett put his money? Berkshire top ten investments are- about $90 billion in Apple, $70 billion split between Bank of America and American Express, $30 billion in Coca Cola, and $30 billion split between 2 oil companies Chevron and Occidental. He has not invested in pharmaceuticals or in renewable energy- in just a piece of America.This has generated a compound interest of about 14% over 3-5 years and about 12% over 10 years. He holds 30% of his investments in cash or fixed, mostly cash at this time. And holds the remaining 70% in stocks. ...

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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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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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After the failure of its venture with Redi-Clinic , which put its clinics business in reverse, Walmart is rebuilding this business. In 2008 Walmart talked of having 400 clinics by 2010. But of the 78 that were running in 2008, all but 17 closed. Now Walmart is partnering with Hospitals. And Redi-Clinic is doing the same. Walmart now has 33 clinics, with 26 having a hospital affiliation.

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Toyota ended its relationship with Tesla to focus on fuel cell technologies. Panasonic is taking up electric car batteries project in stages to limit risk. As Tesla focusses on a car for the mass market at $35,000, both the upside and the downside are evident, as shown in this report by Pulliam, Ramsey and Mullins of the WSJ. The reporters say the arrrangement of interconnected companies Solar City, Tesla, and SPace X through Musk's holdings and his personal loans to companies in difficulty such as Solar City- using his Tesla shares as collateral- is a risky business. This follows the way Valeant shares lost 14% in one day, as market perception changed. Venture capital companies such as Jurvetson with which Tesla has connections, and relatives, round up the ownership of these companies in a tightly knit arrangement with Musk as the key shareholder in an unconventional arrangement, says WSJ.