Tag Archives: Pfizer

Opposition

We all have it, we all see it and I have had my share of opposers too. Most they are a collection of vitriolic vomiters, so I tend not to take notice. This time around it was someone called thecovidpilot who gave his view and it his point of view, so it is only fair that I respond.

The comment was:

“In March 2020 there was a lot we never knew.”
This is utter bullshit. We knew that nursing homes were going to be epicenters of covid deaths from Feb. 2020 based on the Washington nursing home outbreak. We knew that about 40% of people had immunity to covid. We knew that young people had very low risk. We had strong evidence that HCQ cocktails worked in high risk patients if given early. We knew that there was no evidence that either masks or social distancing worked–promotion of these measures was based on SWAGs. People were opposing lockdowns and school closures because of economic, child development, and health harms and giving solid arguments, which we suspected and now know were accurate. Back in March, 2020. We didn’t have proof, but we had strong evidence and there were only SWAGs on the NPI side.
So I call bullshit on your historical revisionism.
“More important, there was no vaccine, there was no protection.”
More utter bullshit. Covid vaccines never protected. The EUA was based on a fraud which we now know from Pfizer documents and there is solid evidence that vaccines cause net harms. US working age deaths are up 137,500 over 2020 in preliminary figures (this number can only increase) and most are non-covid. The increased working age mortality is due primarily to heart disease, cancer, and stroke, all of which have been pointed out as potential risk factors from vaccines.
There will be a lot of money to be made in suits for vaccine harms once fraud has been established in the courts.

My first issues is with ‘were going to be’, what data was out there? Several providers gave us (Feb-Mar 2020) “Due to limited testing and challenges in the attribution of the cause of death, confirmed deaths can be lower than the true number of deaths.” Then we get other sources who (at that time) gave us “On March 22, 2020, at the time of writing, the total number of recorded deaths from the novel coronavirus stood at just below 14,000. This is a large number and is bound to increase, exponentially for a time, but it needs to be understood in context” and when we get to the Nursing home setting we see Washington State (Statnews) give us ‘First Covid-19 outbreak in a U.S. nursing home raises concerns’, and when people hide behind “We knew that about 40% of people had immunity to covid”, a debatable setting I merely see that 195,000,000 Americans were not immune. And at present 450,000,000 have been sick and a little over 6,000,000 are now dead. So I feel confident to call bullshit on the bullshit. And for “We knew that young people had very low risk”, I say not true. They did not get as sick and they usually recovered, but there is no proven factor on the why (not in 2020). Here Nipunie Rajapakse, M.D., / Pediatric Infectious Diseases / Mayo Clinic gives us “We know that no-one is immune to it, because this is a novel, or new, virus that we haven’t been exposed to in the past. So we don’t think anyone has preexisting immunity to it.” And there are theories, but theories are basically educated guesses, it is not evidence, data is required to make it evidence. One theory was “because kids frequently get colds, there is some thought that maybe some of those antibodies are providing them with some protection to this coronavirus”, which would translate into “Kids have a more active immune system”. 

As for the second attack, it is laughable. The attack is on “More important, there was no vaccine, there was no protection”, with hospitals giving us numbers and we get “Of 43,127 COVID-19 cases, 10,895 (25.3%) were identified in fully vaccinated residents, 1431 (3.3%) were recorded among the partially vaccinated, while 30,801 cases (71.4%) were found among unvaccinated people.” (Source: Los Angeles County) which resulted in a research paper which has now been published on the US Centers for Disease Control and Prevention (CDC) website. Is evidence enough. The added information which was given to us in 2021 was ‘Covid patients in ICU now almost all unvaccinated, says Oxford scientist’ and as such, I see that my work holds up, the sources prove me right and as the numbers progress I am merely proven right again. It is “there is solid evidence that vaccines cause net harms” is the BS of a lifetime. A nice example is Polio. In that setting we get “During 1951-1954, an average of 16,316 paralytic polio cases and 1879 deaths from polio were reported each year. Polio incidence declined sharply following the introduction of vaccine to less than 1000 cases in 1962 and remained below 100 cases after that year.” Then we get “the vaccine for pertussis (a.k.a. whooping cough) has saved the most lives, as the death rate fell from 30.8 per million in 1934–1943 to 0.09 per million in 2004”, it is clear that vaccines do not cause net harm. And with the covid numbers we see that they do have an impact, but I am certain that people like Pfizer will respond to your allegations, and perhaps a few people will want you to present that “there is solid evidence that vaccines cause net harms.”, I cannot find any, but I found a dozen articles stating the opposite side, as does the CDC and a few other academic sources. 

So good luck with your believes and you are allowed to have them, it forced me to double check my numbers (which is never really wrong), my thoughts and they remain firm. In a timeline we cannot base 2020 thoughts on what we know now (which was decently the same), we need to base them on what WAS known in 2020 and a first outbreak in a nursing home is not evidence towards “were going to be epicenters”, but that is merely my take on the issue.

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The lever for the nipple for the trigger

It is a setting that made me giggle, I had not heard this for decades, I reckon the last time I heard it was in the 70’s, the full phrase was “the lever for the nipple for the trigger that sets the button is out of stock”, a stage that we see in a complex environment where all the eyes are fixated on the engine, and everyone forgot about the control panel that activates the engine. That was the sentiment when I was confronted with ‘“Russian roulette” in Europe as needle shortages hamper COVID-19 shots’. The article (at https://www.reuters.com/article/us-health-coronavirus-vaccines-needles/analysis-russian-roulette-in-europe-as-needle-shortages-hamper-covid-19-shots-idUSKBN29Y10C) gives us “Laurent Fignon, a geriatric doctor in the south of France, is having to improvise as he gives shots of the COVID-19 vaccine from Pfizer and BioNTech to care home residents and health staff because supplies of the right needles and syringes are short”, a stage where everyone sees the need of the vaccine and there is seemingly a national stage (all over Europe) a stage Reuters warned us about a week earlier with ‘EU scrambles for syringes to avoid wasting Pfizer vaccines and extra cost’ yet a lot of people have not caught on, as people scrambled to get their share of 3,000,000,000 vials. Exactly by whom and where do we see the order of a similar amount of syringes?
So when we see ““accordance with locally approved labelling,” Pfizer said after the EU drugs regulator’s decision to shift to a six-dose label”, yet the question in my mind was “who, what, when, where, how and why was the setting of the change to a 6 dose label?” An important setting as we are faced with an seemingly speculated option that the people got shafted for 16% of all vaccines, especially when we consider the quote “It was initially sold in the EU in vials meant to deliver five doses, but a global shortage of shots and a viability assessment on dosage convinced the EU drugs regulator to approve on Jan. 8 the extraction of six doses from the same vials”, so which yahoo was the ‘EU drugs regulator’ approving this part? That person might have valid reasoning, but when I look back at the times when a 60 people life-raft held 61 people, that one person to stay alive basically condemned the other 60 to death, but the people tend to overlook that part too easily. And as we get to “The decision increased availability, prompting Pfizer to raise its output targets for this year to 2 billion vaccines from 1.3 billion initially envisaged”, so who is looking into the 16% shift to account towards the 60% shortage of doses, or is the 16% step a way to hide the fact that matters were much worse? I am merely asking, because either way shows that I have been right since mid 2020, and is it not interesting that it took the media this long to catch on (which is not their fault in this case, mind you)? 

So when we see everyone shout for vaccines and we are confronted with “Similar shortages are cropping up elsewhere in Europe, complicating a stuttering start to vaccination efforts”, we need to take a look at their syringe orders as well. So when we see “Pfizer now forecasts it will produce 2 billion doses this year, but this assumes it will be possible to extract the full six from each vial. It charges by the dose, meaning the cost of a vial has gone up 20%” we now get to the question “was the vial created to set 6 doses? As such was it bigger, if not, and we give the people merely 96% of the dose, does it still work properly? More important, when you realise that getting 100% out of a vial is almost impossible, just like the 61st passenger on a lifeboat, how many will be endangered by this? Should the danger be 0% (which is always possible) then why are several EU members making such a ruckus on this? Is it to hide the possibility that they forgot to order the syringes?

And as Reuters gives us “The European Commission is pressing Pfizer and German partner BioNTech to deliver more of the low-dead-space needles to extract the extra dose” we get to the heart of the matter. A mere approach to flim-flam the numbers and how many needles were ordered and more important when were they ordered? Yet in all this, looking at numerous sources, we see a lack of explanation where we get ‘meaning the cost of a vial has gone up 20%’, is that merely the needle? I don’t think so, the numbers are debatable and no one is looking, nw I will be the first to admit that this is not my field of expertise, and optionally it was a Reuters interpretation of the facts (which is optionally not wrong), and it could have been handed to Reuters in this way, but the lack of questions on all this is staggering. 

You see, the first in a whole range of questions is seen with “For buyers of the vaccine, however, there was a drawback because EU states face the prospect of paying the price of six doses for each vial, regardless of their ability to extract a sixth shot”, from my point of view I would grasp back to the original sales contract in three cases already the stage was set to emotion, all whilst we are facing the raw sales deal and EU politicians seem to rely on emotion rather than the contract that was drawn up, I wonder why.

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Setting a standard

As I am rewatching the Stand (1996), I am also interested watching the new version when it is released. A stage where we wonder if the Stand is fiction or a stage where it becomes future history, and if that is debatable,  should the Stand now be seen as a documentary? You think I am joking, but merely partially so. You see, the news gives us ‘Ten Republicans voted to impeach Donald Trump. The backlash has been swift’ (at https://www.sbs.com.au/news/ten-republicans-voted-to-impeach-donald-trump-the-backlash-has-been-swift). A stage tht SBS gives and a lot do not, why is that? So as we see “In Michigan, a challenger to Mr Meijer received a boost when Steve Bannon promoted him on his podcast”, we should wonder if Steve Bannon, who was (quote NY Times) “charged on Thursday with defrauding donors to a private fund-raising effort called We Build the Wall, which was intended to bolster the president’s signature initiative along the Mexican border”, should we give any consideration to a person who was pardoned before it went to court? And this is a man who was directly connected to Cambridge Analytica. A person like that is (as I personally see it) tainted, and as such I wonder if we can trust a person who is challenging Peter Meijer in Michigan. I personally see it that anyone pushed forward by Steve Bannon will come at a cost, can we afford to accept that? It is equally an issue that there were only 10 republicans on the impeachment side, I reckon that they are ten people who still have some level of morals and the US has seen enough moral-less behaviour.

The setting is a lot bigger than you think, as we see the far right scrapping for attention, we also see the danger of Trumpism, especially in a stage where its industrial complexes are surpassed by China. We hear all the accusations of IP theft, yet so far the US, Sweden (Ericsson) and Finland (Nokia) are barely catching up with China, they are still decently behind Huawei, and if that IP was stolen, they would at the very least be on par and Europe is catching on. The US is about to become irrelevant. Irrelevant due to a $25 trillion debt, irrelevant due to a lack of innovation and irrelevant due to Trumpism, the US needs to set a standard, the Republicans need to set a standard and they have to do it fast, or they will not be seen in office until past 2035, optionally past 2039. With the Democratic nanny state in charge, and no exit strategy in place, the Corona issues will merely set a much faster downfall than ever seen before. Even now we are treated to ‘New Zealand reports first case in the community in months’, the cause was a woman who had been in self isolation for 2 weeks. And it gets to be worse, what I warned for recently is now a given “The Ministry of Health said the woman had tested negative twice before leaving an isolation facility in Auckland on 13 January”, we see one patient and two false negatives, yet the media is drowning the events. Then we see ‘despite Pfizer shortages overseas’, a setting I expected as the amounts required were nowhere near possible and in all this the stage of properly informing the public is out of the question, we see small bites of events and I see a lot as I check 8-14 news sources, but a lot of it will not be seen everywhere, merely in some places, and why is that? Sop whilst the US is trying to figure things out, the world has its own demons to fight and in all this the media is seen as less and less reliable. 

We need to set a standard, we need to stop facilitating and we need to hold people to account, that includes politicians that facilitate for greed and industrial needs, and as the media (in this case the Guardian give us “World Health Organization estimates air pollution kills more than 7 million people each year”, we still see the absence of the actual issue, even as they source against ‘1% of people cause half of global aviation emissions’, a stage that is debatable at best, the Guardian is actively ignoring the fact that the European Environment Agency told us all that 1% of ALL plants are responsible for 50% of the Air pollution damages, they did not come out against with evidence, no with the Commercial world having 24,000 planes flying, we get “Frequent-flying “‘super emitters” who represent just 1% of the world’s population caused half of aviation’s carbon emissions in 2018, according to a study”, so 80,000,000 people caused that, all whilst the 1% of plants are more manageable, so why keep us in the dark? Hiding behind the word ‘study’ is equally BS. And the setting will get worse as the nanny state pussies will cater to the media again and again, because, as I personally see it, they cater to the share holders, the stake holders and the advertisers and they are the industrials that are greed, revenue driven, contribution driven and profit driven, and if you think that Trumpism is a problem, the sliding of standards is pushing Trumpism to the surface, because the greed driven profit from that side too, and that is debatable, I know that, I get it and I understand it. Consider the quote from a comedy ‘Operation Petticoat’ (1959) where we are treated to the quote “In confusion there is profit!”, we are living the confusion, you better believe that someone is banking on the profit, and until we regain a setting of standards this will continue.

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Back to basics

Yup, even I have to go back to basics at time, it is not a bd thing, it is actually a good thing. I was looking at the language setting for the TV series (Keno Diastima) I designed and I came up with an approach that has three layers, the action, the attached location and the intonation. The idea is based on the old Infocom games, even as their language is more advanced, consider that you are in a location and you do not know each other. Would you make it complex, or simple. The actions would be (for example), Go, Get, Eat, Drink, Move, Grab, Describe, Turn, Say, Examine, Scan, Attack, Defend, Listen, Connect, Make (so far, the list might expand), the location list is set to the same icons, but part of vocal expressionism, in all this, I need to set up a logical icon list that is between 100-200 icons. Then there is the intonation, I thought of setting the relevance and meaning towards the Greek gods (in the series a different setting), as such military instructions will take a note from Ares, sustenance is from Demeter, Liquid needs are Poseidon, and so on. It is not limited to gods, in our world wisdom might also have come from Homer or Plato, in a setting we can grab a person, but under Plato, Apollo and Ares, that meaning could differ a lot. A setting in this is optionally now solved. I got most of season one now done, I merely need to set the events and dialogues, not bad, in this short a time, I have spend in total no more than 12 hours on all of this and I am getting close to 3 seasons, what a nice creative vibe, and I think that going back to basics only assisted the matter. 

Yet it is not merely about TV-Series, if language is important, if proper language makes us set the stage that needs to be set, then which yahoo milk-dud came up with the setting of ‘Google Play is unsportsmanlike, U.S. states likely to argue in potential lawsuit’? In what law is sportsmanlike used in corporate decisions? Consider Kmart, Pfizer, Amazon, Shell, Novartis and several others, so how many were accused and prosecuted for ‘unsportsmanlike acts’? Where is that covered in law?

The stage gets wider from there. This comes with the quote “The lawsuit is expected to be filed in February or March, the sources said, and it would follow complaints about Google’s management of its Play Store even though the company was originally seen as more open about its app store than Apple Inc”, this is optional getting ridiculous, I would like to investigate the raw data on all the complaints, including WHO had been complaining. Some might accept it when we see U.S. Justice Department, yet that is run by Audrey Strauss, no matter who she is and she might be really good at his job, but the premise is to get a conviction and just does not work here. 

A system that is complex, an Android system it is a Google System, as we see “requires that some apps use the company’s payment tools and pay Google as much as 30% of their revenue”, what Diane Bartz and Paresh Dave are intentionally keeping silent on is that there is a stage where apps are FREE, as such there is contribution, 30% of NOTHING, is NOTHING. This is a stage where people pay $1-$10 for micro transactions, some are very much worth it, others not that much, but that is in the eye of the beholder, but what is important that the entire commercial side requires hardware and software valued at $3000-$8000, and this is before the entire banking part comes into play. Google (Apple too on their devices) takes it all away from the software guy, And in the 1st year these software developers are making a tidy profit, when it normally takes 3-5 year to merely break even, if ever. And this is not about these makers, if they are banned from Android Play and they have to provide their own hardware, they fold and the not so bright people in the legal offices know this, I speculate that they are facilitating for players like Epic Games and these people will not care who gets hurt. The setting that follows is third party providers, yet I demand that any criminal transgressions by these third party players will result in the US Justice department being accountable for ALL damages on the players and on Google, but then like little bitches they run away and blame miscommunication. The intonation is important on both, the US Justice Department is a tool that is being used (as I see it), and as such we are ALL entitled to know the identity and the exact complaint. When the US Justice Department interferes with the safety of our gaming time, no matter where we do it (Android, iOS), you better believe that we all want to nail these idiots to a cross, fortunately the distance between the two locations (Google DC and the US Department of Justice) is 1.2 miles, in good Roman tradition we can (as I personally see it) nail all these people driven to greed driven stupidity on a cross over the lengths of the distance, there is likely to be length left, but I am not hopeful on that, even though, some will have a lovely view on the Lincoln statue for as long as they live. I get it, it might be overly emotional, but the stage is set that we see more and more stupidity on trying to get to Google, all whilst the overhaul of the tax laws would have done it, but that might hurt other people on the hill, would it not? A solution available for 20 years, still ignored, even now and even tomorrow.

A back to basics package that Audrey Strauss could have figured out if she had set her mind to an actual solution and not a witch-hunt, but that might just be me.

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As jobs become available

Yup, there is always good news if we know where to look, even as we see a setting where over 50% of all coronavirus cases are in the USA, India and Brazil, we need to think hard of what numbers are not shown. Even as India has well over 3 times the population of the US, there is no way that the numbers add up, with the US having over 9 million cases and India barely passing 8 million, the stage is not completely seen. The population pressure and environment should give India a lot more than the US, so the stage is not clearly seen. I have less doubts (but some) with Brazil, there are over 5 million there and that number seems off (I am emphasising on seems), when we consider the 211 million people there, the pressures in Rio and Sao Paolo, the number seems low, more important, the mortality rate on Brazil merely seems high, in my personal view, either there are a lot more cases, or the mortality rate is skewed, optionally from connected complications. So as more people die, more jobs open up (one would hope). In this stage we could say that every silver lining is the foundation for a new dark cloud.

These numbers are important, especially as the EU goes into a new lockdown. There is the larger issue. We see Spain and France being at 1.2 and 1.3 million. Nothing wrong with that, but a similar setting of populations is seen in Germany with only 510K sick, these numbers do not add up, especially hen you consider that Germany has 83 million, France has 65 million and Spain has 46 million. The German numbers are as I see them off. This matters, because if the numbers are too surreal, the lockdown will merely be a pro forma exercise that does close to nothing in too many places. The problem is that I can see that these lockdowns are the best we can get until there is an actual vaccine, and there is not date on that. One source gives us “On Tuesday, front-runner Pfizer revealed in an earnings call that the first interim analysis in its Phase 3 clinical trial has not yet occurred. That means there hadn’t yet been enough Covid infections among the trial participants to take a first stab at analysing whether the people randomly assigned to receive vaccine were infected at a lower rate than people who were assigned to get a placebo injection”, so consider that phase three is not done and this needs to come and be confirmed before we have a setting where manufacturing can begin. And it is even earlier ‘the first interim analysis in its Phase 3 clinical trial has not yet occurred’, that implies that we get to a stage where any solution would not be here before January 2021, and that is if the second analyses of clinical trials those who precede towards ‘a vaccine is working’ is well over 8 weeks away, making the earliest stage of manufacturing would start on January 2nd, if a solution if found by coming Monday. Are you feeling frisky yet? And all this before the realisation starts that 2 billion doses will take more than a few days. I got (from Vaccine Europe) “On average, it takes between 12-36 months to manufacture a vaccine before it is ready for distribution” and on top of that Sanofi is one source stating that they can make 2.5 million doses a day. This gets us to the 2 billion shots, taking 800 days to make and that is if everything goes right the first time. So there will be a waiting list that is well over 2 years and that is WHEN a vaccine is a reality. Now consider it takes another 12 months before a vaccine is a reality, implying that Covid-19 will be around until January 2024 at the very least. At what stage will we learn that masks are a good idea, and I am happy to set the stage that lockdowns are some proof, but what proof remains the issue, do you still think those Swedes were nuts? 

And in this, consider the news that CNBC gave us in June ‘AstraZeneca is aiming to produce 2 billion doses of a coronavirus vaccine — and it could be ready by September’, do you still think that I was crazy saying that the media is a much larger cause of all the fake news we get?

I am not stating that I know when there is a solution, I am not proclaiming that I have all the answers, yet the numbers are clear and they tell a few stories, and in all those stories we see that some of the reflections offered to us are incorrect, incomplete and dazzled with issues. On the upside, my 5G IP has benefits under Covid (and lockdowns) but they were not designed as such, it is merely an upside to it all. And when we look on, we might see the corporate needs, but they are merely in it to keep their heads above water, and I do not begrudge them that, but a lot of the actions are made on incomplete views and more incomplete data, that much is certain. 

I get it when some state that there is an overreaction, yet some setting (like face masks) are never a bad idea, it makes sense that some lockdown measures are essential, yet how will that ever work in Mumbai, which is 4% the size of Sydney, but has close to 300% of the population, and people under why I doubt the Indian numbers? They test 500 a day, even as they had until recently 100,000 new cases a day. That it’s why the numbers make no sense. And this is merely getting worse, as economic barriers collapse, the setting will continue to degrade. I believe that India is in a much worse state, but that does not absolve Europe (or the US), this will get worse and those governing will be seeing the inside of courts, defending the stage, the setting and their actions. The media (even those with ludicrous headlines) they all want their digital media coin, so they will rely on hardline after headline and it will be about creating flames, not information. That is how I see it and feel free to disagree.

And as November is a mere 2 hours away, consider the time line I gave. Then consider the headline that the Guardian relied on yesterday ‘‘It’s possible’: the race to approve a Covid vaccine by Christmas’, unless the vaccine is properly tested by Friday, that deadline cannot be kept. So when you see “Kate Bingham, who heads the UK’s vaccine taskforce, said the UK was in “a very good place”. But there are still hurdles to clear in the coming weeks” (at https://www.theguardian.com/world/2020/oct/30/its-possible-the-race-to-approve-a-covid-vaccine-by-christmas), and when we see “It could be Oxford University, partnered with drug company AstraZeneca. It could be Moderna in the US. Or it could be Pfizer and the German company BioNTech. All three have either recruited the last of the tens of thousands of volunteers they need for the critical final trials or will shortly do so”, in this I merely wonder whose trumpet she is blowing. I am not blaming her or the three, they have a hard job, yet unrealistic time lines are hard on us and they are facilitating for those trying to manage bad news and that is not right, not in this case (well, most often not in any case).

So if you are hoping or relying on a vaccine, think again. The numbers do not add up, on several sides and the media is not asking questions, so I am.

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Mental health or Medication

We have seen the premise in a few stages in the last decade and for the most people lean towards one or the other and that is fine, it is a hard choice to make and there is no real evidence which of the two is better in the long run. Mental health needs treatment, medication is at times not a cure, merely a way to create a timeline for treatment, or to minimise the impact of the situation. Yet there is also a medial state that is not mental health based, for example treating people with cystic fibrosis who have two copies of the F508del mutation, for them there is Orkambi. Yet, what is the status when this involves a politician? How delusional is a public speaker allowed to become before he is considered unhealthy and unable to perform his function?

That question came up when the Guardian gave me ‘Labour pledges to break patents and offer latest drugs on NHS‘ (at https://www.theguardian.com/politics/2019/sep/24/labour-pledges-to-break-patents-and-offer-latest-drugs-on-nhs). So not only is he making claims, he is basically pronouncing war on the World Trade Organisation, abolishing the TRIPS agreement and throwing it all overboard. As we realise that the World Health Organisation gives us: “As of February 2005, 148 countries are Members of the WTO. In becoming Members of the WTO, countries undertake to adhere to the 18 specific agreements annexed to the Agreement establishing the WTO. They cannot choose to be party to some agreements but not others“, the UK and the EU are both signatories, so Jeremy Corbyn is stupid enough to set a stage of war that endangers millions. To give a little consideration to the metrics, we get the numbers on Cystic Fibrosis, not merely those with these two mutations (a specific subset), we see that more than 70,000 people worldwide are living with cystic fibrosis. Approximately 1,000 new cases of CF are diagnosed each year. More than 75 percent of people with CF are diagnosed by age 2. More than half of the CF population is age 18 or older. Now this is not a good thing, we admit, yet we are looking to a population that is less than 0.001% of the entire population, more important the people that need Orkambi are a mere subset of that. And for the UK it would linearly mean that it affects only 0.1% of the 0.001% that optionally have it. That is his ‘limelight’; can someone please kick this idiot out of the Labour party (preferably out of UK politics altogether)?

And in the second part, no political party has any business being in the pharmaceutical industry, there is a reason why industrials should never have any political power (well, we lost that one ages ago, but still). His voice giving us: ‘party will create company to make cheap versions of drugs‘, whilst the metrics give us that it will be a population less than a 100 that have this version of Cystic Fibrosis that is what he is fighting for? He cannot even properly represent his constituency and now he is starting patent wars as well as a war with the World Trade Organisation on abolishing or severely changing The Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS)? Not only does it not make sense, the impact could be devastating for the UK. This is a person screaming ‘election’ and then spinning silent when it was offered.

It is my personal view that UK labour is better off getting the clown Ronald McDonald to do the Labour party bidding, and it will do a better job than Jeremy Corbyn ever could. His promises are no longer empty, they are now right-out dangerous.

Pharmaceuticals

There is a larger pharmaceutical issue and it has been going on for well over a decade, the issue that patents are reapplied well over 30 years after date, often in a slightly changed form, only barely passing the innovation line is the largest concern for generic medication, yet there are dozens of examples and Orkambi is nowhere near the top 10 in this. Lyrica (Pfizer), Rituxan (roche), Cialis (Eli Lilly), Xolair (Roche/Novartis), Restatis (Allergan) are 5 of the top 10 expiring patents with a value of a little over $16 billion in total, and those owners would like a little longer exclusivity, because the expiration will hit their bottom line in a real hard way. In that list Orkambi does not even stack up to any decent degree and we have larger issues gaining patents with a generic option and Corbyn’s need to make war with TRIPS, whilst the NHS has larger issues, especially as it was Labour who botched the NHS IT project losing £11 billion and small change to the degree of several millions is not one who should be casting voices on ending patents.

The sentiment is not wrong, but the chosen field is a little beyond stupid, making us wonder whether the man is personally dealing with mental health issues. We all have had that moment where we wanted to stand in front of Dwayne Johnson calling him Tinkerbell, not really wise, but we all have those inflated moments of self, to do what Jeremy Corbyn does worse hiding behind one 9 year old with: “Luis is denied the medicine he needs because its American manufacturer refuses to sell the drug to the NHS for an affordable price“, so this is not some Cystic Fibrosis case, this is a very specific case and the medication required many millions to create and pass FDA approval. A medication for CF patients with a rare mutation. With two specific mutations in a disease that knows more than 1,700 mutations that had been found in the CFTR gene. Orkambi works for patients with the F508del mutation in both copies the CFTR gene, the most common mutation in people with cystic fibrosis worldwide. So even if it is the most common, there are 1700 mutations meaning that his war on one medication to a specific subset that comes down to a lot less than 100 patients in the UK. So this idiot (read: Jeremy Corbyn) goes to war, promising to abolish TRIPS and leaving the WTO, all for a subset of people, too small to fill a village? Now consider that the UK has Pharmaceutical interests as well, the top two players in the UK are GlaxoSmithKline and AstraZeneca representing almost £132 billion pounds, because if he does what he does, then those two will vacate as well, this is how stupid Jeremy Corbyn is, but he is hoping that you will not notice this as he is in feigned tears for one nine year old child. I only mentioned the top two, the field is larger than that, but Jeremy Corbyn is willing to throw it all in the air.

Can you please explain to me how the government budget will be met when two companies representing a taxable £100,000,000,000 leave the UK? This is the kind of short-sighted, BS carrying ventures that Jeremy Corbyn is handing its constituents. His claim is ‘In England about 5,000 young patients could benefit, but the NHS said it could not afford to pay the bill‘, if there are worldwide 70,000 Cystic Fibrosis (CF) patients the UK cannot have that many, the claim of “US drugs company Vertex priced Orkambi at over £100,000 per patient per year” might be true and for 100 patients that is still serious money, but we need to recognise that we cannot hand every working person a Ferrari, we do not have the money, and it is that extreme. We are in a position where until a patent ends, the maker gets to set the price, or not sell the product. In light of the numbers I see, I want Jeremy Corbyn to give us an exact list of these 5,000 patients and what medication they need. I reckon that the picture shifts a lot faster at that point. And we agree that larger changes are required, yet making a direct case to the WTO that patents cannot be extended above the 35 years is a lot better than abolishing the WTO. Yet Jeremy Corbyn has no options to do that, so he comes with a delusional plan to start a company that ‘create company to make cheap versions of drugs‘, whilst there are plenty of companies doing that, the case remains that patents hand exclusivity until they expire, this year 26 drugs are facing patent expiration and yet, Orkambi is not among them, but 26 patents will become generic, before 2022 42 patents will expire and that is good for a lot of people, yet this system is already in place, we do not need some delusional politician to add his need to become a rich pharmaceutical cat as well.

To be honest, I have never had such a low regard of UK Labour ever before, the fact that I have twice the regard towards LibDems than towards Labour at present is something I never thought possible in the age of Ed Miliband, whomever thought that Corbyn would be a worthy successor deserved the title ‘Joker of the Year‘, as I personally see it, it is actually that bad at present.

So whomever is happy that this optional mental health case is running the UK labour party is in desperate need of some medication (generic NHS funded options will be available).

 

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On this Friday 13th

There have been a few events going on, with all the hustle and bustle from America we are moving towards a possible point that this nation will be officially renamed, when that happens other domino stones will be pushed into a different direction. Yet there is still time, so we can ignore it for now. What was interesting for me, was a Facebook mail that has all the elements of becoming a flame, a wave of emotions, intentionally set in that way. Yet the part that was actually interesting were the facts that it had. Those facts were indeed interesting to look into, yet not by themselves. At this very moment I am digging to confirm certain numbers and see if they hold up.

 

Income 2013 Income 2014 Change

Aetna, Mark Bertolini

$30.7M $15M -50%
Centene, Michael Neidorf $14.5M $28.1M 93%
Cigna, David Cordani $13.5M $27.2M 101%
Humana, Bruce Broussard $8.8M $13.1M 48%
United Health, Stephen Hemsley $12.1M $66.1M 546%
Wellpoint Joseph Swedish $17M $8.1M -47%

These are health insurances and their CEO’s. This group of 6 have in their hands the health options of the bulk of Americans. Now, before we act in outrage, which we might still do, we see that two of them lost half their income, which in the worst situation, that person (Joseph Swedish) makes in 2 days the same I make in a year. In opposition, there is Stephen Hemsley, who makes in a day, the same I would make in 6 years. Now, we can make this about the imbalance, yet that is not what this is about.

Let’s not forget that these are manages health carers. In September 2016 we saw CNN report “A recent report by Kaiser/HRET Employer Health Benefits forecasts that the average family health care plan will cost $18,142, up 3.4% from 2015. That’s faster than wage growth in America“, and “Premiums on the Obamacare exchanges are expected to rise by double-digits this year“. Now, we need to tread carefully here, health care systems require more work and they need to look to what happens in the future, not just what happens now, So when we see Aetna report in 2016 a total revenue of 60 billion, yet an operating earnings of 2.7 billion, we see that there is a margin, yet not an overly exaggerated one. This is part of a system for 23.5 million members. In this on page 7 we see that the revenue is comprised of commercial and governmental premiums totalling 51.5 billion. Yet it goes further, when we see the growth that Aetna has had, the merger deal with Humana, which is interesting as it is set as a 37 billion merger, yet when we see the quarter of quarter growth of 3 years at least, does it make sense to see this as a mere 37 billion dollar merger when the operating revenue has been in excess of 58 billion for well over 3 years? In addition, Aetna reported an operating gain against costs of over 30%, so when we see the CNBC quote on November 10th 2016: “The Affordable Care Act was built on a flawed model that required getting as many people as possible into the insurance system, Bertolini said. And he said he thinks the Republican Party will make good on its promise to repeal it“, we wonder with their operating profits, a managed health care system no less, what are we not seeing? As stated, compared to the revenue, the profits are not outlandish, yet the entire Obamacare issue seems to give another view, one that clashes with the view that we see at Aetna. Now consider another quote, one we see on December 13th 2016, in bizjournals.com. Here we see: “As one of its arguments against the acquisition, the U.S. Justice Department says the deal would drive up prices on health insurance exchanges in 17 counties where Aetna (NYSE: AET) and Louisville-based Humana (NYSE: HUM) now compete“, you see where there is competition, prices are pushed down, so how come I suddenly see an increase in health insurance exchanges? The final part is one that strikes a sting on the violin of chaos too. Consider the quote: “Bertolini also testified that Molina Healthcare Inc., which has agreed to buy Medicare assets from Aetna and Humana for $117 million if the merger is approved“, now let’s be honest that $117 million is nothing to sneer at, yet what are these Medicare assets exactly? Where is the write-off? You see, two companies with a total revenue exceeding $100 billion annually over the last 3 years, in that light $117 million is close to no blip on the radar (0.11%). So why was it mentioned, why put Molina Healthcare Inc. in the picture? Well, like the other two players, they have had quarter on quarter growth for 3 years too, more important, even as their revenue is not as impressive of the two others, we see that annual on quarter, 2015 brought close to 50% growth, whilst 2016 is expected to surpass the 30% mark, those are operating revenue growths nearly unheard of in this day and age. And this is not the adult media sales, this is healthcare, so as we expect that there will always be growth, we need to see where the interests are of these players. Let’s not forget that the picture is changing. Humana Inc. is a for-profit American health insurance company, they clearly state this, so what will become of Aetna when that merger goes through? How will the picture change and how will that impact the members? They are both Managed health care, yet Aetna is not outspoken ‘for profit’, the numbers do bear this out to some degree. Yet in all this is not about the members or patients. This is about the shareholders and both have plenty, the question becomes what direction will Aetna take? Will we see a board of directors that find themselves in agreement with the senate under Emperor Tiberius Claudius Nero, when in 19 AD they proclaimed: ‘Puer Pauper‘ (fuck the poor), which by the way coincided with the expulsion of the Jews from Rome, life is full of irony at times. The reason to make mention of this is because Israel has a health care system not unlike the Netherlands. A compulsory plan where all Israeli citizens are entitled to basic health care as a fundamental right. There a person can sign up with one of four official health insurance organizations which are run as not-for-profit organizations, this is where we see the massive difference. ‘run-for-profit‘ comes at a price and that price is the additional dividends that the members must pay the shareholders. It is not that simple, but you get the idea. In all this the fact that this approach made Israel 4th in terms of efficiency and Israel was ranked 6th healthiest country in the world by Bloomberg rankings. These are numbers any government could be proud of. Neither the US nor the UK make that top 10, according to the article in Bloomberg, the UK doesn’t even make the Top20. So as we realise a few numbers and this all leads to a lot of questions, we can agree that there is nothing against ‘for-profit’, yet who remains in the US with the option to afford this? Perhaps that is why the link to Molina Healthcare Inc., just a small token proclaiming to remain ‘for the people‘, whilst relying on tax deductions and write offs to remain ‘for the shareholders‘. However, let’s face it, these two (Mark Bertolini and Bruce Broussard) are almost the lowest ones on the Health Care CEO list of incomes, still making per day about what I make per year. Yet even as their incomes drew the attention, it is the coverage, the operating profits and the for-profit sides in some of these Managed Health Care groups, whilst we see places like fortune.com inform its upcoming ‘victims’ that the costs will go up: “costs are expected to grow 6.5% through next year. While costs have finally reached a point of equilibrium after years of double-digit growth” as well as “36% of employers are even considering a defined contribution strategy where they would provide a set sum of money to each employee to pay for health care, and if a health care plan exceeds that sum, the employee is on the hook for the remainder of the cost“, so whatever increased quality of life the Americans did not get, there is information that well over 10% of the employers have adopted this strategy. Such plans, especially with the for-profit health care managers will see a shift in costs, from employer to employee. Fortune.com gives as reason: “There’s two primary factors that affect health care costs: how much is being consumed and the price for services and drugs. As it turns out, prices aren’t what’s primarily adding to the rising trend. It comes down to more people consuming more care“. I personally believe that the truth is somewhere in the middle lane. Both the needs of an aging population and the pharmaceutical patents driving up prices as pharmaceutical patents are chomping down on maximised profit per pill. In this Forbes reported two days ago that the pharmaceuticals are not happy. Here we see the quote “Much of Medicare is now run by private sector insurers like Humana or Aetna, who already bid on drugs to get lower prices (this is known as Medicare Advantage)“, Yet President elect Donald Trump stated: “I worry today that the pharmaceutical industry has a very false sense of relief or security because of a Trump administration and a Republican Congress. I think we should recognize that the drug pricing issue is a populist issue. Americans are rightfully angry. The fault is not, surely, on the pharmaceutical industry’s shoulders, but we bear that because we make the drugs. We innovate the drugs, and as a result of that, whether we like it or not, or we want to try to explain it or not, we have to deal with it.” As stated more than once in the past, I do believe in capitalism, yet at what point does capitalism become plain greed? When we look at the top 20 pharmaceuticals, they are hiding behind a 2% growth, yet these 20 companies which include Novartis, Pfizer and Johnson & Johnson were making 547 billion in 2014, whilst we see that 13 of them are turning a profit with one of them 127%, these are only the 2014 numbers, the profits have been steadily increasing, at the expense of those requiring medication, at the expense of a health care system that can afford less and less. In all this we see that places like Pfizer kept a gross profit of well above 38 billion and they weren’t even the best scoring one. Yet, the connection go on a lot further. You see, with Pfizer we see James C. Smith who is also on the public board of Thomson Reuters, Suzanne Nora Johnson is also on the board of American International Group, Inc. (insurances). James M. Kilts serves on the board of MetLife Inc. as well as Nielsen Holdings N.V. The list goes on. A group of board members already on a massive income, adding the incomes from other boards where they serve with incomes most people dare not dream of. What is more interesting is how we see an almost illuminati sized cloud of interaction with media, insurances and other interactions. All essential and profitable for Pfizer. When we look at Novartis that list of directors takes an even more interesting turn. Ann Fudge who also serves on the board of the US Council on Foreign Relations, with additional functions at Unilever as well as the Northrop Grumman Corporation. Pierre Landolt, Ph.D. who is also the chairman of the Swiss private bank Landolt & Cie SA, a Financial Institution in Brazil and a few other enterprises. Andreas von Planta, Ph.D, linked to HSBC, Moller Finance, and the regulation board of the Swiss stock exchange and finally Srikant Datar, Ph.D., who goes beyond mere Novartis, with additional board placement with ICF International Inc., Stryker Corp. and T-Mobile US. The pharmaceutical boards read like a weave of corporate interaction with links all over the Fortune 500. A conspiracy theorists wet dream.

For us it is not about who they are connected to, but how such links could be used to maximise profits. The idea that the Pharmaceutical industry has its representation, and on the other side we see an optional Novartis with its board member Ann Fudge who also serves on the board of the US Council on Foreign Relations, how is that for hedging your bets on both sides of the profit sandwich?

On this Friday 13th we see news in the Guardian mention of the NHS winter crisis, we have been seeing from all directions the Obamacare and how Obamacare Premiums are expected to Increase by ‘Double Digits‘ in 2017, one can only hope that the first digit is a ‘1’. With pharmaceuticals and insurances both on the maximisation of profit, the people in several places are pushed in a corner with no place to go see about any options.

Only the superstitious will think that the health care news will be better tomorrow, it is Friday 13th after all.

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Behind the smiling numbers

An interesting story got to see the internet light by Nicholas Watt (at http://www.theguardian.com/society/2016/feb/16/income-tax-must-rise-3p-to-stop-nhs-staggering-from-year-to-year). The title ‘Income tax must rise 3p to stop NHS ‘staggering from year to year’‘, which implies initially that the NHS needs £1.95m, which might be OK. Yet the truth is far from that, the text gives us that Lord Kerslake stated “Income tax will have to increase by at least 3p in the pound…. “, which is another story entirely (and first evidence that members of the House of Lords are gifted with a decent sense of humour).

His lordship is quite correct when he states: “big questions needed to be asked to ensure that spending kept up with medical advances, an ageing population and the need to invest in hospitals“, yet these are mere facts that should have been asked almost a decade ago, there was a clear and near immediate danger to the health of the NHS. The logic we see after that becomes an issue (read: worry, concern, and both are debatable) “Health spending needs to rise at least in line with GDP. Arguably, we may need to go faster if we want to match European funding. You might argue there is a discount there because we have a more efficient system. But it’s got to be at least GDP-linked otherwise I don’t think we’ll get there“. So let’s take a look. First the Dutch version (at http://www.rijksbegroting.nl/2015/voorbereiding/begroting,kst199401_25.html) gives us two issues should we be willing to ignore language barrier. The BZK gets €71.3b, which is divided in €7.5b called budget financed expenditure and €63.8b from premium financed expenditures. So for argument sake, let’s take the total and divide that on a population of 17 million, this now implies that there is almost €4200 per person (remember that this is a terribly rough estimate).

Now for Belgium we get the VBO with €23.85b. Now we all know that Belgium is a much smaller nation (not that much smaller than the Netherlands in size) and with 11.5 million calling the Belgium nation their homestead we now see that they end up with €2075 per person (Rounded upwards). Perhaps his Lordship could give a slightly more detailed explanation for the remark “Health spending needs to rise at least in line with GDP. Arguably, we may need to go faster if we want to match European funding“. Considering that the Netherlands and Belgium are next to one another and their budgets per person are apart by a mere 49.404%.

This gets me to the core of the proclaimed matter, can anyone explain why we are linking healthcare to GDP? Perhaps, and this is merely a lose speculation, some people in the House of Lords had the time to read a paper by Santiago Lago Peñas (added at the end) called ‘On the relationship between GDP and Health Care expenditure; A new perspective‘, now that might be a good thing, there is nothing wrong with Spain taking the lead in matters (especially if it is a good idea). Santiago Lago Peñas as well as David Cantarero Prieto and Carla Blázquez Fernández have written an interesting paper.

First let’s take a look at part of the abstract, which states “Econometric results show that the long-run multiplier is close to unity, that health expenditure is more sensitive to per capita income cyclical movements than to trend movements, and that those countries with a higher share of private health expenditure fit faster and following a different pattern“. Now, I am not going to take a deep dive into this one (it is after all an abstract), but it gave me a few ideas on where to dig.

Next are a few quotes: “Attention is paid to several usually neglected dimensions of this link. With this aim, four different specifications are presented, with the logarithm of per capital total health care expenditure as the dependent variable in all cases” this doesn’t seem to be more than just a quote, but it will have impact down the track.

It is part 2 called previous evidence that is a first issue. When we accept the initial statement “the debate on this link has moved on whether the income elasticity of health expenditure is greater or less than 1 (Bac and Le Pen, 2002). An income elasticity less than 1 classified health expenditure and income inelastic, therefore, as a “necessary” good. On the other hand, if the elasticity is higher than 1, health will be classified as a “luxury” good“, which will do for now. You see, my issue is when we see the part that follows:

  • The seminal paper by Newhouse (1977)
  • An earlier study by Kleiman (1974) for a different set of countries
  • Leu (1986) using cross-sectional data for 19 OECD countries in 1974
  • Parkin et al. (1987) using similar methods and data from 1980
  • Brown (1987) using a sample of 20 OECD countries

Here we have the first issue. You see, this is not regarding the methodology, it is about the data, methods of data collection, usage of weights (if done), these numbers regarded in contrast towards those temporary populations in reflection to the whole. Health expenditure is one part, but based against which healthy part. Now consider the initial reflection I had on the Netherlands and Belgium. They have very different norms in respect to mental health care. Now consider the statements ‘19 OECD countries in 1974‘ and ‘20 OECD countries in 1987‘ I will again make a clear speculative declaration that the mental health norms are not equal, especially when considering economic differences, which gives my first thought, how useful is the paper on a whole (I am not attacking it) and how applicable this would be (read: could be) in reflection towards the whole.

You only need to scan for ‘psychology, psychiatry and mental health’ to see that the paper does not take this into consideration. As we know that the EEC nations have had their own approach to mental health in the past, is not a statement that they did anything wrong, but if this is the first element that does not align, what else will not align (there are a few). One that shines directly behind the ‘previous evidence‘. You see in my head the question comes to mind when I see “The econometric analysis relies on annual data for 31 OECD countries from 1970 to 2009 gathered from the OECD Health Data Set 2011“, so is this aggregated data or raw data. if it is aggregated data the foundation might not align giving an unbalanced and invalid view (in my personal opinion), if it is raw data, what ground line data (the full population) is added so that the individual record compares towards the national whole, if that is missing how can any calculation be truly reflective of what was, especially taking into account the data is reflective over different time zones with very different social pressures. In that case I wonder if I can get a similar result by calculating Z-scores and run a Crosstabs in IBM Statistics #JustSaying!

Now we get back to the article which comes with the image of a smiling Lord Kerslake. Does this paper validate or invalidate the idea? No it does not, but it leads to questions, serious ones.

The quote “John Appleby, the chief economist at the King’s Fund, has estimated that NHS spending is due to fall from 7.3% of GDP to 6.6% in 2020-21. If health spending were to keep pace with economic growth, Appleby estimates an extra £16bn would have to be found every year by 2020-21 to take the NHS budget to £158bn. This works out at 3p on all rates of income tax, according to the IFS” is next!

The term ‘NHS spending is due to fall‘ reads like an event Baron Munchausen could have come up with (the character from Raspe’s book in 1785, not the syndrome). Of course the prediction is 5 years away, which makes it speculative. Now we know that John Appleby is more than the Chief economist for The King’s fund. He is also a Visiting Professor at the Department of Economics at City University and he has a whole range of publications to his name, so why am I opposed?

Well, part of this starts with his own article ‘Social care: a future we don’t yet know‘ (at http://www.kingsfund.org.uk/blog/2015/11/social-care-future), the two quotes that get the foreground are “In our submission to the Spending Review we called for social care to be protected from further cuts and for the money previously agreed for the postponed Care Act funding reforms to be retained and invested in social care. But non-protected departments have been asked by HM Treasury to model cuts of 25 and 40 per cent – so further cuts seem inevitable“, as well as “What would happen if the spending cuts applied to social care over the past five years continue over the next five? Spending on social care for people of all ages as a share of GDP has already begun to fall. It was roughly 1.2 per cent in 2009 but if cuts continue at the same rate it will have halved by the end of this parliament to barely more than a half of one per cent of GDP“. Now there is nothing wrong with any of the texts, John Appleby is not where he is because he is silly, he is very (read: extremely) clued in. I am stating that the environment has changed, it has changed drastically from 2011 onwards and in addition; the changes the UK faces over the next three years will take some of these prediction to town in not so nice a manner.

You will now ask why, which is the question you should ask!

We get part of this from the London School of Economics and Political science (at http://cep.lse.ac.uk/pubs/download/special/cepsp26.pdf), the initial answer is given on page 13. Where we see “To summarise, treatments for the “common mental disorders” of depression and anxiety can be self-financing within the NHS. By spending more, we save even more. This is different from much of NHS expenditure. At the same time we relieve one of the main sources of suffering in our community“, in addition page 15 gives us “According to the 2007 survey, which covered a random sample of households, only 24% of people with depression and anxiety disorders were in any form of treatment“. This now gives us the first part in all this. The overall costs are not in league of the budgets because there is a missing foundations of equality on what falls ‘within’ the NHS. There is no option for the NHS other than to evolve into something ‘more’ complete. The UK is about to get 20,000 refugees from war torn Syria (over several years), the initial approved £1b seems to be nothing more than a drop of water on a hot plate, the ‘why’ will be clear shortly.

The UK has seen a massive rise in mental health issues in the last year alone. Depression and anxiety mainly due to economic events (cost of living) is now a serious concern, especially as the pressures of the economy are likely to continue a few more years. Consider my article two days ago (at https://lawlordtobe.com/2016/02/15/is-there-a-doctor-on-this-budget/) called ‘Is there a doctor on this budget?‘ where we saw the link to ‘Health Care for Undocumented Migrants: European Approaches‘. The graph shown on page 3 is the charm. If we consider the cube, we see that on the X-axis we see subcategories of undocumented migrants, yet the same expenditure would apply to refugees (or the population for that matter). Now consider the Y-axis which is about the type of services and the Z-axis are the funding arrangements. Now this can be treated like a glass with liquid. If we increase the base (X or Y) the funding arrangements go down, it is the simplest of physics, a bigger glass requires more fluid to fill, so we have a population with more health care needs, mental health care in this case and the types of services is not just against depression or anxiety, it will require the coverage of war trauma and shell shock. This will impact refugees of all ages. So the glass gets bigger and bigger and more and more funding will be required to keep funding arrangements on an equal level, this is merely the application of logic.

This is why I opposed John Appleby’s approach, it shows little application of a changing population, merely a greying one (which is a form of change), but it does not hold water against the massive change the UK has faced since 2013 and will face until 2019. This is why I am not in agreement with the statements of John Appleby. Now we get back to Lord Kerslake. You see, the paper I mentioned is an example. It might not even be the foundation of Lord Kerslake’s approach. Yet a multitude of papers clearly show that there seems to be no real no equality in the setting of healthcare (read: cost of health care). It seems to be wearing a different hat in nearly every European nation, it would already be a great leap forward if they all had the same colour, which does not seem to be the case either.

Now we get the quote that wakes us all up “Appleby estimates that NHS spending would have to increase by 30% or £43bn a year to take NHS total spending to the EU-15 average by 2020-21. The IFS estimates that this would involve an 8p increase on all rates of income tax“, which is one side of the option. How about the other side? When we see that AstraZeneca has been able to avoid corporation tax on a massive scale, which dwarves when we compare it to the mergers Pfizer and Allergan have achieved. Is it perhaps possible that his lordship looks at another solution like closing that tax abyss? Might I suggest an idea where any corporation involved in tax avoidance gets its medication ‘grey’ listed? Which means that any drug that could be begotten in a generic form from a place like India will be selected as a first solution? It could even result in India starting businesses in the UK (with the economic benefits that those places will give). It would also send a clear signal that if corporations would like to avoid taxation, which in legal correct way is just fine, but at that point other distributors of pharmaceuticals will be found. I reckon that between that announcement and the offer of reduced medications (read: less costs for the NHS) from pharmaceutical firms would be forthcoming within 24 hours of making the announcement.

Yet, this was not about the costing, it was about the increase and setting against the GDP. The fact that health spending and economic spending are on par reads more like an option for deferred payments to big pharma and medical supplier than anything else. In case of doctors it would mean that their incomes would go through the roof (which might be a deserved reality), but it is one that the coffers under the care of George Osborne cannot afford.

There is wisdom in his lordship stating that “a royal commission should be established to build a national consensus on NHS funding“, which sounds a lot more ‘reliable’ (read: acceptable) than the Labour party giving way by letting a banker (Sir Derek Wanless) set the NHS spending levels. It is of course desirable to go with the people and keep the directly funded NHS free at the point of use, yet that comes with a price tag that is no longer realistic in this day and age of deficit, in addition harder times are coming for a while longer, making the price tag we already have a non-linear shifting one. Yet I feel adamant to speak that mental health must be fully accepted as part of the NHS (for all people, anywhere in the UK), which slides the scales of budget by a lot. A reality many papers (as I expect it to be) did not take into account. Raising income taxation as implied could equally be an issue as that could potentially drive depression and suicide statistics overnight (the latter would lower rents but that seems just too harsh a solution).

What is a given is that Lord Kerslake is the catalyst that is making us ask several serious questions.

I am however not entirely convinced that his lordship took the best path in getting these issues out into the open.

On the relationship between GDP and Health Care expenditure; A new perspective

 

 

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Penis Aqua Rosa Congressista

The Dutch used to have interesting names for classifying people. There was ‘Penis jujubes’ (originally: Droplul), which amounts to Liquorice Penis, which captions the non-Dutch titles dick, asshole and idiot. The other one was ‘Penis Aqua Rosa’ (originally: Lulletje Rozewater), which gets us Rosewater Dick, which is an expression for a man that has no backbone, a man that is weak and submissive. The latter one seems to apply to the US Congress in a few ways.

You see, the  article ‘Drug company boss Martin Shkreli refuses to testify to Congress‘ gives us part of it all (at http://www.theguardian.com/business/2016/feb/04/martin-shkreli-refuses-to-testify-congress-drug-daraprim), an issue that might be seen in the wrong light, if you only go by the one side of the story. You see, this is situation that Congress and their US laws created for themselves. Even if we get the ’emotional’ statement: “One member begged him to examine his conscience“, we all seem to ignore, that this is something Congress achieved all by themselves. You see the quote “Earlier, Shkreli and Turing’s chief commercial officer, Nancy Retzlaff, were criticized for hiking the price of Daraprim despite the fact it is the only government-approved treatment for the rare infection toxoplasmosis, which can be fatal for some Aids and cancer patients and endangers babies in-utero” is at the core of this.

Instead of setting up the law that fairness was at the centre of it all, politicians set the speculation that every pharmaceutical company and their fields would be ‘distributed’, that there was no overlap (for the larger extent), as such pharmaceutical had a clear field for maximised profits. How long did you think it was going to take before someone weaselled themselves into that crowd, with the simple goal of maximising his Return-on-Investment? The United States of America has always been about capitalism and living the dream. Martin Shkreli is doing just that, now we get what some might call ‘sissy noises‘ from the Halls of Congress!

Let’s be Frank (or Punch and Judy; whatever works for you), what Martin Shkreli does is utterly unacceptable, yet, it is Congress that did not legislatively clip the wings of unbridled greed. They sat around as President Bill Clinton called for the end of the Glass–Steagall Legislation. As the majority remained silent additional doors to greed got opened. In all this, the lack of visionaries in Congress, even after 2008 lacked action when it came to protecting the citizens of the United States of America. So when I see the response from a member of congress “member begged him to examine his conscience“, I will kindly tell that congressperson to cry me a river and I’ll do so whilst playing worlds tiniest violin.

Congress is in an emotional state, suddenly crying for those who cannot afford it, yet what clear provisions in legislation has it given to the coffers of the United States? You see when we consider November 23rd (at http://www.forbes.com/sites/antoinegara/2015/11/23/pfizer-and-allergan-merger-ranks-as-biggest-ever-pharmaceutical-deal) and we see “On Monday, Pfizer PFE +0.10% and Allergan unveiled an all-stock merger that will allow the combined company, Pfizer PLC, to move its headquarters to Ireland and focus on corporate cost cuts“, which is set at $160 billion, you better believe that this impacts the taxability of that corporation by a lot. As far as I can tell from the surface, the total of pharmaceutical mergers LAST YEAR ALONE is well over 600 billion, so half a trillion dollars, all now going via Ireland. How much noise is congress making there? Or do these ‘respectful’ members of congress have a few too many friends in ‘those’ circles? Better to loudly focus on the one man out as Pfizer, Allergan and a few others. Can we all agree that the difference of 600 billion, being taxed at 25%, or being taxed at 17% is worth moving house over? You see, I love Sydney, but when someone tells me that moving will get me $48 billion, I will start singing ‘My heart is in Ireland‘ and I will enthusiastically pack my bags. You see, I can always get a second apartment in Buenos Aires and life of my self-made cash cow, getting me $50K a day and still allow me to double my fortune before I retire, making me live of $200K a day until I die. That is the track that Congress left open. This can be seen (at http://www.forbes.com/sites/antoinegara/2015/11/23/pfizer-and-allergan-merger-ranks-as-biggest-ever-pharmaceutical-deal), the quote there “move its headquarters to Ireland and focus on corporate cost cuts“, can be seen as ‘tax cuts’ and now guess what a chunk of those cost cuttings will go? You probably guessed it, the gents (ladies too) of the board of directors of Pfizer.

So, when I state to the person in Congress ‘go cry me a river’, I am being pretty serious. For the mere reason after all those hard words that the media published on how this was going to get stopped, on how some African American in a non-circular room (according to whitehouse.gov) decided to call for ‘Closing Corporate Tax Loopholes’ in July 26th 2014. I am guessing that this was unsuccessful as Pfizer basically walked out with well over half a trillion. The move started in November 2015 and the press has been absent of any failure to stop Pfizer from moving away from the American non-tax havens, towards the shores of paddy’s Irish Whiskey and the real tax havens.

Let’s be clear, that this does not excuse Martin Shkreli from the acts he is doing, or would it stop me from legislatively going after Martin Shkreli if I could. The mere reality is that it will be close to impossible to do because the US Congress had enabled much of what Martin Shkreli did, which is not what they intended to do, yet it is what is the non-emotional result, so in that matter ‘examine his conscience‘ applies to a much larger extent to Congress and its need to clean up the mess that allows corporate American to get around taxation. A mess congress might not be willing to fix for the simple speculation that when not re-elected those members of Congress need to rely on large corporations for their next pay check.

I am not the only one on this horse, as far as I can tell ‘the New Yorker’ and a few others are starting to realise that no matter how objectionable the acts of Martin Shkreli are, there is now a focal point change. This focal point is about how Congress itself is part of the problem, not part of anyone’s solution (at http://www.newyorker.com/culture/cultural-comment/everyone-hates-martin-shkreli-everyone-is-missing-the-point), how there is an unlabelled coffer with funds to buy items of survival for people who cannot afford it. The New Yorker states it as “mysterious corporate bargaining, and occasional charitable acts“, this includes (as I personally see it) Pfizer and their transplanted plus 600 billion, moving to Ireland.

So even when we consider the acts of Martin Shkreli to be vile and evil, how is the inaction of Congress not worse? How is it that we cannot condone the acts of a failed administration, whilst the acts of a person who was in it for the money from day one to be such a surprise?

A man that graduated from Bernard M. Baruch College of the City University of New York, who became a hedge funds manager, ‘evolved’ as an entrepreneur and who is living the American dream.

How are any of the unfolding elements a surprise to anyone?

 

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Show me the money!

That is what I wanted to shout out loud today, not because of a scene between Tom Cruise and Cuba Gooding Jr, but because of the story written by Larry Elliot (the Guardian economics editor). He is not wrong, probably with his insights and degrees he is more right than anyone else so why am I all up in arms about it? You see, if he is right then there is something extremely wrong with this world. Here is the crux, either he is wrong, or the bulk of the planet has become demented. What will it be?

Why do I consider this to be my view?

The view evolves when we consider the following aspects of the British economy. First there is “The budget deficit will be almost £100bn this year and is rising. It was supposed to be below £40bn. If the current Treasury chief secretary, Danny Alexander, is foolish enough to leave a little note for his successor, he will only need to insert one word into the one penned by Byrne: still” and “Britain currently enjoys the sort of growth rate that Germany, France and Italy can only dream about. The economy should expand by 3% this year, making the UK the fastest growing G7 nation. Jobs are being created at a record rate, a development that explains why Britain is proving a magnet for migrants from the rest of the EU“, we have seen this. Yet, as immigration is not capped to the extent it should be, jobs go to the cheap Polish workers, whilst we see a massive +50 workforce unable to get jobs, which we get from the Guardian (at http://www.theguardian.com/society/2013/nov/13/unemployment-fall-masks-jobless-over-50s). “Bennett is one of more than 400,000 people over 50 in the UK who is registered as unemployed, according to the latest official jobs data released yesterday“, you see, the mature experienced workforce is deemed useless in many areas and as such, the economy will take two hits. The first one is that these people in the end still cost money, in the second that as companies rely on cheap labour; we see that they go three steps forward, two steps back; it is getting them nowhere fast and at great expense too. So as those people have an income, the companies are just scraping by, having therefor the dubious benefit of living at tax level zero. That keeps the Osborne coffers (also known as the UK treasury) pretty empty.

Let’s take a look at some events linked here “Former BBC director general Mark Thompson has said sorry for the £100m failure of the BBC’s Digital Media Initiative (DMI)“, “Siren police IT project’s £15m failure a ‘debacle’” and not to forget “Abandoned NHS IT system has cost £10bn so far“. There is a level of sheer incompetence that is beyond measure. Yet, I think it goes further than that, I think that as areas have cut back and scrapped from the bottom of the barrel, we see cogs of non-comprehension that just twirl having no connection to any other cogs. Companies, which are no longer structured in the old ways, but still presented as such, they are niches into rooms, where only the manager has access. Like the American cubicles, that only one person oversees, absent of checks and balances, whilst the people no longer talk to each other, no clear communication. That represents the new era of work. The 50+ population have seen why there are issues with the cubicle approach and the manager who needs to get the task short-sightedly done is barring 50+ from being hired, this results in a sliding slope of minimised success.

What do they have to do with one another?

Let’s get back to the writing of Larry Elliot at this point “It took until 2013, however, for the level of output to get back to its pre-recession level, the slowest recovery of the post-second world war era. Osborne thought the economy would cope with austerity better than it did. He underestimated the impact of higher VAT and cuts in spending on growth. The chancellor thought his tough deficit reduction plan would boost growth by generating more confidence in the private sector that the books were being balanced. He was wrong. The upshot was weaker growth, lower than expected tax revenues and higher than expected borrowing. Half way through the coalition’s term in office, Osborne abandoned the idea of sorting the deficit in one parliament, and reverted to a more modest plan akin to that drawn up by his predecessor, Alistair Darling

The crux is “The upshot was weaker growth, lower than expected tax revenues and higher than expected borrowing“. I think that it is not entirely correct! Yes, Elliot writes the truth, but behind the curtains we see projects failing due to bad decision making (like the headlines mentioned earlier), in addition we see mergers of an unparalleled size “The chemist chain Boots is being sold to the American retail company Walgreens in a £10bn deal that is delivering a huge pay-day for its private equity owners“, which sounds nice, but how does that fill taxation coffers? It does not!

Corporate choices are made to avoid taxation like “U.S. Treasury Seen Loser in Tax-Avoiding Pfizer Move to U.K.” is at the heart of the second tier of failures. Not a failure by George Osborne, but a failure by their corporations that bleed nations dry, whilst not being held accountable, there the nations have failed themselves by not alter the proper legislations to avoid these acts of non-taxability. Whatever happens next will happen too late, the coffers are empty and those who walked away will do so in non-taxable luxury for the rest of their lives and the lives of the next 3 generations of their family to come.

The next part has a few issues (none of them are Larry Elliot) “The foundation notes that two-thirds of people who have moved from unemployment into work in the last year are paid below the living wage, the average self-employed person earns 13% less than they did five years ago and there are around 1.4m contracts not guaranteeing a minimum hours. Over half of them are in the lower-paying food, accommodation, retail and administrative sectors” Many of these lower paid jobs are all about areas where we see high rent, a massive drive to turn around orders and well above counted hours are needed. Life in London (as well as in Sydney) has become a life not unlike hyenas. These bosses are trying to stay afloat, which they do by hiring the weak, the cheap and the manipulative. One waitress mentioned this in a forum “Now I understand I am competing with people on the dole who can be near enough forced to work for free but it still sounds a bit shady“, the mention has bearing, as people are pushed more into unpaid extra hours, less rights, less options and less energy, we see a community that has devolved from symbiotic into parasitic, with only one winner in the end, the landlord!

Both the UK and Australia have been unwilling to deal with this entity, leaving the people at large to fend for themselves without any support.

The next part is a statement of fact, there is nothing against it in any way “If it is taking longer than expected to knock the budget deficit back into shape, the same can be said of Osborne’s other objective – to boost exports from a re-invigorated manufacturing sector so that Britain once again pays its way in the world

How to go about it is at the heart of it and several options are open as they always are, but consider that out of a dozen avenues, one is a solution, three are deadly and the rest tend to have a costly non solving effect. Several parties in play, not Just George Osborne, but in that same view, Alistair Darling and Gordon Brown all had the same flaw (as I personally see it). Instead of finding a solution that is a mere band aid, they all failed to seek the solution which had the visionary idea to include the next generation. I had that idea on two instances; the one that matters here is the article ‘What’s in a health system?‘ on June 29th 2014, where I state “When people ask which company will do this, the answer should be ‘None!’. The UK is filled with universities, some of them regarded as the most prestigious and brightest on the planet. Consider that most IT people, might claim experience, yet their drama skills are the only ones that improved for the most, is it not up to the Universities, those who are introduced to the newest ideas, design a solution that would make the work of the doctors and nurses at the NHS better, slightly more efficient and a truckload of less hassle! Is that such a tall order?

Like a regional solution for a independent Scottish IT environment, the visionary approach is to bring this to the universities, to develop a new system, not just a mere frame that goes on top of something else, but an actual new system, LINUX based option, a security enhanced LINUX for healthcare, one that is designed, not for 2016, or 2017, but for the next generation. Why not give the universities access to design their new future, not leave it to these current so called executives that waste up to 20 billion not delivering anything. That visionary approach is missing and it could be the death of us all (UK and Australia alike), we have so many similar issues, why not tackle them together, open up avenues that have never been considered. If you want visionary, then look at the Netherlands, they decided to change the bicycle lanes into solar panels, do you have ANY idea how many bicycle lanes the Netherlands has? It is actually a visible percentage of that nation’s surface. Now, they decided to give it a second function, which means generating electricity, without needing any space at all, illuminating the bicycle road through fluoresces, making it safer at night. They decided to attack road safety and energy issues all at the same time. That is the level of innovation we need to see, preferably without spending another 20 billion pounds. So how about changing, or better stated evolving universities and giving them a real hand in innovation and solving future problems we have ignored and left dead for granted (like the NHS).

The last part is seen here “Ed Balls, the shadow chancellor, said: “I am not that bothered about being behind on economic competence. In opposition, we are always behind on economic competence. Brown and Blair were at this point before the 1997 election. “I would rather we were further ahead in the polls but the Tories are leaving it a bit late for a feel-good surge. That’s why Cameron is talking about red lights flashing on the dashboard. Maybe he thinks he can scare people into voting Tory.”

I disagree, Ed Balls needs to get scared shitless real fast! George Osborne needs to do something similar! Economic competence is not something that is behind, the indicators are that they are close to non-existent. As numbers are hidden behind the statistics of ‘% of GDP‘ we are diluting ourselves that we have a handle on things, once the message is that the total debt has decreased below 750 billion, we have an actual message, but for now, that 25% decrease is nowhere in sight. Life in the UK is all about meeting the payment of the interest debt, whilst none are tackling any solution regarding the total debt for the future. That danger has been voiced by several players all over the field. The message now is that ‘Investors Underpricing Risk May Threaten Growth, IMF Says‘ (at http://www.bloomberg.com/news/2014-09-17/investors-underpricing-risk-may-threaten-growth-imf-says.html) as well as ‘Flug Flags Underpriced Risk as Investors Drop Corporates‘ (at http://www.bloomberg.com/news/2014-09-30/flug-flags-underpriced-risk-as-investors-drop-corporates.html), which gets a punch from today’s news ‘New York Hops on $15 Billion Israeli Corporate Bond Boom‘ (at http://www.bloomberg.com/news/2014-11-30/new-york-hops-on-15-billion-israeli-corporate-bond-boom.html). Like the housing in Hackney through Westbrook Partners and Round Hill Capital in the Netherlands, we see again a change in markets (like they always will), but this is different. Like Greece (again) last week with “A Greek official says the country is under pressure from rescue creditors to impose new austerity measures to resolve an ongoing budget disagreement worth a reported 2 billion euros ($2.5 billion)” (at http://www.cnbc.com/id/102222375), we see a market that keeps on getting pushed whilst there is no money left. By the way, those two players (Westbrook Partners and Round Hill Capital), did you consider combining these facts?

Have you considered when Westbrook goes market value and they merge with 2-3 other players (perhaps Round Hill Capital as one of them), when they merge, how much taxation will be missed out then, also, what danger will these tenants be placed in at that point?

So back to Greece and their dwellings, Greece should both be dissolved and offered to Turkey (just to make it sting a little more) or they need to clean up their act, including dealing with these massive strikes. Let’s not forget that Greeks themselves did this to Greece (partially through Goldman Sachs). We see cogs of greed interacting, finding new connections not to be held accountable, whilst its population gets the bill, blaming Germany for all of this. In that same light we see how we are now confronted with underpriced risks. So, not unlike the 2008 crash with all these “sub-prime” borrowers and bailing on 8 trillion, we now see governments trying to intervene by ‘forcing’ banks to make low cost loans to the underprivileged “sub-prime” borrowers, trying to create a fake boom, whilst at the same time, they have created a more likely than not risk that it will only explode in their faces, whilst imploding their economy (this is as I personally see it). Here in the end, we see that the bank wins no matter what, either the government pays them, or they just own it all. Like the landlords of London, it will destroy the quality of life for more and more people, whilst not showing any resolution in solving the actual problems.

This all comes together when we consider the IMF part on underpricing risk (mentioned earlier), there we see the part that is truly linked to all our woes: “Policy makers from the Group of 20 nations meet this week in Cairns, Australia, to discuss ways of boosting global demand. The Fed today maintained a commitment to keep interest rates near zero for a “considerable time.” At the same time, Fed officials raised their median estimate for their policy interest rate at the end of 2015 to 1.375 percent, compared with the 1.125 percent estimate made in June“. The crux: “ways of boosting global demand” it is at the heart of the failures we see. It is worse than bad marketing. The last thing we need to do is boost demand. We need to resolve debts. Yes, the US wants to see demands boosted, as it was one step away from bankruptcy 5 steps ago. They are trying to bluff into a new era of not being dead, whilst they have been unsuccessful in dealing with their debts, having no solution and even less options. We must find another way. If the Netherlands, one of the smallest nations in the world can turn around an age of innovation to their advantage in a novel way never seen before, then so can we! If you wonder how this linked, then consider how their solution can become a new era of energy independence all over South America, parts of America and all over Europe and Africa. Solar panelled roads, a patented solution that can change the face of the earth in one mere step. Once the high pressure solution is done for cars, we will see a new era of energy. Not bad for a place that is famous for wooden shoes and a leaky dike! So where are we in the Commonwealth? Where is our innovation?

In the end Larry Elliott spoke the facts, the truth and wrote an excellent article, I just disagree with the views they link to, in the end, it might be me who was wrong and it is all in the eye of the beholder!

In this age of debt, innovation and Intellectual Property are soon to become the only currency that will have any true value! The Commonwealth needs its own share of those, less it becomes as desperate as America currently is.

 

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