Tom's blog - october 2015


Although we don’t have a say in the matter, it is of some importance to the rest of the world who becomes President of the United States.  And what strikes me most forcibly as an outside observer right now (ignoring the antics of Donald Trump) is that Mrs Clinton has gone from being a front runner to finding herself on the back foot, caught in a blizzard of  spite – a lot of Americans seem to seriously dislike her.

I beg to differ. For me I always thought she was always a better bet than the present incumbent. She had spent years in the White House, observing its modus operandi  at close quarters, and was we assume party to many of its deepest secrets. On a personal level she had been the victim of serial infidelity on a scale which while unpleasant and unfortunate, must have been extremely character forming.

Eight years on, she has added to her experience as a senior Senator a deep understanding of foreign affairs, as Secretary of State. Even part of all this leaves the competition standing. The fact that she may be appear arrogant and high handed is frankly irrelevant: if you are hiring someone to deal with  the likes of Vladimir Putin, you do not choose a shrinking violet.

Call me old fashioned, but in our precarious world, I am also attracted to the idea of the US nuclear button being under the finger of a woman and mother.

On a related topic, a prominent US political blog recently quoted Mrs Clinton as saying that a priority policy of her administration would be to intervene to control drug prices, one assumes an old hobbyhorse from her doomed attempt to reform healthcare. As members will be aware, we launched our iFHP Expert Panel on High Cost Drugs with this possibility in mind: with pressure mounting in the US to restrain pharma margins, we may very likely see  attempts at a compensating rise in (often far lower) drug prices in non-US markets.

In support of the need for action the author cited various charts from our latest iFHP Health Price Survey, part of which demonstrated the unwarranted and often significant drug price inequalities between the US and the rest of the world. This was gratifying – we hope to launchanother survey very soon.    

The Mayor of London, the buffoonish but brilliant Boris Johnson, recently returned from a trade mission to Japan. Among his various wacky utterances I was struck by the following.  First, there are more pet dogs in Japan than children under 15. Second, more nappies (diapers in US speak) are sold for use by elderly people than for babies. These two facts illustrate what some readers may already know, that while Japan is a very successful and industrious nation, it faces a stark population crisis. Overall numbers are rapidly declining, just as the average age is rising.

What has this got to do with the rest of us? The Japanese problem of finding younger people willing and able to take care of the elderly, whether in hospital or at home, affects all of us to varying degrees. It will be very interesting to see how Japan (which also runs a tight immigration policy)  deals with this in the years to come. Most advanced countries are doing little or nothing to face up to the challenge – we may be able to learn some lessons.