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Elizabeth Rosenthal looks at Obamacare's contribution to cost containment in 2013-2014. Rosenthal says its is a kind of delicate maneuvring at the edges, because serious work needs to be done. The fee-for-service and many of the drivers for increases in medical costs, the old system of pricing, are still in place. In 20 years at the current rate and after Obamacare health care will still take 25% of the U.S. budget if nothing is done. Healthcare costs are about half that of the U.S. in some of the advanced European countries. She calls Obamacare a trickle down theory of cost containment becaue it leaves most of the drivers for cost increase in place and works at the margins. Princeton economist Uwe Reinhardt calls it an ugly patch on a somewhat ugly system. Rosenthal cites the armies of consultants anticipating every move to reduce prices, and working on "strategic billing'' to increase revenues for hospitals and doctors. For those who say the prices are now up more slowly than in the past, Michael Chernew of the Harvard Medical School, has this to say- its like a diet, reminding us that that we haven't even lost weight, just gaining weight slower than before. ...

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Jim Yardley points out the controversial nature of the referendum in Greece on July 5, 2015. It is flawed in 3 respects- it makes no mention of Europe, the details of the agreement are not clear to voters, and the "No" vote is framed in terms of the "Oxi" or "No" vote of 1940 in Greece to Mussolini for annexation of Greece. No sane minded person can confirm that this has anything to do with the annexation of Greece by foreign powers. It had one additional flaw- the government and Tsipras simply went ahead and campaigned for a "No" without talking to its European partners. Landon Thomas Jr shows how the difficult dynamic and confrontation between the eurozone negotiator Dijsselbloem and the Greece negotiator led to the collapse of talks on June 25, 2015, playing right into the paranoia of an inexperienced Greece administration about the EU's intentions. Only over a week later July 7, 2015 the new Britain trained Greece negotiator Tsakalotos from St Pauls School and Oxford was able to change the very tone of negotiations leading to the Third Bailout Program. ...

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In this Agenda column Simon Nixon takes on the U.S. Treasury's criticism of Germany for its current account surplus of 7% of GDP in 2012, and not doing enough for the economies of southern Europe. The German government called it "incomprehensible." Nixon says it is better for the German economy to remain strong and to boost competitiveness and consumer spending in Spain, Portugal, Italy and Greece. He says the low eurozone inflation of annualized 0.7% for September 2013, which prompted the ECB to cut rates by 0.25%, is healthy to the extent that consumer prices are declining to adjust to a decline in wages. The reduction in labor costs is a way to restore lost competitiveness, just as Germany did in the last decade. The criticism is considered by many economists to be misdirected, and seen as "incomprehensible" by Germans, as Germans ask what would the U.S. have them do- provide stimulus when the government debt to GDP ratio is currently 82%, increase wages and how would this help Southern Europeans. Focussing on Germany's current account surplus says Nixon, is obscuring the larger issues of increasing consumer and business confidence and spending in the eurozone, and increasing bank lending. The new ECB bank resolution arrangements and other changes including deposit insurance if done right should help the recapitalization and restructuring needed for restoring bank lending to support recovery. Spain is furthest along in regaining competitiveness, with changes in Portugal, Italy and Greece also supporting a gradual return to growth....

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Frederick Harris of Columbia University says there is a price to be paid for a black president and it may just be too much for the average black person. There is a difference betwen symbols and substance, betwen a role model and accountability in a representative democracy, which is sadly lacking when the black elites, clergy and politicians fail to debate the issues about the problems facing the black community. Problems related to the increasing poverty among black Americans, and the 14% unemployment for black people. There is he says a strange reticience among the black elite to hold the president accountable on these issues just as they would have done for any Democratic president, even one who was as popular with blacks as Mr. Clinton. He says the experience with Obama is not even remotely comparable to the transformative nature of the work of Rev. Martin Luther King in the black community. It may stem from Obama's multiracial background, growing up in many countries, his elite education and being part of a liberal elite more than of the black community. The price is too high in economic and social terms for the poor or average black person and it has created a divide between the average black person and the black elite, with different concerns and different priorities. Harris points out that poor and poverty are words not mentioned often by Obama. Related to this is the foreclosure crisis in which ordinary black people were hardest hit with no effective help from the president to homeowners badly needing relief. Sheila Bair of the FDIC and Martin Feldstein advocated aggressive help for homeowners under water which did not come from the president. Showing not just the limits of a black presidency, but false hopes, inexperience and lack of leadership in issues that mattered to all Americans in the housing and foreclosure crisis. A populist from Kansas, as Sheila Bair describes herself, had the right instincts and courage of convictions which the president lacked and the entire country needed....

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Steven Mufson reports in the Washington Post that oil exports from Iran will only gradually increase by 400,000 barrels a day in the next 6 months, because Iran does not want to depress prices further than $30 a barrel. Foreign investment in Iran is also likely to improve gradually because of the remaining sanctions and the slowly improving economy.

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The Tunisian revollution was middle class, un-Islamic and pro-western. The people in the streets of Cairo are young, connected, non-ideological and pragmatic. They are looking for an end to despotic regimes. This is the way Cohen describes the demonstrators after his visit to Tunis. Egypt's opposition leader El-Baradei tells Cohen's colleagues Kirkpatrick and Slackman that he is pretty sure that an elected government in Egypt woulld be a moderate one. The policies of a community activist from the south side of Chicago, who as US President fails to take a clear stand in favor of freedom from repression and economic freedom for people in the Arab world.

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The results of the February 24, 2011, CBS/New York Times poll show strong support for public workers in schools, firefighters, police and other functions. On collective bargaining 60% opposes weakening the bargaining rights of public workers, only 33% support it. On reducing the benefits and pay of public workers to reduce deficits, 56% opposed cutting pay or benefits, only 37% support it. Are public workers overpaid or have overly generous health and pension benefits. On this issue 61% -including over half of Republicans- say the salaries of public workers were either "about right" or "too low" for the work they do. So how are states to reduce their deficits? The people polled say they prefer tax increases over benefit cuts for public employees- only 22% chose to reduce the benefits of public employees, 40% said they would increase taxes, 20% said they would cut financing for roads, only 3% said they would cut financing for education. How this breaks down in politcal groups. 71% of Democrats opposed weakening collective bargaining rights, the opposition was also strong from Independents with 62% of Independents opposing weakening of collective bargaining rights. Followup interviews showed independents saying the public workers work hard and still struggle to have a home, saving for retirement, and sending their kids to college, with both spouses generally having to work, which is why they oppose weakening collective bargaining rights. Which segment of the populations support cutting pay and benefits of public workers? The one income group that showed support for cutting pay and benefits- those earning over $100,000 a year! There 45% said they favored cutting pay and benefits, even here 49% opposed it. On the intentions of the governors and state legislators trying to cut pay or benefits of public workers- 45% said they did this to cut the deficits, and as many as 41% said the saw this as an effort to weaken unions. Which takes one to the last question, so how are unions perceived in the U.S. in 2011? A far smaller number of people, 37% saw unions as having "too much influence" on American life and politics vs. 48% who said that unions had the "right amount" or "too little" influence....

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Both sides harden positions before the June 30th deadline for 1.5 billion euro repayment of debt to the IMF. Greece's prime minister Tsipras accuses the IMF of "criminal responsibility" for the pain of austerity programs in Greece. Eurozone leaders says Greece's default on its debt and exit from the eurozone is a possibility. The Economist points out that a Greek default and Greece's exit from the eurozone would be a mistake. It points out that this means repudiating debts of 317 billion euros, or about 180% of GDP. Yet the repayment is at low interest rates spread out over decades. Until the early 2020's interest rates are about 3% of GDP a year. In theory a devaluation would help exports, but Greece with its small trading position, may not see much benefit. The drop in nominal wages by 16% has not led to a surge in exports. The cost in terms of broken banks, sharp decline in savings, and collapse of confidence could be disastrous. The very people Syriza is trying to protect the poor and elderly, would be hit hardest, as the collapse in the currency would lead to a shift to a barter economy as in Argentina during its default crisis. For the European Union, the problem would not go away, as it would have to deal with a bigger problem of a failed state on the Aegean on the EU's southern flank. Syriza's gamble that this can be used to extract concessions by holding off till the last minute is failing, because it is leading Greece back to contraction after the small growth in 2014 under prime minister Samaras- with capital flight from the banks and investors leaving in a general fall in confidence. The management of the economy and negotiations by Syriza is now seen as incompetent and has jeopardized any difficult progress made....