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Samuelson points to the risks to the American economic growth from excessive health care costs. This is hurting take home pay and shows up in consumer spending. It is hurting government spending in other areas such as needed infrastructure spending and efforts to reduce the deficit. This hurts private capital investment to create jobs because of lower demand from constricted consumer spending. The U.S. budget has as its largest single expense 27% on health care compared to 20% on defense the next largest expense, with growth in health care spending taking this to one third of the budget in coming years. Without addressing health care, says Samuelson, the Supercommitte in Congress even if successful at deficit reduction will basically have failed to do its job, and it did not have the time, resources or conviction to do this. According to a new study from the Organization for Economic Cooperation and Development (OECD), U.S. healthcare spending per person is $7,960 per person in 2009. This compares with Norway $5,352, Britain $3,487, France $3, 978, an OECD average of $3,233. Life expectancy in the U.S. is 78.2 years, compared to Japan 83 years, OECD average of 79.5 years. Chile and the Czech Republic have life expectancy equal to the U.S. Except for cancer care where the five year survival rate is 89.3% in the U.S. and the OECD average is 83.5%, the U.S. lags far behind in much needed critical areas such as diabetes and asthma. Rates of emergency hospitalization for asthma are 3 times that in France and 6 times that in Germany and Italy. The U.S. has fewer doctors per thousand population and higher cost per medical procedure- with more frequent use of the costliest procedures- creating a supply shortage that induces higher prices, and less preventive and early action care through physician visits. The number of practicing U.S. doctors is 2.4 per thousand population in the U.S. compared to 3.1 per thousand for the OECD average; and number of annual doctor consultations 3.9 per capita in the U.S. versus 6.5 for the OECD average. Appendectomy cost $7,962 in the U.S., $5,004 in Canada and $2,943 in Germany. Coronary angioplasty cost $14,378 in the U.S., compared to $9,296 in Sweden, and $7,027 in France. Knee replacement cost $14,946 in the U.S., $12,424 in France, and $9,910 in Canada. Knee replacements, angioplasties and MRI exams are twice as common in the U.S. compared to the OECD countries. ...

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The WSJ's Iliff and Luhnow's interview with Emilio Lozoya, CEO of Petroleos Mexicanos (PEMEX). Lozoya says about the new oil law that allows foreign companies to compete with Pemex, as something that should have happened decades ago. President Calderon of the PAN party pushed hard for this, but failed to get the support of the PRI during his term in office 2006-2012. It made sense for Mexico because President Cardozo (1997-2002) of Brazil already set a successful example by doing this for Brazil's state oil company, Petrobras. The main point is that competition is good for Pemex, and good for Mexico and Mexicans, and Lozoya emphasizes this. Under the law Pemex can keep oil fields it already has and have the first pick in future fields. Pemex is expected to partner in oil field exploration in deep waters of the Gulf of Mexico where it needs the technologies of foreign oil companies. Under the new rules Pemex will have 2 years in which to make the transition to a well managed business enterprise. A new tax code works to increase nonoil tax revenues, so that Mexico does not depend on Pemex profits for one third of its budget. It also gives Pemex autonomy and control over its budget, and lowers its tax burden to international levels. This frees up badly needed resources for investment opportunties to increase Mexico's growth rate. Lozoya says the investment budget could be increased from $25 billion to about $30-$35 billion as a result. He gives a list of badly needed projects not taken up by Pemex for lack of funds- developing natural gas from Mexico's large reserves where Mexico imports its natural gas from Texas increasing the cost of manufacturing, building pipelines where Mexico transports fuel by truck which is 15 times more costly, making its own fertilizer and petrochemicals instead of importing it in a country where 60% of farmland is not fertilized. There is so much to be done that Lozoya realizes his main challenge will be execution. Enormous responsibility rests on Lozoya's shoulders to get the execution right. Pemex has 160,000 employees and crude oil sales of $130 billion in 2012. He has a Masters degree in economic development from Harvard and managed investment funds in New York before this position. Cardozo also picked an investment banking professional for the job of recharting the course of Petrobras and attracting foreign investment....

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The U.S. Justice Department files a civil lawsuit accusing S&P and parent company McGraw Hill of giving improper ratings to poor mortgage investments which allowed them to inflate in value, creating the conditions for a crash in these investments when the crisis happened in 2008. The penalty sought by the Justice Department and the attorney generals for 16 states is $5 billion to cover losses to investors such as state pension funds and federally insured banks and credit unions. The civil suit comes 5 years after the onset of the financial crisis of 2008, which created the greatest financial crisis since the 1930's. Negotiations for a settlement were conducted by the Justice Department with McGraw Hill for an extended period of time. The talks broke down in January 2013. In these negotiations the Justice Department sought a penalty of over $1 billion and S&P's acceptance of wrongdoing. S&P countered with a proposed settlement of $100 million. The government pushed for admission of guilt on at least one count of fraud. It is not known why the Justice Department filed this lawsuit 5 years after the crisis when the public's memory of the ratings issue is beginning to fade. Is it because the preparation of the case required this much time, the action not taken because it would be seen as punitive in 2011 when S&P downgraded the U.S. sovereign credit rating, the fragility of the economy in 2011, because of the approaching election in 2012, or some other reason. One of the reasons why it was important to take corrective action early was to preserve the integrity and credibility of financial markets, so critical for public confidence. An additional reason was to secure from credit ratings companies the internal reforms and change in leadership and culture that would prevent recurrence and damage to the economy. An example of this change is the change in leadership and culture underway at Barclays bank in Britain after the investigation into the manipulation of the London Interbank Offered Rate or LIBOR. The Justice Department action in this respect is an advance from the policy at the S.E.C., which has not insisted that companies involved in the crisis admit wrongdoing, setting up the process for changes in leadership and culture such as the one at Barclays....

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T.S.R.Subramanium, India's most senior civil servant and his thoughts about Indian development, the civil service politicians and the judiciary, expressed in abook titled GovernMint in India. He was Cabinet Secretary under three prime ministers. He is interviewed here by the WSJ New Delhi Bureau chief, Paul Beckett. He talks about the timidity of the civil service in the face of political ineptitude and the political class using government to benefit themselves without the checks on them. He says the politicians have come to dominate the civil service , have no checks on what theydo, and are twisting the civil service for their own gain. He knows of three cabinet level ministers in the last government that made money from their positions, with nothing done about them. Proble here could be that the framers of the constitution had some tough problems to deal with. If they made the civil service all powerful, could it turn out that the civil service like in Japan would not bend to the wishes of the people? And if they made the civil service subject to the wishes of the people the politicians could use it for their own narrow purposes and affect the task of delivering essential services and progress to the people. They chose the latter. Its true that the British civil service was disciplined and honest but they did not have to respond to the wishes of the people. The only safety valve left by the framers was in the electoral process and the wisdom of the people in throwing out politicians who did not deliver. The problem of dignity and national purpose in politics had to be left to the people themselves, their leaders and the thinking public in the society. He sees the judiciary as having failed too, in controlling the politicians. And he sees part of the problem in that the judiciary stems from the same English educated class as the bureaucrats. Says T.S. R. Subramanium, the political class is the only one that is not constrained by checks and balances, follws no effective code of conduct, and considers itself king. Subramanium's solution of a messiah type figure, is quickly disapproved of by all his colleagues, and he takes pains to clarify that what he means is someone who can get the public backing to cleanse it. ...

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Laffer says that starting in September 2008, the Bernanke Fed has radically increased the monetary base, comprised of currency in circulation, member bank reserves held at the Fed, and vault cash, by almost $1 trillion. See graph. The percent increase in the monetary base is the largest increase in the last 50 years by a factor of 10, he says, and its outside of anything we have ever experienced. The currency in circulation component which previously comprised 95% of the monetary base, has risen by a little less than 10% while bank reserves have increased 20 fold. With such large reserves banks are lending more money. The 12 month growth rate of M1 is now in the 15% range. But he sees reduced demand for money as confidence is restored in the banking system. He sees the drop in output and manufacturing and employment leading to further reduction in the demand for money. His view is that the reduced demand for money, and the rapid growth in the money supply, will lead to higher interest rates and inflation, unlike anything experienced in th 1970's. The backdrop to this is the huge liabilities taken on by the federal government in the auto and banking bailouts, and through the stimulus and other programs, with a deficit he projects at 13% of GDP. Steps the Fed could take such as issuing $1 trillion in new bonds to contract the monetary base, become difficult, considering that the Treasury plans issuance of $2 trillion in new bonds in the next 12 months. The alternative is to increase the reserve requirements of banks to restrain the growth in the money supply. A too rapid contraction of the money supply would cause the economy to go back into a recession. See Paul Krugman in the NYT, June 15, 2009, who cautions against reversing course. Krugman says the Fed increased reserve requirements in 1937, leading to putting the economy back into a slump. Krugman responds to Laffer by saying that the economy faces deflationary trends, and is in a liquidity trap where policymakers cannot cut interest rates further, making inflation less of a threat at this time. Krugman says overcrowding of private investment is not happening, as government is only stepping in where private investors have retreated....

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Founded in 1880, Carl Welcker's company has seen the changing fortunes of manufacturing for over a century, during depression and after the wars. Still the 50% drop in orders for this company, which makes the machines that make 80% of the spark plugs in the world, is like nothing Carl Welcker has experienced. Its a tragedy he says. Its the speed of the manufacturing decline that is causing concern. In Europe where a fifth of GDP comes from manufacturing industrial production is down 12% from ayear ago. In Brazil it is down 15%, in Taiwan 43%. In China exports are down 25%. In the USA, industrial output went down by 11% in February 2009, according to the Federal Reserve. The pattern of this decline recalls the pattern of 1929, as tightening creedit and consumer fear reduces demand for manufactured goods in one country after another, creating a downward spirtal that reduces global trade. And of concern is that trade is declining even faster than manufacturing.German exports are down 20% from ayear ago, Japan's have plunged 46%, and in the USA exports fell at an annualized rate of 23.6% in the fourth quarter of 2008. A company like Schutte in Cologne, Germany, expanded rapidly as globalization opened new markets in Eastern Europe and Asia. Sales more than doubled in 5 years from 58 million euros to 100 million euros. Which suggests that the extraordinarily rapid expansion of the last few years may have its reverse effect heightened in a slowdown, as those additional sales to China and Eastern Europe disappear. For the USA manufacturing accounts for 14% of GDP, for the world 18%, and for China 33%. But this creates a misperception about the importance of American manufacturing exports. First, manufacturing contributed more to GDP growth than any other sector of the US economy, and accounts for two thirds of American exports, says the chief economist for the National Association for Mnaufacturers in Washington. America's share of global manufacturing output, he says, has remained steady at 20 to 23% for the past decade. This covers jet engines, locomotives, pharmaceuticals, and high tech products. For countries like India where manufacturing accounts for 16% of GDP, the last quarter of 2008 saw the first quarterly production decline in over a decade. And industries like handicrafts exports have fallen by 55% to $1.35 billion, and textile makers have cut half a million jobs. ...

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How the French health care system works. France comes in first and the USA 37th in aWHO health care ranking. THe difference in deaths from respiratory disease is half that in the USA, and lower rates of death from heart disease and diabetes. IT has more hospital beds and doctors per capita than the USA. 65% of French people are satisfied with their health system compared to 40% in the USA, and yet France spends 10.7% of GDP on health care and the USA spends 16% for poorer results. THe French system is more generous to its seniors. Unlike Medicare there are no deductibles, just modest co-payments that are often dismissed for chronically ill. And diabetes and critical surgeries are covered 100%. French also buy supplemental insurance like Medigap for extra expenses like dental and eyglasses. Cancer patients are treated free of charge. Avastin treatments costing $48,000 a year are provided at no charge. France's PMI or Protection Maternelle et Infantile, is rated highly. It is anetwork of thousands of healthcare facilities, that ensure that every mother and child in the country receives basic preventive care. Mothers even receive afinancial incentive for attending their pre and post natal visits. France makes this care affordable by reibursing doctors at a much lower rate. The average yearly net income for doctors is around $55,000, about athird of what doctors in the USA make. But French doctors don't have to pay back huge student loans as medical school is paid for by the state and malpractice insurance premiums are only a tiny fraction of that in the USA. And again the French government pays two thirds of the social security tax for most French physicians- which is typically 40% of income. So the $55,000, is more like $92,000 taking that into account and more like $110,000 when student loans and malpractice is taken into account at US levels. Specialists who have 4 or more years experience can charge what they want, but as one gastroenterologist says, there in an unspoken and undefined limit to what you can cahrge or what is socially acceptable. Yet even in France there is inflation in health care costs that the government deals with through price controls and more spending. The French national insurance system is running increased deficits each year and this is now $13.5 billion, and it has led to higher taxes for employers and workers. ...

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Experts say this is the worst economic crisis since the Great Depression and it has gradually accelerated since October 2007 from a gradually unfolding housing crisis into a full blown credit markets crisis with the lack of transparency in mortgage securitization and the loss of confidence in the credit markets as mortgage securities values collapsed. The worst is still ahead as home prices have only fallen to a small extent so far and experts expect another 20% drop in prices this year and 2009. In the face of this crisis Immelt can be faulted for not using caution in his promises to the analyst community but to be so unforgiving for GE shares to fall 13% in one day and calls for breaking up the company or frustration at GE's inability to overcome what were clearly extremely unusual financial and real estate market conditions that may be a first in 40 years, is clearly overdone. Jack Welch who said he would be shocked beyond belief and shoot Immelt if he doesn't make what he promises now is also expressing some of that frustration, but beyond this is the inability to grasp the true extent of the situation in the markets that Welch never experienced first hand as he demanded and got his managers to deliver on results quarter after quarter or be fired for credibility problems ,because Welch's batting averages reflected a stretch of years where there were no crises of the magnitude of what Immelt is facing today. Upon further reflection Welch still stands by Immelt saying that this business about breaking up GE and Immelt's in trouble is crazy. And Immelt is building GE around the growth engines of the next big success stories in the growth engines of the future in Asia and the Middle East and emerging market countries of infrastructure, energy, aviation, health and environment, which would also be supported by the smaller but still significant growth of industrialized countries. And these things take time to put together a collection of winning businesses to be well positioned for future growth. Can GE accelerate sales or are there any shortcuts? Immelt doe not think so. Can he change things in a "severe and protracted" economic downturn as the Fed put it last month? Its beyond even large companies like GE....

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Interesting when 53 economists were surveyed by the WSJ 51% attributed the rising fuel prices to demand from China and India, only 15% attribute it to supply constraints, and 15% attribute it to foreign exchange issues and 11% attribte it to speculation. That is that 3 times as many economists think demand from China and India is the culprit compared to supply constraints, and twice as many economists think foreign exchange speculation and central bank issues are the cause than supply constraints. Why? Once you remove this outsize demand from China and moderate the growth there then the supply constraint does not become so critical. In previous years declining prices made exploration less attractive or the fact that price was not stable going up and then coming down making it difficult to invest based on a stable return. Now the basic component of additional energy for countries like India and China's people increasing demands could be accomodated within existing and new supplies coming onstream, without the red hot demand component of growth rates at above 10% and close to 10% in India and China exacerbating prices upto some current estimates of $200 per barrel. In effect the price spikes would reverse the demand growth, and the essential needs of more people needing everything from electricity and fuel and gasoline to improve living standards in China and India at a moderate pace would prevent oil prices from falling to levels that make aggressive search for new oil finds and increased production from more difficult locations unattractive. This would correct the previous imbalance where exploration at low prices near $30 or $40 a barrel and uncertain price levels made for little new exploration while consumers were on a consumption binge in the use of gasoline which created this present situation. And in future oil at sustainable price levels would make it easier to meet the needs of poorer people in countries like China and India as more aggressive growth resumes at some future date after this expected worldwide slowdown. So correcting the previous and current imbalances helps to create a better situation in the future to better meet the hopes and expectations of millions of people in the developing countries for better nutrition, better electricity supplies and other needs of modern living....

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Amazing! Just fresh from the foreclosure crisis and as the worst of the foreclosures are taking place between now and 2009 for subprime and other loans homebuilders and home sellers are financing the 3% downpayment required by FHA for loans from the is government agency. What do they hope to accomplish sell homes and have the government foot the bill when these homes also go into foreclosure in a downturn? Already above average default rates for seller assisted down payment programs will make this government agency the Federal Housing Administration ask for a government subsidy for the firtst time in its 74 year history. The FHA will need $1.4 billion next year. FHA estimates that down payments provided by nonprofit groups account for 34% of all 200,000 loans backed by the FHA so far this year, up from 18% in all of 2003, and less than 2% in 2000. And FHA says that borrowers are 2 to 3 times as likely to default on their payments when they receive a down payment from a nonprofit. The reckless manner in which homebuilders are selling these homes is unbelievable, more so in today's difficult economy. See the ads for these homes in this WSJ article and its is shocking. D.R. Horton is advertising 100% financing for 2 and 3 bedroom homes near the beach in Maui, costint $498,000, and a Seattle area builder Quadrant corporation is advertising townhomes for $500 downpayment. Use your coffee budget says a online promotion in the St Louis area! And though the risks are known to housing officials in the government they face a battle from well funded and coaltition of homebuilders, lowincome housing and minority groups. though its hard to understand how a home that ends in foreclosure for a low income group or minortiy group can benefit a minority group. Yet the Black and Hispanic caucus, people in Congress like Maxine Waters and Barney Frank still think it does as they continue to support the lobbying that keeps these kinds of loans going. Two examples given here of a Dick Whitmore and a Gloria Harris one saying it was impossible for him to come up with the $5000 downpayment and the other saying she was living from week to week suggest that they are likely to end up having difficulty making payments. ...

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Simon Nixon says the main problem with the E.U. bank stress tests of 2011 is that it did not test for sovereign defaults. For example Greek debt that is trading at 50 cents on the euro, was marked down 15%. And the lack of urgency to raise fresh capital is another problem. He says the real value of the tests comes from the asset disclosures that accompanied the tests.

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How one war widow is coping with the death of a husband in the war in Afghanistan. Lisa Hallett in Puget Sound with three small kids has kept alive her husbands memory as she makes a 26 mile run through the streets near Puget Sound, Washington.

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The PRI party defeated the ruling PAN (conservative nNational Action Party) of Presidetn Calderon in midterm elections. PRI won five of six governorships and won 237 seats to the PAN's 143. Mexico is facing its worst economic crisis since 1995 with the devaluation of the peso and American loan assistance. THis time it is aflow-through of the American economic crisis, adrop in exports, a collapse of the auto sector, and drop in remittances from Mexican workers in the USA as well as tourism. The GDP of Mexico dropped 5.9% in 1st qusrter 2009. Unemployment and underemployment have doubled leaving one in six Mexicans without ajob. Poverty also has risen in this situation. Meanwhile a stalemate in the legislature has led to stagnation in terms of addressing critical areas of education, investing in the petroleum sector. And monopolies and oligopolies in a range of industries from tecommunications to cement trim GDP growth by 1% according to Guillermo Ortiz, central bank governor. Oil revenues are dropping, and proven reserves now are equal only to 13 years of current output. And public spending on infrastructure is declining. Disillusionment with the political system is growing, so much so that 5.4% of the ballots were spoiled in response to a campaign by political activists fed up with corruption and paralysis in the political system....

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Investing strategy that is in contrast to PIMCO's Gross and El-Erian view that we are entering aperiod which is the "new normal"- aperiod of diminished expectations with stocks playing a smaller role. This means that investors hold as little as 30% in stocks. Barry Ritholtz, CEO of Fusion IQ, a quantitative research firm says he sees this recession as similiar to the 1973-74 recession and sees growth picking up by 2013, or 5 years into this one. Ritholtz thinks its wise to have larger investmetns in fixed income and similar investments, but also to have exposure to stocks in growth areas of the world. Robert Arnott of Research Afiliates, aresearch and analytics firm, suggests a mix of five even baskets: Us stocks paying healthy dividends, stocks and bonds from mature foreign economies, stocks and bonds from emerging markets, stocks and bonds built around oil and commodities to hedge against inflation, and 20% in bonds. including Treasury inflation-protected securities. Such aweighting would increase stocks as apercentage of the portfolio to 50%....

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The stock market rally is due to government support and quantitave easing. Once that government support is withdrawn this recovery will not be sustained. There is a lot of liquidity that is driving this. About $332 billion has been withdrawn from money market funds yieding today .01% in interest. Quantitative easing is a significant part of the liquidity. Equity and bond markets have received a big boost from central banks creating money to purchase mostly government bonds.This keeps yields on Treasury bonds low, it is now 3.5% even though record amounts of debt are being issued.If this QE stops yields will rise and drive up borrowing costs. In this way it is a government sponsored bull market.

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A democracy activist in China inspired by Nelson Mandela who now teaches at National Chengchi University in Taiwan.

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Much overdue respect for Eisenhower with the plans for the Dwight D. Eisenhower memorial. Eisenhower's greatness in ordinariness and good sense. Reminders of another president who avoided heroics and persevered with simplicity and good judgement- George Washington.