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The Economist quotes experts saying that drug innovations would not be affected by price controls on drugs. Pricing reforms can accomplish the reverse, spur innovation by doing as Britain and Germany are doing- pioneering comparitive reviews of drugs effectiveness and cost-benefit analyses aimed at reimbursing firms for new drugs based on their performance. Sanford Bernstein, a financial advisory firm, says in its study that a 20% reduction in what Medicare pays for drugs would not kill off innovation, it would reduce earnings per share of big pharma firms by 3-8%. As drug research is now done in many countries, and its a globalized industry, innovation is not likely to be automatically affected by price reductions in one country like the USA, according to Alna Garber of Stanford University and Patricia Danzon of Wharton Business School.

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Mario Draghi faces his first test as head of the European Central Bank as Italian bond yields approach 8%. Draghi has limited purchases of bonds of troubled EU countries to 5-10 billion euros each week. This has been sufficient to keep Italian bond yields from going out of control, but high enough to keep pressure on governments in Italy, Spain, Portugal and Greece to make necessary changes. France, Germany and other countries in the EU are working on new rules for making strict budget discipline legally binding, with enforcement sanctions by a EU budgetary authority. Germany is pushing for the new rules. France's Sarkozy with a legacy of Gaullist reluctance to surrender sovereignty in such matters had resisted such calls in the past, but is moving in the direction of convergence of fiscal policies as the only way to preserve the euro currency and the EU idea alive. Draghi is taking a flexible stance on inflation and lowering rates compared to his predecessor, Trichet. He sees signs of slowing manufacturing activity and credit tightening in Europe as signs that inflation will come down from above 3% to something closer to the 3% target set by the ECB. Economists expect him to lower interest rates for the eurozone to 1% from 1.25%, when the ECB meets in a week. The manufacturing purchasing manager's index went down to 46.4 in November, below the breakeven point of 50, which signals a contraction. Output and orders were down across all of Europe, including Germany. Economists say Draghi has left open the possibility of larger bond purchases if the new rules are made legally binding on eurozone members....

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Bank of Spain Gov. Miguel Angel Fernandez Ordonez said Spain finds itself in an "exceptional situation," as it goes "back into recession," and only exports acting to contribute to gains in GDP.

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Following the events in Charlottesville where a car drove into protesters, president Trump's remarks seemed to equate the actions of white supremacists to protesters. This has led to strong criticism from the business community with most business leaders withdrawing from the president's advisory councils from the business community- the Strategy and Policy Forum,  and Manufacturing Council. This includes the CEO's of Johnson and Johnson, Merck, JP Morgan Chase, GM, GE, 3M, and other companies. In his response president Trump disbanded both councils. JP Morgan Chase CEO Dimon said of the president's remarks- 'Constructive economic and regulatory policies are not enough and will not matter if we do not address the divisions in our country." Members of these councils had hoped to use their presence to have a voice. Yet by August 2017, 6 months into the Trump administration this appears to be changing, with CEO's of many companies expressing the view that the Republican policies favoring business would not matter if the basic consensus on tolerance and openness and what the U.S. stands for is allowed to deteriorate. ...

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French president Sarkozy, and German chancellor Merkel, announce the decision to seek treaty changes to make fiscal discipline a critical part of the new EU treaties. They issued an ultimatum to other EU countries to decide within a week whether they wanted to be part of a eurozone under this arrangement. In any case France and Germany will move ahead for a tighter union. Merkel stated- "We need structural changes. It is not possible to do this in the framework of the current treaties." Germany secured France's acceptance for having national budgets submitted for review by a supranational European body and automatic sanctions. France secured Germany's acceptance of a way to override this if automatic sanctions are blocked by a strong majority of members voting to this effect. On the issue of bondholders, of private creditors sharing in losses, France and Germany agreed to limit this to Greece. Merkel stated: "Greece is and will remain an exception," to which Sarkozy added, "the message to investors from across the world is that in Europe we pay back our debts."...

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The IMF in April 2012 said Spain may have moved too aggressively with austerity measures. The IMF said: The new deficit target in Spain "could have accomodated more fully the impact of the weak growth outlook." This supports the Spanish government's view that it has to balance controlling spending measures and redctions in spending with considerations that take into account the weakness of the economy and high unemployment. One of the important considerations is that the private sector and banks faced with losses in the housing bubble are not likely to generate growth at this time, leaving growth dependent on government spending; which if cut too quickly could lead to declining GDP and even lower tax revenues with higher deficits. The government of prime minister Rajoy is faced with the difficult task of creating credibility in financial markets about controlling years of spending by regional governments during the housing boom, and at the same time applying prudence in not taking steps that would hurt the economy at a delicate time....

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Steven Erlanger describes the mood in France as it faces problems of improving competitiveness in a rapidly moving global economy. A sense that the actions of the Hollande government will not be enough to tackle the need for deeper changes.

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A cross-referencing initiative by the new government of Mario Monti in Italy called the "income-o-meter," will be setup in the next few months. Under this initiative the government will cross reference different transactions and compare bank accounts with declared income to take action against tax evasion. Tax evasion is so widespread in Italy that an estimated $150 billion is lost in uncollected taxes. This would help Italy bring down its defict and reduce the debt burden in the current crisis. Attilio Befera, director of Agenzia delle Entrate, Italy's internal revenue service, says that the new cross-referencing initiative will prevent someone from declaring income of $26,000 and buying real estate worth $1.3 million. Tax officials say that in a country with 2.5 million luxury cars, only 2% of 41 million taxpayers showed an annual income of more than $260,000.

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Fiat plans to expand manufacturing in Italy by making the Panda small car in Italy instead of using a plant in Poland. This would expand production by Fiat in Italy from 650,000 to 900,000 cars, with an investment of 8 billion euros in 2 years. One of 5 unions gets 40% of the vote at the Fiat plant in southern Italy that will make the Panda. Fiat had asked for new working conditions at the plant in exchange for its investment and a new social pact with the unions.

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China shifts its policy to allow 3 children per family after it sees the percentage of people in the population over 60 rising. This WSJ report show that the policy shift is being followed by changes in policies related to education with more equitable educational resources and reduced expenditures for education for families. Policies that were seen as making families hesitant to have more children.  Changes of the Mao era policy of one child, one family, are very recent. Not till 2013 has this policy changed, since its implementation after the Communist Party took over mainland China in 1949. In 2013 the government allowed families to have 2 children if one of the parents was an only child, and two years later in 2015 the policy was changed to allow 2 children per family. Only half of Chinese couples are willing to have 2 children, according to a study by the state backed All China Women's Federation. A once in a decade census shows 12 million babies born in China in 2020. In 2016 there were 17.9 million births. China's leaders noticed a change in the census for people over 60 as a percentage of the population, which was growing much faster than imagined from 13.3% in 2010 to 18.7% in 2020.  The perception of experts and Chinese couples in their thirties shows that the policy is seen as not enough to convince young couples to have another child. Typical is the situation of one parent cited in this report, a Beijing father of two. He says the policy has changed but it does not mean that he would have another child. He says it takes a lot of money and energy to take care of another child. It also affects the standard of living and education of the two children as he has already moved to a new 2 bedroom apartment to be near top schools in the Chinese capital. Another facet of this development is women in China postponing children to pursue their careers. Government policy is now to raise the retirement age with fewer people of working age to support the senior population. The percentage of the population of working age 15 to 59 years dropped from 70% in 2010 to 63% in 2020. Fewer people for working at Chinese factories and manufacturing. China's retirement age is now 60 for men and 50 for women, giving the government room to do this by bringing it up to western levels that are much higher in the US and Europe.   ...

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After over two decades of focus on GDP growth targets, China under prime minister Li Keqiang is giving more emphasis to job growth and problems of air pollution, education, and quality of life indicators. Premier Keqiang tells a news conference in Beijing in March 2014 that China needs to create 10 million new jobs each year. More bond defaults can be expected as the financial system is being changed with new rules. Li says China will no longer be "preoccupied" with GDP growth targets. Li made the new priorities clear-"The GDP growth we want is one that brings real benefits to our people, helps raise the quality and efficiency of economic development and contributes to energy conservation and environmental protection."

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Ireland and Portugal both have debt to GDP ratios of more than 100%. Still Ireland is better positioned to weather the eurozone crisis. Foreign investment attracted by low taxes and an educated labor force gives Ireland signficant advantages to return to growth. Citigroup forecasts show a 5.5% decline in GDP for Portugal in 2012, and large probabilities that the deficit will overshoot. Ireland expects 0.5% growth in 2012. Ireland's exports are 60% of GDP, compared to 24% for Portugal. Yields on Portuguese bonds due 2020 are at 13%, compared to less than 7% for Ireland. But funding Portugal through the end of 2015 is expected to cost 40 billion euros, according to Capital Economics estimates, or only 0.4% of eurozone GDP, making the problem in Portugal very manageable for the EU.

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Germany opposes aggressive buying of the bonds of Italy and Spain by the European Central Bank. Prime Minister Zapatero of Spain calls on the ECB to take action as Spanish bond yields reach 7% on Nov. 17, 2011. Germany sees the crisis as serving a constructive purpose as forcing the fiscally unstable countries to make changes.

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The Gallois Report and France's efforts to improve competitiveness under the Hollande administration.

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France's finance minister says the government will focus on growth and set deficit targets that will support growth. There is a feeling in the business community that France has reached the limit for tax increases. The government has given up the goal of reducing the deficit to 3% of GDP in 2013. The government says the deficit will be about 4.1% in 2013 and 3.6% in 2014. Economic growth is expected to be only about 0.1% for 2013, and 0.9% for 2014, lower than earlier forecasts. Muscovici has said the French are fed up with higher taxes, and he is looking for savings in spending. About 15 billion euros of savings are planned in the 2014 budget from ministry expenses and healthcare spending. Extra taxes of 6 billion euros planned for the 2014 budget will now be cut to 3 billion euros. To increase growth it is necessary to stabilize taxation and give business a clear picture for 2014-2015.

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The costs of fraud in medical care from spurious Medicare claims to kickbacks for unecessary services is estimated at $125 to 175 billion. Costs of unnecessary care from overuse to unnecessary lab tests are between $250-325 billion. The amount wasted for on treatment for preventable conditions such as heart disease and diabetes. is $25-50 billion. This number is much higher when all the complications from obesity are figured in. These amounts alone add up to $500 billion. Add to it the problems and the costs of medical errors leading to bad drug reactions or other misdiagnosed procedures which cost an estimated $75-100 billion and the the total is upto $600 billion. These amounts are not going to be tackled by computerization of medical records. The whole manner and ways in which medicine is practiced today and the manner in which the public takes care of its health would have to change for an impact to be made in these numbers.