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Friedman's ambivalent position on the situation in Syria on one hand in a recent op-ed on Israel pointing to the need for the U.S. to concentrate its attention on Bethlehem, Pennsylvania, instead of Bethlehem, Israel; and on the other speaking of the situation being out of control in Syria with the proxy war between Sunni and Shiite. U.S. public opinion and media opinion has consistently supported the struggle for freedom in the Middle East against dictatorial military regimes, yet the Obama adminstration has either followed the lead of France and Britain or acted in a vacillating manner.

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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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The costs of fraud in medical care from spurious Medicare claims to kickbacks for unecessary services is estimated at $125 to 175 billion. Costs of unnecessary care from overuse to unnecessary lab tests are between $250-325 billion. The amount wasted for on treatment for preventable conditions such as heart disease and diabetes. is $25-50 billion. This number is much higher when all the complications from obesity are figured in. These amounts alone add up to $500 billion. Add to it the problems and the costs of medical errors leading to bad drug reactions or other misdiagnosed procedures which cost an estimated $75-100 billion and the the total is upto $600 billion. These amounts are not going to be tackled by computerization of medical records. The whole manner and ways in which medicine is practiced today and the manner in which the public takes care of its health would have to change for an impact to be made in these numbers.

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Peter Orszag's role in the healthcare debate and the formulation of health care policy proposals. One proposal of Orszag, who heads the Congressional Budget Office, is to set up a new agency with powers to cut spending and implement changes in Medicare. Says Orszag, "one of the reasons we have such disjointed and skewed incentives is that we have an excessively political process." At a recent meeting with House Democrats, one Congresswoman said her top priority is winning higher payments for oxygen suppliers, and Orszag was taken aback. For years officials have been trying to cut payments to oxygen and medical equipment suppliers, which are said to be inflated. When a new competitive bidding process was set to take effect last year, industry supporters in Congress were able to delay the plan, and these supporters are still fighting to block changes says the WSJ. Here is a 40 year old Orszag, with degrees from Princeton and London School of Economics, who got his early experience in the Clinton adminstration at age 24. He then followed this with a number of policy oriented jobs, ending with appointment to head CBO in 2007. And he faces the whole system of Congressmen from both parties beholden to interests in the healthcare industry, who provide the donations for them to finance their election campaigns. Dan Eggen describes this in the Washington Post, 7/21/2009. Max Baucus of Montana, and to some extent Grassley of Iowa, are senators from both parties who Eggen points out are beholden to the healthcare industry because of large donations they receive from the interests in the healthcare industry. These interests want to see their payments system protected. The further escalation in health care costs, which would make the whole healthcare system unaffordable even as it delivers poor results, can only be prevented by making cost control an exercize that is not influenced by healthcare industry donations. Jackie Calmes describes the huge hurdles in achieving a deficit neutral move to universal health care in the U.S. in the NYT 6/26/2009. See the link. The exchange between Grassley and Orszag on the issue of the $177 billion in savings needed from the payments to health insurers under the Medicare managed care plans- which allow seniors to obtain Medicare coverage outside the government run program -went as follows. These are dubbed overpayments by outside experts and efforts have been made to cut them in Congress. When Mr Grassley raised concerns about the impact of such cuts in a hearing, -and Grassley has opposed the cut for this overpayment to insurers- Orszag responded saying: "I very firmly believe that capitalism is not founded on excessively high subsidies to private firms. This is what this system delivers right now." ...

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In his plain talk on Syria Trump said the primary message to Russia was: "You should have peace in Syria; its enough." This is the message foreign minister Tillerson is delivering in Moscow. He described the Russian support for the Syrian government as: "I think it's very bad for Russia, I think it's very bad for mankind, it's very bad for this world." He also described Chinese president Xi Jinping's response at a state dinner during dessert when Trump told him about the U.S. missile attack on Syrian airfield, as expressing the sentiment that it was OK considering the chemical attacks by the Syrian government on civilians and children. The closest any president gets to the plain talk given by Trump is during the period of the Cold War when Truman also had this kind of plain talking style to deliver the message that needed to be heard.

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Francois Hollande is elected French president. Greek voters vote against the austerity measures by giving a majority of the votes to parties on the far right and far left.

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Concern about stimulus spending for infrastructure. Are the best projects being funded? Are some projects that are shovel ready but not the ones we should be doing first going to get done before other essential projects. The lack of acoherent plan for rebuilding the nation's crumbling infrastrure of roads, bridges and highways. Martin Feldstein says that this recession will last longer than others, so the stimulus spending even if slow will show its impact in 2010 and 2011.

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Experts say there may not be much difference whether a voluntary deal is reached between Greece and the Institute of International Finance or a deal is forced on private bondholders by Greece for the 93% of Greek bonds that are based on Greek laws. Most of the large banks that hold Greek bonds will be subject to persuasion by European authorites (EU, ECB) to accept the deal offered by Greece that brings debt down to 120% of GDP by 2020. The remaining holdouts are the hedge funds that will want to opt out of a voluntary arrangement anyway, because a forced deal by Greece would allow them to collect payments on their credit default swaps. Adam Lerrick, an expert on sovereign debt restructurings, says the hedge funds and other private bondholders are framing the discussion into one of a voluntary agreement that is orderly and an involuntary agreement that is disorderly, as a tactic to scare the European authorites (the EU, ECB) and Greece. He says not only can forced restructurings be orderly, but in this case the improved prospects for Greece with serious debt reduction would lead to a ratings upgrade for Greece. Some hedge funds have said they will sue if forced into the deal. Michael Waibel, at the Lauerpacht Centre for International Law at Cambridge University, says the case would first go to Greek courts where it would be received without much sympathy, and then to the European Court of Human Rights. Only the small number of bonds under Swiss and English law with pari passu clauses insisting on equal treatment of bondholders have any prospects, and even then legal enforcement of any awards is uncertain as shown in the case of Argentina. The 93% of bonds under Greek law have no such clauses and this gives Greece the option for special treatment of bonds held by the ECB....

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Dart Management, a vulture fund based in the Cayman Islands, received 90% of the 436 million euros bond payment by Greece on May 15, 2012. Dart is one of the holdout investors who did not participate in the Greek debt restructuring deal. It planned to sue the Greek government. This has implications for the other holdout investors with about 6-7 billion euros of Greek bonds. The reason given by the Greek government was that this caught Greece at a bad time- suing Greece could have tied up European bailout funds that Greece needs to make interest payments on its debt. The timing is bad from another standpoint, as it will further exacerbate voter discontent with the parties associated with the government just before the second Greek elections in June 2012.

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As the market in larger cities matures, the market in Tier 2 and Tier 3 cities is where most of the growth is expected in China's market. An expanding middle class is one source of buyers. One forecast is for 51% of Chinese families having disposable income of 106,000 yuan to 229,000 yuan or between $17,000 and $37,000 by 2020, according to McKinsey. There were only 6% in that income range in 2010, showing how skewed the income distribution was, and why the growth of luxury cars has benefitted BMW, Benz and GM. A new generation of younger buyers is another source of growth- Nissan's chief planning officer, Andy Palmer estimates the youth market at 240 million. This group is being called the Transformers generation. A big surge in buying for SUV's has helped companies such as Ford Motor Company. Benz and Ford plan to add new dealerships, with Benz planning dealerships in 40 new cities and opening 100 new stores in 2014. Audi is planning a new certified used car program to keep used car resale values high....

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Regional rivals in each of China's 31 provinces make it difficult for foreign retailers, such as Tesco, Carrefour, Metro AG, Home Depot, to scale up and increase market share. Metro AG says it will pull out of China after testing electronics stores for 2 years. After years of losses Home Depot shut down its 7 large stores in China in 2012. Profit margins can be as low as 2%, making it unprofitable without the scale needed. Tesco's market share in China declined to 2.4% of China megastore sales in 2012 from 2.9% in 2008, and Carrefour sales declined to 6.9% from 8.6% in the same period, according to Euromonitor. Tesco now plans to partner with China Resources Holdings to merge its stores with the larger domestic Chinese chain's 4100 stores under 10 retail brands, with Tesco holding 20% of the joint venture. The CR Vanguard brand of China Resources 3000 stores would be merged wih Tesco's 131 stores.

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David Albright, a former weapons inspector in Iraq, says 24 days is enough time for Iran to wipe out traces of nuclear work, such as working with explosives to trigger a weapon or construction of a small plant to make centrifuges. A situation actually happened in 2003 when the atomic energy agency wanted to inspect the Kalaye Electric Company site in Iran in 2003, where Iran was using centrifuges received from Pakistan. Iranians removed all traces of illicit work at the time while delaying inspectors. This case was cited by Olli Heinonen, a former deputy director of the agency. Heinonen says smaller scale activity such as manufacturing uranium components for a nuclear weapon can be carried out and the traces deleted in 24 days. Senator Corker points out that the time allowed would be more than 24 days when all the time is added up correctly.

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This Journal editorial says Germany and France will have to pay for preserving the Eurozone one way or another. It suggests a direct approach of the German and French governments injecting capital for recapitalizing German and French banks that would take losses on bad loans to Greece, Ireland, Portugal, and Spain; combining this with bondholder haircuts for creditors, and reforms that include spreading the burden for Irish bank debt and cleaning up the cajas savings banks mess in Spain. This would mean exactly the opposite of what is taking place now, including the abandoning of individual country rescues and bailouts; which the Journal calls extending loans and pretending the problem is not with German and French banks that would have losses on the bad loans. The problem is that this places the entire burden on austerity measures in each bailout country which reduces growth and raises unemployment to levels that make the problem much worse than before. This is not happening because of a serious failure to reach agreement on the shared sacrifice and cooperation between the governments, creditor banks, the ECB and other parties in the eurozone, on a serious debt restructuring across the eurozone that would put the euro back to stability with some mechanism for serious financial discipline in eurozone states....

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Joe Nocera compares the German insistence for tough austerity measures in Greece, Italy, Spain and Portugal, to the insistence ofthe Allies for large reparations from Germany after the First World War, which Germany was not able to pay and left it bankrupt by the late 1920's. He cites the failure of orthodox positions on financial and monetary policy to tackle complex issues such as the overvalued currencies of southern Europe, as productivity moved in opposite directions between Southern Europe and Germany. Austin Goolsbee, a former chairman of Council of Economic Advisors, makes the same point in an op-ed piece in the Journal, 11/29/2011. Nocera says this position is simiiar to the position on debt reduction for homeowners facing U.S. foreclosures with government intervention, where little action has been taken worsening the housing crisis and derailing the U.S. economy.

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The Washington Post's veteran Middle East correspondent, Jim Hoagland, says there are some important lessons to take from the experience in Libya. The Arab rulers who entrenched themselves for decades wasted the bulk of their oil wealth. It was right for Palestinians to disassociate themselves from these regimes. The French took the brunt of the fight in helping Libya free itself from the Gaddafi regime. This is an understatement as without Sarkozy's initative and Cameron's unflagging support, without France and Britain's early support, Gaddafi's forces would have overrun Benghazi and ended the struggle for democracy in this part of the Arab world. U.S. President Obama and Defense Secretary Gates did little in the early days when there was dire need. Germany's chancellor Angela Merkel continuously resisted supporting France and Britain in Libya. The U.S. Obama administration and Turkey gave their support only after the perilous period- when the fate of the rebels fighting for freedom hung on a thread- was past. Hoagland calls Gates view of "feckless Europeans" shortsighted. Hoagland sees this as an opportunity for Europe to take a larger more active role. ...

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The first signs of a return to growth are seen in the European automobile market. The European Automobile Manufacturers Association reports a 1.7% increase in new passenger car registrations for May compared to April 2013.

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The terms of the Greece bond deal with private bondholders of March 2012, in which Greece's bondholders (mostly French and German banks) took about 53.5% loss from the face value of exisiting bonds. The deal was accomplished through a swap of new bonds with extended maturities of 10-30 years for bonds with shorter maturities and by reducing the face value of the new bonds.