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Th cost of cancer drugs Avastin and Erbitux and the need for putting life savings at risk for a few months of treatment create tension among families, doctors and treatment providers. A course of Avastin could run $56,000 and take 90 days for reimbursement by meicare or pricate insurance, and a 20% co-pay comes to $11,200.

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This editorial in the WSJ says Reagan negotiated with the Soviets from a position of strength, while president Obama has made concession after concession till the Ayatollah could not turn down a deal. It says Iran is run by the Revolutionary Guards and the Ayatollah, who see the deal offered by Obama in their interests, and that the deal took place because of this, not because of the willingness of the Rouhani government to negotiate. It says even the relatively small sanctions against specific individuals and companies have been held back by the Obama administration because of an election in Iran.

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The story of how prime minister Naoto Kan's distrust of TEPCO, the electric power company operating the nuclear power plant at Fukushima, and of the bureaucrats in the government, played out in the first days of the nuclear crisis in 2011. Kan bypassed the crisis management system set up for just such a situation because of a deep mistrust of the collusion between industry and bureaucrats. Instead he relied on a close group of advisors, who felt that the company was not sharing all the information but could do little about it. This led to lack of direction in the crisis from the highest levels of government, including a lack of response to U.S. offers of support and assistance with nuclear experts and technology.

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The government of president Hollande in France added about 7 billion euros of new taxes after May 2012, and an additional 20 billion euros in the 2013 budget. Spending cuts totaled about half the tax increases. France's taxes are the highest of the major EU countries and there is concern that this may hinder the economic recovery. French businesses are cutting back on capital spending. Insee survey for April 2013 showed French manufacturing businesses planning cuts in investment of 4% for 2013. The government says spending cuts go up in 2014 to about two thirds of the deficit reduction and tax increases about 6 billion euros. France's statistics agency Insee says economic growth was 0.5% in the second quarter of 2013 compared to the prior quarter. The recovery was supported by consumer spending, with private capital investment lagging behind. This is about 1.9% growth in GDP on an annualized basis, according to J.P. Morgan.

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President Trump announces the U.S. withdrawal from the Iran Nuclear Agreement of 2015 signed by president Obama. He calls it a bad deal and "a one sided agreement, that "didn't bring, calm, didn't bring peace, and never will." Since the signing of the agreement the conflicts in the Middle East have increased and relations between the U.S. and Iran have deteriorated under the Trump administration. During the election campaign candidate Trump and Republicans had criticized the deal and deal never gained Republican support. It was also not initially supported by France which called for stronger safeguards on nuclear weapons development. The appointment of John Bolton as National Security Adviser, and Mike Pompeo as the new Secretary of State, who were strong critics of the Iran nuclear deal also influenced president Trump. He was also influenced say aides by the success of his policy with North Korea of imposing strong bargaining pressure with tough sanctions on North Korea including Chinese sanctions, which led to the talks between North and South Korean presidents and the planned Trump meeting with Kim Jong-Un of North Korea. Iran's president Rouhani says Iran will stay with the agreement as the EU countries Germany, France plan to support the agreement. This could also leave an opening for future talks with Iran on a new peace agreement as  president Trump talked about Iranian people deserving a better deal at the end of his 11 minute announcement. As Stephens points out in a op-ed in the NYT Iran's economy needs the removal of sanctions so that focus could shift to economic development, as the lifting of sanctions have yet to result in increasing living standards and building infrastructure neglected during the sanctions years. ...

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Japan's new prime minister told the Japanese Parliament in a policy speech, that a crisis like that in Greece was possible in Japan, if trust in national bonds was lost and the policy of public spending to lift the economy was not reversed. This speech followed the resignation of Shizuka Kamei, as banking minister. Kamei was seen as an advocate of continued public spending. He cautioned that a policy of relying heavily on issuing debt could not be sustained for long. Japan has government debt of $9.7 trillion, which is close to twice its gross national product in 2009. Much of this debt is held by the public in Japan, but analysts have cautioned that with the aging population, it is possible that people who retire will need the cash from bonds, requiring the government to turn to the debt markets for financing. Among the proposals Kan suggested is raising the 5% sales tax to pay for rising social welfare costs for an aging population. Satoshi Arai, the new national strategy minister, says the government will draft a plan by June 22 to address the public debt. He said the government would not exceed $500 billion in bond issuance for fiscal year ending March 2012....

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Reforms planned by the administration of prime minister, Naoto Kan. Plans to raise the consumption tax, to make changes to social security, and to commit Japan to join the Trans Pacific Partnership. Japan's business community supports the plan to join the free trade community called the Trans Pacific Partnership. This group consists of USA, Australia, New Zealand, Singapore, Malaysia, Peru, Chile. South Korea has signed free trade agreements with the USA and the EU, and Japanese business does not want to be left behind.

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European banks have been slow to get rid of risky assets such as collateralized debt obligations, subprime mortgages and other risky assets after the 2007 financial crisis. As a result sixteen top European banks hold 386 billion euros of suspect credit-market and real estate assets, according to Credit Suisse analysts. The Royal Bank of Scotland has 79.6 billion of assets dating from the 2007 financial crisis. Over the three year period since the 2008 financial crisis, the top three U.S. banks shed 80% of this type of risky assets, compared to 50% for European banks. The four largest British banks have reduced these risky assets by more than 50%, and four French banks have reduced these assets by only 30%. At 29 billion euros, French bank Credit Agricole had the largest amount of such risky assets among the leading French banks. This adds to the difficulties facing French banks which also have large amount of loans to customers in Greece and Greece's sovereign bonds. Deutsche Bank has 20.2 billion euros in commercial mortgages and whole loans and 2.9 billion euros in U.S. residential assets including subprime loans. Mediobanca analysts estimate that Deutsche Bank's exposure to such assets is more than 150% of its tangible equity....

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Akio Toyoda of Toyota Motor praises prime minister Abe's "tremendous leadership," as Abe takes a drive in the hydrogen fuel cell Toyota Mirai in the front lawn of the premier's residence in Tokyo, Japan. Toyota benefits from the yen at 110 to the dollar as this generates higher profits from exports. Sales in 2014 were $230 billion, and net profit $18 billion. Prime minister Abe's economic program depends on companies and their suppliers increasing wages, especially companies with a supplier base as large as Toyota with estimated 1.35 million employees at suppliers in Japan. Toyoda says "both the government and the private sector are of one mind in fighting deflation." Toyota's wage increases in 2014 were only 0.8%. In 2015 hope are high that Toyota will take stronger action. Toyota has refrained from asking suppliers for price cuts in fall 2014, and is likely to do so in spring 2015, so that its suppliers can raise wages. Toyota's 65,000 employees are pushing for a 1.7% monthly base salary increase in April, with bonuses and seniority adjustments bringing the wage increase up to 4%....

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The IMF's managing director, Christine Lagarde, pointed to the urgent need to recapitalize European banks in September 2011. European banks face potential losses of 120 billion euros for Belgium, Spain and Italy, 60 billion euros for Greece, 20 billion euros for Ireland and Portugal, and 100 billion euros for other banking exposure, for a total of 300 billion euros, according to the International Monetary Fund. In the absence of recapitalization there could be further damage to EU economies from restricted lending by banks. IMF estimates show that deteriorating credit conditions could damage growth in the eurozone countries by 3.5 percentage points, and in the U.S. by 2.2 percentage points, creating another recession.

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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 questions about LIBOR rate manipulation were first raised in front page articles in the Wall Street Journal in spring 2008. In 2013 Deutsche Bank's U.S. financial systems were strongly criticized by the U.S. Federal Reserve. In April 2015 Deutsche Bank made a $2.5 billion legal settlement with the U.S. and British regulators for LIBOR rate rigging and admitted wrongdoing. It took BaFin the German regulator a long time to flag these irregularities in a strong manner, in its letter to Deutsche Bank. The comments in the Senior Management Review section of its report for the first time expressed in this level of detail the problems at Deutsche Bank, including problems with 11 current or former executives of Deutsche Bank. The letter and report were sent to the bank's management board May 11, 2015. A month later co-CEO's Anshu Jain and Jurgen Fritschen resigned. Ba Fin's top supervisor of large banks, Frauke Menke sent the letter. By the time BaFin acted many other regulators had already flagged the problems at the bank, and the media including the WSJ had already covered the problems in great detail. Between the first report in the WSJ on Libor rate irregularities and the May 11, 2015 report was a period of 7 years. ...

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Gross exposure for derivatives, credit default swaps and other financial instruments tied to a default in five EU countries- Greece, Portugal, Spain, Ireland, Italy- is about $616 billion according to information from Markit, the Bank for International Settlements and and data firms. Christopher Whalen, editor of the Institutional Risk Analyst, says the financial industry is not cooperating to provide the information needed to understand the true extent of the exposure and the risks involved. This is why the Europeans are afraid of a default, he says, they have no idea what to expect out there. Darrell Duffie, Prof. at the Stanford School of Business, says this raises questions whether regulators know what contagion might occur among swaps holders.

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An intimate biographical account of new Chinese leader Xi Jinping and his connections with Muscatine Iowa, where he visited as a head of a Chinese farm delegation in 1985. Xi Jinping remembers the trip vivdly and plans to spend time with friends from that visit during a visit to the U.S. in 2012. He spent two nights during that visit in the bedroom of two college age boys of the Dvorchak family. This revealing account of Jinping's life shows that the actual story of his life is quite different from the title of "princelings" or privileged sons of former communist leaders that is suggested by this reference in the media. Because of the volatile nature of Chinese politics, his father Xi Zhongxun, who led communist partisans in the struggle of the pre World War II years, was rehabilitated twice after falling out of favor. The first period was in 1962 and it was not till 1979 when he was fully rehabilitated. During this period which coincides with the growing up period of Xi from 9-26 years of age, Xi experienced many hardships. During the years of the Cultural revoultion Xi was sent at age 15 to Shanxi province where his father had led partisans. He lived there for 7 years in a traditional cave dwelling in the village of Liangjahe doing farm work. He was denied admission to Tsinghua University twice before being accepted in 1974. There he graduated with a degree in organic chemistry. This was followed by three years working as an assistant to Geng Biao, defense minister and a partisan who was a colleague of his father. The next job was deputy Communist party chief of Zhengding county in Hebei province. Iowa Governor Branstad visited Hebei in 1984, and Branstad played host to a animal-feed delegation led by Jinping in 1985- the visit to Muscatine was part of this trip and which Jinping has told others he enjoyed more than his visits to Oregon or California that year. The second time Xinping's father went out of favor was after his criticism of the crackdown of protests at Tienanmen Square. These experiences have given Xinping a confidence and experience in different situations that other Chinese leaders including the current leaders lacked. If Jinping has inherited some characteristics from his father he may also have the courage to take China in a new direction, and make the kind of changes China needs as it shifts away from an export based economy. At the same time rule in China is by consensus of leaders on the communist party's standing committee. His father helped initiate the special economic zone in Guangdong province in 1978, and Xi Xinping held senior posts in the provinces of Fujian and Zhejiang and in Shanghai, giving him close ties with industry and local government in areas that led the export based economy. Prime Minister Lee Kuan Yew of Singapore puts Jinping in the" class of Nelson Mandela type leaders, who has great emotional stability to not let his personal misfortunes and sufferings cloud his personal judgement." Of political positions Jinping has a certain wariness. He once responded to mention of him as the potential leader with the words: "Are you trying to give me a fright."...

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Peter Altmaier is director of the chancellery in Berlin, and is the person closest to Angela Merkel. This report in the Economist points out that Altmaier has played a critical role in steps taken by Merkel- as chief whip in parliament for the CDU during the Greece financial crisis and bailouts, as environment minister implementing the program away from coal based electricity, and in negotiating deals such as the deal with Turkey on refugees, and now with Brexit negotiations. Merkel has asked Altmaier to write her manifesto for the September 2017 election. A member of the CDU's liberal wing, Altmaier is known for being a scholar on German history, especially Bismarck, and a workaholic. Here he is mentioned as a bridge maker for the CDU to the Greens Party and was part of a group of CDU and Green Party politicians who met at an Italian restaurant in Bonn. As the moderates are now dominant in the Greens Party, a CDU coalition with the Greens could be shaped by Altmaier if the election results move in that direction. ...

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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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France, Germany, Italy, Spain and Britain agreed to have automatic exchange of information for offshore accounts to fight tax evasion. Luxembourg agreed to join this group. The EU nation move follows the U.S. Foreign Account Tax Compliance Act of 2010 which requires foreign banks and entities to disclose accounts of U.S. citizens, in an effort to fight tax evasion.