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Doctors face a 21% cut in the amount of Medicare payments for treating seniors having Medicare, though this cut will be delayed till 2011 under legislation in Congress. This issue goes back to 1997, when a budget law set spending targets, and stated that if they were exceeded formulas to reduce doctors payments would go into effect. The formulas seriously cut into doctor payments by Medicare in 2002, so the formula was put off. The result of this is that the cuts based on the formula now amount to 21%. The cuts are not expected to go through, but at the same time Congress has an headache on its hands with the growing deficit. In the Senate there is opposition to a $120 billion bill to extend long term unemployment benefits which lapsed in June 2010, for tax breaks, and other expenses. Senators want to pare down the bill's price tag, as $80 billon of this is unfunded and will be added to the budget deficit. For a primary care doctor in Washington state, Medicare pays about $95 compared to private insurers payment of $129, and a plan for state workers that pays $140....

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John Harwood provides an insight into the polarized positions of each side in the negotiations and the changes in the national scene that have led to a polarized political climate and a polarized Congress. The political positions on the Republican and Democratic sides in Congress and the Senate are different from any other time in many decades of government. Between Tea party members of the House and Pelosi Democrats in the House there is a serious divide. The senior leaders of each party command less support. Consider the loud "no" given by newly elected House Republicans led by Rep. Cantor to Senate Republican leader Mitch McConnell's backup plan. The written pledge for no tax increases has given the Cantor House Republicans little room for compromise. And as Harwood points out each side, the tea party House Republican group, the Democrats in Congress, and the President, all know there is every chance that they could be voted out of office in 2012.The media is also splintered with vocal positions on either side. As Senator Chambliss of the Gang of Six Senators said on a talk show a week before the August 2 deadline for raising the U.S. debt ceiling: "Frankly, we don't know what's going to happen for sure." ...

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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 problems facing U.S. Speaker of the House of Representatives, John Boehner, as a government shutdown occurs in October 2013. Republicans and Demorats fail to agree on raising the debt ceiling and financing of the government. Boehner faces a movement in the Republican party led by Senator Ted Cruz of Texas for defunding the Obamacare law.

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Talks between Speaker Boehner and the Obama White House reached an impasse on debt ceiling and deficit reduction with strong opposition from members of their own parties.

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Costas Paris interviews Lucas Papdemos, former prime minister of Greece, and a former vice president of the ECB. Papademos points to the grave consequences for Greece of an exit from the euro with high inflation and higher interest rates, and gains in price competitiveness diminished by the inflation. He says Greece must stick to the committments for cutting spending and new taxes made earlier under his government.

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The Journal cites figures from the U.S. Department of Agriculture showing 44.7 million participated in the Supplemental Nutrition Assistance program in fiscal 2011. This is a big jump from the 28.2 million people in 2008. Texas has 4 million on food stamps, California 3.7 millon, Florida 3.1 million.

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U.S. States faced a shortfall of $86 billion during the 2011 budget season, according to the National Conference of State Legislatures. This was after a rise in tax collections during the last year from an improving economy, and about $30 billion of tax increases passed in 2009 and 2010. States faced the end of $66 billion in federal stimulus aid, and their share of Medicaid costs are expected to go up by $16 billion in this fiscal year, according to the National Association of State Budget Officers. The political mood has shifted with worries about the deficit and fears that tax increases could make the states less attractive for employers. As a result there is a focus on spending cuts with very few tax increases. Forty six states began a new fiscal year this week after legislatures focussed on spending cuts, mostly avoided tax increases, and some states placed restrictions on the pay and benefits of public employees.

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The lack of economic opportunities for an increasingly urbanized African younger generation is a major challenge. The median age of 19 makes Africa the world's youngest continent. Megacities are growing up in places such as Lagos and Kinshasha as millions leave subsistence farming to go to cities. Unlike Asia and Latin American countries men and women are coming to shantytowns in cities at a time when Africa is much poorer for a similar level of urbanization that Asian and Latin American nations reached decades earlier. In 1993 this WSJ analysis and graphs show the Asian emerging economies and sub Saharan Africa had similar GDP per capita of $2415, by 2019 this was $4000 for Africa and $12,000 for Asian emerging economies. Latin America was at $10,000 in 1993 and in 2019 was at about $15,000. The gap widened considerably between Asia and African countries. Asian emerging economies increased GDP to 5 time from the same starting point as Africa in 1993, Africa doubled GDP over the period of 25 years to 2019. Latin America started from a much higher point and increased GDP by only 50% over 25 years. Asian economies that performed better over this period did better because of stable even entrenched governments such as in Singapore with Le Kuan Yew and in China with stable successive governments under CPC leadership of prime minister Deng. The difference in Asia was a commitment across all classes and groups to development, a sense of development as a way to make up for the years lost under colonialism of foreign powers in the eighteenth and nineteenth centuries. A sense of correcting historical injustice and wrongs. This is a missing ingredient in the processes unfolding in Latin America and Africa in the last 25 years. ...

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With the strong positions taken by Clinton and Trump on China in the 2016 election campaign, U.S. relations with China enter a new phase. The strident tone in the campaign on China on trade deficit, women's issues, human rights, comes with the issues relating to China's role in the South China Sea and cyber espionage already in the background.

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The skills to navigate different personalities and work patiently on the issues surrounding changes to the U.S. tax system of Rep. Dave Camp (MI), chairman of the U.S House of Representatives Ways and Means Committee, will be immensely useful in the effort to make changes to the U.S. tax system. Camp works well with fellow House Republican leaders Boehner, Ryan, Cantor, and his Democratic counterpart in the U.S. Senate Max Baucus. Camp is a good listener, refuses to engage in partisan criticism, and has the patience to work through difficult issues of achieving savings and keeping fairness in the the tax changes. Earlier efforts to achieve consensus in late 2011 failed, making it even more important to have leadership which can create productive debate and bridge the differences. The tax changes are part of the overall effort for U.S. economic recovery by reducing the deficit.

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The Bernie Sanders 2016 U.S. presidential campaign is compared to the Howard Dean 2004 U.S. presidential campaign. Both are from Vermont- Sanders was Mayor of Burlington, Dean was governor of Vermont. Dean and Sanders draw many white, educated, affluent voters to their campaign rallies. Yet the situation in 2015 is different. Dean's major issue was his opposition to the Iraq war started in 2003. Sanders says his position is more class based, and calls for a revolution to help working class Americans gain upward mobility as wages remain stagnant, and educational opportunity restricted. The Democratic Party today is also different, with more ethnic voters, and 40% female.

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Mervyn King, the governor of the Bank of England, is coming under increasing criticism for supporting the Conservative-Liberal coalition government's austerity plan, and for lack of efforts to fight inflationary pressures. On a major issue on which King has taken a clear stand- that the largest British banks should increase capital levels exceeding the international standards- not much has happened. Consumer prices in Britain were up at a 3.7% annual rate in December, and the government's austerity policies will also cause pain. In a recent speech King said that the Bank of England had limited ability to fight the higher unemployment and increased inflation. It was an admission of the limits of central bankers in the current situation. King said "a squeeze in living standards is the inevitable price to pay for the financial crisis and the subsequent rebalancing of the UK and world economies.

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The Washington Post points out the damage to civil society and the rule of law in Egypt in 2014-2015. It cites the Working Group on Egypt's conclusions that repression only works to increase the extremism in the region. A bipartisan group of seven senators including John McCain and Marc Rubio, in a letter to Mr. Kerry, the U.S. Secretary of State, says the U.S. foreign policy must always support human rights, political reform and civil society. It calls these core principles.

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Britain's Tax Service reports the number of taxpayers reporting incomes of 1 million pounds a year declined by over 60% in fiscal 2010-2011 from the prior year. In 2010 the Labor government of Gordon Brown introduced a 50% income tax rate for this income group, up from 40%. The number of million dollar incomes filed declined to 6000 from 16000 in 2009-2010, and revenues declined from 13.4 billion pounds or 9% of total taxes from taxpayers to 6.5 billion pounds or 4.4% or about half. The Labor government had hoped for additional 2.5 billion pounds in revenue, showig unintended consequences and surprises in economic policies.

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Voter fatigue with the Conservatives under prime minister Harper is showing up in the province of Ontario. The area around London, Ontario, and Toronto is critical in the 2015 general election. A large loss of manufacturing jobs has left this key manufacturing region of Canada so weakened that the recent 20% decline in the Canadian currency is not leading to a rebound in the manufacturing sector. The Liberals under Justin Trudeau have promised to run a slight deficit to invest in infrastructure that would help the manufacturing sector, while Harper's Conservatives plan to keep the status quo. The vigorous campaign run by Trudeau, the son of a former prime minister, is also helping the Liberals, who are moving ahead in the polls.

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The Trump administration's early proposal for NAFTA moves away from campaign pledges to completely renegotiate the treaty, instead taking the approach of working to improve the U.S. trade position in relation to Mexico and Canada. It includes seven objectives for tougher rules for labor and the environment favored by Democrats in Congress, and it also has support from Republicans with its effort to update NAFTA for changes in technology and in other areas since the accord was signed during the Clinton administration. The area in which U.S. and Mexican business are wary is one in which the Trump administration still seeks to keep the option of imposing protective tariffs, and a border-adjusted tax to level playing field for differences in taxes, as well as other measures to protect American jobs and interests. Because any renegotiated NAFTA also has to pass both houses of Congress this proposal took into account the different constituencies and interests for this issue. Robert Lighthizer, trade representative under president Reagan is likely to become the next U.S. Trade Representative and lead negotiator. We first profiled Lighthizer in a group in Lyrarc for pointing to the need for a level playing field in trade. As early as 2010 Lighthizer argued in op-ed articles that globalization and trade practices should ensure a level playing field for the U.S., and was covered in Lyrarc. ...

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Narendra Modi is now the choice of the BJP party in India to lead it against the ruling Congress party of Sonia and Rahul Gandhi. The corruption in government and the slowing growth have improved the chances of Modi, the chief minister of Gujarat state in northwestern India, near Mumbai. Modi has done well in Gujarat state in a number of areas- from foreign investment in manufacturing, infrastructure development, and better governance. His plan is to replicate this at the national level. His slogan is minimum government and maximum governance.