USL20 Health Care Forecasts

Recently, the PBS News Hour interviewed a Primary Care Physician (here) to discuss problems in the US Healthcare System.

The summary of problems (from Google AI) suggests the following solutions to get control of the system:

To help understand the problems and difficulties, I ran four forecasts with the USL20HC Model (presented in the graph above). Both the Business-As-Usual (BAU) model and the USL203 Model as input** are unstable. Stabilizing (controlling) the BAUC model produces more moderate growth until after 2100.

Controlling specific parts of the system (Prices and Hospital Investment) without affecting Quality of Service will not be easy. Attempts to control Prices have failed (see Pasdirtz, 2007) largely for political reasons. ChatGPT notes:

A reduction in demand for Healthcare when the Baby Boomer Generation has aged out of the system might help. Until then, I do not see the political will necessary to change the system.

Notes

• Healthcare in the United States  largely provided by private sector healthcare facilities, and paid for by a combination of public programs, county indigent health care programs, private insurance, and out-of-pocket payments. The U.S. is the only developed country without a system of universal healthcare, with around 92% of the population covered under some kind of health insurance for some, or all of the year.
  
  
• The Affordable Care Act  formally the Patient Protection and Affordable Care Act (PPACA) and informally known as Obamacare, is a landmark U.S. federal statute enacted by the 111th United States Congress and signed into law by President Barack Obama on March 23, 2010. Together with amendments made to it by the Health Care and Education Reconciliation Act of 2010, it represents the U.S. healthcare system's most significant regulatory overhaul and expansion of coverage since the enactment of Medicare and Medicaid in 1965. Most of the act remains in effect.
  
  
• Medicare Sustainable Growth Rate a method used by the Centers for Medicare and Medicaid Services (CMS) in the United States to control spending by Medicare on physician services.

** The idea behind using the USL203 Model as input is to keep growth of the US Healthcare system in line with growth of the US Economy (see Pasdirtz, 2007).

Pasdirtz (2007) Controlling the US Healthcare System with Policy Wedges Springer Health.

For more of my posts about the US Healthcare system, see Blog Roll: Healthcare. For more information about how the State Space models were constructed and the data sources, see the Boiler Plate. You can run the USL20HC Model model yourself using the R-code on my Google Site.

USL20HC Measurement Model

The indicators above implement the basic Kaya Identity: N -> L -> Q -> K -> GDP.

Expanding the Kaya Identity to fit the US Healthcare system, we get the Directed Graph above.

Three components in the USL20HC State Space (computed using Principal Components Analysis, PCA) explain 99.80% of the variation in the indicators. HC1 is the Hospital-Growth Controller. HC2 is Output Controller and HC3 is the investment controller.

Using the Expanded Kaya Identity (above) chatGPT suggests controlling the US Healthcare system by direct interventional in the following indicators: Capping Prices, Controlling Investment and limiting Hospital Consolidation. Healthcare labor and insured population would depend on the growth limits imposed. Direct intervention would allow direct control of growth rates.

USL20HC BAU Model System Matrix

The USL20HC Model has two unstable components, HC1= (Hospital-Growth Controller) and HC3 = (Investment Controller).

USL20HC BAUC Model System Matrix

Notice that stabilizing the USL20HC Model model turns the HC1 = (Hospital-Growth Controller) into a Random Walk while HC3 = (Investment Controller) requires a reduced growth rate.

 

Should Canada Join the EU?

 

INDIA: The New Axis of Evil and Hardship

 

In a prior posts (here and here), I looked at the Geopolitical Effects on Hardship as a result of India's "Cockroach" Protests and the possibility of a New Axis of Evil forming involving Russia, China and India. In this post, I'll explore the effects of potential alliances between China, Russia and India on Hardship in India.

Notes

• The Axis of Evil   The term "axis of evil" is a reference to the Axis powers of World War II (Nazi Germany, Fascist Italy, and the Empire of Japan). An updated grouping consisting of China, Russia, Iran and North Korea, also known as CRINK, has been referred to as the "new axis of evil" by U.S. politicians and commentators, sometimes includes India.
• The New axis of Evil: Russia, China and India? 
• INDIA: Hardship and Protest
• MSN Two Decades of Mass Protests in India
• MSN India's Cockroach Protests called off
• CNN Why Political Fury is Boiling Over on the Streets of India's Capital 
• Economy of India a developing mixed economy with a notable public sector in strategic sectors.
• History of India Anatomically modern humans are estimated to have first arrived on the Indian subcontinent between 73,000 and 55,000 years ago.
• Politics of India  India is a parliamentary secular democratic republic, described as a “sovereign, socialist, secular democratic republic” in its constitution.
• Geography of India  On the south, India projects into and is bounded by the Indian Ocean—in particular, by the Arabian Sea on the west, the Lakshadweep Sea to the southwest, the Bay of Bengal on the east, and the Indian Ocean proper to the south.
• 2026 Delhi Jantar Mantar protests also referred to as the Indian Gen Z protests and the Cockroach protests, were a series of demonstrations initiated on 6 June 2026 by the Cockroach Janta Party (CJP), an Indian youth-based satirical political movement, alongside student organizations including the All India Students Federation, All India Students Association, and Students Federation of India.
• AIC Statistics The Akaike information criterion (AIC) is an estimator of prediction error and thereby relative quality of statistical models for a given set of data.
• Shefner et. al.  (2015) Austerity and Anti-Systemic Protest: Bringing Hardships Back In JWSR
• Globalization in India The goods produced in India had long been exported to far off destinations across the world; the concept of globalization is hardly new to India.



INL20 Hardship Measurement Model










HARD1 =  (Growth - mortality and longterm unemployment ),  HARD2: Unemployment and poverty, HARD3 = Business cycle, Unemployment and reduction in CPI.  From the World Development Indicators.

HARD1 CN-RU-BAU-RW AIC STATISTICS

The best short-term model, using the AIC Statistics, is the Random Walk (RW). 

IN CN-INPUT HARD1 MODEL

Hardship and Protest in India

India has had two decades of mass protest culminating in the 2026 Delhi Jantar Mantar protests or "Cockroach Protests". My questions are  (1) how much of the protests are a result of material conditions (Hardship) and (2) What possible response might the government consider in the face of discontent?

My Hardship Index (HARD1) for India has been increasing since the 1960s (see the graphic above). The Business-as-Usual forecast (BAU) suggests that, even though the model is stable (see below), Hardship will increase linearly until well after 2100--not a desirable outcome.

Linking India Geopolitically with the United States would result in a Hardship peak around 2040 and decline after that. Future increases in Hardship before the decline might or might not be sustainable politically.

Linking India Geopolitically to the World System keeps Hardship steady until after 2040 when it starts decreasing. This would be the best outcome but the most difficult to achieve politically (I will explore the difficulty of linking to the World System more fully in future posts).

Of course, India can keep muddling through, randomly responding to Protests (a Random Walk, RW) and hope that  protesters will retreat from the streets, pushing problems off into the future at the current level of Hardship. 

For more of my posts on India see Blog Roll: India. The WL20 India Model in R-Code is available on my Google site. INL20 BAU is an example of a moving equilibrium model that can both easily be stabilized or destabilized. Also, see the About page and the Boiler Plate.

 Notes

• MSN Two Decades of Mass Protests in India
• MSN India's Cockroach Protests called off
• CNN Why Political Fury is Boiling Over on the Streets of India's Capital 
• Economy of India a developing mixed economy with a notable public sector in strategic sectors.
• History of India Anatomically modern humans are estimated to have first arrived on the Indian subcontinent between 73,000 and 55,000 years ago.
• Politics of India  India is a parliamentary secular democratic republic, described as a “sovereign, socialist, secular democratic republic” in its constitution.
• Geography of India  On the south, India projects into and is bounded by the Indian Ocean—in particular, by the Arabian Sea on the west, the Lakshadweep Sea to the southwest, the Bay of Bengal on the east, and the Indian Ocean proper to the south.
• 2026 Delhi Jantar Mantar protests also referred to as the Indian Gen Z protests and the Cockroach protests, were a series of demonstrations initiated on 6 June 2026 by the Cockroach Janta Party (CJP), an Indian youth-based satirical political movement, alongside student organizations including the All India Students Federation, All India Students Association, and Students Federation of India.
• AIC Statistics The Akaike information criterion (AIC) is an estimator of prediction error and thereby relative quality of statistical models for a given set of data.
• Shefner et. al.  (2015) Austerity and Anti-Systemic Protest: Bringing Hardships Back In JWSR
• Globalization in India The goods produced in India had long been exported to far off destinations across the world; the concept of globalization is hardly new to India.

INL20 Hardship Measurement Model

HARD1 =  (Growth - mortality and longterm unemployment ),  HARD2: Unemployment and poverty, HARD3 = Business cycle, Unemployment and reduction in CPI.  From the World Development Indicators.

INL20 HARD1 AIC STATISTICS

Best model is W-input.

INL20 HARD1 W-INPUT MODEL

The model is stable. Commodity Markets have the biggest negative impact on Hardship.

WL20 MEASUREMENT MODEL

W1 = (Growth-LP), W2 = (LP+P.Wheat-TEMP), W3 = (Commodity Markets).

Austerity Forecasts for the UK (1980-2060)

The AUST index (see the details below) captures a number of issues of importance in UK Politics: (1) Increasing military expenditures to meet Russian Challenges and US withdrawals from NATO, (2) Increasing Health Expenditures to upgrade the National Health Service (NHS) and at the same time, (4) Not reducing Education Expenditures and (5) Not increasing overall Government expenditures.

Notes

• Shefner, 2015 here and here Austerity and Anti-Systemic Protest, JWSR.
  
  
  

UK AUST Measurement Model

The AUST index has three components that explain 96% of the variation in the indicators. AUST1 = (Overall Growth), AUST2 = (GE+G+GE-GH) and AUTS3 = (G+GM-GE-GH) where GE=(Government Education), G=(Total Government), GE=(Government Eduction), GH=(Government Health) and (GM=Government Military).

Overtime, AUST1 increased and reached a asymptote around 2010, AUST2 peaked in 1975 and 2010 and AUST3 increased from 1975 until 2000 and then started increasing again after 2010.

UK AUST1 AICs

The best AUST1 model takes the W-index as input.

UK AUST1 W Input Model

The AUST1 W-Input model is stable with negative effects from W3 (World Commodity Markets).

Over time

W3 peaks around 1980 and increases again after 2010.

Hardship Forecasts for the United Kingdom (1980-2060)

Notes

UKL20 HARD Measurement Model

UK1 AIC Statistics

 

UKL20: Shrinking the Financial Sector (1980-2060)

 

A 2026 change in political leadership in the United Kingdom (UK) triggered by a no-confidence vote, brings up the issue of what policies might be expected from the new Labor Government, potentially headed by Andy Burnham, champion of the Green New Deal UK. One of the core goals of the Green New Deal UK (see Notes below), based on analogies to the 1930s New Deal in the US, is to restructure the UK Financial Sector.

In this post, I am going to present an index of UK Financialization (FINZ) and how it might be affected by various Geopolitical Alignments as a result of Brexit, Britain leaving the European Union (EU).

The graphic above shows five possible Geopolitical Alignments and how they might affect the FINZ1 index (see Notes below, the growth component). Business-as-Usual (BAU) creates unlimited growth in the Financial Sector while other alignments (a Random Walk, RW, the US, the World System, W, and the EU) stabilize or contract the Financial Sector. The biggest contraction comes from alignment with the EU, which may have been another motivation for Brexit.

As a result of Brexit, the UK now has the opportunity to stabilize the Financial Sector by regulation Capital-Asset Ratios, Nonperforming loans and Commercial Banking growth. Whether it can redirect investment toward Green Energy Deployment is hard to predict. Although the UK has been every successful reducing CO2 Emissions; investments in dirty energy projects will not be very attractive.

Notes

• A Green New Deal First Report of the Green new Deal Group
• Stern Review (2006): The Economics of Climate Change
• The Global Justice Report A plan for equality and prosperity within Planetary boundaries.
• Institute for New Economic Thinking UK economists and thinkers from a range of disciplines who challenge conventional wisdom and advance ideas to better serve society.

UKL20 FINZ Indicator Codes

UKL20 FINZ Measurement Model

The components explain 96.7% of the variation in the indicators. FINZ1=(CommercialBanking-BankCapital-LiquidReserves). FINZ2=(BankCapital-NonperformingLoans), FINZ3=(Growth).

Historically, FINZ1 (Banking Capital and Liquid Reserves) was in balance until after 1975 as the period of Neoliberalism started. FINZ2 (BankCapital-NonperformingLoans) came into balance after 1965. FINZ3 (Overall Growth) was cyclical throughout the late 20th Century.

UKL20 FINZ1 AIC Statistics

UKL20 FINZ1 EU Model

UKL20 FINZ1 US Model

UKL20 FINZ1 UK Model

UKL20 FINZ1 BAU Model

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