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Fears that India may be falling behind China, Mexico and Brazil in healthcare for the people. A planned budget increase was never implemented. Today the Indian government spends only $20 billion on healthcare for a population of over 1 billion people. Annual spending on healthcare is about 1.4% of GDP. Now the Indian government is planning to increase this to 2.5% of GDP. One senior health official Amarjeet Sinha, says other emerging economies such as Brazil, Mexico, Malaysia, now have better public health indicators than India. In 1990 India's public health indicators were similiar to those countries. Another serious problem in India is malnutrition with an estimated 4 of 10 children malnourished. Underinvestment in healthcare is a significant problem as needs grow but there is a shortage of resources and trained healthcare personnel. Arvind Singhal, chairman of consutancy Technopak, says India needs an additional 1 million doctors and 2.5 million nurses to meet the needs of the current level of the Indian population. To do this 600 new medical colleges and 1,500 nursing colleges are needed. The child care advocacy group Save the Children UK, points out that just to meet India's committment to reduce the infant mortality rate by two thirds of the current level by 2015- to meet India's commitment to the UN Millenium Development Goals- India will need 2.6 million additional trained health workers. This shortage is most acutely felt in rural areas, especially in the large states of Uttar Pradesh and Bihar....

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The 2010 census reveals significant changes in the population mix in the U.S. The number of Hispanic people increased significantly, especially so in the under 18 age group. The Hispanic population went up by 43%, increasing to 50.5 million in 2010, compared to 35.3 million in 2000. Overall Hispanics make up 16% of the U.S. population of 308.7 million. One of the striking facts in the change is that children under age of 18 make up one third of the Hispanic population compared to one fifth for the white population. Texas by itself added 979,000 people under age 18, with 931,000 being Hispanic. 92% of the population growth since 2000-of 25.1 million- came from minorities of all kinds. And mixed race is another major category with nine million people. Asian American population also increased, especially in major cities such as San Francisco, San Jose and New York. Overall 63.7% of people identified as white, 16.3% as Hispanic, 12.2% as black, 4.7% as Asian, 0.7% as American Indian or Alaska natives. New York and Washington saw black populations decline. Detroit dropped out of the top ten cities replaced by San Jose. Chicago's population declined, New York's went up by 2% to 8.2 million people. ...

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Christina Passariello's exceptional report from Richard Toll in Senegal on Danone's 10 cent Dolima drinkable yogurt, which is a popular snack for Senegalese. This is part of an effort to reach customers in emerging markets such as Indonesia, Mexico and other countries who live on food budgets of 1-2 dollars a day. Sales of Dolima are growing by 10% each month. The first emerging market yogurt product was a 10 cent plastic 70 gram bottle introduced in Indonesia, which took off quickly with 10 million bottles sold in the first 3 months at the end of 2004. It is popular with low income Indonesians and especially with children. In 2006 Danone introduced a 7 cent yogurt product called Shakti Doi "gives strength" in Bangladesh, with sales initially planned for rural villages but later placed in urban stores. In 2008 the concept was taken to Sengal. To do this Danone's CEO, Franck Riboud, sent a senior product manager Isabelle Sultan who had worked on the Bangladesh project to Senegal. She came up with several new ideas to improve an existing product by improving the flavor and making it creamier, using the Senegalese flag colors of red, yellow and green on the package to help illiterate customers recognize the packaging, and priced it at the 50 CFA coin or 10 cents, a common coin used in Senegal. The name "dolima" means "give me more" in the local Wolof language. In 2009 42% of Danone's sales were from emerging markets, increasing from 6% 10 years earlier. Danone now reaches 700 million people and is aiming at reaching one billion customers by 2013. Other products include water at 15 cents in Mexico- where the alternative for many rural Mexicans is soft drinks that increase obesity. P&G is promoting hygiene for women in Mexico with its low price shampoos and feminine hygiene products and helping improve the quality of life for ordinary Mexicans. ...

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A letter from 600 American economists to the Speaker of the House and party leaders in Congress outlines the case for increasing the U.S.minimum wage in 3 steps till 2016, with 95 cent increases each year taking it to $10.10 an hour and indexing it to inflation. This would help take the wages for the full year of 17 million Americans- most disproportionately women struggling to make ends meet, working age of about 35 years and older, and parents of small children- from $15,000 to $21,000 a year. Another 11 million who are just above the new minimum wage would benefit as companies adjust their internal wage ladder. The letter points out that negative effects on employment are little or none even at a time of weakness in the labor market. It says that instead there would be "a small stimulative effect on the economy as low wage workers spend their additional earnings, raising demand and job growth, and providing some help on the jobs front."

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The reduced availability of child care services, longer time it takes to get steady jobs in a slow growth economy, and the "safety trap" of becoming used to a freer lifestyle, areincreasing the average age at which Italian women have their first child. It has moved up from about 30 to 31.4 in 2012. As more women pursue higher education and get university degrees the trend is to focus on jobs and lifestyle. As grandparents get older and the lack of enough preschool centers this makes child care harder, in a nation where 68% of children under 10 are still cared for by grandparents. At present only half of Italian mothers work, according to the OECD, compared to 74% in France. This worsens the demographics with currently 150 people over 65 years for the 100 under 14 years, and the figures increasing with fewer young people to support retirees, according to Istat.

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Bernie Sanders presents the case for Medicare for All, healthcare for all legislation in the U.S. Congress introduced in September 2017. It has the support of 15 Senators. He says the current system is costly, wasteful and bureaucratic. It is time says Sanders for the U.S. to join the rest of the industrialized world, join Britain, France, Germany and other countries of Europe, Japan and Australia, Canada, with healthcare for all Americans. After all he says only 50 miles north of his electoral district in the Burlington, Vermont area is Canada, where the system of healthcare for all works better than in the U.S.  And the Canadians, Germans, French, and British do this spending less than half the U.S. does. In 2015 the U.S. spent $10,000 per person for healthcare, this means that it cost less than $5000 per person in these advanced countries and the way they do it can be studied and its best aspects adopted by the U.S.  He says this is because the U.S. healthcare system is designed to maintain profits for the medical-industrial complex. A major problem is the manner in which the issue is distorted by different sides on the issue of health care in the U.S., without a consensus being developed on what the common interest is in a civilized society. Mostly because the U.S. unlike other societies is still grappling with the issue of what values it embraces on healthcare being made available to all. Under this legislation the transition to healthcare for all would take place over 4 years. In the first year eligibility for Medicare would start at age 55 years, and children under 18 would be covered. In the second year the eligibility starts at 45 years, in the third year at 35 years, in the fourth all are covered.  ...

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The trial of Tian Wenhua, of a large dairy company in China, for failing to monitor the safety of baby milk powder, and covering up knowledge that dairy products contained impermissible amounts of melamine. The problem of milk powder tainted by addition of melamine chemical to watered down product to falsely raise protein count has been found to be widespread in China. About 300,000 children were sickened by the formula leading to 6 deaths. Tian and three other Sanlu executives are on trial. Tian says she knew about the contaminated milk powder in May 2008 but did not alert officials till August. By that time Sanlu had made 900 tons of the contaminated powder. Executives at Fonterra Group of New Zealand, which owns a large stake in Sanlu, came to know of the problem and insisted Sanlu make a recall. China's effort to bring western companies like Smithfield Foods to enter China's pork industry is part of the effort to build safety and credibility into food products sold in China.

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Capital outflows from China by legal and other methods tolerated by the authorites comes to $225 billion or 3% of GDP in the year ending Sept. 2012, according to research by the the Wall Street Journal. The research looked at foreign exchange reserves and factors that affect reserves such as foreign direct investment, trade surplus, interest on foreign assets and exchange rate fluctuations. Estimates by Lombard Street Research are higher- at $300 billion for this period. By comparison Journal research shows the capital outflows for 12 months to March 2009 during the global financial crisis was $110 billion. An extreme situation is the 23% of GDP in capital outflows from Indonesia during the global financial crisis. Money transfer agents are widely used by wealthy Chinese to move money overseas and are tolerated by the authorites- everything from financing tution for children to buying condos in Cyprus can be done this way. Cyprus gives EU citizenship to any person investing 300,000 euros in a property. Increased foreign investment by Chinese companies and earnings by exporters that are kept overseas are also part of this outflow....

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June 21 is designated International Yoga Day by the United Nations. India celebrates International Yoga Day with 35,000 children and adults doing Yoga in central Delhi. Narendra Modi leads the effort to promote yoga for fitness and health. Yoga research centers are being established to improve health and treat diseases such as diabetes alongside modern medicine. Yoga day practice sessions of yoga were organized throughout India, with the participation of millions of people. Yoga Day activities in Paris, France, included a outdoor yoga session below the Eiffel Tower. In his address to the UN General Assembly on September 27, 2014, Narendra Modi said about yoga: "yoga is not about exercize, but to discover the oneness with oneself, the world and nature." It is part of a 5000 year old tradition from ancient India that promotes meditation, spiritual development and health. This ancient tradition is gradually being revived and is useful in India, China, the Middle East, the U.S. and other countries that see the spread of obesity, diabetes and other health problems. It helps improve spiritual concentration of mind, and increases the body's vital energies....

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This editorial in the NYT points out that the new minimum wage proposed of $10.10 only provides 17 million working age people with about the same purchasing power that the minimum wage in 2013 dollars of $9.40 did in 1968. It also shows how far behind working age people many with small children have fallen behind. The $8 for the minimum wage in New York is now about one third of the $21 average wage in the U.S. in 2014. At $10 it would be about half. Another 11 million Americans slightly above the $10 per hour wage would also see their incomes increase. Even with the increase the incomes would only be $21,000 a year for this group of Americans up from about $15,000, many who are disproportionately women of average 35 years of age struggling to make ends meet. For 5 years the U.S. has seen no increase in the federal minimum wage. 600 American economists have sent a letter to leaders in Congress calling for the change without delay, saying that it would have a "stimulative effect on the economy" through higher consumer spending and spillover effects in jobs created by stimulating demand....

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Japan has accomplished a remarkable transformation of its workforce and its economy even as the working age population is declining. For years Japan was seen as a stagnant economy with a rapidly aging population. In recent years Japan has shown how a change in policy can work. Since 2012 working age population declined by 4.7 million, yet the number of people working increased by 4.4 million. The proportion of the population in the workforce rose sharply since 2012. To do this Japan turned to three underutilized parts of its workforce and population- the elderly, women and new immigrants. Japan has pursued an active policy of reviving the economy by bringing women into the workforce and breaking taboos on new immigrants. In 2004 Japan raised retirement age from 60 to 65, and then made it mandatory for companies to raise or abolish the retirement age, or introduce a system for re-employing workers who retire. This has changed Japan a lot with Japanese men working well into their 60's and 70's. In the west coast city of Kanagawa which now has a bullet train to Tokyo, out migration was a big problem that added to a declining workforce. The head of Ohara, a family owned company that makes desserts tried a novel method of advertising to seniors in apartment blocks and starting attracting seniors to fill worker shortages. It found that seniors came to work on time, performed even tedious tasks, and brought a great deal of experience. Since then the regional government has started programs to get more retirees and women into the workforce. The special programs teach small companies to adapt to the needs of retiree workers who can work in shorter shifts of few hours and do less physical jobs. Women need predictable hours to pickup children from school and shorter work weeks, for which the regional government program helps companies adapt by sending in specialists to guide the companies. As a result female participation in the workforce, for very long a big handicap is no longer so. Female participation has jumped to 63%, higher even than that in the OECD where the average is 62 years.  Japanese women had a M curve that meant they worked most in their 20's. less in the 30's with children, and more in the 50's. First the government tried to correct this with extended parental leave, increased childcare, and rewarding companies with good work-life balance. Then in 2009 the effort accelerated with employers required to offer 6 hour days if a worker asked for this. Under prime minister Abe's "womenomics" effort child care was significantly expanded- by 2015 Tokyo went from 28 to 38 spots open for every 100 two year olds. Alongside these efforts the Abe government tried to get companies to rethink their assumptions about quantity of work and overtime as productive effort. One could work shorter hours and be productive, and the old notions were seen as resulting in lower productivity. As fathers with parental leave took on more responsibility the changes transformed the attitudes for women at work. Most remarkable is the quiet change in immigration policy. The government allowed foreign construction workers to address shortages for work on the 2020 Olympics. It introduced a 3-5 year visas program for nursing care workers. Two new categories of visas will add 340,000 additional blue collar workers over next 5 years. The total foreign born workers in Japan doubled from 2012 to 2017 to 1.3 million. ...

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Problems with China's one child policy are becoming more urgent. New census figures show China's birth rate has dropped to below the replacement rate. Based on the national census in 2010, the figures show the total population at 1.34 billion. The average annual population growth rate for 2000-2010 is 0.57%, which is half the rate of 1.07% in the prior decade. This data suggests a total fertility rate, the number of children a childbearing woman can have at just 1.4, way below the replacement rate of 2.1. This is also happening as the population is ageing rapidly and the gender balance is being skewed because of the bias towards males under the one child policy. The percentage of the population above age 60 is 13.3%, up from 10.3% in 2000. The percentage of the population under the age of 14 declined from 23% to 17%- a big drop. This means that the demographic dividend China experienced is being exhausted. Wang Feng, director of the Brookings-Tsinghua Centre for Public Policy, is one of those trying to get the governmet to change its one child policy. He says the demographic patterns in China were changing even before the one child policy came into effect in 1980. The total fertility rate of 2.3 in 1980 had gone down significantly from the 5.8 in 1950. Indonesia and other countries in Asia also saw signficant drops in the total fertility rate without a one child policy. A large Chinese bureaucracy has formed around the one child policy and it is reluctant to admit the need for change, but policymakers are now paying attention to the facts from the census. ...

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U.S. president Trump's 2017 budget is an effort to reshape spending priorities by the Republican party. Apart from Medicare and Social Security all other entitlement programs from the days of Lyndon Johnson's Great Society are subject to cuts. Deep cuts to Medicaid and food stamps, including introducing work requirements. The philosophy behind it is that compassion will now be measured not by how large these programs are but by how much the government can get people "off these programs and back in charge of their lives,"  according to Budget Director Mulvaney.  The cuts are $616 billion to Medicaid and Children's Health programs, $193 billion in cuts to Food Stamps, $143 billion in student loans, $72 billion in disability programs. The overhaul of the Affordable Health Care Act is part of this change. The reallocation would put more money into infrastructure for $200 billion, and in tax cuts, $19 billion in a parental leave program and $29 billion for veterans programs, plus added spending on the military. William Hoagland of the Bipartisan Policy Center, a Republican who worked on budget issues says it will be politically difficult as the cuts to lower income groups come with tax cuts for small businesses and higher income individuals.  Beyond the policy priorities there is an area where both Republicans and Democrats are skeptical of the budget. This is how it impacts the U.S. debt. Under Congressional Budget Office estimates the U.S. debt as a percentage of GDP which rose to about 75% after the Great Recession starting in 2008, is projected to grow to about 85%. In sharp contrast the Trump administration estimates of the Office of Management and Budget are for it to drop to 65% based on rosier estimates of 2% inflation, 3% growth for the decade ahead. Experts say this is unlikely once the Fed raises interest rates and the unemployment rate currently at 4.4% leads to rising inflation, undercutting growth which has remained below 2% for a long period. These concerns are also voiced by Hilsenrath in the WSJ based on the experience of other countries such a Britain that cut corporate taxes without seeing an uptick in economic growth. ...

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To make custom loan modifications of the type that became necessary overnight on a large scale requires resources, investment in people and technology. On top of this a bank makes about $500 a year on a $200,000 mortgage loan, and if the loan is delinquent the bank may already have lost $2500, say experts, so there is little incentive to do much about custom loan modification. As a result, they used what a former J.P. Morgan executive called "Burger King kids." Or the banks outsourced the operation, some to law firms like David Stern, which in turn used outsourcing firms in Guam or the Philippines. The result is a largely chaotic process according to former mortgage officers of banks, and clerical staff that did not know what they were doing. Now atttorneys general in all 50 states have stated that they will investigate foreclosure practices of banks. It all started with the lone effort of Pine Tree Legal Assistance in Denmark, Maine, in succesfully challenging one of these improperly conducted foreclosures. See the NYT article on Pine Tree. In that case it was about a mother with two children who had her payment go up to $474 after loan modification, who is on food stamps after losing her job as an employment counselor....

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The story of the Pfizer BioNTech vaccine is the story of 2 chikdren of Turkish immigrants to Germany. Sahin the son of a engineer working at a Ford factory in Cologne, and Tureci the daughter of a surgeon working at a hospital in Mainz Germany. Sahin was born in 1965 on the Mediterranean coast in Iskerundun, Turkey and he went to Germany when he was 4 years old, his father being recruited in a new effort to rebuild Germany with foreign labour. Both are motivated by scientific research and the drive to come up with some method to tackle cancer for patients with new research and cures.  Both did their doctoral dissertation on experimental therapies at the Johannes-Gutenberg University of Mainz in Germany, and both joined the faculty there. Sahin spent years studying the mRNA , genetic instructions that can be delivered to the body to help it defend itself against viruses and other threats. Much of this mRNA research was already at an advanced stage in January 2020 when Sahin heard about the coronavirus in China. At that point he saw the potential of retargeting the mRNA research to tackling the coronavirus. By this time he already had his own company with over 200 million euros invested in it  by investors including Helmut Jeggle, now supervisory board chairman of BioNTech. This report says he sat down one Saturday, January 25, 2020 and working on his computer designed the template for 10 possible coronavirus vaccines, one of which would become BNT162b2, the vaccine now approved in Britain. On the same day he told a surprised Jettle that he would refocus the company on the new virus that had not yet hit Europe. Shain he says cited the Hong Kong flu that claimed 4 million lives. Why Pfizer. Pfizer had already been working with BioNTech on a new flu vaccine based on mRNA technology. A cooperation deal was signed with Pfizer in March for organizing clinical trials, manufacture globally, and distribute the vaccine. BioNTech then acquired a U.S. company and a German pharmaceutical factory in Germany. ...

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Bill Gates describes the successful work of 2 million volunteers and millions of children and parents in India's poorest rural areas to get all the children in India vaccinated for polio. This includes the work of the Bill and Melinda Gates foundation. He decribes his visits to India and realizing over time how bringing vaccinations, healthcare, improvement in agricultural development would enable hundreds of millions of India's children to participate and contribute to bringing out India's full potential. Harnessing their full potential is the next big challenge in India's development and modernization.

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This report in WSJ shows how European countries are maintaining salaries of employees who would otherwise be laid off. Governments have setup programs in France, Britain, Germany and other countries to provide employers with the money for 80-84% of salaries up to 2500 pounds ($3165) in Britain and 5330 euros a month in France. As a result 1 worker out of three in the private sector in France for subsidy applications for 6.9 million workers are already received. For the German program 2.4 million workers will get this benefit. About 1 million companies in Europe retain employees with this program of governments simply sending out the salaries with funds directly to households. This helps to keep out the stress for families, particularly families with children. It is as if the employees are not really laid off but asked to stay at home for manufacturing facilities and work from home in shorter hours where work can be done remotely.  Money is quickly deposited into the bank account of employees in these countries, though it is slower in Italy and Spain. It is as if the European approach is put the whole economy on pause for 2 months and restart it almost like before with only a small dent in employment once the coronavirus is pushed out with lockdowns and strict control actions. This will cap German unemployment at 5.9% compared with 5% last year, only a modest increase. The cost is not that much considering what it accomplishes. 10 billion euros is the cost in Germany where the state fund for this has 26 billion euros. 10 billion pounds in Britain. And 20 billion euros in France.  The U.S. adopts a similar approach also through its $349 billion program which provides loans to companies with less than 500 employees to meet payroll for 8 weeks and pay some overhead. Loans are forgiven based on job retention and employees on the payroll and only if the employees are retained. Another program is for companies larger than this. And a third program targets entire industries such as airlines, aerospace, and companies in other industries so that they do not have to layoff employees. U.S. unemployment insurance is modified to work along similar lines maintaining incomes of employees laid off because of the pandemic. Another program sends checks directly of $1200 to households with lower incomes to help them and to help people at poverty level or without jobs. The thrust of both the European and American efforts is the same, lose as few jobs as possible, keep people's incomes steady, and do this in a way that the economy can pick up quickly to the former level in as short a time as possible. Compared to Europe U.S. unemployment will be higher predicted at 9.8% with the expected rebound lowering the unemployment in 2021. ...

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A World Food Program report says India is home to over a fourth of the hungry people in the world, about 230 million people. Purnima Menon of the Food Policy Research Institute in Washington D.C., says India ranks below two dozen sub-Saharan countries on a Global Hunger Index. It ranks Madhya Pradesh, a state in central India, as somewhere between Chad and Ethiopia. And serious hunger and malnutrion persists in states that have done better in economic growth, like Gujarat and Maharashtra. The number of children suffering from malnutrition in 2009 is in the range of 42.5% in India compared to about 7% in China, according to figures cited by Rieff.

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What Krugman makes of the $1.089 trillion dollar U.S. deficit for fiscal year ending in Sept. 2012. He points out that the U.S. can have a stable to declining debt to GDP ratio with $400 billion debt. He cites the Clinton years (1992-2000) when the debt to GDP ratio declined from 49% to 33% with steady growth. What about the remaining $600 billion. He attributes this mostly to temporary factors which are reversible as growth picks up. Of this remaining excess deficit he says $400 billion is from lower tax payments to Treasury because of the 2008 economic crisis and the recession that followed. This includes the payroll tax cut which is also temporary to keep up consumer spending in the recession. The $150 billion is from unemployment insurance, food stamps, and other aid which is also reversed once growth picks up. He places emphasis on restoring economic growth as early as possible and reducing unemployment and using the recession for business to continue to invest in R&D, productivity, and government to preserve the social fabric, invest in education, and provide incentives for growth. S&P Nov. 8 report says the net government debt to GDP ratio is estimated to be over 80% in 2013. It will have to stabilize at current levels for S&P to preserve the U.S. credit rating, says S&P executive Chambers. The higher debt to GDP ratio in 2013 and lower growth rates expected makes the situation different from the lower debt to GDP ratios during the Clinton period. Britain, France and other major industrialized nations with political parties at either end of the political specrum have also chosen to stabilize or reduce debt to GDP ratios rather than take on the risks of them going much higher. The U.S. has the added problem of health care costs out of control with an aging population and about 17.9% of GDP going to healthcare costs in 2010 expected to increase significantly, as Medicare actuaries estimate enrollee numbers jump to 80 million in 2030 from 50 million in 2012. Democrats and Republicans have largely sidestepped this underlying problem in fiscal cliff negotiations....

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Al Maktoum is prime minister of Dubai. He points out some important facts about the Arab world. About half of the 300 million people in the Arab world are under the age of 25. Unemploment is very high among these 150 million Arab youth. About 50% of the jobless are youth, according to the prime minister. About 65 million of the Arabs are illiterate, and 10 million children under the age of 25 are not enrolled in any school. He points out that with so little education, the Arab youth are especially vulnerable to propaganda that creates extremism and is hostile to the west and the USA. One of his key points is that the Arab world is the most militarized place in the world, and spending on conflicts in the Middle East in the last 60 years is about $3 trillion. And in the last 15 years he says the spending on education which is 20% of what the world's 30 wealthiest countries spend, has dropped to 10% of that amount. And very little is being done to educate girls and give them opportunities. As a result of these convictions, Al Maktoum, who is also the ruler of Dubai and from the royal family, has committed about $3 billion to various initiatives to provide schooling to children, especially girls, and education for young people. This makes him one of the more enlightened leaders in the region pushing for new directions. This also reveals the critical weakness among the Arab peoples and why they tend to be so radicalized. Improvements in education and more opportunities for jobless youth, and creating a peaceful region -with the US and the EU countries committing to policies that lead to much diminished military sales to Mideast countries and reducing hostilities in the region -would do more to reduce anti-American sentiment in the region and improve US security than any other policy actions. As Iran, Pakistan and Afghanistan, and the Muslims of India share the same characteristics as the Arab peoples, and the same cultures, the same is true of this region, actually more so. Education has been even worse neglected in the South Asian Muslim region than among the Arabs. It is the key to peace, does more than troops to ensure the peace. The need is for more schools to be built and run in the region, for essential services like healthcare and development, and financing of job creating industries. ...

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A range of opinion from concern for the sourcing of products from a country with no environmental or other regulation, concern for Chinese workers exposed to toxic substances, to concern for hundreds of millions of Chinese children exposed to leaded paints from aa Professor of Environmental Health. The Professor states that 5 of 11 brands of paint that he bought in China had 100 times the US limit, and calls for a Chinese ban on lead in paints.