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Russia is embarking on a huge wave of infrastructure spending and construction of roads, airports and railways. Russia is planning to raise about $1 trillion over the next 10 years to for infrastructure investment with 80% of it coming from private sources. Russia is planning to construct 39000 miles of new roads and 5300 miles of railways by 2015. The first major project is the Western high speed diameter near St Petersburg n eight lane 28 mile expressway that will link St Petersburg with expressways to Helsinki and Moscow by 2015. By early next year the local government will select one of 4 international groups, Bechtel, Bouygues of France, Deutsche Bank and a fourth group. The winning consortium would work under an arrangement that it will operate the expressway for 30 years charging tolls starting at about $1.60 per car. For foreign investors the expressways as toll highways can generate reliable returns that are better than the equity markets considering the risks in equity markets, and this is how the toll highways would be financed. There is some risk involved though for the investors because toll highways is a new concept for drivers in Russia, and construction costs may go up significantly if an investment boom takes shape (cement prices doubled in the past year and are the highest in Europe) which would cut into returns. But the investment community is looking at it as an opportunity considering the number of American and European investors showing interest. Also with Russia's high growth rates well into the future just as in China and India, a growing middle class and growing automobile numbers, this should be a decent bet for investors. ...

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The startling truth about health "reforms," - they won't control spending, and without that the whole system of health care will rapidly become unaffordable and unsustainable. Obama's Council of Economic Advisors points out in new report that since 1975 annual health spending per person, adjusted for inflation has grown 2.1 percentage points faster than overall economic growth per person. At this rate health spending which was 5% of the GDP in 1960, and is 18% of GDP today, would grow to 40% of GDP in 2040. Medicare and Medicaid would increase from 6% of GDP now to 15% in 2040, or equal to three fourths of federal spending. Employer paid insurance premiums for families which grew 85% in inflation adjusted terms from 1996 to $11,941 in 2006, would increase to $25,200 by 2025 and $45,000 in 2040. This would force employers to reduce take home pay. Samuelson says the uncontrolled health spending is singlehandedly determining national priorities, reducing discretionary income, raising taxes, widening budget deficits and squeezing other government programs, while it is producing large amount of waste in medical spending. See the link to Prof. Tyler Cowen of George Mason University in NYT, 6/14/ 2009, who cites the habit of doctors to write many expensive tests as one of the prime culprits in the wasteful spending. And in the process it delivers higher cost for lower overall quality of health for the American people. This at a time when many European countries provide live examples of doing it in a better way- lower cost, better health. The serious problem with the Obama health reforms says Samuelson is that it talks about restraining spending but may end up increasing spending. Its talk about controlling spending he says is good intentions, but based more on hopeful thinking, public realtions and risks becoming cosmetic reform. Because to really control spending will require coming to grips with its fundamental cause- hospitals and doctors are paid mostly on a fee-for-service basis and reimbursed by insurance, private or governmental. Such a system encourages doctors and hospitals to provide more services, expensive tests, favors heavy use of expensive medical technologies to increase profits, and for patients to expect them. Samuelson puts his finger on the root of the problem - there is no incentive and every disincentive for all the players in this game , doctors, hospitals and patients to seek reform of this system. For doctors and hospitals the hope would be that this cosmetic "reform" would leave the system basically unchanged, and patients to continue with a lifestyle and expectations that do not not acknowledge the fact that a lot of healthcare does not come from spending but from preventative care, education, good eating and exercize habits, and healthy lifestyles. And the uninsured are no exception, they would simply start consuming the expensive care for lower quality of overall health like everyone else. With this kind of situation confronting us, the views of Samuelson, and Professor Tyler Cowen of George Mason University, as welll as a growing chorus of informed public opinion on this subject, is that insuring the uninsured is a good idea, but doing it within the bounds of the present system, can only increase the costs. And too much is at risk, to rely on what Samuelson calls a scattershot of measures to control costs made up by Congress such as "evidence -based guidelines," "electronic record-keeping," "bundled payments to hospitals, to give the illusion of progress that won't make a serious difference. A sweeping restructuring of health care is needed, that would overhaul "fee-for-service" payment and reduce the fragmentation of care. It will also need what has not even be touched on adequately in the debate. This is the massive need for education in the schools about nutrition, eating, exercize, healthy lifestyles. It would also require opinion leaders in each field from sports and other fields to lead by example and with constant public presence, the media, and companies to form a partnership with private institutions to change existing eating habits and lifestyles that encourage obesity, smoking, fast food eating habits, large portions in restaurants....

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NATO's new guiding document and security concept now includes China for the first time as a shared security challenge. In the past there were concerns about China yet Germany and France continued economic engagement with China as before. The clearly worded statement by Xi Jinping and Putin expressing strong disapproval of a world in which the US and the EU play a prominent leadership role, made just before Russia launched its attack on Ukraine, has changed the sentiment in Europe. It is now becoming clear to Germany that the world has changed.Under Merkel Germany expanded trade ties with Russia on energy and with China as a major trading partner. The first steps are now being taken to decouple the trading relationship with China and restructure Germany's trade away from China towards other parts of the world including India, Vietnam and other Asian countries. Mr Scholz pointed to this needed shift during the Trade Fair in Hannover. As part of this shift NATO now sees cooperation with Indo-Pacific partners Australia, Japan, and South Korea and India essential for meeting the challenge of Russia today and of China over the long term. The NATO document says about China that "its stated ambitions and coercive policies, challenge our interests, security and values." Here are some of the ways the world has changed today. There are new administrations and newly elected leaders in the US, Japan, South Korea, and Germany. The new administrations are led by leaders in Japan and South Korea that are keen on working hand in hand with the US to meet the challenge from China. In the US president Biden seems determined to build up America's strength to meet any challenges China can pose. In Germany the administration is run by the SPD socialists with the Greens and the Free Democrats coalition. The Greens led by Robert Habeck and Annalena Baerbock have taken a strong position to face up to Russia's invasion in Ukraine, and Mr. Scholz is following step by step and has distanced himself from old SPD and CDU policies of  Angela Merkel of close commercial ties with Russia and China.  Indian prime minster Modi was a close partner at the G7 conference in Munich, Germany. The leaders of Japan and South Korea attended the NATO summit in Madrid and met with president Biden as shown here.   ...

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Louis Gallois, CEO of EADS gives his views about reviving European industrial competitiveness.

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A health care practitioner says the real problem is the high cost of medical care in the U.S. when compared to other countries. She points out that the Obama bill in 2008 did not take effective steps to bring down the cost of health care before enacting legislation to cover the uninsured, leading to higher premiums for the middle class. The link between healthcare and profits is seen as the main problem. 

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The effort by Prince Bandar, a senior advisor to King Abdullah of Saudi Arabia, to send arms to Syrian rebels through a command center in Jordan, after differences with Turkey and Qatar on how to arm rebels. WSJ reporters Entous, Malas and Coker provide a detailed account of the Saudi effort under Prince Bandar. The Saudis are determined to bring down the Assad regime especially now that chemical weapons are involved.

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U.S. president Obama called Libya and the policy of not following up on helping establish a stable democratic government in Libya his biggest mistake. Kristof of the NYT says people looking back would say Syria and not establishing safe zones is Obama's biggest mistake. He describes the 470,000 deaths in Syria as a huge tragedy that could have been avoided to a large extent by setting up safe zones. In addition the UN estimates that millions of refugees on a scale similar to the partition of India in 1947 were created.There is bipartisan opinion on this. Kristof cites General Cartwright's opinion in a conversation he had with Cartwright that this should have been done. Others who agree are Madeleine Albright, Bill Clinton's Secretary of State, who spoke at the Democratic Convention about how America helped change her life as a young refugee after Russia's invasion of Czechoslovakia following Prague Spring. Albright says force should be used carefully so as not to aggravate the situation but action taken where needed, something that was done successfully under Bill Clinton in the Bosnian conflict following Serbia's ethnic cleansing policy under Milosevic. Not only that, with the diplomacy of ambassador Holbrooke Clinton was able to negotiate the peace accords that hold till today- a huge achievement.  Kori Schake, director of defense strategy in the George W. Bush White House also agrees. This would have improved U.S. relations with Turkey as this was a key Turkish request. And it would have reduced the dimensions of the refugee crisis in Europe, which has hurt the European Union. The Brexit "No" vote many in Britain have attributed to ads showing refugees in endless numbers streaming across Europe's borders. Similar ads were used in Austria's elections. Kristof points out that Secretary of State Kerry's job of negotiating a peace is difficult in these conditions. Another issue raised by Kristof is the lack of Obama's leadership in helping the refugees in Jordan, Lebanon and Turkey, as he points out only 41% of this is funded. David Miliband former British Foreign Secretary, who heads the International Rescue Committee , says 200,000 Syrian kids are growing up in Lebanon without an education. George Washington counseled against getting involved in the wars on the European continent for a young nation, this advice was not followed in the Reagan and other administrations without showing the carefulness needed before action is taken. As Hillary Clinton has once pointed out the situation has resembled a pendulum swinging in the other direction under president Obama, and former Defense Secretary, Panetta, has expressed similar views. Hillary Clinton and Leon Panetta, Gates, Gen. Jones, served in the first term of the Obama administration, many of these mistakes were made in the second term by president Obama and his White House advisors Dennis McDonough, Valerie Jarrett who clearly lacked the deep foreign policy experience of Hillary Clinton, Leon Panetta (who served under Bill Clinton), and Gates who served under many presidents). ...

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This was one of the last reports written by Anthony Shadid, New York Times foreign correspondent, before his death in Syria. It covers the Islamist movement's shift to modernism and incorporating an outlook that includes ideas of liberal democracy from Britain, as seen from Tunisia. No longer is the main source of ideas coming from Egypt. A diverse group of thought is being developed in Arab and North Africa, and in places like London, where emigres from the Middle East during the years of repression gathered to discuss ideas for the future. Said Ferjani's as one of these emigres is one of sources of the new thinking and approaches of Islamist thought.

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A report by the Longevity Science Panel for the UK says the life expectancy gap between the richest and poorest neighborhoods in England has increased since 2001. In 2001 this was 7.2 years, by 2015 this increased to 8.4 years. The government points to cancer rates, the Longevity Science Panel report authors say income inequality was the main factor. To do this report LSP looked at data from the Office for National Statistics for 2015, which divided England into 33,000 residential areas and rated them on factors ranging from income levels, health, education and crime. This report points out that men and women from the bottom fifth were 80% more likely than the top fifth to die in any given year. 

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A failed policy of the Obama administration in Syria leads to a situation in which chemical weapons are used by the Assad government without a response from the U.S. or its allies in Europe.

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Former Defense Secretary in the second term of the Obama administration, Chuck Hagel, says U.S. president Obama hurt his credibility when he failed to act on his own comments of a "red line" being crossed following the chemical attacks in Syria by the Assad government. Hagel was critical in an article in Foreign Policy magazine of the way the national security advisor, Susan E. Rice, ran discussions on foreign policy issues, with too many meetings and discussion followed up with deferring difficult decisions.

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Tunisia's president Moncef Marzouki comments on the violent demonstrations in Arab countries after the anti-Islamic video in Sept. 2012. He says the violent demonstrations do not reflect the true feelings of the vast majority of Arab people. He says the Arab Spring is not pro or anti-western but focussed on social justice and democracy, and not even about religion when truly understood.

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This WSJ editorial in September 2014 says many of president Obama's statements and decisions on Obama healthcare legislation and implementation, Syria, NSA and privacy, the Middle East, Russia, showed poor judgement. It refers to a piece by Peter Baker in NYT where it is said that Obama mocked how people see him as too professorial, diffident, in a sarcastic statement. The problem says WSJ is that president Obama has poor judgement. Being academically credentialed and quick grasp of subject matter is not the same as having the ability to discern things, instinct and grasp of the essence of the matter. George Bush senior had a long resume and was academically credentialed. By comparison Truman had a short resume and was not academically credentialed or quick with data and analysis. He had something more essential and important- a discerning mind and grasp of the larger picture, as well as listening abilities for exceptional advisors such as General Marshall and Acheson he gathered around him....

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This exceptional report by Chulov in the Guardian shows the changes in the war in Iraq and Syria in 2015-2016 since the downing of a Russian jet by Turkey in late 2015. It says that the Syrian government's future was uncertain in late 2015 with Turkish support for rebel forces in the north. During this period Russia curtailed trade and tourism relations with Turkey, and improved relations with the Kurds. Russia intervened in northern Syria directly to prevent a collapse of Syrian government forces in the north. Kurdish forces were already controlling large parts of the Syrian territory adjoining Turkey, and Turkey was concerned about the support to Kurds within Turkey from Kurds in Syria and a historical movement for  Kurdish independence. In April 2016 Russia made a move to win Turkish support by saying it would support the territorial integrity of Syria, so that no support would be given to the Kurds. As the U.S. consistently supported the Kurds in the fight against ISIS, Turkey under prime minister Erdogan changed its policy of support for rebel forces in Syria to focus on what it perceived as the threat fom Kudish control of the region at its Syrian borders. Rebel forces were told to focus not on the Syrian government forces but on ISIS, leading to withdrawal of support in Aleppo. What remains now of the war in Syria and Iraq is Iranian influence in Iraq, the Russian influence from support of the Syrian government in Damascus, and for the first time U.S. ground forces in the north with 900 troops supported by artillery on the side of the Kurds. The next stage in the war to take ISIS controlled Raqqa is being negotiated between Russia, Turkey and the U.S., according to this report.  ...

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This Journal editorial points to the 3 page letter from Gen. Dempsey that make a U.S. response in Syria seem difficult and laborious, cost $1 billion a month, and endless. Gen. Keane points to the Syrian air force operating from just 6 main air strips and with about 50 aircraft out of 100 operational, using this to terrorize the opposition and the countryside indiscriminately including civilian population. Taking these out with cruise missile and other strikes is all that is needed, not even a no-fly zone says Keane. Short of a proper response the U.S. and the Obama administration could only end up leaving the Assad regime in place for longer, says the Journal. Aid to rebel groups that can then do the work of completing the transition is the right strategy, says the Journal.

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France's deficit is at 4.3% of GDP in 2014, exceeding the EU target of 3% and putting at risk France's committment to reach this by 2015. Unemployment is at 11% in early 2014. President Hollande appoints a new prime minister, Manuel Valls, to tackle the economy after losing local elections in France.

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Prime minister Matteo Renzi focussed on some critical aspects of how other Europeans see the negotiations in the Greece bailout in June 2015. Considering that the EU had relaxed conditions for the surplus, a critical condition for reducing austerity programs in Greece and focussing on reforms, and considering the high unemployment not insisted on further cuts to the public sector employees, the conditions put forward focussing on reforms such as collection of taxes are seen as essental by other eurozone countries, including Spain, Portugal, Ireland and Italy. Renzi told II Sole 24 Ore- "The point is that Greece may get different conditions, but it has to abide by the rules. It's not the case that we have taken early retiremnt pensions away from the people of Italy just to allow the Greeks to have them! We have brought in labor reform, but it is not the case that, with our money, a number of Greek shipowners can continue not to pay taxes.. I could go on." If he went on he would cite the tax collection laws and methods in Italy which were changed under prime minister Monti to tackle tax evasion in Italy, with no effort to collect the $11 billion in estimated taxes that are not collected in Greece. Italy banned cash payment above 1000 euros and started a cross referencing initiative to tackle tax evasion under premier Monti. Greece took up tax evasion legislation in 2010 in parliament but opposition from many groups led to no action. In 2012 Labor minister Elsa Fornero broke down in tears as she described raising the retirement age for women to 66 in the private sector from 60, saying this was to prevent "collective impoverishment." Italy lacks childcare and older women help with childcare for grandchildren. Renzi was probably thinking of these changes in Italy. He went on to say- " If there is a mass get-out clause over the rules, what will happen in Spain in October? And in France in a year and half? It is one thing to ask for flexibility amid abidance by the rules. It is another thing to think that one is the craftiest of them all, in other words to be the that does not abide by the rules. We want them to save Greece. But the people of Greece also have to want that." On tax evasion and other issues for long term financial health Greece is seen as not following basic financial rules for sustaining the euro....

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Comparative effectiveness research will be conducted to evaluate what is the best treatment for any ailment or disease or health problem under the $1.1 billion allocated for this in the Stimulus Plan. What are the alternative methods of treatment, what is the effectiveness of each treatment, what are the comparative costs and so on. Is it better to treat neck pain with surgery or acombination ofphysical therapy, exercize and medications? If there is ablockage of arteries in the lower leg and leg pain, how does drugs and watchful waiting compare with surgery? For chronic heart failure how does home monitoring of blood pressure and weight and exercise in addition to medications provide an alternative route as opposed to just medications. Dr Fisher of Dartmouth Medical School cites these as examples of questions that can be asked in comparitive effectiveness research. The money will be available to the Health and Human Services Department and will be used over several years. About 15 federal employees will form a council to coordinate the research and advise President Obama and Congress on how to use the money. In 2007 the US spent $2.2 trillion, or 16% of GDP, on health care, and the Congressional Budget Office says it will grow to 25% of GDP at the rate its growing by 2025 if left to its own devices. ...

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Of the people asked the question "what issue do you see as the most important for health care" 44% in a NBC/WSJ poll said they considered Cost as the biggest issue, and 37% said that they considered the Uninsured as the biggest issue, 11% said quality of care was the biggest issue. The President is focussing on cost as he develops the health care plan. He is also saying that to provide health care for all and cover the uninsured without controlling costs would break the bank. Another thing that the White House shows it has learned from previous failed attempts, is that it is doing this with an open Health Care Forum with participation of different sides in the health care discussion. Clinton's effort in 1993 ran into problems because it was developed secretively, and without much discussion, and little effort to get different people's views. The previous attempt also waited too long after the election, and this time the President is moving quickly when he enjoys large popular support. Its also true now that there is serious concern especially in this downturn of what a threat spiralling costs of health care are becoming to the future prosperity of the American people. This time the leaders in Congress are setting an aggressive schedule to get health care palns legislation on the floor by June and get a floor vote in August 2009....