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India enters a complete and total lockdown as no one is allowed outside in a country of 1.3 billion people lacking the public health systems found in Europe, China and the U.S. Experts say this was a needed step.

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The NYT Editorial Board on efforts in the U.S. Senate by lobbying groups to have the 2.3% tax on medical devices- to pay for medical coverage of the uninsured in the Obama health Care law- repealed.

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France was exceptionally well prepared says France 24, citing a report in Le Monde, for the SARS crisis in 2002 and the H1N1 influenza in 2009. A billion masks were stockpiled by 2009. Following the H1N1 influenza not appearing in any significant way the media, political parties and the public shifted their attention away from public health crises preparation. For H1N1 the government spent 1 billion dollars some of it going to pharmaceutical labs. The eurozone financial crisis that followed the global financial crisis shifted policy to austerity measures. The entire preparation effort for influenza type health crises was abandoned as too costly.  The same pattern repeated in Britain which was also well prepared before 2010. Austerity budgets after 2010 had little room for public health investment.  One could say a similar pattern was seen in the U.S. Today the worst hit countries are U.S., Britain, France and other European countries. France which had 1 billion masks in 2009 to tackle a possible H1N1 epidemic finds itself with 150 million masks in March 2020 and scrambling to find masks. Some masks which were usable were even destroyed as expired, ministers and experts who had built up the prevention effort in 2009 were even demoted and forgotten, as was much of the preparation in these years. It wasn't just medical supplies pubic awareness had practically disappeared. In the U.S., in Europe, the same situation of a lack of public awareness so that experts, government, and the public could work together quickly, was clear to see. In countries such as Taiwan the preparation led to speedy response at all levels, making contact tracing, isolation of clusters effective. In the U.S. and Europe this early, early, period was lost leading to makeup mitigation measures and the growing sense of a loss of control over the virus. ...

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Weigel of the Washington Post compares how the Affordable Care Act was passed in Congress in 2012 with the push by Speaker Ryan and the Trump administration for the American Health Care Act in 2017. Republicans he says are making the same mistake as Democrats by rushing this through Congress. There is no broad consensus on whether all Americans should be entitled to health care as in Europe and Japan for their citizens, and health care is priced in a way to make it expensive for the state to provide- until the twin problems are solved by creating a new culture in the U.S. that sees things differently, politicians will come up with their own plans based on their interests and which groups they serve.

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Breaking the norm of jobs requiring sitting down in one place for long hours that is killing us with health problems is desperately needed today. 20,000 NPR listeners joined this study by the Columbia University Medical Center to see if they could break the habit and set a new model for work behaviours. Participants were asked to take a break of 5 minutes every hour. 70% took the break showing that given the right encouragement people are willing to try something new that improves job performance, mental health, and physical health.

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Chancellor Merkel has shown exceptional leadership during the coronavirus health crisis in Germany, leading to increasing popularity for her government. Her approval ratings are the highest of any coalition government in the last 23 years. The government says this report in DW.com has appeared level headed in its actions, and Merkel has paid careful attention to advice from Germany's Robert Koch Institute, the German public health agency. Merkel also shared important facts for tackling coronavirus in an effective television address. By listening to the expertise of RKI public health agency the government has maintained calm and better handled the crisis. In the U.S. a similar process is taking place with the heads of the public health agencies, Dr. Fauci and Dr Birx playing a similar role, and president Trump paying careful attention to health experts. DW.com says doctors, nurses, police officers, and people working at supermarkets and pharmacies, are being applauded by the public, with people taking to the balconies to applaud. This is also happening in Spain. The hope expressed by DW.com is that going forward these professions will be better paid and public health become a top priority. ...

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The US House of Representatives voted 245-189 in favor of repealing the health care law. Only 3 Democrats joined the entire Republican caucus in voting for repeal, compared to 34 Democrats who voted in March 2010 against the health care law. This is a largely symbolic move as the Democrat controlled Senate will not consider the repeal, and even if it did the President would veto it. Republicans favor some aspects of the health care law which allow children to be on the parent's insurance till age 26, and a ban on insurers denying coverage due to pre-existing conditions. Opinion polls show 46% of respondents opposed repealing and eliminating the law, and 45% favored repealing it. The health care issue ranks third among the economic issues important to respondents, behind unemployment and reducing the federal budget deficit.

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U.S. president Trump set up a separate task force called the Great American Revival Industry Groups. He read each of the names out loud during his press conference on Monday, a list of about 200 industry leaders from all the main industry groups, many of whom he personally knows. The first meeting of this group met in a hour long call with about 35 participants.  Most of the leaders praised the strong action taken by the president. On the task of reopening the economy the participants told president Trump that current testing levels were inadequate for effectively reopening the economy.  This is the first of four calls the president plans to make and included leaders from banking, retail, hospitality,  and food industries. The tasks facing the task force are to provide advice on how to reopen the economy and how to respond to the economic damage.  The U.S. president decided to set up this task force after talking to his friends in the business world so that he could get the broadest possible range of advice and thinking. Dr. Fauci, the leading helth expert on the president's team along with Dr. Birx, said on April 14 that reopening would require testing and virus tracking that was efficient and reliable and that the U.S. was not there yet. U.S. has conducted about 3 million tests. Health experts say there should be millions of tests per day before people can return to work. ...

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Wealth for top 7% of U.S. households averaged $3.2 million in 2011, compared to $133,817 for the other 93% of the population. Third quarter 2013 household net worth is 615% of after tax income, up from 570% in 2012. The uneven distribution of household wealth and the gains from the stock market recovery going disproportionately to wealthier investors, does not provide strong enough underpinnings for robust consumer spending.

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How the importance of health and wellness is changing the restaurant industry in the U.S. which has long neglected this.

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This Washington Post editorial says Obama and the politicians, both Democrats and Republicans, want something for nothing. The Ryan budget, Obama's health care plan, all require paying for it with higher taxes, but the mention of the word "tax" is the last word any of the politicians will say. These comments come as the U.S. Supreme Court considers the mandate that young Americans and others be forced to pay for health care along with the rest, as required by the health care mandate, with the idea of keeping costs down. The idea of getting something for nothing was also emphasized in an op-ed in the WSJ, March 29, 2012, by Mayor Bloomberg of New York City, where he called for letting the Bush tax cuts expire for all income groups, and an up or down vote in Congress on the Simpson-Bowles deficit reduction plan, as part of a two step plan.

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The dangers to public health from Tobacco use in China are huge. About 1 in 3 cigarettes in the world are smoked in China says the WHO prominently on its site. The result high levels of cancer, lung and heart disease that could be prevented. A similar situation exists in India and South Korea. Asian countries have performed badly in tobacco use and production creating catastrophic public health risks, even countries that have adopted new technologies and caught up with Europe and the US. 

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Every day lost in the struggle with coronavirus is a big thing, which is why Itay's most affluent northern region has gone from being well equipped with resources of healthcare to seeing the health system overburdened to the point of disaster. This WSJ report shows why this has a lesson and an early warning for how the U.S. and other countries should design their response. It is also why the White House team that includes President Trump in the U.S. emphasized the plan for just the first 15 Days in the news conference at the Brady Room in the White House on March 16. It is saying the first 15 days are critical, not a day to lose.  It does not matter if you are an advanced economy with state of the art hospitals. Social behaviours must change, old rules rewritten and implemented throughout nations, quickly in days. Here WSJ shows lessons learned by Dr. Cereda at the Hospital of the University of Pennsylvania who trained in Milan and was in constant contact with colleagues in Milan and elsewhere. Many of the lessons relate to not overburdening hospitals and health systems and protecting health systems. This means mild to moderate cases are managed from home and not in the hospital, through massive deployment of outreach services and telemedicine. It means therapies can be delivered at home or through mobile clinics. The second major lesson from Italy is to protect healthcare workers and doctors. The entire White House team with Dr Faucci of CDC and Dr Brx, head of Infectious Diseases in the U.S. news conference of president Trump March 16, focused on the goal of protecting healthcare workers, doctors and hospitals, so they remained strong to take on the crisis. The second goal of the White House team is to protect the elderly with medical conditions. To do this only the most serious patients are treated in hospitals the rest for mild to moderate at home.  Studying the conditions in Bergamo and other parts of Lombardy and northern Italy, is helping U.S. medical leaders to prepare for the current nationwide effort, the 15 days plan announced by the White House. The lessons from the Papa Giovanni Hospital in Bergamo are important say U.S. medical leaders, including Dr. Brendan Carr, head of emergency medicine at Mount Sinai Health System in New York.  He says build capacity in hospital beds before we need it. Clear out hospital space and add new hospital beds.  ...

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UK underinvestment in health care infrastructure and NHS is leading to it "underperforming significantly," says a King's fund health thinktank study. UK annual capital spending in healthcare is about 0.33% of GDP in 2019 compared to 0.65% in the US. A lack of doctors and nurses is a severe problem for the NHS in UK.

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This WSJ report looks at the efforts of sugarly cola companies such as Pepsico under a new CEO to push their cola products aggressively with advertising, and modern logistics. It cites Barry Popkin, nutrition professor at the University of North Carolin School of Public Health that they are making products that are killing us more slowly. With less sugar than before but still at a time of dangerously high obesity levels in the world just as dangerous or more dangerous to humans, because they are not as healthy as previous generations. The pandemic proved the danger of higher obesity levels. The numbers say it all-1% of children 5-19 years obese in 1975 going up by 8% to 9% in 2020, and doubling to 19% in 2035, says the WSJ. That is doubling by 2035 to 19%-  simply astounding. Popkin says the fact that Americans are living more years with disabilities, and fewer disability free years, is very much linked to the food intake. On The Guardian's pages was an article about a surgeon who has a startup in Austin, Dr. Attia of Early Medical, that promotes "healthspan." It focuses on getting healthy living habits  through better nutrition, exercize, to start at an early age as being critical for a healthy life span. It is not the same starting at an early age with good food and exercize habits vs starting later in life as this means fewer disability free years when starting later in life.  ...

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US $1.5 trillion budget request for 2027 fiscal year by the president for military and defense spending is about 4.7% of US GDP forecast of $31.8 trillion in 2026. In 1960 it was 9% following the Korean War. It dropped to 3.1% of GDP by 2000 and stayed around 3.4% till the current effort to modernization of the US military is thought to require about 5% of GDP.  (World Bank charts). The US spent far higher during an earlier period reaching 14% of GDP in 1953 during the Cold War with the Soviet Union. This report shows WSJ Analysis of where the $1.5 trillion request for Defense is going-  $1.1 trillion for War Department and $350 billion for critical munitions. The munitions are in short supply and war in Iran shows that it plays a critical part in defensive systems such as intercepting of missiles as missiles in short supply affect overall capabilities. An additional $200 billion for Iran War. Pay raises for Defense personnel. $66 billion for shipbuilding- 34 ships to put the US back in the lead for shipbuilding it has lost to China, with the help of Japan which is also ramping up the shipbuilding it has lost to China. US and Japan were leading shipbuilders in the  1930's and in the 1960's, then lost it to South Korea and China. About a 12% decrease in other Department's budgets including Health and Human Services, Treasury, Commerce, Interior, Housing and Agriculture.  These cost reductions some of it coming from more efficient functioning and from concepts such as zero based budgeting where every line item in the budget gets reviewed every year for how much is needed for the purpose, is the purpose still valid, and can it be done more efficiently costing less. $660 billion is coming from the savings. The Nation's capital will also get a facelift, a major renovation, after being ignored for years. In the new Budget is $10 billion for the Presidential Capital Stewardship Program within the National Park Service for beautification projects in Washington D.C., which will give the National Capital a much needed new look for millions of visitors from the 51 states in the Union.    ...

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Labour Party's strategy in the coming British election is to tie Boris Johnson to Trump. This resonates especially on the issue of the National Health Service, with Labour saying a trade deal with the U.S. planned by Johnson is likely to raise costs of NHS with costly U.S. priced drugs. Mr. Trump says he sees little chance of the Johnson negotiated trade deal with the European Union allowing for a trade deal with the U.S. negating Conservatives plan to make Brexit work by negotiating trade deals independently. 

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US Senator Bernie Sanders and Shawn Fain of the United Auto Workers make the case for a 32 hour week.  No that's not right Sanders and Fain are calling for hours and wages that make for a healthy life after making significant contributions using technologies and higher productivity during a normal week more like 35 to 40 hours instead of 50-60 hours a reality today.  Even with this productive work effort they say workers have not benefitted as most of the gains have gone to the top with top managers and CEO's making hundreds of times more in compensation. In this years negotiations the UAW made long hours at work and its effect on worker health an issue. A 40 hour work week was established in 1940 under the Fair Labour Standards Act passed under president Franklin Roosevelt. Sanders and Fain point out that 28.5 million workers even today work over 60 hours a week and more than half of full time employees work more than 40 hours a week. It comes as a surprise that according to the authors US workers logged 204 hours a year more than employees in Japan, and 470 more hours than German workers. Sanders and Fain point out that today adjusted for inflation the average worker in America makes about $50 less a week than 50 years ago in 1974. There is definitely a need to consider the health of workers as the highest priority and wages that make it possible to raise families and educate children in decent living conditions. France and Denmark have a 35 and 37 hour work week. ...

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The asymptomatic coronavirus infected people are a large fraction of the people with coronavirus. This is a huge problem as these people unaware of the danger are unwittingly spreading the virus. This is one of the most unusual aspects of this virus compared to other virus epidemics, and why it has become so dangerous. It is also why social distancing alone is not enough. Strict enforcement of stay at home orders by public health authorites, state and federal governments is essential as the unwitting spread by asymptomatic people who are not following the required guidelines is a huge problem.  Even as the public now calls for stricter action the lax behaviours in March in U.S. Britain, France, Germany, and in Italy in February, have created a population of infected people that acts as a backlog for testing, creating a surge in April. One of the novel features of this public health crisis is that lax behaviours stemming from a lack of understanding of the severe contagiousness of the coronavirus is making it a larger crisis on a scale not encountered before.  The contamination potential of this virus is only now being tackled with experts in fluid dynamics at labs such as the MIT Lab in the U.S. looking into how it can contaminate environments, as shown on BBC News.  With pieces of the contamination puzzle only now being put together. Heeding public health expert warnings and guidelines is all the more essential for this reason. ...

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This NYT report says US president Biden is different from past presidents in two ways. He is pushing for infrastructure spending on a big scale from the very beginning of his administration. He is also not interested in shrinking his plans for multi-trillion dollar infrastructure spending to win support from Republicans. A big reason is that he sees the opportunity to go ahead because the perceptions of the American people have changed in the last five years, and have changed even more in the last year with the pandemic. Health, education,  infrastructure, and competitive technology leadership resource development spending with government playing a leading role is seen as indispensable for the US as a nation if it is to play the leading role that it has played over much of the last 100 years. Government leadership is seen as indispensable including in redesigning the existing global supply chain so that the US is no longer dependent on other nations and taking on risks. ...

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The Labor Department reports that the U.S. added 255,000 jobs in July 2016.Unemployment remained steady at 4.9%. Of the jobs added, 70,000 were in business and professional services, 43,000 in health care, 38,000 in government mostly in local education, 18,000 in financial services. Yet growth remains slow at 1.2%. Businesses are willing to hire new employees, but reluctant to make new investments in the prevailing uncertainty. Wage growth for average hourly earnings was about 2.6% for the year. Improvements in the jobs picture is likely to influence the U.S. presidential election.

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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.