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Peter Orszag's role in the healthcare debate and the formulation of health care policy proposals. One proposal of Orszag, who heads the Congressional Budget Office, is to set up a new agency with powers to cut spending and implement changes in Medicare. Says Orszag, "one of the reasons we have such disjointed and skewed incentives is that we have an excessively political process." At a recent meeting with House Democrats, one Congresswoman said her top priority is winning higher payments for oxygen suppliers, and Orszag was taken aback. For years officials have been trying to cut payments to oxygen and medical equipment suppliers, which are said to be inflated. When a new competitive bidding process was set to take effect last year, industry supporters in Congress were able to delay the plan, and these supporters are still fighting to block changes says the WSJ. Here is a 40 year old Orszag, with degrees from Princeton and London School of Economics, who got his early experience in the Clinton adminstration at age 24. He then followed this with a number of policy oriented jobs, ending with appointment to head CBO in 2007. And he faces the whole system of Congressmen from both parties beholden to interests in the healthcare industry, who provide the donations for them to finance their election campaigns. Dan Eggen describes this in the Washington Post, 7/21/2009. Max Baucus of Montana, and to some extent Grassley of Iowa, are senators from both parties who Eggen points out are beholden to the healthcare industry because of large donations they receive from the interests in the healthcare industry. These interests want to see their payments system protected. The further escalation in health care costs, which would make the whole healthcare system unaffordable even as it delivers poor results, can only be prevented by making cost control an exercize that is not influenced by healthcare industry donations. Jackie Calmes describes the huge hurdles in achieving a deficit neutral move to universal health care in the U.S. in the NYT 6/26/2009. See the link. The exchange between Grassley and Orszag on the issue of the $177 billion in savings needed from the payments to health insurers under the Medicare managed care plans- which allow seniors to obtain Medicare coverage outside the government run program -went as follows. These are dubbed overpayments by outside experts and efforts have been made to cut them in Congress. When Mr Grassley raised concerns about the impact of such cuts in a hearing, -and Grassley has opposed the cut for this overpayment to insurers- Orszag responded saying: "I very firmly believe that capitalism is not founded on excessively high subsidies to private firms. This is what this system delivers right now." ...

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Barney Frank, of the Dodd-Frank Wall Street Reform and Consumer Protection Act, is interviewed by the New York Times one year after the passage of the legislation. He says we did not punt anything, it was because the legislators couldn't get everything right that they set up the provision for extensive rule making. He would rather forget financial matters as they are not his strong point, he has learnt more about repos and derivatives than he ever wanted. Critics have pointed to the extensive rule making delegated to regulators in Dodd Frank as a major weakness. It makes Dodd-Frank as effective as the regulators want it to be, something that goes back to an earlier period before 2008 when lack of regulatory discipline led to the financial crisis. He gives the regulatory agencies CFTC and the S.E.C. good grades for writing some of the rules because of the difficult conditions they face. His main fear is the stalling by Republicans in Congress and efforts to weaken the law by crimping resources for the agencies. And he fears the Republicans with support from the banking industry see the 2012 presidential elections as an opportunity to reverse the legislation....

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The relationship from college years at Amherst College in the U.S. of Greek political leaders Antonis Samaras and George Papandreou. The efforts to setup a national unity government that failed. The increasing support for the opposition New Democracy Party led by Samaras- with 16% unemployment- and the prospect of new elections. Samaras supports spending cuts. He also favors tax cuts, and a flat tax rate of 15% on business. Greece has a long history of tax evasion and distrust of central authority going back to centuries of Turkish rule. Samaras believes that the lower tax rate of 15% would help change the Greek cultural trait of evading taxes becaue it would be on the honor of people to pay such a basic tax. EU leaders are skeptical that lower taxes are the right policy to reduce the deficit. This adds to the political uncertainty as the new government would have to implement the measures agreed to between the current Greek government and the EU leaders. A similiar situation existed in Portugal but the recent elections there, participation of the opposition party in talks, and the newly elected government conducting its own negotiations, has removed that element of uncertainty which exists in Greece. ...

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Walt Mossberg, who writes the Wall Street Journal's consumer technology review section, watched Steve Jobs up-close over the years since 1997. They met one-on-one for product introductions, long discussions about the industry, and recently after Jobs illness, at his home in Palo Alto. Mossberg describes a long walk to a nearby park after Jobs had undergone a liver transplant. It provided an insight into the man Steve Jobs was. Persistent- he called Mossberg for 4-5 straight weekends during the dark days of 1997-1998 to convey his vision of Apple products or discuss aspects of reviews. Patience and optimism about the future- Jobs always maintained a positive tone and a vision of what could be in the digital revolution, and Apple's role in it in these discussions. There is the opening of the first retail store in the Washington D.C. area, and Jobs patiently handles Mossberg's incredulity about Apple and its inexperience with retail stores. And Jobs saying that he had taken a serious interest in the details- down to the translucency of the glass. There is the meeting with Bill Gates at the fifth All Things Digital Conference, when both made their appearance together for the first time and Jobs hands a cold bottle of water to Gates. By this time Jobs had already come to the conclusion- as he once said after accepting a $150 millon investment from Gates in 1997-1998- that it was no longer true that Microsoft had to lose for Apple to succeed....

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David Gelernter, Yale professor of computer science, says above all things Steve Job was designer-in-chief. At his Stanford commencement address in 2004, Jobs recounts his experience in a calligraphy course at Reed College as one of the singularly important experiences of his life, and something he carried over to the the revolution in portable devices- portable Macs, iPod, IPhone and iPad. The search for and building of elegant, easy to work, fun to use devices. Job was able to grasp the potential of such devices, says Gelertner, from his very first visit to the Xerox research labs in Palo Alto in 1979. In doing this he gives credit for long forgotten pioneers of the personal computer, who were just as important perhaps even more so, Douglas Engelbart and Alan Kay. At Xerox, Kay built on the earlier innovations of Engelbart. Engelbart was first to develop the mouse, onscreen window, and the concept of computers doing more than just computing, such as controlling machinery, doing everyday stuff, and doing things with pictures. Xerox's corporate executives failed to grasp the significance of the developments in their labs. Jobs grasped this rightaway and put all his efforts into developing the Apple Macintosh in 1984 incorporating these ideas. A decade later Gates copied the Mac's eay to use features and created economies of scale, creating the personal computer that we know today. The internet was a parallel development during that decade after the pioneering work of Tim Berners-Lee on the worldwide web. Jobs took the experience one step further and created new devices like the iPhone and the iPad that brought mobility, ease, and refinement to the internet experience....

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Helene Cooper and Worth point to the vacillating response to the Arab Spring and movement for democracy and freedom in the Middle East of the Obama administration and President Obama. The dangerous overtones of this lack of U.S. leadership in the region as the U.S. completes a withdrawal from Iraq without an agreement for a residual presence, sees diplomacy reaching an impasse with Iran's development of nuclear weapons, and the Syrian civil war drawing in Turkey with its long border with Syria, and drawing in Saudi Arabia as a defendor of Sunnis in Syria. The stakes for Russia in Syria were minimal compared to that of people in the Middle East and the U.S., yet it had an outsized influence with its early military assistance to the Assad regime and the lack of U.S. leadership to resolve the situation in Syria in favor of the democracy movement.

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IMF Managing Director, Christine Lagarde says Greece should have 2 more years to achieve the deficit targets. Speaking at a news conference during the annual meeting of the IMF in Tokyo in Oct 2012, Lagarde said: "it is sometimes better, given circumstances.. to have a bit more time... This is what we advocated for Portugal, it's what we advocated for Spain, and it's what we are advocating for Greece, where I have said repeatedly that an additional two years was necessary for the country to actually face the fiscal consolidation program that is considered." A two year extension would add an estimated 20 billion euros to the financing cost for Greece, at the same it improves the chances for growth and means having a program that is more likely to work.

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China's shift in emphasis from heavy manufacturing and the auto industry to other technologically advanced and less environmentally sensitive industries including new energy sources. The National Development Reform Commisson lists industries in 3 categories- encouraged, allowed, and restricted. The auto industry is now in the allowed or permitted category, and is no longer encouraged for the purposes of foreign investment and the granting of preferential tax or streamlined approval processes. Alternative energy cars, internet equipment and some service industries are moving to the encouraged category. The growth in the auto industry has slowed to about 3% in 2011 from 32% in 2010, with the change hitting the domestic Chinese brands the most. As a result more laws are expected to help technical know-how flow towards Chinese auto companies, according to IHS Automotive.

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China's National Bureau of Statistics made an announcement in Beiijing that 51.27% of the Chinese people now live in urban areas. In 1949 the figure was 10.6%, in 1979 it was 19%. In the space of three decades China has urbanized rapidly. This has brought with it economic growth, infrastructure development and increased employment in the manufacturing sector as new workers moved from rural areas to the cities. With it also come major problems for the country and the leaders of the Communist party led government. Of the 691 million urban residents, 253 million are migrant workers- 37% of urban residents and 19% of the population are in this grey zone described as the "hukou" or household registration system. Under "hukou" these migrants from rural areas cannot access public services in the cities, and have rights to access them in their own villages where they are registered. Integrating these migrant workers who are different than their more affluent and better educated neigbors in the cities so that they become truly a part of the urban areas will remain a huge challenge for China. One of the ways China is addressing this is with the plan to build 36 million units of affordable housing for these migrant workers by 2016. Ever so gradually Chinese officials are relaxing the restrictions on migrant workers- such as Shanghai Mayor Han Zheng's announcement for allowing all migrant workers to rent subsidized housing in the outer parts of Shanghai and committing to "increase the migrant population's involvement in the community affairs, cultural life and show genuine care for them." Food security is another issue as more development on prime agricultural land means less land available for agriculture. Appropriation of agricultural land for industrial use is bringing the country down to the limit of 120 million hectares of agricultural land needed for self sufficiency in food, according to the Land Ministry. At the same time China's leaders want to avoid what the World Bank calls "the middle income trap," where a country reaches a level of modernization and urbanization, and then stalls at that level- the level being around $3000 per capital GDP, which is China's GDP per capita today, according to the National Bureau of Statistics in China. Li Keqiang, who takes over from premier Wen Biao, sees the building of affordable housing for migrant workers as a critical way to continue the urbanization process, and shift the country from its export focus by increasing consumption and the development of industries that support this. A slowing economy dominated by state owned companies focussed on a decelerating export model and an aging but still growing population- NBS says China's overall population was up by 4.8% in 2011 over 2010 and has reached 1.35 billion- presents a tougher set of challenges to the new leadership in China than was faced by the current leadership....

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Analysts see the likelihood of Greece exiting the eurozone at over 50%. The actions of the ECB under Mario Draghi to provide funding to weak banks through the Long Term Financing Operation have reduced the effect the effects of contagion from a Greek default spreading to banks in other EU countries. The fiscal pact signed in Jan 2012 at the EU summit with automatic penalties for countries lacking budget discipline provides Angela Merkel more room with her domestic political base to support the EFSF's capacity to help other eurozone countries. Greece with its deteriorating economic situation would then be considered a special case.

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William Daley, the head of Washington lobbying for JPMorgan Chase, is appointed Chief of Staff to President Obama. He also serves on the board of directors of Boeing and Abbott Labs, companies which a strong interest in Washington lobbying. William Daley is with Chase since 2004, and was hired primarily to strengthen Chase's Chicago connections. In the past he has served as the main liasion with the White House. In 2007 he joined the bank's senior leadership as head of its new Office of Corporate Social Responsibility, which oversees the company's global lobbying efforts.

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An inherent division between the two sides about the merits of a large scale involvement- as advocated by a tactical military man McChrystal and the limited involvement advocated by Vice President Biden considering the lack of a reliable Afghan partner - have now spilled out into the open after a compromise was patched together about a year ago. That compromise involved sending more troops but with a deadline for withdrawal set for July 2011. Now as the war reaches a stalemate -as a war of this type in the mountainous terrain of Afghanistan, and as ordinary Afghans see no particular interest in either side in this war, was largely expected to turn out into- the frustration has spilled out into the open. General McChrystal, in an interview with Rolling Stone magazine this Spring, made comments with disdain for Vice President Biden, and an aide to McChrystal called National Security Advisor James Jones , a clown.

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India's ruling Congres party suffered losses in the two major states of Uttar Pradesh and Punjab. In Uttar Pradesh, the socialist Samajwadi party gained an absolute majority of 224 seats in the 403 seat assembly. The Bahujan Samaj party of Kumari Mayawati lost its majority winning only 80 seats, the BJP won 47 seats and the Congress won only 28 seats. Rahul Gandhi of the Congress party campaigned heavily in the state and the results show that his campaign against Mayawati did not result in Congress gaining enough seats to form a coalition government with the Samajwadi party led by Mulayam Singh Yadav and his son Akhilesh Yadav. Yadav has held the position of chief minister three times before, and campaigned for greater rights for lower castes and for a quota in education and jobs for Muslims. His other campaign promises included increasing electricity production, and improving the business climate. In the Punjab state, the Shiromani Akali Dal party won 56 of 117 seats, with the Congress getting 46 seats. National elections will be held in 2014, and the results reflect a repudiation of the Congress party after corruption scandals, slower economic growth, and lack of clear policy direction....

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A New York Times/CBS poll shows 69% of Americans polled between March 21-25, 2012, feel the U.S. should not be involved in a war in Afghanistan. This is up from 53%, in a poll only 4 months before this poll.

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Reflecting the volatile nature of the global economy with systemic risks remaining, impact of sharp cuts in spending, and the danger of oil prices exceeding $150 with a mideast crisis, the IMF provided a wide range of possibilities around its basic forecast. The IMF says it expects the global economy to grow 3.5% in 2012, up 0.2% from a Jan. forecast, and a forecast of 4.1% for 2013. But the IMF says this depends on the eurozone crisis, which could take off 2% from global output and 3.5% from output in the eurozone if things went wrong in Europe. Higher oil prices above $165 with supply disruptions after Iranian sanctions are another danger. Its forecast for Europe is 0.3% contraction in 2012 and 0.9% growth in 2013. Because of the risks in the outlook the IMF cautions countries from cutting spending too quickly, and says the best approach is to reduce deficits gradually over the long term and not to move too fast in the short term. This word of caution applies to Spain, the UK, France and Germany. To maintain enough funding in a crisis the IMF plans to increase its lending capacity from $380 billion by an additional $280 billion, with pledges of $60 billion from Japan, $26 billion from the Nordic countries, and $200 from other eurozone countries. ...

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Public sector layoffs in Spain in 2012-2013 under the governments deficit reduction plan- as mandated under fiscal compact rules agreed to in the December 2012 eurozone meetings- will worsen Spain's severe unemployment rate of 25%. These public sector layoffs are only now taking place. Upto now local governments had helped offset rising layoffs in the private sector by preserving employment. The result will be a further increase in unemployment in Spain, creating a crisis of large proportions.

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In 2000 student debt in the U.S. was at $200 billion. In 2010 student debt at 1 trillion dollars will surpass credit card debt. Student debt is now become a serious macroeconomic factor. Budget cuts will also increase the level of student debt as fewer grants are available and tution goes up. It is expected to shape when young people can afford to buy a home, start a family, or save for their kids education. This would have serious economic implications for the future.