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According to the General Accountability Office inquiry, 28 drug products had price increases over 100% in 2000, in 2008 71 drug products had such large increases. Medicines like Adderall for attention deficit disorder, Inderal for chest pain, Sumycin for infections were in the list of 416 brand name drug products where makers or distributors raised prices at least once by 100% or more for period 2000-2008. As large pharmaceutical companies sold their marginally profitable drug products or small selling products to smaller companies, these smaller companies would immediately increase prices to recover the money they paid to the large pharmaceutical companies. 26 of the brand name products saw prices raised 10 fold. A third of the drugs with large price increases treat depression and disorders of the central nervous system.

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In an interview with Rolling Stone magazine, the commander in Afghanistan, General McChrystal, responds to a question about Vice President Biden, and says, "who is that?" An aide jumps in saying, is that "Bite Me?" These and other words of disdain for the Vice President and other policy advisors, are seen as the kind of frustration facing commanders from the slow progress in the enlarged effort in Afghanistan. It also brings to the fore the serious questions that have always remained, some raised by Biden, Reidel and others, of how any kind of success could be achieved without a reliable partner in the Afghan government, with the complicated situation in Pakistan where the Intelligence Services pursued a different agenda from that of the government, and with little interest from the people in the rural areas in a vast rural mountainous country, Kabul a little urban dot in a huge landscape of deserts and mountains. See the groups and links for Afghanistan and Pakistan for background.

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Are high prices for pharmaceutical products and healthcare services putting a severe burden on U.S. finances and defunding education, infrastructure, R&D in new technologies, which provide the underpinnings for future U.S. competitiveness? Yes say experts. In 2009 Americans per person cost of healthcare was $7,960. By comparison Canada was $4,808, Germany $4,218, and France $3,978. And without necessary efforts for educating people about caring for health and preventive care, the health conditions of Americans are no better than these countries, and poorer in some dimensions. Klein says deficits would not be a problem for the U.S. if prices for pharmaceutical products and healthcare services in the U.S. were similiar to that of the largest developing countries. Experts say the Obama healthcare law simply postponed the addressing of this problem.

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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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Bradley and Nabhan of the WSJ report from Quara Tepe in Iraq and the weak Iraqi military unable to control parts of the country from attacks by better armed and trained ISIS militants, some from the old Iraqi army before the U.S. invasion and others from the war in Syria. The failure of the Maliki government to bring together Sunnis, Shiites and Kurds, as a new election apporaches and Maliki is likely to be elected for a third term. A divided parliament and the lack of U.S. presence after the withdrawal in 2011 at Malik's insistence. The U.S. has refrained from supplying the Iraqi military for fear of aggravating ethnic tensions, with the Sunnis saying Maliki is practicing ethnic cleansing under the guise of fighting terrorism. Under Maliki Iraqi airspace has been used to supply the Assad regime from Iran, according to some reports, making the U.S. wary of supplying the Iraqi military as it has little influence left.

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How GM is seeing the value of new technologies not just for their value in commercialization but in the value in brand image. To be seen as the innovation leader does a lot for brand image and this does a lot for selling cars across a whole lineup which does't remotely use that technology. This is the case with hydrogen fueled cars and GM is now taking this challenge seriously. Refueling remains an issue but all untested technologies have to start somewhere and GM wants to be seen as an innovator from now on.

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"Defend blue sky and breathe together" says a painting on a brick wall in the coal producing region of Shanxi, northern China. China is finally acting seriously to impose strict environmental rules from the top. Old coal stoves are thrown into a dump as China shifts away from coal stoves to heat homes. So many new homes shifted to natural gas in Shanxi province. population 37 million, that demand overwhelmed natural gas supplies. Results are to be seen in cleaner air in Taiyuan, capital of the province and in Beijing itself.  President Xi's commitment to climate change accord reached in Paris is seen as firm in this report in the NYT. The head of the gas, coal and power markets division of the International Energy Agency, Mr. Peter Fraser, says that even though homes use only 6% of total coal used in China, the effects are disproportionately high because homes do not have any emission reduction mechanisms. Natural gas demand has increased by 16% in 2017 as provincial officials eager to meet the demands issued in Beijing to cut coal emissions even let some homes and schools go without heat in an early winter spell. This extraordinary report shows how in cities in northeastern China the people welcome the change to natural gas and cleaner air. Even in coal country, in cities like Linfen population 4.4 million, the change is seen as people welcome the clean air and officials build natural gas connections to execute the plans issued in Beijing. In Beijing itself Greenpeace estimates show 54% reduction in PM 2.5, harmful particulate matter for breathing by 54%, a startling fact showing Beijing's determination and effectiveness of its actions. Natural gas is more expensive and citizens do not complain in neighboring provinces near Beijing because the state provides adequate subsidies to compensate people. Decrees are being enforced to avoid coal stove use with people knowing they could see action by authorites if reported. Compare this to the problems of crop burning around New Delhi, in Haryana and Punjab provinces, and one can see that centralized control and direction has advantages when used in the right way for a good purpose and supported by people who want to breathe clean air. ...

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With Whitacre in charge at GM there is a change of style and substance that just flows from who the man is. He is a no-nonsense guy, who once told a colleague from his days at Southwestern Bell, that God gave us two eyes and one mouth for the right reason so we should use it in that proportion. He is quite matter of fact about approaching the probems at GM right from the beginning. From those early meetings at the Westin airport hotel in Detroit, where he would tell GM executives and Henderson that if things did not happen the way they should and quickly he would find the right people. After there was a lot of soul searching about Henderson's decision to sell Opel- and three directors with private equity background decided it was bad for GM, that GM needed Opel for its compact and midsize car engineering and sales volume- Henderson was replaced as CEO. The decision was reversed. Within 3 months of Henderson's departure four other executives were let go, 20 more were reassigned and seven outsiders were brought in to fill top jobs. Lutz was marginalized. Reuss in his forties was placed in charge of N. America. The metrics were simplified from Wagoner's days to six: market share, revenue, operating profit, cash flow, quality, and customer satisfaction. His approach to get managers who make decisions fast and correct mistakes speedily. Vice chairman and CFO, Christopher Liddell, is from Microsoft and joined in January. Liddell points out that 12 of the 13 person GM executive committee are either new to the auto industry or outsiders. And the seniormost Whitacre and Liddell, are new to the auto industry and outsiders, so Whitacre can point out that GM has run the business in a more complicated way than it needs to be. The big changes are cultural. And making these changes for a company the size of GM and with the trauma that happened at GM with the speedy decline, required someone with the experience Whitacre gained in tackling the problems he faced at Southwesten Bell and the new AT&T, with its changing culture. The tough down-to-earth nature of the guy, with no affectations or layers to his personality whatsoever, proved an asset at the new AT&T and now at GM. Other decisions he has made at GM, are some strategic ones like bringing down incentives to sell cars, the latest being letting market share drop in March in the face of Toyota's heavy use of incentives to recover from the recall crisis, but sticking to reducing the incentive dollars by $1200 to $3500 per car. This made it possible to achieve sales goals. And some tactical but of great significance, from a common sense approach to GM advertising with his remark "I'm sick of Howie Long." Pitchman Long was a football player, and what Whitacre insisted on was showing off GM's best models and features to blow the competition, like the "May the Best Car Win," campaign. That many of GM's ads didn't focus on the cars and didn't make any sense, like little Cadillacs flying out of a birdhouse, makes this truly incredible to an outsider. Other things Whitacre brings are a change in his expectations, and his overall demeanor. This impatience may be a good thing for GM especially with the capital investment in new models, plant investment and better decisionmaking, and commonsense approach, to back it up. In the car industry it can't hurt for the top guy to look at the car clay models and ask why they can't be brought to market in 12 months. It gets people thinking differently. Asking a Cadillac dealer he knows in San Antonio why they should'nt be selling twice as many Cadillacs if the marketing was better. It helps when the top guy can visit a plant and have "diagonal slice meetigs" with plant staff, workers and UAW people, to talk about things in sweat shirt and jeans with no airs about yourself whatsoever, and to follow this up with a repeat meeting some months later and announce a $136 million investment, as he did with the Fairfax plant in Kansas....

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Here are 11 big infrastructure projects that are planned across the country. They are part of the $2.2 trillion of projects to build or repair infrastructure, that is estimated by the American Society of Civil Engineers as needed by America today. But there is only $100 billion for infrastructure spending in the Stimulus Plan, and much of this will go to keeping existing infrastructure, a dilapidated bridge here or road there in repair. Only $50 billion is available for transportation projects. The rapid transit planned for California with trains twice as fast as Acela for a 800 mile track is estimated at $45 billion, but there is only $11 billion in the Stimulus for mass transit aand cities like Washington DC for Dulles airport with its need for a airport train, and other mass transit projects around the country wil compete for the same money. As a result most will go unfunded. The Second Avenue Subway in New York at $4.35 billion, Miami Port Tunnel at $1 billion, Bridge to Canada from Detroit for $1.8 billion, Hudson Rail Tunnel for New York at $8.75 billion, Seattle Highway Tunnel at $4.24 billion, Gulf ports at New Orleans and Gulfport, Mississippi at $2.04 billion, tens of billions for new California aqueduct bypassing the delta around Sacramento to bring water from north to arid Southern part of California, NestGen Air Traffic Control for $15 billion to $22 billion, are the other projects on this list. Many of these are badly needed and have been waiting for years to get the necessary investment. This is only a partial list, and suggests that there are a lot of projects that can productively use government investment, so that wasteful spending does not occur. It appears that the projects are there because these areas were neglected for a long period, more like the situation faced during the post Thatcher period in the UK, where infrastructure and services had been neglected for so long that Labor governments could productively channel new investment in these areas to avoid wasteful spending. And it appears that the situation is very different from Japan where the Liberal Democratic Party had a vested interest in keeping its farm and rural base happy with new projects, like a bridge to nowhere, that led to wasteful spending for a decade or more, leading to rising deficits and investments that did not create productive returns in terms of economic growth. By contrast these projects have potential to generate productive returns for years into the future and also are large enough to create jobs and be spread out over a number of years. This could end up being a real bright spot in the current situation. Felix Rohatyn, who helped New York rebuild its finances afte a crisis, has a new book "Bold Endeavors: How our Government Built America, and Why It Must Rebuild Now", using examples like the rebuilding of the Erie Canal, the transcontinental railroad, and the Interstate Highway System, and says the US needs to build for the future with more ambitious, better planned projects today. He says, that infrastructure is not an expense, it has to be seen as a vitally needed and productive investment. People like Rohatyn and others see the Stimlulus plan as a missed opportunity because a lot of these projects mentioned here and the numerous others not shown here will simply not see much money from the government to support them and get them off the ground. The idea that this is wasteful government spending that is spreading, may be a danger to this vision and opportunity. At the same time the reality is that if all this was happening during the time of the Erie Canal or the postwar period of the Interstate Highway System it would have been much easier to support. The banking crisis fix is taking away so many of the dollars that could have gone here, that this may be the missed opportunity, the lack of room for visionary investments because of the danger of pushing the government deficit to 60% of GDP with the current spending plans. ...

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See the important link to Keith Johnson, 7/9/2007, WSJ, on the economics of wind energy, suppliers, and the industry in the US and Europe, and the shortage of turbines because of some 800 parts that go into the turbines and blades making it a complicated supplier issue to get more turbines. We can make only more turbines as fast as we can access the last of some 8000 components says a Vestas executive. Windmill generated electricity was only 0.4% of the electricity generated in the US compared to 0.1% for solar and 0.4% for geothermal but of the new energy added in the US in 2007 it was 30% of the new energy generating capacity added. So it has a disproportionate share of the increase in generating capacity starting from an insignificant base. Its a new industry but with many companies the largest being Vestas of Denmark, GE Energy, Nordex of Germany and Accoiona of Spain. Germany, the US, Spain India, and China are countries at the forefron of the wind energy business. Because the business is relatively new manufacturers were not providing the installation and maintenance required in emerging market countries in 1995 when Suzlon which had powered its yarn business in Surat, Gujarat with 2 wind energy turbines from Vestas entered the business seeing an opportunity. Mr Tanti of Rajkot, Gujarat, Suzlon's founder saw the opportunity and used European firms to design his turbines and blades and provided energy to Bajaj Auto and large Indian companies that have an erratic supply of electricity because of chronic electricity shortages. Starting with a tax break which allowed Suzlon to deduct windmill costs against its sales tax bill enacted in 1999 and retracted in 2002 Suzlon took advantage of lower manufacturing costs in India. Its main plant is in Pondicherry, India. By 2002 sales had increased to $131 million in India from $32 million in 2000. The company entered the US market in 2003 and in 2004 with the boomin stock market in India Citigroup took a 9% stake in Suzlon for $22 million. By 2005 Suzlon because of lower manufacturing costs had margns of20% compared to 8% for European companies and Suzlon raised $340 million in an IPO. With loans from Barclays and Deutsche Bank Suzlon bought European parts makers Hansen Transmission in 2006 and set up a factory in Tianjin, India. Early on in the 1990's it had set up an R&D center using engineers in Germany of a supplier company in wind energy Sudwind that had exited the business, this R&D center now designed its largest turbine for US and European markets of 2.1 megawatts and blades 50 yards in length. Today Tanti and Suzlon are faced with problems accessing the world class technology of the western companies as its technology has not kept up with the technological advances especially in addressing the needs of western markets. It has about 8% of the US market and about $1.8 billion in global sales. Its pricing to Edison Energy in 2006 for 1.2 megawatt turbines was 20% below European and American manufacturers. Its latest designs have flaws because Edison Energy of Irvine , California, has seen cracks in the blades at 3 windmill sites in the midwest USA and Suzlon has withdrawn 1251 blades, the majority of the ones sold in the US. Deere and Company another customer has experienced the same problem. And even though it has moved to acquire technology by taking over 33.6% of REpower which has advanced technology and makes 5 megawatt turbines. its mired in its efforts to get the blueprints of advanced designs from REpower because German law considers minority shareholders like Suzlon as competitors, other shareholders Areva of France and Martifer of Portugal have to be bought out and minority shareholders also bought out before Suzlon can access the designs. Speed, funding, tax breaks, and timing to attract capital, and most of all insight and courage to see a growing opportunity from its own experience of using two 2.1 megawatt turbines from Denmark's Vestas, and looking deeper into problems with maintenance and support in Asia and lack of technology for homegrown development that hamstrung development of energy alternatives in dire and chronic electricity short Indian companies, this has helped bring windpower to India and a new company in a new industry from scratch. ...

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Hispanic immigrants make up a big part of the construction industry and a big part of industries like carpet making in Georgia. This has been hit hard and jobless rate for Hispanics is 6.9% according to the Labor Department up from 5.5% in April 2007. States with expandig Hispanic populations like Florida, California, Georgia and Nevada are hit hard by Hispanic job losses. Overall the jobless rate has gone up from 4.5% last year to 5% during th same periodand when one takes out the Hispanic component the jobless rate is down much less, which also tell us something about why the pace of the economic downturn is felt less among the whites and the rest of the population, because the construction industry got hit the worst and the Hispanics especially immigrants who dominate the construction industry are taking the brunt of it. The subprime story plays up here as well. From 1994 to 2006 the rate of Hispanic homeownership climbed to 50% frm 41% according to census data, at a rate more than double for the increase amon non-Hispanics. By 2006 47% of the loans issued for home purchases by Hispanics were subprime or loans with poor credit histories, double the rate for non-Hispanic whites, according to a paper by the Joint Center for Political and Economic Studies, only exceeded by African Americans. In 2006 homeownership fell among Hispanics and one in 12 mortgages made to Latino households in 2005 and 2006 is likely to fail according to Catherine Singley, a policy fellow at the National Council of La Raza, an advocacy group in Washington. Georgia has one of the heavy concentration of new Latino immgrants, with a 70% increase in the state's Hispanic population between 2000 and 2007, according to census data. From one fifth of the construction work force in 2000 Hispanics made up one third by 2006 according to the Economic Policy Institute. Among foreign born Hispanics construction was responsible for 46% of the growth in employment from 2004 to 2006 according to Rakesh Kochhar, an econist at the Pew Hispanic Center, which tells us that the new Latino immigrants dominated the construction industry in places like Atlanta and in the rest of the country and are now getting hit the worst. Not only construction but industries that parallel the growth in construction like carpet making based in Dalton, Georgia, were dominated by Latino immigrants, so that as construction fell these towns and Latinos there are hit hardest. Investment manager El-Erian of Pimco points to employment as the key the critical thing to watch for the next 6 months and its useful to see that unemployment has increased by about half a percentage point to 5% from 4.5% April 2006 to April 2007 according to Labor Department data. As most of this unemployment has probably been taken up by the new Latino immigrants to the USA its probably not changed much excluding that component, which is possibly why the economy has not felt like it is in a recession when all around the signs of recession or what causes a recession are evident around us. Another way to say this is that there are built in hidden mechanisms of the American economy in its present form such as immigration, and possibly others that act as delay mechanisms that throw the recessionary impact back by anywhere from 6-18 months depending on how they operate and can blind one about the reality of oncoming storms. This was to be seen in 2005 for the economy with consumption spending and mortgage industry excesses, and which is why Pimco decided in 2005 at its spring meeting, that the big secular story was about the economic downturn. It actually took until 2007 for this to occur because of similiar things to what we are seeing now in terms of recessionary pain, then the new structured investment vehicles and other ingenious innovations in the mortgage industry may have extended the boom and delayed the economic downturn being felt till 2007. There is a lot of grief among Hispanic people. The numbers tell the story. For the 19 million Latino immigrants in the USA...