Relevant and even prescient commentary on news, politics and the economy.

Tax cuts are pledged why??

We do know from Mike Kimel’s Presimetrics that the political message that tax cuts raise revenue is false. In particular, here are two looks at the topic from data from the last decade. It does appear that many want to continue what was done during this last decade…hold on to your wallet!!

David Cay Johnston at notes (h/t Mark Thoma):

Just as they did in 2000, the Republicans are running this year on an economic platform of tax cuts, especially making the tax cuts permanent for the richest among us. So how did the tax cuts work out? My analysis of the new data, with all figures in 2008 dollars:

Total income was $2.74 trillion less during the eight Bush years than if incomes had stayed at 2000 levels. …

Even if we limit the analysis by starting in 2003, when the dividend and capital gains tax cuts began, through the peak year of 2007, the result is still less income than at the 2000 level. Total income was down $951 billion during those four years.
Average incomes fell. Average taxpayer income was down $3,512, or 5.7 percent, in 2008 compared with 2000, President Bush’s own benchmark year for his promises of prosperity through tax cuts. …

Bruce Bartlett at Fiscal Times notes:

Republicans are heavily invested in permanently extending the tax cuts enacted during the George W. Bush administration, all of which expire at the end of this year exactly as the legislation was written in the first place. To hear Republicans, one would think that the Bush tax cuts were the most powerful stimulus to growth ever enacted and only a madman would even think of allowing any of them to expire.

The truth is that there is virtually no evidence in support of the Bush tax cuts as an economic elixir. To the extent that they had any positive effect on growth, it was very, very modest. Their main effect was simply to reduce the government’s revenue, thereby increasing the budget deficit, which all Republicans claim to abhor.

Contrary to Ronald Reagan’s 1981 tax cut, which was a simple across-the-board marginal tax rate reduction, the Bush plan was a hodge-podge of tax gimmicks designed more to win the support of various voting blocs than stimulate growth.

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CGI, Day 4 – Clean Technology and Smart Energy: Deploying the Green Economy

Moderator is John Holdren, Science and Technology Advisor to President Barack Obama and Director, White House Office of Science and Technology Policy. Participants are:

Ms. Al Dossary is introduced as one of the few, if not the first, female business leader in Saudi Arabia. (See her comments later for a variant opinion,)

Mr. Holdren opens by speaking of the three levels of technology adoption:

  1. Barrier Busting: “overcoming obstacles to the use and diffusion of technologies” that are available today.
  2. Incentivizing: changing the economic or the regulatory landscape to make socially- and environmentally-attractive technologies more attractive.
  3. Inventing and Improving: R&D demonstration that makes technologies with improved characteristics and lower costs.

Mr. Hattem, whose duty is “to direct capital to people and places that are currently outside of the economic mainstream,” means that his attention focuses on rural areas, and works with a data focus to ensure that the returns are realized.

Ms. Al Dossary, an English Literature major who is very fond of Disneyland, found herself moving the business into new directions, concentrating on “the carousel of progress,” and noting that she has often failed but ends up ahead.

Mr. van Oostrom moved primarily into green building technologies after meeting with Al Gore. Discovered that there was abundant information about how to build green buildings, and moved to that space.  Decided to make buildings “for half the money, in half the time, and completely carbon-neutral” after finding abundant support for the transition within his firm—middle and upper managers enthusiastic about being at the forefront.

Mr. Hattem notes that the emphasis on building development has to be on energy efficiency. (He points out that NYC is relatively energy efficient even now)  Concentrated on the transition in lending and investment practices in NYC and applied the information gained there to developing structures and investments in green technology.  Seeing even residential buildings being developed with expectation of cutting energy demand by 30% or more through technology such as using solar panels to provide hot water.

Ms. Al Dossary emphasizes that it is necessary to link green technology with people’s interests, not the glories of the technology. We are presenting it as reducing electricity and water bills and providing a better environment for your kids. Competition abides: the more competition in the marketplace, in the presentation of the products, improves results.

Mr. Holdren notes that Ms. Mumpuni has been working from the ground up, and her effort has often been more successful than the governments that have been pushing from the top.  Ms. Mumpuni takes a “community-based approach”; what has worked have been to utilize the local resources—especially water—with local people developing and maintaining (and therefore having a sense of ownership of) the microhydro technology.  One of the things she noted is that the microhydro technology leverages the existing environment—maintaining the local forests instead of cutting them down enabled leveraging the existing terrain without having to engage in destruction, creative or not—and therefore makes adaptation easier.  She has been expanding and adopting this practice into the rest of the Asia-Pacific area and Africa.

Ms. Mumpuni re-emphasizes that development and dissemination of Green Technology must be done on a community basis.  This is, she says, essential to the small (ca. 1,000 household) villages that are attempting to move to greener technologies.  She is later asked what effect those community developments have on the larger utility companies in Indonesia.  She noted that the initial reactions—once the communities became prominent enough—was that the large companies had government support to force the communities to buy power they did not need.

However, as a woman, she was able to outwait the system.  Over the next four years, she got the government to start buying power from the communities, and the result over time was that the government and the utility companies (which no longer needed to maintain so many long, “technologically inappropriate” power delivery lines) realized that the “creative destruction” (not her phrase) could be good for everyone. (AB readers note especially: the restriction in this case was first supported by the so-called “private enterprise.”)

Mr. Holdren notes that in many cases the pitch for alternative energy is “you will have to pay more, but the externalities are worth it.”  Conrad van Oostrom notes that “the real economics” (Mr. Holdren’s phrase) works well for new buildings, where you can (for instance) “bring forward” the energy savings over the next ten years. (Businesses understand Present Value.) We are seeing that many new cities in China and India are being built using green technology.

The difficult part is retrofitting buildings, where there have to be multiple negotiations with existing tenants. Even there, though, it is much less difficult to do that when you can give them “a real guarantee” that their future energy costs will be reduced by 30-50%.

Mr. Holdren then asks Gary Hattem to provide a macroeconomic perspective on what retrofitting and green technology development is and will be doing for the job market.  Mr. Hattem notes that they are doing detailed studies of how the ARRA dollars generally and are working to align policies to workforce training for where the jobs actually will be.

Mr. Holdren asks Ms. Al Dossary if she, as “a business leader and a woman,” is an inspiration to other women in Saudi Arabia and the Middle East. Ms. Al Dossary notes that women in Saudi Arabia and the Middle East are “not really interested in [being on the] media that much. There are so many successful stories for women.…I’m just in front of the TV; that’s the difference.”

António Guterres, the UN High Commissioner for Refugees, asks about the “Small is beautiful, big is necessary” conceit, especially the last part. He notes that they had a very successful experience installing solar energy in a refugee camp, but did not see any expansion of solar into other areas; no one overcame the institutional and cultural issues.

Ms.Mumpuni notes that they need to create trust be able to address the needs of the community.  She always tells them in advance that there must be continual community participation, from the planning to the maintenance, or her organization cannot risk its reputation on working with them.  Effect is that the community has customization and ownership, which goes a long way to overcome those issues.

Remy Chevalier of the Environmental Library Fund asks about the lighting of green technology buildings. Mr. van Oostrom notes that, in Western Europe, the issues of heating and cooling have been solved entirely for purposes of a “green building.”  The issue is lighting.  There has been some progress from the use of smart glass technology.  One thing that has helped in their buildings is to automatically have the lights go off at 6:30pm in the commercial buildings, while allowing people to press a button to relight the area. (I’ve worked in buildings that were set up that way in the U.S. as well.)  This simple move cut electricity costs by about 20%.  Mr. Hattem notes in that context that 1.6 billion people in the world do not have access to electricity, and that solar has become “an access point” for both the technology and distribution.

Ms. Mumpuni is asked about costs.  She notes that production via microhydro costs depend on geographic situation: from about $800 per Kw installed to as $4,000 per Kw installed.  But again there have been breakthroughs that are reducing that cost steadily: now producing a “community hydro” that produces ca. 500 Watts –enough energy to power to run five (5) to ten (10) houses—for about $1,500.

Ms. Al Dossary—asked to discuss possible obstacles to expansion into the “new clean energy” in Saudi Arabia—notes that, “Nothing is everlasting, not even water” and urges people to investigate all types of alternative energies, even as the Saudis are.

An audience member asks about the best retrofit idea.  Mr. Hattem notes that the best innovation is not going to come from the technology, but from the users and the culture.  “Technology is there now.”  Mr. van Oostrom says that it is “all about business models” now; the technology is there and ready; have to convince current residents to do things.

Ms. Mumpuni notes that in the developing world, the people need the technology: lights for children to read, to be able to cook (see the Cookstoves Initiative announced on Day 2; for a dissenting view of that initiative—though not the idea that people need energy to cook—see this guest blog at Bill Easterly’s Aid Watchers).  In that context, people use energy as they need it, not because it is accidentally left on.

Mr. Holdren notes that about one-third of what we need to do in the next twenty years is such “low-hanging fruit” that we should be able to realize it.  Putting a full price on carbon emissions would reach the next third.  It is the final third—new innovations,

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Drawdown of Brigade Combat Teams in Europe…

by reader Ilsm

Consider GAO-100745R take on keeping 4 brigades home stationed in Germany and Italy:

In the Quadrennial Defense Review released in Feb 2010, the US Army decided to reverse the drawdown of Brigade Combat Teams and retain 2 brigades to retain the current order of battle of 4 brigades home stationed in Germany and Italy. This means that 30,000 soldiers will remain stationed in Germany, and that infrastructure improvements are required.

GAO recommends the Army delay infrastructure “investments” in Germany pending determining future forces stationed there in support of new NATO strategy plan due in Nov. 2010. The Warsaw Pact formally dissolved in July 1991. The Red Army began withdrawing in phases from forward deployments in the Warsaw Pact states in 1991. The phasing was required to accommodate Red Army forces returning to already stressed facilities in the Soviet Union. In many cases the Red Army demobilized forces as forward deployments ended.

GAO sees two issues to explore: the questionable “need” for the 4 Brigade Combat Teams and the Army’s determination of support requirements and consolidating stations and facilities to achieve costs savings.

The report includes the following:

“The Army estimates that, depending upon the assumptions used, it will potentially cost between $1 billion and $2 billion more from fiscal years 2012-2021 to keep the two brigades in Europe than it would cost to return them to the United States. DOD is reconsidering retaining the brigades in Europe in part because senior military officials in Europe have said that four brigade combat teams in Europe are needed to meet operational and mission requirements.”

What are these operational and mission requirements and why does the US Army keep 30,000 troops in Germany while the Bundeswehr is reducing its force structure from 250,000 to 163,000 by 2014? What of these missions require the 2 combat ready brigades and what is the need for 4? The Red Army, which is not in a high state of readiness, is on the other side of Poland and Hungary. NATO, includes the countries in between and these countries, should provide the bulk of forces for their independence.

Since 1999, NATO and the UN have forces deployed forces in Kosovo, termed KFOR consisting of around 10,000 soldiers plus supports. See here for more information. Once an occupation begins it is very hard to end, the US is 40% of NATO and the UN contribution should limit US troops far below 4,000, and these formations could be rotated from the Uniter States. Standing up a Kosovo Security Force seems to be a daunting open ended task. The US should seriously consider why it has any brigades in Germany much less keeping 4.

The second issue is facilities to house the 4 brigades. GAO finds inconsistencies with “quality of life” standards used to establish requirements for troop quarters, military family housing. It also questions savings from consolidations and suggest delay of building a US Army regional medical center at a projected construction cost of $1.2B. The medical center is a major hospital that provides primary care for more than 40,000 military personnel and 245,000 beneficiaries in the European Command. Interesting is the number of beneficiaries needing medical support in Germany. This is a result of the all volunteer force.

GAO conclusions: Plans for forces in NATO are uncertain and costs are likely understated, keeping the 2 brigades in Europe could cost $2B in the long term. DOD’s plans for reviewing U.S. global defense posture are unclear, but alternatives under consideration are limited. Inconsistent processes to develop facility requirements hampers validation of facility needs.

GAO Recommendations include:

1. Conduct a comprehensive analysis of alternatives for stationing forces in Europe. At a minimum, the review should be done as expeditiously as possible upon the completion of the North Atlantic Treaty Organization’s strategic concept announcement and consider the costs and benefits of a range of force structure and basing alternatives.

2. Develop a consistent process to determine specific facility requirements associated with the various options.

This audit reveals many of the issues with DoD investment decisions: the needs that form the objectives for planning force structure and forces are ill defined and often fraught with politics and prejudices of senior officials to maintain some preferred status quo ante. Also, once alternatives are developed analyses are not well formed and the resulting management decisions are neither effective against needs nor efficient to implement.

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Open Thread on Personal Stories of the Great Recession

by Linda Beale
crossposted with Ataxingmatter

Naked Capitalism’s Open Thread on Personal Stories of the Great Recession

Yves Smith opened a great comment thread on naked capitalism that anyone interested in the way this Great Recession has hit people across the US (and world) should read. It was triggered by the NBER analysis that the recession is over. Her question opens a thread for readers to comment on the recession from their own personal perspectives.

The comments address a range of perspectives, and consider whether the recession is over, what it has meant for them personnally or for their communities and what they see for the future. There are reports from Lansing (like Detroit, hit by white flight to the suburbs –I’ll add that in Detroit, it does gall to see all the suburbanites driving into Detroit to earn their pay at their jobs, then driving out again to spend it in their comfortable, mostly white, middle-class or above suburban communities, so that the dollars created because of Detroit don’t get spent to benefit Detroit at all), from Ohio with its loss of manufacturing, from upstate New York, where are more gradual and longer term slowdown meant that housing prices didn’t inflate as much and the economy stayed more stable, and from all other the country and abroad.

Politicians in Washington who don’t understand the impact of foreclosures, joblessness, and the sheer stress of worries about job security and the future should read the entire string, word for word. People whose job it is to apply economic theory to policy proposals should read it to help them understand how far divorced the mere fact of increasing GDP is from the well-being of ordinary Americans. Everybody should read these comments to better understand the variety of pain and distress that are affecting millions of our fellow Americans. And we all should start demanding more transparent and fact-based discussions of the economy and of processes that create jobs, so that the propaganda sound bites that are being used to determine the votes in this November’s election are at least modified to be closer to the truth and more relevant to the daily lives of ordinary Americans.

Readers, please jump in here or at Naked Capitalism and share your own views on this issue. What bothers you most about the way we as communities have dealt with the incredible impact on middle-class America? What has the recession meant for you personally, in terms of lifestyle and hopes for the future? Do you think it is “over” or do you think that we must adjust to a “new normal”?

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Rare earth supply and trade implications

Dan here…Lifted with permission from an e-mail from Tim Worstall, an expert in rare earth issues and resources, in response to my sending him the NYT article suggesting China was using rare earth resources as both a trade issue (notice NYT suggestion the pass on processed product versus raw material export)) and political leverage with Japan using their detention of a Chinese fisherman.

by Tim Worstall

In brief, the Chinese have just f**ked themselves over if the NYT take on the issue is accurate.

By showing that they’re willing to use RE supplies as a political lever they’ve just made them political for everyone else.

Thus there will be a political insistence that non-Chinese sources will be found.

It will make Mountain Pass’ environmental problems easier to overcome, make funding Mount Lynas easier. It’ll make it more likely that I’ll get my grant to extract REs from the wastes of alumina production (yes, it does work, we just don’t know whether it’s economic as yet, thus the grant).

Most importantly perhaps, it’ll make the politicians concentrate on what’s actually important here. REs aren’t rare but the ability to separate them is. There are any number of places around the world where I could scare up a few tens of thousands of tonnes of rare earth ores. Really, almost trivially simple.

However, separating them can take thousands (yes, really, thousands) of iterations of boiling them in hot acid. And when you’re done you’ve still got the thorium almost always associated with them to dispose of. So, politicians will have to accept that if they want windmills and electric cars then they’re going to have to allow people to play with boiling acids: and they’re going to have to find a repository for all that thorium (for it is radioactive, if only mildly so).

There is, other than the boiling acids thing, a possibility that we’ll go off and find another way of separating the rare earths. While there have been academic advances in this subject over the past 30 years there haven’t been any practical ones, no attempts to apply them. Why bother when China is doing it all for us? I could even tell you what one of the likely and useful methods to investigate is: but then I’d have to kill you as that’s the subject of my next grant application.

Finally, a political point. No, this doesn’t show that we must at all times maintain a domestic industry to do this or that for the fear that someone will start to play politics with our supply of this or that. We do have a few years ahead of some fairly serious amounts of money to be spent on getting RE supplies. But we’ve saved 30 years’ worth of subsidy, a far larger sum, by not maintaining a domestic industry until we needed to.

For almost all commodities, metals, foods and so on, there are so many alternative sources we could develop if we needed to that no one can actually, in anything other than the short term, control our access to them.

If Chile started to use tellurium supplies as a political weapon then I might get a little more worried: anything else I just don’t see it being possible. And it’s certainly not a serious medium or long term threat to anyone other than the Chinese RE producers themselves that China is playing politics with the supply. All they’ve done is increase the funding available through political channels for the creation of alternative sources of supply.

Sensible advice to China would have been that if you want to start behaving like a monopolist you’d better make sure that you actually are a monopolist first. And they aaren’t, not over any reasonable timescale.


(Dan…slightly edited for readability)

Update: h/t MG for the following links:

Alexis Madrigal provides an update on restarting U.S. production. Of course, it will take $500 million and perhaps as long as 15 years to put all production back in place.
Worried About China’s Monopoly on Rare Elements? Restart American Production
Sep 23 2010, 12:25 PM ET

In the U.S. House, there is the Rare Earths Supply-Chain Technology and Resources Transformation Act of 2010 or RESTART Act which was introduced in March 2010. No major action…yet.

H.R.4866 – RESTART Act

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Payroll Tax Cut

Labor cost as a share of business output is now at a post WW – II low. and has fallen about eight percentage points since 2000. This would suggest that the weak demand for labor does not stem from high labor cost. Actually since the third quarter of 2000 while labor cost as a share of total business cost has plunged, private payroll employment has also fallen from 111.2 million to 107.6 million in the second quarter of 2010. Yes, this data contradicts the theory taught in introductory economics.

But, if as this data series implies that weak employment is not because of high labor cost why should further cuts in labor cost via a cut in the payroll tax lead firms to hire more employees? I strongly suspect that those advocating cutting the payroll tax simply remember the theory they learned in their introductory economics class and have never actually looked at the data. If they had they would know that changes in the demand for labor and changes in labor compensation have a strong positive correlation. Of course this directly contradicts the theory they learned in introductory economics that labor demand is a downward sloping function of labor compensation. But remember, that theory is simply a massive over-simplification used to explain basic economic concepts to some teenagers. The theory assumes that all other things are constant and in reality that never really happens. In reality, the demand for labor is a function of many things of which labor compensation is only one factor and generally a relatively minor factor at that. In the real world the demand curve for labor is not a downward sloping function of compensation. Remember, when Alfred Marshall the great economist who did more to develop graphical analysis than anyone else was asked why he developed this approach his answer was,”so the gentlemen in the back row can understand what I’m talking about”.

Labor demand is a derived demand. Firms hire labor because they think they can profitably sell the goods and/or services the labor produces not because they derive some utility from hiring labor. Consequently, the dominant factor in the demand for labor is the firms perception of the demand for that firms output. Even if the cost of labor falls, firms still will not hire more labor to produce more output if the firms does not expect to sell the expanded output. Consequently, those claiming that cutting labor cost will induce firms to hire more labor are just spouting some ideological fantasy that has no basis in reality or even in advanced economic theory.

So what drives the demand for labor. If I want to forecast employment I make it a simple estimate of GDP less productivity. In this estimate labor cost does not play a enter the equation at all. In my experience labor costs is only important in the labor supply equation where higher labor payments induce individuals to enter the labor force.

In response to questions in the comments that if labor’s share fell, what rose, I’ve added this chart.
PS. The last time I published this chart it was of an index number that was derived by dividing one index number by another. So anyone could download the data from the BLS and reproduce it. But this chart is of the actual raw data that shows labor cost as an actual share of business output. BLS does not publish this raw data. Haver Analytics made special arrangements to get the raw data from the BLS so they could generate this data series. Consequently you will not be able to reproduce this data series from publicly available data.

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CGI, Day 3 – Addressing Cancer in the Developing World: Health Equity and an Overlooked Public Health Crisis

The panel is preceded by this video.

Dr. Sanjay Gupta (Chief Medical Correspondent, CNN) leads the panel, featuring:

Lant Pritchett’s old point notwithstanding, the reality has become that the “developing world” now originates 56% of the cases of cancer in the world, up from ca. 14% a decade ago.  (Actually, this somewhat presents evidence for Mr. Pritchett’s point about trade-offs; the developing world is now able to live long enough and well enough that death from cancer has become important.)

Dr. Gupta starts by celebrating that some cancers that were not able to be treated anywhere in the world are now treatable everywhere in the world.  But the developing world cannot afford treatments for some types of cancer to the level needed. Dr. Gupta is a Board member of Livestrong, and speaks about the way the organization—especially through the discipleship of Lance Armstrong—has changed the way many people think about cancer.

HRH Princess Mired notes that much of the progress in Jordan occurred after King Hussein himself went very public with his battle with cancer, putting a public face on the disease.  HRH Mired notes that since then, the major cancer treatment center—the King Hussein Cancer Center—now includes the word “cancer” in its name and provides access to consultations, information, and treatment for people who live near the center and those who can communicate with it through a regional center.

She notes that there are areas in which they would like to make progress in Jordan, such as establishing Cord Blood Banks, and other things that people in the developed world “take for granted.”

Dr. Gupta asks Dr. Paul Farmer to speak specifically about Haiti.  Dr. Farmer notes that there is one (1) oncologist in Haiti, and none in Rwanda or Burundi.  It is difficult to use preventive measures once one already has leukemia—but need to make that much more of an effort in prevention and early detection.  Dr. Farmer notes that cervical cancer is a communicable disease;  there is a “cervical cancer belt” in the developing world.  There is a vaccine, there are preventive care activities, and there are many other possibilities for reducing the rate of death from cervical cancer—it is delivery mechanisms and education that need to be provided. (Dr. Farmer notes, for instance, that Partners in Health teamed with Gardasil to provide vaccinations for young girls and women in Haiti.)

Next up is Dr. Charles-Patrick Almazor, who reaffirms that there is significant progress that has been made, and notes some of the “on the ground” successes in post-earthquake Haiti.

Felicia Knaul and Lance Armstrong join the group.

Dr.Gupta notes that Lance Armstrong came to CGI and announced that he would be racing again, primarily to extend the reach and successes of Livestrong.  Armstrong notes that he wasn’t worried so much about the idea of winning another Tour de France or any “knock on [his] legacy” as he was in extending the work of the Livestrong Foundation.  And he believes that the effort has paid off well in those terms.

Ms. Knaul (who has a Ph.D., and therefore might be more properly referred to as Dr. Knaul), whose original commitment was “enhancing and empowering women health care workers,” notes that breast cancer is now the #2 killer of young (ca. 30-54) women in Mexico and the developing world. Ms. Knaul is a breast cancer survivor herself, and notes that what is worse than “having to take it in the vein is not being able to because you don’t have enough money to be able to pay for it.”  (Note: Ms. Knaul’s last round of treatment was last Wednesday; technically, she is not yet “a cancer survivor.”) She moves on to speak of “other kinds of failures,” such as the women who do not get mammograms because they expect that their husband will leave them if they are diagnosed with breast cancer. In that context, the Commitment made yesterday to teaching men is most encouraging for her.

Ms. Knaul also notes that she was in the audience when Lance Armstrong announced his Commitment in 2008, and that she herself was inspired by his actions to expand her own efforts.

Dr. Gupta highlights a few people in the audience who are also working to reduce cancer, including John Noseworthy of the Mayo Clinic, who “established the Healthcare Alliance for Tobacco Dependence Treatment” to work to support realization of the WHO Framework Convention on Tobacco Control; Dr. Lawrence Shulman of Dana-Farber and Harvard, which is working in several of the developing areas; HRH Princess Ghida Talal, who is leading an effort to establish a “personalized medical center” at the King Hussein Medical Center; and Letha Sanderson of Uganda, the founder of Wrap Up Africa.

Dr. Gupta asks Dr. John Seffrin of the ACS to talk about the American Cancer Society’s efforts to reduce tobacco use in developing countries. Dr. Seffrin notes that cancer is becoming the #1 cause of death in the world “for the first time in all of history.”  Livestrong and the ACS published a study about a month ago, noting that the cost to the world is about $895 Billion per year, “not including health-care costs associated with the treatment of cancer.”  The economic burden of the top fifteen diseases shows clearly that cancer is far and away the worst.  And the spread of smoking tobacco has clearly exacerbated this in the developing world.  Killed 100 million people in the last century; will kill 1,000,000,000 in this century if there is no intervention.

The first question from the floor is about possibility of using of local herbs and natural

Fran Drescher, a CGI regular whose own commitment in this area can be found at the link,  follows, asking how we educate and motivate women to go from “My husband will leave me if I have cancer” to “What will happen to my family if I die of cancer?”  Princess Mired notes that taboos don’t come from nowhere; they come from ignorance. People start from the expectation that cancer is contagious, that prevention and early detection are not possible.  Need to have the information disseminated, and especially to work on the men to change both the social behavior.  In four years, they have reduced the rate of people in Stage 3 and Stage 4 cancer from 70% to 35% through an”early detection” program that was started after people started to see survivors. Need to show survivors.

Ms. Knaul notes that the mortality rate in Mexico from cervical cancer has gone from 16% to 8% in the past ten years—primarily because of earlier detection and treatment, but also because of improvements in the treatment itself.  She notes that this especially can be applied in the Developed World, where opportunities for research and

Jonathan Quick of Management Sciences for Health noted the parallel between treating cancer and treating AIDS in the developing world. In the case of AIDS, they got through the four “barriers”: (1) the mental barrier (“it can’t be done”), (2) the cost barrier (treatment costs reduced from $12,000 to $3,200), (3) the money barrier (addressed by a global fund), and (4) the “practicality barrier.”  Where are we with cancer?  Dr. Farmer notes that those four barriers have been overcome in many cities, but that rural areas still need all four barriers to be overcome.  “People who say “there is no market” are trying to stop a conversation, not start one.”  When you don’t know any survivors in your neighborhood, it’s more difficult to accept that one can survive.  (The examples of King Hussein and, especially, Lance Armstrong seem especially relevant.)

Dr. Gupta asks Lance Armstrong about Livestrong’s decision to “go global.”  Armstrong notes that they were responding to demand: discovered that the idea of Livestrong resonated in places such as Mexico and India.  It is left to Mr. Armstrong to note that cancer is such a diverse disease—“we talk about cancer—boom, six letters—but it’s different than that.”  It’s correct to be honest about it:we’re going to have to knock of this disease on type at a time.  We know the diseases we can cure today (testicular cancer, some lymphomas, cervical cancer and breast cancer with early detection).  “It’s not a simple three-page document, but it is doable.”

With straightforward chemotherapy approaches, have been able to cure kids with various sarcomas.  We do have to scale up the program.

Former HHS Secretary Donna Shalala asks about geography: having to travel reduces ability to treat rural cancer patients..  She notes that more than fifteen years ago, Egypt set up regional cancer centers and flew oncologists to those areas once a month—a great political and popular success. (There were also pay incentives for the oncologists, to cover the travel requirement.)

Ms. Knaul notes that. when you add the technologies available, you don’t necessarily have to move the patient or the doctors so much; St. Jude’s is able to offer pediatric cancer care in Jordan while the oncologist remains in Memphis.  Princess Mired re-emphasizes this, nothing that the Jordanian doctors have weekly “training sessions” with the doctors in Memphis.

Have to understand that cancer has potentially become the most curable of all diseases; could be saving 10,000 lives a day if could apply the advances in the United States alone to the rest of the world.

Lance Armstrong again takes it down to a human level:  if we teach a kid never to pick up a cigarette, we just “cured” cancer.  Need to re-emphasize sharing: information, resources, programs.

Ms. Knaul notes that there are some countries, such as Mexico, that are considering financing reform so that people have access to cancer treatment—a move that will strengthen the health care system itself.

Dr. Farmer talks about competition, competing for scarce resources.  Only a partnership will work.  Resources are less limited than at any other time in human history.  Cannot make the same mistake—contrasting prevention with care—that was made in the past.  One of the main causes of death is that people become destitute providing care.  Need for that not to happen.

Dr. Almazor presents optimism; Princess Mired notes that we cannot change our future without change.  “Cancer does not even appear as a line item on any Global Health Agenda.” All of the successes and survivors—AIDS, TB, etc.—have the specter of having to face cancer and heart disease.  She closes by noting that we need to measure the cost of cancer not in human deaths, but prefer to see hospitals and treatment centers that remedy the problem.

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Rand Paul’s History Lesson

Robert Waldmann

Republican candidate for Senator from Kentucky Rand Paul said
“In 1923, when they destroyed the currency, they elected Hitler. “

He’s off by a decade. Hitler was elected in 1933 not 1923. This is not just a slip or a typo. The German hyper-inflation ended in 1923. At the time Hitler was in jail having taken over a beer hall.

Paul wouldn’t have been twice as far off if he had written “In 1914 when they invaded a country that hadn’t attacked them, they elected Hitler.”

German democracy ended during the depression when sensible moderates decided that there was no fiscally sound way to fight unemployment.

This man could be a US Senator.

via Steve Benen

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CGI Day 3 – Harnessing Human Potential, or The Bush Family Extravaganza

The original schedule for this program was Riz Khan of Al Jazeera English moderating

  • Laura Bush, Former First Lady of the United States
  • Jack Ma, Chairman and Chief Executive Officer, Alibaba Group
  • Shakira Mebarak, Founder, The Barefoot Foundation
  • Rajendra Pawar, Founder and Chairman, NIIT Group

but Shakira was unable to attend, and was replaced by

  • Jenna Bush Hager, and
  • Barbara Bush

Mr.Khan opens with a joke about a policeman who pulls a woman over who is driving very slowly, having confused the Route sign (10) with the speed limit.  “Why do your passengers look so scared?”  “Oh, we just came off Route 120.”

Mrs. Bush starts by talking about how great things are for women “since the fall of the Taliban.”  Mentions one who has opened about forty schools in Afghanistan in cooperation with the U.S.-Afghan Women’s Council.

Jenna Hager speaks of girls who “escaped early marriage.” She’s very enthusiastic, but appears to have problems dealing with being on-camera with a microphone.  (What she lacks in presence she tries to make up in enthusiasm.)  She speaks about the need for education to address the problem, referring to her experience as a teacher. (My impression from her presentation was that she is currently teaching; Wikipedia’s mileage appears to vary; anyone know?)

Barbara Bush—who does not have her younger sister’s problem—notes that she worked at a children’s hospital in South Africa, and that one of her jobs was basically “staying with the babies” so that the mothers—who otherwise would have lost their jobs—could go back to work.  The story in itself tells us about the impediments to harnessing human potential, but those who have attended for the past two days know these tales well enough, and probably would have preferred hearing from someone at the Barefoot Foundation who could get into more specifics.

Jack Ma of the Alibaba Group, a for-profit enabler of small businesses, declares that we are entering “the century of the small,” and that small businesses create not just jobs but hopes.  (Given the relative success of “small businesses,” he may have that backwards.)  Hope is his theme; sees good things occurring when now that the worldwide Solvency Crisis is over.

Rajendra Pawar starts with a discussion of how Bhutan (“the world’s youngest democracy”; two years) has for the past thirty-plus years concentrated on GNH (Gross National Happiness), not GDP. This includes constitutionally limiting the destruction of forest area in the country, educating the leadership in creating opportunities, and expanding connectivity and computing (leveraging solar energy) to make the society more horizontal.

A question comes in regarding the opportunities in alternative energy. (Also discussed yesterday by Governor Jennifer Granholm.)  Jack Ma notes that people recognize the issue and the benefits of alternate-energy: he has polled workers in coal-intensive China and never yet found a person who does not know someone who has or had cancer. “This has become a skills issue” in much of the world. (The U.S. currently exports slightly over $1 billion worth of solar panels each year;; China produced almost twice as much revenue from solar panels two years previously.)

Khan asks Laura Bush (“I’m asking you, not your daughters”) whether there is a generational complaint.  Ms. Bush notes that her daughters and their friends are all enthusiastic about working with and helping the world.

Khan ends, as he began, with a joke.  I will spare people it, since it wasn’t even as funny as the one with which he opened.

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