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The Internet has had disruptive effects on how scientific research is conducted, how education is delivered and knowledge transmitted, how health services are provided, and how individuals and organizations communicate and do business. We postulate that the emergence of the Internet, and in particular the rise of commercial transactions conducted over the Internet (e-commerce), is having a major disruptive effect on biological arms control. The project we conducted, as reported in this paper, aims to support our supposition. The current approach to prevent the proliferation of biological weapons development relies heavily on the existence of effective export controls for equipment particularly suitable for use in the production or dissemination of biological agents. The Australia Group (AG), an informal forum that brings together 41 countries and the European Union, seeks to harmonize national export controls on such equipment. We state our concern that the rise in biotechnology e-commerce will significantly disrupt the effectiveness of current efforts undertaken by AG participants. As we make clear in this paper, we are concerned with the emergence of e-commerce in dual-use equipment; i.e., equipment that is useable for the production, processing, and dissemination of biological agents. Our primary focus is on equipment listed on the AG's Dual-use Biological Equipment and Related Technology and Software list (AG Biological List for short), which are referred hereafter as AG-grade items. We investigated the extent to which AG-grade items from eight equipment categories are available from Internet vendors. These categories are: Fermenters; Centrifugal separators; Cross (tangential) flow filtration equipment; Freeze-drying equipment; Spray-drying equipment; Protective and containment equipment; Aerosol inhalation chambers; and Spraying or fogging systems and components therefor. Our research depended largely on tracking down vendors of AG-grade items on the Internet and investigating their wares and business tactics. We focused on vendors headquartered in non-AG participating countries, such as China, India, and Russia. Our searches found AG-grade equipment from at least seven out of these nine categories offered for sale online. Our analysis of the information provided by vendors on their websites found that a significant proportion of them were particularly vulnerable to proliferator exploitation. These typically were small firms with limited resources, facing significant competition, and offering transactions of single units (for example, a single fermenter, or a single Class III biosafety cabinet, etc.). We found no indication that the vendors in question are cognizant that they are offering to sell AG-grade equipment; i.e., that their offered product has the potential to be misused for BW applications. At the same time, we emphasize that we do not allege that any of the vendors we name in this paper are involved in illicit activities. Since vendors did not disclose information about their export policies on their websites, we attempted to contact several AG-grade equipment vendors with questions about their export policies. We had no success; i.e., none replied to our queries. All AG-grade items are inherently dual-use, with both legitimate and illicit end uses. A biotechnology equipment order intended for a biological warfare (BW) program can therefore appear identical to an order going to a legitimate end user. Transactions serving BW programs can be carried out openly, in effect hiding in plain sight amongst lawful transactions. Compounding these issues, we found that online vendors routinely offered payment options that could be utilized by unscrupulous buyers to hide their identities and to launder funds. In the course of the project, we found that a host of new biotechnology innovations had emerged in the last ten or more years that potentially have BW-related applications and are being offered for sale by vendors on the Internet. Of the newly emerged technologies, we are particularly concerned about the dual-use applications of algae photobioreactors, freeze-dryer gas sterilization upgrade kits, hand-held aerosol generators, DNA kits, synthetic biology kits, and 3D bioprinters. These technologies are not listed by the AG, although we believe that they should be to some degree. We have included a brief overview of these technologies and documented their online availability to facilitate discussion on this issue. Thanks to the Internet, we found it relatively easy to gather large amounts of information about vendors that was useful for comparing the many offerings of dual-use items. We assume that would-be proliferators would be similarly able to conduct Internet searches that would allow them to rapidly discover and instantaneously contact large numbers of AG-grade item vendors. We fear that the availability of these items, as well as the characteristics of the AG-grade equipment vendors, poses a significant challenge to all states attempting to preempt, identify, or interdict purchases by would-be proliferators. To highlight the combined disruptive impact of the new trends in international business, we compare how Iraq's BW procurement network operated in the 1970s and 1980s with how a modern-day proliferator could use the Internet to acquire the equipment necessary for instituting a modern BW program. Finally, we offer a number of recommendations for participating AG states. These include: suggested outreach efforts to online sales companies; suggested ways of ensuring e-commerce industry input is heard; means to improve the monitoring of online biotechnology equipment offers and sales; and a new process for updating the AG biotechnology list. These suggestions have the potential to alleviate, albeit not solve, the problems raised in this paper. [ABSTRACT FROM AUTHOR]

The article highlights key points in a discussion paper about the access of Americans to affordable health care coverage, released by the Hamilton Project, Gerard Anderson and Hugh Waters. The paper is guided by the principle that a practical and feasible reform for universal coverage should minimize disruptions and costs. The proposal also extends Medicare to all Americans who do not have other public or private insurance.

The article focuses on the increasing challenges in preventable diseases. It mentions that the costs for acute illnesses is being affected by disease prevention gaps. It states that the failure to make prevention and primary care accessible also contributes to high rates of utilization of emergency rooms for preventable problems.

The article presents an update on the blockchain bitcoin and cryptocurrency industry as of August 14, 2017. The segregated witness (SegWit) solution to bitcoin scaling issue was launched on August 9. A blockchain technology for better healthcare access will be piloted by the Medical Society of Delaware in partnership with healthcare services firm Medscient. The National Bank of Ukraine is planning to discuss cryptocurrency regulation.

Blankstone Sington will roll out the Client Portal to all of their clients and intermediaries [ABSTRACT FROM AUTHOR]

Archived report. Medicine will change from its current reactive mode, in which doctors wait for people to get sick, to a mode that is far more preventive and rational and is known as P4 medicine, a system that is Predictive, Personalized, Preventive, and Participatory. P4 medicine will have a big impact on many industries, including pharmaceuticals, food and insurance, as well as health care. Research will also have to change because diseases such as diabetes, cancer, heart disease, obesity and Alzheimer's are so complex, the traditional approaches to studying them have had only marginal results. Powerful new systems approaches, individual measurements and computational technologies will transform our ability to deal with complexity and fashion new drugs and approaches for therapy and prevention. Groundbreaking e-health and m-health projects are underway around the world, ranging from simple tools to monitor fitness, to important devices with potentially life-saving applications. Aged care services are at the forefront of developments. The following report provides information on interesting e-health and m-health projects and initiatives from around the world. In a separate BuddeComm report we explore the reasons the world need to move towards a healthcare system which fully supports a future based on e-health, see Global Digital Economy - E-Health and M-Health - Insights, Stats and Analysis. [ABSTRACT FROM AUTHOR]

Medicare law specifies a formula for calculating the annual update in payments for physicians' services. The formula resulted in an actual negative update in payments per service for 2002. Additional reductions were slated to go into effect again beginning in 2003; however, congressional action has prevented these reductions for 2003-June 30, 2008. Many Members have been concerned about the impact of potential payment reductions on patients' access to services. Medicare payments for services of physicians and certain nonphysician practitioners are made on the basis of a fee schedule. The fee schedule, in place since 1992, is intended to relate payments for a given service to the actual resources used in providing that service. Payments under the fee schedule were estimated at $56.4 billion in FY2008 (about 12.5% of total benefit payments, including those made under the new prescription drug program). The fee schedule assigns relative values to services that reflect physician work (i.e., the time, skill, and intensity it takes to provide the service), practice expenses, and malpractice costs. The relative values are adjusted for geographic variations in costs. The adjusted relative values are then converted into a dollar payment amount by a conversion factor. The conversion factor for the first half of 2008 is $38.0870, 0.5% above the 2007 level. The fee schedule places a limit on payment per service but not on the overall volume of services. The formula for calculating the annual update to the conversion factor responds to changes in volume. If the overall volume of services increases, the update is lower; if the overall volume is reduced, the update is higher. The intent of the formula is to place a restraint on overall increases in Medicare spending for physicians' services. Several factors enter into the calculation. These include (1) the Medicare economic index (MEI), which measures inflation in the inputs needed to produce physicians' services; (2) the sustainable growth rate (SGR), which is essentially a target for Medicare spending growth for physicians' services; and (3) an adjustment that modifies the update, which would otherwise be allowed by the MEI, to bring spending in line with the SGR target. The SGR target is not a limit on expenditures. Rather, the fee schedule update reflects the success or failure in meeting the target. If expenditures exceed the target, the update for a future year is reduced. This is what occurred for 2002. It was also slated to occur in subsequent years; however, legislation has prevented this from occurring through June 2008. By law, the conversion factor was slated to be cut 10.6% on July 1, 2008. On June 24, 2008, the House passed H.R. 6331, the Medicare Improvements for Patients and Providers Act of 2008. This legislation would freeze physician fees at the June 2008 level until January 2009. In January 2009, the fees would increase by 1.1%. On June 26, 2008, the Senate failed to invoke cloture on a move to consider H.R. 6331. Senator Reid has stated that the Senate will be given an additional chance to consider the measure shortly after Congress returns on July 7, 2008. In the interim, the Centers for Medicare and Medicaid Services (CMS) announced plans to instruct its contractors not to process any physician and non-physician practitioner claims for the first 10 business days of July; this is in accordance with current law requirements. This report will be updated as events warrant. [ABSTRACT FROM AUTHOR]