LyrArc Article Gist
Now that finance ministries around the world are trying to save their economies with trillions of dollars in aid packages their finances are stretched to the limit. The so called digital tax is not really a digital tax. And efforts to recover lost tax revenues in Europe are being opposed by the U.S. because tax levies by France go only to France, not the U.S. The U.S. Treasury or U.S. government or the American people would not turn down tax revenues that it normally gets when its finances are stretched to the limit with trillions of dollars for cornavirus leaving little for crumbling infrastructure and essential public health services, other services that determine quality of life in America.  This Washington Post report shows that there is greater awareness that the right approach is to pay taxes based on where revenues are located and by the number of users in each country. But the problem goes deeper than that. The coronavirus changes the entire perspective and take this back to roots. Companies pay taxes because it is the right thing to do. In Japan Panasonic's founder Matsushita felt that it was a national duty to pay its share of taxes as it too was sharing in the benefits provided by society- in the health, sanitation, education and transportation, parks, and hundreds of services provided by government. Once this is seen as dispensable or somebody else's problem, then these very services and infrastructure can be starved of capital. Coronavirus changes this perspective. People crave for outdoor spaces- who is going to maintain them and set up new spaces. People crave for not moving around on crumbling bridges, roads, subway systems. Who is going to provide them? People crave for good schools, community colleges. Who is going to provide them? People crave for good sanitation systems? Who is going to provide them? People crave for good public health systems. Who is going to provide them? Its just good common sense. Is it possible for common sense to be missing? It is- just ask people today, and it is good common sense to have good critical infrastructure such as sanitation, medicine, public health, and local manufacturing of medicine, yet economic experts and economic theories thought it made sense not to do this.  ...

LyrArc Article Gist
On October 28 France reported 36,000 daily coronavirus cases. French president Macron announced a new lockdown starting October 30 that last till December 1.  Under this second lockdown people can leave home only to go to work, to go to school, to give assistance to loved ones, for essential shopping and for 1 hour of physical exercize. People will have to show documentation when leaving home. Travel between regions is banned. Bars and restaurants and nonessential businesses will be closed. Universities and higher education will be done online. Schools will remain open, essential businesses will remain open. Most public services will be open. Factories, farms and construction sites can continue to operate. There will be extensive economic support for business and people. Small businesses will have access to 10,000 euros per month of assistance, employees get short term work assistance, and people having trouble with rent receive assistance. About half of intensive care beds are now taken in France. And Macron said transferring patients to other regions will not be possible as the virus is everywhere. ...

LyrArc Article Gist
WSJ looks at the changes in the way medicine should be practiced in the light of what we have learned from the pandemic.  Medicine practiced before the pandemic and still today relies mainly on a visit to the doctor or specialist who is short of time. There is a shortage of doctors. Patients have many illnesses as a result of decades of neglect of proper nutrition, and exercize habits. Obesity is at about 40% in the U.S. about 30% in the UK and 17% in France, and high also in other parts of the world. These high rates were unknown throughout history and result in many illnesses and increase by four times the vulnerability to the coronavirus. One authority in medicine calls obesity pouring gasoline on a fire for effects of the virus.  A doctor's appointment with doctors short of time with no coordination around a whole range of factors related to obesity, illnesses, health checkups, mental health, is now seen as a heavily handicapped way to practice medicine or for patient healthcare and wellbeing. The alternative is discussed here as the way forward. A  team will be responsible for a patient's care not just an individual doctor. The team would care for general health after a patient's checkup, cover individual illnesses, weight issues, mental health, exercize nutritional needs and other good healthcare habits. Instead of relying on doctors at a time of shortages of doctors the team would be led by nurse practitioners.  A nurse practitioner is someone with a bachelors degree and a masters degree or doctoral degree in nursing with 1000 hours of clinical training. Studies have shown that they are effective and even more effective than individual doctors. Today particularly with the problem of doctors with limited time compounded by the built up problems of decades of bad habits in nutrition and exercize and poor "cultural" habits getting entrenched, there has never been a greater need for a better way to practice real healthcare for a person's wellbeing. Particularly in rural areas with an even larger shortage of doctors the health practitioner led team will play a big role. Patients will under this setting receive more care virtually and get more followup care by phone and video messaging. The numbers tell the story- there are shortages of doctors in USA, Europe, Africa, Latin America and Asia. In the U.S. shortage of doctors is 55,000 projected to 2033 by Association of American Medical Colleges. There are 290,000 nurse practitioners licensed in the U.S. and 131,0000 physician assistants. The goal will be to get an adequate number of nurse practitioners licensed in this decade to take care of these teams. The pandemic has made virtual visits to doctors and nurse practitioners popular. Medicine reimbursement should and would be practiced on the basis of how well a patient is doing not on a fee for each micro service that is delivered. For this to happen the teams led by the nurse practitioner have to commit to patient education of the benefits from good practices and good habits for nutrition, exercize, caring for oneself. A doctor short of time is hardly the person to carry on this patient education which is where the major opportunities for a new system arise. The virtual care also provides a new medium for patient education and awareness of the risks of getting illnesses, preventive actions to be taken in advance. One approach being tested in California and Texas is for a monthly fee for patients more payments by health plans to doctors or healthcare teams if the patient is healthier. Additional health professionals are added to the team including health coaches, dietitians and medical assistants to increase its effectiveness in counseling and education and monitoring.  The nurse practitioner team approach is already being practiced in parts of the U.S. including the example of New Hampshire shown here, and is predicted to be the approach for primary care in the next decade. ...

LyrArc Article Gist
Marie Le Pen and the National Front performed very poorly in French elections. Perceptions of voters are changing. The efforts in tackling the coronavirus, effective vaccination drives, public health protection, and building access to vaccine supplies, have shown the need for good leadership that believes in a science driven direction. Immigration is no longer the issue it once was and in some polls it is seventh on the list after climate change, economy,  education, pensions. The National Front in France and AfD are losing regional elections and popularity is dropping to about 10%. The Greens party in Germany and the Gaullist Republicans in France are being revitalized. Other factors are also present. The search for authenticity and effectiveness. After dismissing a popular prime minister who tackled the health crisis in 2020 France's president Macron fared badly in recent regional elections. His party En Marche was hastily put together in the last year of the administration of Mr. Hollande, the predecessor from the Socialist party. Its initial popularity has not turned into grassroots support. Mr. Hollande, Mr. Macron, are now seen as one term presidents. It is not so much that the centrist parties are gaining as a search for parties that can provide effective alternatives in the face of the challenges placed on the world by the pandemic- renewal of supply chains. climate change, public services, infrastructure, health, education, lives of the elderly. In the US, Europe, and India, countries in Latin America, there is a growing awareness of the need to rebuild with the people in mind, the people who have suffered badly in this health crisis and the financial crisis that preceded it in 2009. ...