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The Dean of Harvard Medical School says the Health Reform bill gets an "F" grade. He say its disingenuous to call this reform, and Congressmen and the White House are deceiving the public if they attempt to pass this off as reform. What it will do is accelerate health care spending in the US, and the bill has simply postponed most of the major health care problems, especially the ones that drive cost including the fee for service system and delivery of health care.There are no substantial efforts to control the growth in health care costs or improve the quality of care, which makes this effort unacceptable as reform. In his discussions with other health care leaders and economists, Dean Jeffrey Flier, says he has found the opinion unanimous on this point, that whatever the final legislation looks like in Congress, it will only serve to accelerate health care spending rather than contain it. On the present system's failings he is explicit- the current system he says promotes fragmented care making it difficult to assess outcomes, the true costs of care are disguised, and competition based on price and quality is made impossible. The new legislation while expanding access to coverage makes a terrible tradeoff of an accelerated crisis of health care costs and merely continues the current dysfunctional system. The experience of Massachusetts, where access to care was expanded but spending went up, is that this won't work. He points to the Special Commission on Health Care Payment System in Massachusetts recommendation, that the health care system there must be changed from a fee for service system to one with "capitated" payments. So what is really disingenuous about this whole affair? Congressmen making it look as if reform has happened and congratulating themselves on increasing access to health care, when many of the serious problems of funding health care, skyrocketing costs, and a dysfunctional system, have only been kicked further down the road for some future legislators to tackle. With the national debt about 12 trillon dollars when this plan is factored in, this is cause for serious concern. ...

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The U.S. plans to join the EU's WTO complaint over Russia's recycling fee for automobile imports which does not apply to domestically manufactured cars. EU officials say the levy has cut the imports of European automobiles into Russia by 7%. The levy was imposed for five years following Russia's admission into the WTO and is seen as unfairly discriminating against imported cars. Russian automobile sales reached 2,935,000 in 2012, increasing by 11% over 2011. Sales are estimated at 2.8 millon by the AEB trade group for 2013. All ten of the leading models by sales for 2012 were Russian domestically manufactured automobiles. The case goes before the WTO in July 2013.

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This is an interview with Columbia University economic historian Adam Tooze about the international trade and economic issues brought about by globalization. The rapid emergence of China in manufacturing and overcapacity in steel has led to action on steel tariffs by president Trump. Tooze is typical of opinion that sees action by Trump not as limited action to level the playing field  as proposed by Trade Representative for the U.S., Robert Lighthizer, but as reckless move on trade.  Lyrarc.com shows articles from the WSJ and NYT showing how opinion got to this point in the U.S., on Robert Lighthizer's views that the U.S. was not facing a level playing field, and  on how trade has hurt communities across the U.S. a long distance away from Silicon Valley. President Trump's views reflect a different perspective that says the U.S. has to balance the favorable situation obtained by China and the European Union through moves of its own to protect U.S. interests. Political commentary that the U.S. was starting a trade war is not supported by the facts showing China's response as muted and a willingness by China to negotiate a balanced trading relationship as its trade surplus with the U.S. continues to grow. The trade surplus is so large that the Trump moves do not tell the real story. They are likely to be overshadowed by the increasing value of the U.S. dollar leading to a continued favorable situation for Chinese exports and a larger trade surplus in 2018, regardless of Mr. Trump's action.  Trump's moves are more significant in other areas- limiting China's access to advanced technologies, with the European Union also taking the same action. This is now the new field of competition for the major world economies. ...

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Bret Stephens articulates an idea presented earlier by Robert Kagan, Walter Mead and others, about the world of western liberal democracies needing the U.S. as a leader. He points out that the policies of U.S. president Bush committed the U.S. to activist policies worldwide following 9/11 terrorist attacks, followed by a backlash in the form of president Obama's policies that have reversed these policies to the other extreme leaving entire regional neighborhoods such as the Middle East to unravel, and undoing the very gains made under Bush at so much cost. Stephens says the "broken windows" theory for keeping streets in cities safe -by regular patrolling and making sure broken windows or other appearences of disorder and breakdown do not send the wrong signals to passersby and those with inclination to break the law- has application and lessons for America in the regional neighborhoods of Asia and Eastern Europe.

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In the light of the Irish No vote to the Lisbon treaty for a closer political union in the EU region, and the response from from propornents of the Lisbon treaty that this would delay the process of extension of the EU towards the parts of Eastern Europe still outside the EU, what does this mean for these countries that are looking to join the EU at some point? A new World Bank study says the future for countries that remain outside the EU does not look good. Lack of competition and contacts with the outside world keeps productivity low, poor education systems and an ageing work force, and millions of people in backward regions being left out. An economist at Poland's biggest bank sees closer ties to the eastern countries outside the EU including opening up their labor markets and free trade in goods and services as a way of reinforcing the Eastern partnership that Poland and Sweden and the Czech Republic have supported for closer ties to the EU with Ukraine and other Eastern European countries outside the EU. This means bringing some of the same benefits that have helped integrate Poland into the EU....

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In an effort to normalize trade relations Pakistan's government plans to move forward with a step by step approach that will end the restrictions on Indian imports by Jan 1, 2013. The first step is ending a system that allows a list of 2000 import items from India and replacing it with a list of 600 items from India that are banned, allowing the flow of all other goods. This negative list will be eliminated by the end of 2012 leaving in place restrictions on sensitive defense items and some staple goods. Ashfaque Khan, dean of Pakistan's National University of Sciences and Technology Business School advises the government on trade issues. The trade between India and Pakistan stands at $2.7 billion for the year ending March 2011. This is much smaller than the $60 billion in trade between India and China which is growing. The trade between India and Pakistan is likely to grow significantly in the next ten years as trade barriers are removed and normal trade is established.

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Pakistan prime minister Nawas Sharif's friendly overtures to India. The need for improved trade and economic relations with India to improve Pakistan's economy and fears that the military and intelligence services or extremist groups could torpedo these efforts.

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Freeman contrasts the speeches given by Obama and Trump, one in Cairo after becoming president, and the other in Riyadh. Freeman says Obama did not give enough credit to American leadership and progress on women's rights, and was not critical of Iran during a period in which sectarian strife has led to the situation in Syria and Iraq. 

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Among the things that make the U.S. different from Britain, that Roberts does not mention, is the character of the U.S. as a nation of immigrants. As true today as it was for millions who came to these shores from Ellis Island at the turn of the century. This makes for a much more adaptable society with different strains of thinking. Another point that makes the U.S. different is that it has striven to be an anticolonial power in its policies- working to ease the transition to independence of countries in the former French and British empires. The U.S. business and economic system has worked to bring development and economic progress in all parts of the world, as a partner in contrast to a colonial power. In this sense the U.S. has a very different character and a different capability for renewal than the empires of an earlier period- and new basis for belief in itself renewable from period to period.

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A lost sense of moral purpose for the U.S. Presidency during the Obama years, ironically from a president who was eloquent in his writings about the rights of minorities and people struggling for basic rights everywhere. He wrote years ago that words written two hundred years earlier had to mean something, that the words made their claim on the community called America. The questions he raised have not gone away by being ignored during the presidency.