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The recent effort to eliminate funding for Planned Parenthood clinics in the U.S. because some of the money goes to abortions has run into a cloud of misinformation. In reality only 3% of the funding goes to abortions. Title X funds that help support these clinics cannot be used for abortion care at any time. Medicaid funds going to the clinics in 17 states can be used to reimburse abortion providers only if the life of the mother is endangered. The clinics see 5.2 million low income and uninsured women who need tests for infections, breast exams, pap smears, preventive services and screenings, contraception services. By reducing low income women's access to such health services through defunding the clinics would only increase the number of unwanted pregnancies and abortions. Planned Parenthood centers provides contraception to about 2.5 million patients each year and educates women about birth control. By burdening the U.S. healthcare system- adding most of the 5.2 million who access these clinics -with problems ranging from cancer to other serious health issues when they could have been detected by tests at an early stage and treated earlier or prevented altogether, would also add to the burden of healthcare costs. In addition the 800 Planned Parenthood Clinics in the U.S screen 3 million patients each year for other problems such as blood pressure, diabetes, smoking and obesity related issues, also help treat these problems at an earlier stage, which is essential if costs to be brought under control. ...

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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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WSJ interview with Narendra Modi before he meets Joe Biden at the White House. This interview talks about India seeking larger role in world affairs, about Indian democracy. Seen from inside India the perspective is different. India is at the same stage where China was in 1990-2000 with the rising aspirations of a billion people, Japan in the Meiji period in 1900. It is all about jobs, investment, technologies and manufacturing on a scale that surpasses China in that period with newer technologies to meet the rising aspirations of 1.4 billion people. China's trade with the US was three times higher than the Indian trade with the US in 2022, India desperately wants to catch up and fast. The Danish ambassador to India was asked what he saw in India today and he said it was the rising confidence of people that struck him most. The digitalization that has changed the way government benefits are provided to 1.4 billion people and opened bank accounts for all, provided delivery of services to all parts of the population. The infrastructure that is being built at breakneck pace, and new colleges and universities expanding access to quality education, healthcare.   ...

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The author of the study Youth in Germany Kilian Hampel says, German youth after the pandemic have increasing stress about soaring housing costs, inflation, war in Ukraine, and fears about old age poverty. This is similar to what is happening in the US. This will be a factor in the European elections. Though a lot is written about far right parties. Much of the work that remains is about ensuring fairness, and equity, tackling inflation and building housing. This needs greater investment than Germany is today undertaking. Much of the Greens and Socialist party plans to invest in the last federal election were stalled when they did not get a majority and had to depend on the FDP which is too conservative for making the investments needed in the economy. In the US Biden forged abipartisan effort and invested heavily in Republican areas in the south and west. A similar task is needed in Germany including investing in the East and in education, healthcare and building new infrastructure. Rail, road, airport and bridge infrastructure in Germany is dilapidated and only by investing in it can the economy gain strength to meet the aspirations of young people. ...

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$700 million loss on a clean beauty brand during the pandemic by Carlyle taking money from investors. During the pandemic Carlyle private equity invested $700 million of investor's money in Beauty Counter, a direct seller of a clean beauty brand started by Mrs Renfrew. The product and concept failed. This is $700 million that could have been invested in much needed nation's infrastructure projects, in climate change action, in renewable energy, in healthcare, in education, with reasonable returns. Capital market misallocation is a huge problem for the last 2 decades, with hundreds of billions of dollars lost or wasted in dubious products such as $100 million for a new golf ball with hundreds of such projects and products that are not vital needs for the American people. Tax benefits for such dubious projects and ideas lead to more revenue that is diverted away from the essential needs of the Nation and the American people. Over two decades this adds up to huge losses which would mean a lot of the Nation's infrastructure could have been replaced by now using this money. The capital allocation system needs to be rebuilt from the ground up to meet the vital needs of the Nation and the American people. ...

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Germany, the UK and Canada offer additional models for health care insurance that vastly improve results for dollar spent over the dysfunctional U.S. model. Here Jamie Daw take a look at the German social health insurance system which dates back to hte period of Bismarck in 1884. The German system is funded through progressive taxation which charges for healthcare based on incomes not on health needs.

About 100 nonprofit health insurers provide insurance and all Germans are required to have health insurance. Contributions to sickness funds are centrally pooled and allocated using a formula to insurers. Insurers can only charge small out of pocket fees limited to 2% of income annually. Sickness funds combine market power to negotiate lower prices.

Administrative and governance costs are 3% in Canadian system and 5% in the German system. 

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Recently Abbott has expanded in international markets with the acquisition of Belgium's Solvay Pharmaceuticals, and collaboration with India's Cadila Healthcare Ltd. for generic drugs. Abbott CEO says he is comfortable with the price of the Piramal acquisition in India because he lost out in a bid for another company in an emerging market a few years ago. Piramal Healthcare will receive from Abbott an upfront $2.12 billion, and $400 million to be paid every year for 4 years beginning in 2011. Advantages Abbott's CEO White sees in this acquisition of Piramal, is that 70% of the Indian market is self-pay. And therefore not subject to government cuts in payment for drugs.

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Allan Blinder gives a spirited account of what he sees in the Paul Ryan Republican deficit reduction plan. He says that with the voucher plan retirees would fall further and further behind the increasing cost of health insurance. With no explicit cost containment proposals it assumes that some kind of miracle will occur for costs to be kept in check- especially as Republicans want to repeal the cost containment proposals in the President's healthcare plan. He asks whether someone is saying, that we have to destroy Medicare so it can be saved. Ryan woulld also turn Medicaid into a block grant, then underfund it and let the states figure it out when they are in a budget squeeze. Blinder points to the estimates of the Center on Budget and Policy Priorities, that show about two-thirds of Ryan's budget cuts would come from programs that serve low and moderate income Americans. And to make matters worse the steep spending cuts go to finance tax cuts that largely benefit the wealthy. He calls this Robin Hood operating in reverse, and coming on top of 30 plus years of rising inequality. David Stockman makes a similiar point on the editorial pages of the New York Times, April 24, 2011; also adding the point that the middle class will have to pay higher taxes for the deficit to be addressed, something President Obama's plan fails to do. Blinder says that the Bowles-Simpson and Rivlin -Domenici proposals attack the deficit reduction problem in a better way, that asks something from all classes and interests. ...

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Gerald Seib of the WSJ points out that the winners in the passing of the Republican healthcare bill in the House by a 4 vote margin are Speaker Ryan who never wanted the job in the first place, and president Trump who showed he could cajole Republicans into getting it passed because he likes winning. Now comes the hard part says Seib, when it goes to the Senate- House conservatives are not going to be happy when they find major changes they dislike. If the bill clears the Senate in a modified version Republicans will now have to own any issues with healthcare, including says Seib things that may not work out for pre-existing conditions- or for groups that are disadvantaged, including older people.

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Tory MP's rebels in the southern part of England are opposed to prime minister Boris Johnson's second lockdown for the whole of England. This report in The Times of London looks at how Johnson's conservative government might have to get Labor party support to pass the lockdown measures in parliament. Or Labor may decide to abstain from the vote. Mr. Gove says the NHS risks being overwhelmed if the lockdown does not take place. Responding to the statements that southern England does not have high or has falling rates of coronavirus Mr. Johnson says it has been shown that a low rate catches up in one area when it is next to a high rate area for coronavirus so that the result is the spread of the virus to the point where the NHS cannot cope.  The NHS like the French health system and other health systems in the European Union, U.S.  India, and other countries are strained to the limit. Most healt care workers in hospitals have felt severe strain on themselves and their families during the first wave. Most are exhausted and are in a situation of fatigue with the added factor of some healthcare workers on leave from the virus illness. This puts additional burdens on the system. Without the action taken the health system may be overwhelmed in many countries leading to disaster.   ...

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Vindu Goel of the NYT gives this report on IBM's expansion in India including an interview with Vanitha Narayanan, chairman of IBM India. In 2017 IBM had 130,000 employees in India, at operations in Pune, Calcutta, Chennai and Bangalore and other cities, double that in 2007. The U.S. operations have about 100,000 employees. As IBM's revenues have declined with technology disruptions, it has concentrated on expansion in India with its vast base of knowledge workers and costs of about one half to one fifth of what it would cost in the U.S. IBM has 380,000 employees worldwide, with 26% in the U.S. and 34% in India, and 40% in other countries. Microsoft employs 8000 employees in India and 124,000 total worldwide, Google has 1800 in India and 72,000 worldwide.  IBM removed operations in India in 1978 after a dispute with the Indian government. In 1993 it started operations in India in a joint venture with Tata. By 2004 the operations had expanded and IBM took full control. A $750 million 10 year contract was signed in 2004 with an Indian phone company Bharti Airtel. As Goel points out the shift is happening towards expansion in India with the growing demand from industry and government in India. The Watson venture has expanded in healthcare in India with contracts including one with Maniphal Hospitals. In 2016 this had reached $38 billion in hardware and software, services, to Indian industry and the government agencies. IBM's work is not simply in offsourced work from American companies. High tech and cutting edge research is also taking place and expanding. IBM is now uniquely positioned to get an expanding share of the business as more tech services are provided to the hundreds of millions of people in India who did not have access to tech and tech services before. Research concentrates on doing this at a fraction of the cost and in new ways suited to the local region, so that services can be delivered with a wider reach. This report provides a new perspective on how the next decade could see American companies with a long term focus take advantage of the rapid growth in the fastest growing large economy in the world, with advantages for both the U.S. and India. ...

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Kansans come out at a town hall meeting in rural Palco, Kansas, setup by Senator Moran, to say they have serious problems with the healthcare bill in a Republican Congress. Kaplan of the NYT says few Republicans in Congress have setup town hall meetings to hear the views of people in their constituency because of the strong criticism from older Americans hurt by the bill's provisions. Rural Kansas is affected by the bill. Senator Moran says of the bill that he is from rural Kansas and wants to hear what people think. Senator Moran is one of the few Republican Senators who have come out against the bill. Kansans are realizing that policy matters after the experience with actions taken by Governor Brownback to cut taxes and spending. Now Kansans are also realizing that there is a cost to being ideologically driven in coming up with solutions whether from the right or the left of the spectrum. Senator Moran after all is in the mainstream and led the 2014 effort to give Republicans control of Congress. It is also the state of Dwight Eisenhower, whose hometown was Abilene, Kansas, known for being moderate on issues, a descendent of down to earth Pennsylvania Dutch families, and for saying- "a people that values its privileges above its principles soon loses both." Here Moran does exactly that, listening to how the Republican healthcare bill affects rural Kansas, without getting muddled up with the politics on the issue. ...

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The coverage of the Republican healthcare bill and how it affects the elderly, and people on Medicaid, people in rural areas, is likely to have changed public opinion in the U.S. about the necessity of ensuring all Americans have health coverage. The Pew survey cited here in this NYT report by Zernike and Goodnough was done in Jan 2017, and shows a shift. The shift would be much higher today after people look hard at the consequences of what were simply hypothetical positions or ideological positions taken without looking at consequences in daily living. On Medicaid that opinion by July 2017 compared to Jan 2017 has shifted 10 percentage points for Republicans to 53% who think Medicaid is important to them and their families, according to Kaiser research. There is stronger sentiment about people having benefits taken away.  [article-55059] The opinion has shifted to where people see that coverage is important and people should not have coverage denied or benefits taken away from them. Opinion remains strong in favor of changes to reduce the high premiums, but not to replace the existing health benefits and law with no law at all to replace it. That leaves 20 million more uninsured according to the Congressional Budget Office. Changes have to be constructive is the popular view today,  and this requires dialogue between Republicans and Democrats- which has not taken place. ...

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Indonesia continues to experience surging growth in consumer spending as more people enter the middle class and buy everything from motorbikes, consumer appliances, mobile phones and other products. It is similiar to the growth in China and India. GDP increased by 6.5%in 2011, and most of the growth comes from consumer spending. Mr. Riady of the Lippo Group says spending is growing to unprecedented levels. About 50 million people in Indonesia are in the middle class out of a population of 250 million- when measured at the level of $3000 per year incomes- and this will grow to 150 million by 2014, according to PT Nomura Indonesia. Another important demographic fact is that the average age of the population is 28.2. Motorcycle sales doubled to 8 million in 2011, twice that of 2006. Mr. Riady of the Lippos Group says its home sales are expected increase to $450 million in 2012, up from $100 million in 2010. Sales at Lippo Groups hypermarkets are expected to go up by 40% in 2012 and sales at its department stores increase by 25%. Lippo Group plans to add 10 new hospitals each year, to the 14 it plans for yearend 2012. Philips Electronics NV says healthcare equipment sales in Indonesia will quadruple in by 2015. This pace exceeds that in India and China for Phillips Healtcare....

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India is a major partner for Africa in the areas of energy and healthcare. India is a critical partner for Africa during the coronavirus pandemic in providing medical supplies and maintaining the critical supply chain. Indian oil and gas firms have invested $7 billion in Mozambique. India is Africa's third largest export market and India has $54 billion in investments in Africa. Foreign minister Jaishankar called India a reliable partner for Africa interested in developing the region. In fact Gandhi first started his nonviolent struggle in South Africa on behalf of miners in the region and fought for rights of African and Indian people in British South Africa. As a leading member of the British Commonwealth of nations India has a long history of ties with South Africa, Kenya, Tanzania, Nigeria, Ghana and other former parts of the British Empire. Indian workers and merchants played a large role in development in Africa after and during British rule. There are also older ties with Portuguese ruled Africa (Mozambique and Angola) with Portuguese settlements on the east coast of India. The Indian Ocean ties go back to the 15th century. ...

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The failure of the 117th Congress to pass key parts of president Biden's agenda for hard hit families and workers in America is now taking place. The 50-50 standoff in the US Senate and failure of two Democrat senators Sinema of Arizona, Manchin of West Virgina to support Biden's Families and Workers Plan leaves key parts of the safety net being left out. This leaves out the education, and paid leave part of the agenda and provisions for utilities to accelerate shift away from coal out of the bill. It fails to implement a new national agenda for upward mobility, child care and paid leave to help stressed out mothers and families. The failure to include even a modest community college 2 years of support at a time when men's college enrollment is dropping to disastrous levels for America's economic competitiveness is a failure of the 117th Congress to grasp the needs of families and workers in America today. Only a new Congress in 2022 can take up the needed action for families and workers in education, health care, child care and help for families. The passage of the infrastructure bill and the current version of the social spending bill can only be seen as a first step in the right direction, after three decades of different administrations neglecting infrastructure, education, healthcare, childcare, elderly care, upward mobility, and climate change. On the plus side as the first step to restore dignity and health of families and workers in America it includes- $150 billion for rental assistance, home buying help, public housing repairs, and building 1 million affordable housing units. $150 billion for federal programs for home health care and community care for older Americans and people with disabilities $165 billion to reduce premiums for people under Affordable Health Care Act, cover additional 4 million through Medicaid, adding hearing coverage but not dental or vision to Medicare. $200 billion for child care tax credit to parents. $400 billion to reduce health care costs and give universal pre-kindergarden for 3-4 year old children. $40 billion for worker training $555 billion for fighting climate change including through tax incentives for sources of energy that are low emission and low carbon. It will be paid for by additional taxes on incomes of very high income earners in annual $1 million plus range, and by having a corporate minimum tax of 15% for large corporations, including on profits overseas, that previously did not pay this tax. A wealth tax on unrealized capital gains of billionaires or other wealth of the richest Americans is left for a future Congress to consider for financing the key parts of climate change provisions, education and health care that were left out. The education and healthcare provisions need to be expanded to restore America's historic mission of upward mobility for all. A provision for Medicare to comprehensively negotiate prices with pharmaceutical companies that would be taken for granted in any advanced country as in Europe, is also left for a future Congress that understands and responds to the dire needs of families and workers in America for affordable healthcare medicine neglected by administration after administration for the last three decades.   ...

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Argentina, South Africa, Mexico, India, UK, European Union elections are taking place by June 2024 and US in November 2024. Yet it is misleading to lump them together. Much discontent is there to see as in the UK with cost of living, governance, time wasted on Brexit, India with lingering effects of the pandemic on rural voters, caste based voting. In India protest vote of lower caste Dalit voters in Uttar Pradesh and Maharashtra, even with government support in forms of universal healthcare, food for poor households during pandemic extended, cooking gas, housing support, clean tap water, direct bank account deposit to accounts of poor and farmers. Yet in the states in the south and east in Orissa and Andhra Pradesh, and generally in the south the BJP vote count increased so that losses in the north were made up leaving the percentage of vote for India for Modi's BJP party at 37 percent in 2024 instead of 38% in 2019, losing the absolute majority 240 seats of 543 yet having campaigned heavily for partners who added seats 294 of 543. In the UK Keir Starmer may see some vote preference for Labor erode yet the Conservative record is in shambles even conservative experts will say, as in India where the opposition parties offer no prospects for the future and little track record for making India the second or third largest economy in the world which the BJP has set and shown to have achieved over 10 years by taking India to No. 5 in the world economies. ...

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The Republican House Health Care pLan in 2017 relies on tax credits of between $2000 and $4000 based on age. Under the Affordable Health Care Act the elderly poor in high cost insurance areas received additional help. These people would lose over $2000 per person and may forgo full coverage or coverage entirely under the Republican House Health Care Plan. A report by Standard & Poor's estimates about 2 to 4 million people who are in 50's and 60's not yet qualifying for Medicare might lose their coverage they now have under ACA. The Republican plan also gives incentives through tax credits higher for older people, $4000 for a 60 year ol and $2000 for a 25 year old. Under the ACA the insurers are not allowed to charge more than three times what is charged for younger people, under the Republican plan this goes up to five times. 

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Einer Elhauge, professsor of law and founding director of the Petrie-Flom Center in Health Law Policy at Harvard University, says there are limits to Congressional powers under the Commerce clause such as enacting a law requiring Americans to eat broccoli. If the health care law required all Americans to subject themselves to health care this would be the case. But the law only requires all to buy insurance so that insurance can cover the costs of healthcare for all. He points to the "necessary and proper clause" as also authorizing the health care mandate. That clause gives Congress the power to pass laws that are "rationally related" to execution of constitutional powers, such as criminalizing the interference with mail, on the basis of the constitutional power to setup post offices. In this case the health care law mandate is related to the constitutional power to regulate premiums and prohibit rejecting the sick, says Elhauge.

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The healthcare reform bill has lost the support of the SEIU (the Service Employees International Union) , and the AFL-CIO union. Its also lost the support od Howard Dean and of his Democracy for America. Voters aged 18-34 and Hispanics are much less enthusuastic for he party. And only 23% of blue collar workers in December 2009 express positive feelings about the Democratic party in a Wall Street Journal/NBC News poll, a 30 point drop from February 2009. And the same poll showed that there just isn't the same level of interest in voters who back Democrats or Obama.