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This Washington Post editorial says vice president Biden's comments that "I guarantee you, flat guarantee you, there will be no changes to Social Security. I flat guarantee you," made to a voter in Southern Virginia, is downright disheartening. It points out that this is not the conclusion of the trustees of the Social Security Fund, which includes the secretaries of Treasury, labor and health and human services of the Obama administration. The April annual report of the trustees says that the disability portion of the trust fund "becomes exhausted in 2016," and the overall fund "becomes exhausted and unable to pay scheduled benefits in full on a timely basis in 2033." Actions suggested by the trustees include: raising the payroll tax, tweaking the inflation calculator, reducing benefits, or some combination of this. It is clear from polls that the U.S. voter does not want either party to touch Social Security, but the reality is something different. The idea of a flat guarantee in the light of facts that all can see is seen by the Post as going too far, trying to win votes at the cost of postponing necessary decisions which will become harder and costlier if not addressed early....

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Stephen Harper's Conservative party won 167 of the 308 seats in Canada's House of Commons, the NDP won 102 seats, the Liberals 34 seats and the Bloc Quebecois 2 seats. Harper gave indications of how he would govern by saying that he would stay on the same path the Conservatives followed when they were a minority party. He said there would be no changes to Canada's public health care system. He told a news conference in Calgary, Alberta: "Even as a majority you have to, on an ongoing basis, keep the trust of the population." The Conservatives won only 40% of the popular vote, and this may be a reason for the caution in making major changes. The Conservatives maintained their base in western Canada, and gained seats in Ontario. The gains in and around Toronto, came because the left-of-center vote was split between the Liberals and the NDP. Experts say Harper will shut down a disputed registry for rifles, end direct government subsidies of political parties, and maintain scheduled corporate tax cuts. The Conservative government is also expected not take any significant steps to cut greenhouse gas emissions that are opposed by the oil and gas industries in western Canada. ...

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Portugal's foreign minister, Paulo Portas, resigns in protest against continuity of austerity measures signalled by the selection of Ms. Albuquerque as the new finance minister. Portas's party is part of the coalition of centre right parties in the administration of prime minister, Pedro Passos Coelho. Cuts in public employee pay and spending on health and education, income and sales tax increases, have cut the deficit to 6.4% of GDP by 2013 from about 10% in 2010. The cost of this is an economy that is shrinking more than expected- by 4.8% in 2011 and 2012, and an additional 2.3% in 2013. Unemployment exceeds 17% in 2013. The loan terms negotiated for the 78 billion euro bailout with the IMF and E.U. in 2010, were renegotiated so that the 3% of GDP target for the deficit for 2013 was relaxed to 5.5%. Portas's party and other leaders are calling for a further renegotiation to take into account the economic conditions in Portugal and boost growth. Portas's party opposed the effort to cut labor costs of companies with a large increase in worker social security contributions, a measure seen as counterproductive even by business leaders that was later dropped. In financial markets the 10 year Portugal bond yield increased 0.22% to 6.615%....

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Walmart comes out in favor of requiring employers to provide health insurance to all workers, a central feature of President Obama's effort to provide near universal coverage in the USA. As the country's largest private employer, employing 1.4 million Americans, this change is significant. In a letter to the President, Walmart CEO Mike Duke, joined by Andrew Stern of the Service Employees International Union, and John Podesta of the Center for American Progress, who also signed the letter, say they are for an employer mandate which is fair and broad in its coverage. Walmart had a couple of reasons for doing this. For one Walmart needed to join the negotiations, as the Senate Finance Committee is considering other proposals that are less favorable to Walmart than employer mandate. Already Walmart is covering 52% of its employees, and has improved health benefits in recent years in response to criticism of the company. The industry average is 45%, according to a 2008 Kaiser Foundation study, and some companies do not provide the health benefits that Walmart does, so this helps level the playing field by requiring all large companies to share the burden. Walmart wants to see effective cost controls to keep costs down, and Rahm Emmanuel, the President's chief of staff, assured Walmart that "cost control and employer mandate are heads and tails of the same coin." Under the plans considered by the Senate Finance Committee under Max Baucus, small businesses are exempted from the employer mandate. Republicans have opposed employer mandate. And the U.S. Chamber of Commerce has opposed it saying it would make companies lower wages and cut jobs. Walmart's shift has been gradual. From a company used to providing skimpy benefits, it has evolved as it improved benefits, and two years ago it joined the SEIU union to call for affordable health care for all Americans by 2012. It has Mr Dach as its governmental affairs vice president, and this is significant, as Dach is an advisor to Democratic party politicians....

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All sides joined the President at the White House, as part of his consensus building efforts, and to get aseat at the table in restructuring health care. The insurers and health care providers, including technology providers, all committed to cutting the cost of health care. New social insurance programs to cover 45 million uninsured Americans, and to make health care affordable for businesses and individuals, will be unworkable at currently projected rate of increase in health care costs of 6.2% a year for the next decade. The industry promised to reduce that by 1.5% through voluntary efforts, even though there is skepticism about whether they will deliver. The insurers are against a government sponsored health plan fearing it will drive them out of business. Insurers and health care providers are lobbying against the cuts in their Medicare payments, and insurers are fighting Obama's cuts to their private Medicare Advantage plans by a total of $176 billion over 10 years. Doctors are fighting a 21% cut in their Medicare fees scheduled to take place in January 2010. Pharmacuetical companies and makers of medical devices are concerned that new products will have to pass a cost-benefit test before being approved for coverage under Medicare. Its just that they all see the continued rise in costs as somehow unsustainable, especially in the current economic crisis, and share the feeling with business and the rest of the country that the system is broken. At the same time like the banks and bank executives, health care companies and their executives go on lobbying aggressively and doing things the old way, which raises questions about how well these systems that are broken can be put on the right path....

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Questions being addressed to get health care to the uninsured and to all Americans at an affordable level.

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A study by ITEP, Institute for Taxes and Economic Policy shows the top 1% pay less in taxes on income than every other group in 42 American states. The poorest fifth pay taxes 60% higher than top 1%. The most regressive states are Florida, Washington, Tennessee, Pennsylvania and Nevada. The tax systems seen as reducing inequality are D.C. Minnesota, New York, Vermont, New Jersey. This happens at a time of growing inequality, high cost of living, and the aftereffects of the pandemic on health and mental health, with high cost of pharmaceuticals with entrenched lobbies, low enrollment of men in colleges with increasing dropouts, the huge burden of student debt on young people.

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With 5.7 million jobs lost since December 2007 fewer people are paying payroll taxes to support Medicare and Social Security says Labor Secretary Solis. As aresult Medicare will run out of funds by 2017, 2 years earlier than predicted last year. Medicare and Social Security issued their annual report yesterday, suggesting the nation cannot afford the cost of Medicare at the rate of current expenditure growth. Social Security will run out of money by 2037 four years earlier than predicited before. The only way to keep Medicare solvent says Mr Geithner is to reduce the rate of growth of health care costs.

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CEO Ryan at CVS/Caremark. An unassuming man with a sharp focus on things, joined CVS right out of pharmacy school at University of Rhode Island. At 29, CVS owner Stan Goldstein gave him the chance to run pharmacy operations for CVS, then a regional drugstore chain in the eastern USA. Over the years CVS has made a number of successful acquisitions, the latest being the acquisition of Longs Drug store chain on the west coast, and it is now one of the largest chains in the USA. It has nearly 7000 stores and more than 50 million users of its CVS loyalty card in the US. As the pharmaceutical business evolved pharmacy benefit management (PBM's) companies like Caremark, Medco, and Express Scripts, came into being to manage burgeoning prescription costs. PBM's work with companies to save money, by filling recurring prescriptionsin 90 day quantities through the mail at reduced per pill cost. Now drug store chains instead of competing with PBM's are either creating or acquiring these larger PBM's. THe result is that a company like CVS which acquired PBM Caremark in 2007 for $27 billion, now has extensive computerized databases with patients information and drug usage histories. Ryan's clear focus is on these IT records as a distinct advantage, if he can use it to help the Obama administration's efforts to control health costs of chronic diseases like diabetes and arthritis, and back or neck pain, high blood pressure, and others, that end up clogging the hospital system and raising health care costs. By using these IT records to flag when a patient is not compliant or taking his medications and call the patient, Ryan can increase drug sales, get more visits into drugstores if the drugs can also be picked up at CVS stores, and increase sales through ancillary purchases during visits. This is now his strategy. It also includes setting up more clinics at stores and at corporate locations that divert the patient flow for small care like sore throats, flu and the like. As this is the way health care costs can be controlled, Ryan sees himself as helping achieve national goals while keeping CVS in the sales and profit picture for the US, even as health care as we know it goes through a complete transformation that removes the waste and unnecessary cost, and improves effectiveness and health. He sees CVS/Caremark right where it wants to be with its large patient drug database from about 1 billion prescriptions it fills each year, and as the largest single buyer and dispenser of prescription drugs in the country. ...

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What Krugman makes of the $1.089 trillion dollar U.S. deficit for fiscal year ending in Sept. 2012. He points out that the U.S. can have a stable to declining debt to GDP ratio with $400 billion debt. He cites the Clinton years (1992-2000) when the debt to GDP ratio declined from 49% to 33% with steady growth. What about the remaining $600 billion. He attributes this mostly to temporary factors which are reversible as growth picks up. Of this remaining excess deficit he says $400 billion is from lower tax payments to Treasury because of the 2008 economic crisis and the recession that followed. This includes the payroll tax cut which is also temporary to keep up consumer spending in the recession. The $150 billion is from unemployment insurance, food stamps, and other aid which is also reversed once growth picks up. He places emphasis on restoring economic growth as early as possible and reducing unemployment and using the recession for business to continue to invest in R&D, productivity, and government to preserve the social fabric, invest in education, and provide incentives for growth. S&P Nov. 8 report says the net government debt to GDP ratio is estimated to be over 80% in 2013. It will have to stabilize at current levels for S&P to preserve the U.S. credit rating, says S&P executive Chambers. The higher debt to GDP ratio in 2013 and lower growth rates expected makes the situation different from the lower debt to GDP ratios during the Clinton period. Britain, France and other major industrialized nations with political parties at either end of the political specrum have also chosen to stabilize or reduce debt to GDP ratios rather than take on the risks of them going much higher. The U.S. has the added problem of health care costs out of control with an aging population and about 17.9% of GDP going to healthcare costs in 2010 expected to increase significantly, as Medicare actuaries estimate enrollee numbers jump to 80 million in 2030 from 50 million in 2012. Democrats and Republicans have largely sidestepped this underlying problem in fiscal cliff negotiations....

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The Economist cites estimates from the Bank of England showing Britain's national output peaking at 1.5 trillion pounds in 2007 and not likely to return to that level till 2015. It points to fears of a lost decade. Meanwhile debt is rising from 600 billion pounds in 2008 to 1.1 trillion in 2012, making reducing the debt to GDP ratio by 2017 even more difficult. Lower growth affects tax revenues even as social benefit costs increase. Part of the problem is that from 2009-2010 to 2011-2012 public sector net investment declined from 48.5 billion pounds to 28 billion pounds. The Economist suggests Chancellor Osborne take up an additional investment in infrastructure of 28 billion pounds, even borrowing 14 billion pounds in the bond markets if needed, as a prudent step to revive growth. Small improvements in rail, roads and bridges could make up for a lack of large projects. Other suggestions include expanding the "funding for lending" scheme with banks to get capital to small business, finding more savings in the National Health Service, and changing the way Britain taxes development land that remains undeveloped. Britain, now joins, Portugal, Spain, France and Italy, in the failure of austerity measures alone creating a return to economic growth and lower deficits. In 2013 improving competitiveness and boosting economic growth become critical following years of austerity measures....

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With only 44% of Catalan people supporting independence and 48% opposed there is considerable division in the Catalan region about independence from Spain. The WSJ looks at different neighborhoods in Barcelona some working class and others more affluent and sees a sharp division along lines of class, age and language. People in the working class neighborhoods of Ciutat Meridiana are opposed to separation from Spain. The independence movement is mostly popular among younger, middle class and Catalan speaking people. Meridiana in northern Barcelona is one of the poorest neighborhoods. In the hip central neighborhood of Gracia with leafy squares dotted with art galleries and vegan restaurants the pro-separatist movement has major support. Support for independence is highest under age 25 and declines with age and is lowest for people at 65 years. More popular with middle class and less with people earning less than 1300 euros. Today Spain has a constitution that gives greater autonomy to individual regions such as Galicia, Basque and Catalan regions that have their own language and traditions. This was suppressed during dictator Franco's rule after the Spanish civil war in the 1930's. The Spanish constitution was written after Franco's death and ratified under King Carlos in 1978 providing freedom with self-government for all nationalities and regions, and an unusual degree of autonomy.  Poorer people in Barcelona feel the young people supporting separation are spoiled brats and dismiss charges that the state is fascist as a lack of knowledge of what fascism really is.  As the division and dispute drags on following the 2017 referendum that was declared unconstitutional, support for independence is declining, as reported in the Guardian recently.  All this has hurt the Catalan economy and foreign investment adding an economic dimension to this as Catalonia is now seeing growth lower than the national growth rate in Spain. In addition to this the new socialist government of Pedro Sanchez and some Catalan separatist parties are supporting new negotiations to address Catalan grievance. Catalans have felt that they are not getting a fair share of revenues that can be invested in housing, health and other services, that they are giving more in tax revenues than they are receiving. The 2009 financial crisis has also affected Catalonia in ways that increased support for an independent state as Catalonia was growing more than the rest of Spain at that time.  ...

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The supporters of free university education bring up some practical and important points. Not providing free university education at a time of rising inequality after a severe financial crisis that worsened inequality and led to a lost decade for middle class families in the U.S. leads to a situation in university attendance is restricted to people from wealthier backgrounds. Studies in Britain show this says the Economist magazine.  A report by the Institute for Fiscal Studies, a think tank, showed an increase in tution fees paid out of pocket of 1000 pounds ($1243) is associated with adecline of 3 to 9 percentage points in university attendance. Work by Thomas Kane at Harvard University confirms this. Other studies in the U.S. show attendance and completion rates higher for university education with  education being more affordable. Results of studies also show that the tangle of application processes and eligibility rules can reduce the benefits of tackling this by the current approach of financial aid. For this reason free tution which is easy to adminster and easy to understand for all is the real option for today's situation. Wealthy students can pay for it later in life with the progressive taxation. Warren proposes higher taxes on multimillionaires, and Sanders would tax financial transactions such as on stock and capital markets, as ways to address this and bring back free university. As the Economist magazine for the first time  puts this in its Free Exchange column the real support for free university comes not from economic efficiency, or even the way it benefits all in a free, open and equal opportunities society, but from the values that society believes in. There are broad social benefits to a well educated citizenry. The nation is stronger economically, more open to new ideas and more open to technological change to be able to grow when it has promoted to the fullest extent the education of all its citizens. This is especially true in today's world where more than 12 years of education are needed to build a strong base for a country to grow its economy and industry. A warning is presented by the Economist magazine that as the rich pull away from the rest of society they can actually undercut the very values based solutions that are needed today. Their increased political power can restrict the tax increases needed to fund the higher education the nation deserves, that the people deserve.  Social safety nets are also reinforced and societal harmony is strengthened when everyone cooperates to help everyone.  ...

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Dan Balz says former prime minister Blair's policies in Britain (1997-2007) closely followed the policies of moving to centrist positions of U.S. president Clinton, with Blair's election in 1997 following Clinton's wins in 1992 and 1996. Clinton followed the Reagan years and Blair the Thatcher years in government, in modifying the early postwar ideas about the economy. The election of Corbyn by 59.5% of the vote of Labor party members, exceeds the 57% achieved by Blair in 1994. The opposing candidates did very poorly. Yvette Cooper, who most resembled Blair's positions was seen as waffling on issues by not taking clear positions. She lost badly with 4.5% of the vote, showing that something significantly has changed with the the deep recession following the 2008 financial crisis, and the recovery through years of austerity policies under Cameron's Conservative government. Balz's view is that this is likely to bring up the same debate in the Democratic party- Corbyn proposes a national investment bank for large investments in education, health services and infrastructure, and a reversal of Labor policies introducing fees for college education to increase opportunity. Sanders has not proposed a national investment bank, but says he would invest in education ( including reversing the spiralling education costs), health services, infrastructure, and other areas. Hillary Clinton has made the issue of upward mobility for the middle and working class a central issue in her campaign, but lacks the authenticity claimed by Sanders, who has tapped into anti-establishment feeling following the lack of recovery in wages under 7 years of the Democratic party government in the U.S. In this context Jeb Bush has also stated at the 2013 CPAC conference that social and economic mobility is the central issue of our times, only he would approach it by giving business incentives to increase business investment to create jobs and increase wages; and by adopting a tax code that would be also fair to the middle and working class....

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Gerlad Seib points out that one should look less at what president Trump accomplished in the first 100 days and more at how he operated and learned during this initial period. This is certainly true because much of what happened in the first 100 days contradicts some of the tone that Trump setup during the campaign. When it comes to governing Trump has made an effort to learn and adapt and show resilience in the face of early setbacks on the travel ban and the health care bill, the Flynn episode. After this early period Trump took on a more disciplined approach, gave more room to and listened to more respected advisors- Tillerson on foreign affairs in shaping policy with Russia leading to Tillerson's presence at Lucca massacre memorial in Italy sending a clear signal about U.S. policies in line with its role in the past century in world affairs, Gary Cohn and Ross on economic policy and seeking Cohn's advice on tax plan, Ross's on NAFTA negotiations with Mexico. As a result the NAFTA fears were calmed down with statements by Wilbur Ross, the Commerce Secretary, that the goal was a win-win relationship with Mexico. Trump worked with his party in Congress to have the Supreme Court nomination of Gorsuch approved. Meetings with Merkel of Germany and Jinping of China were carefully planned and new relationships established as Seib points out, without ruffling trade relations. The appointment of Robert Lighthizer, as Trade Representative, also shows that efforts to give the U.S. a more level playing field in trade will be resolutely pursued in the win-win context. Lyrarc has profiled Lighthizer earlier in this decade after his op-eds in the media as he correctly anticipated the changing public mood on the need for fairness in trade relations. On relations with China and South Korea, Jim Mattis has taken the lead, and Pence's visit to South Korea also show deftness in handling what is one of the most difficult issues in foreign affairs. Mattis and Tillerson also have helped reinforce the Republican party policies on NATO and Europe, with the visit of NATO secretary general Stoltenberg to the White House. In the end it is how much you can learn in the first year, how much you listen, and the courage to act in difficult situations, the willingness to act contrary to one's instincts and self interest where necessary, that matters. This is especially true in an environment where as Seib points out the Democratic Party stands opposed to the Trump administration following a bitter election campaign.   ...

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The public option as anecessary step for effective cost control in healthcare in the USA. The potential for higher healthcare costs in the future gutting the whole effort to provide universal health care if there isn't the money to pay for it. Which means that if the public option brings costs down its anessential part of any healthcare program that is sustainable years from now. Krugman calls for audacity from the President.

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The American Medical Association came out against the public option in President Obama's health care reform plan. The outpouring of comments on this article show that public opinion today seriously questions the actions of the AMA, and think that this is not in the best interests of the nation. Its the kind of outpouring of criticism that GM's old management received from readers fed up with the management of the Detroit automakers, before the GM bankruptcy. Out of the 26 most read or recommended comments on this article shown on the link to the article in the NYT, 25 were strongly critical of the AMA's position on health care, none were in favor, and one was critical of the insurance companies. The 25 that were strongly critical had a total of reader recommends of 6539 readers when they were totalled up for all 25 comments. Some of these comments were strongly critical and explained at length why. Some were from doctors who disassociated themselves from the AMA. One suggested that the American College of Physicians also represented doctors, and the AMA represented only one group of mostly older doctors who are against any change. The financial crisis and the election of a new President, the changes in the country since the last failed reform effort in 1993, the new mood of the country as it changes to its more frugal past, a new generation of doctors and a new generation of young people coming to the fore, all may mean that things are no longer the same, and actually very different. Are the people running the AMA, like the people who were running GM a short time ago, not able to see how they are perceived by the public? ...

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To overcome resistance on Capitol Hill Obama takes his proposals for health care to the states and back to the grassroots support that got him elected. He will hold atown hall meeting in Virginia on health care. Obama advisor Axelrod says the main thing is to show what widespread support Obama's proposals have across the country. As ameans to this Obama's main political group Organizing for America will swing into action in the weeks ahead.Obama is talking to governors, Democrat Christine Gregoire of Washington, and Republican Michael ROunds of SOuth Dakota,

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The Institute of Medicine releases areport of the 100 health topics that should get high priority, as the Obama adinistration proceeds with a plan to $1.1 billion to compare the effectivenesss of treatments. Some of these areas for research are prostate cancer treatments, a surgical procedure called ablation, and others.

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The NYT editorial says budget reconciliation should kick in if by a certain date in the fall bipartisan agreement is not reached. With budget reconciliation, the term for a expedited processs, health care legislation can pass by a simple majority vote. NYT says bipartisan agreement is a good thing, but more important is effective health care reform. And there is little evidence of Republican cooperation so far on any issue.

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WSJ's CEO council advocates a goal of 10% electric cars by 2020 and upto 50% of the fleet by 2030. Other top priorities of the CEO's from Google, Intel, Time-Warner, Fedex and other companies at a recent 1 day conference were obesity, a stimulus program in excess of $300 billion, and restarting the Doha round of talks for global trade.

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With 10.3 million workers unemployed according to the Bureau of Labor Statistics, and this includes 2.8 million added this year so far in 2008. Most of the people who lost their jobs also lost their health benefits. This increases the urgency for the Obama administration to come up with action in the health care area as the ranks of the uninsured will grow in 2009.