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Comparative effectiveness research will be conducted to evaluate what is the best treatment for any ailment or disease or health problem under the $1.1 billion allocated for this in the Stimulus Plan. What are the alternative methods of treatment, what is the effectiveness of each treatment, what are the comparative costs and so on. Is it better to treat neck pain with surgery or acombination ofphysical therapy, exercize and medications? If there is ablockage of arteries in the lower leg and leg pain, how does drugs and watchful waiting compare with surgery? For chronic heart failure how does home monitoring of blood pressure and weight and exercise in addition to medications provide an alternative route as opposed to just medications. Dr Fisher of Dartmouth Medical School cites these as examples of questions that can be asked in comparitive effectiveness research. The money will be available to the Health and Human Services Department and will be used over several years. About 15 federal employees will form a council to coordinate the research and advise President Obama and Congress on how to use the money. In 2007 the US spent $2.2 trillion, or 16% of GDP, on health care, and the Congressional Budget Office says it will grow to 25% of GDP at the rate its growing by 2025 if left to its own devices. ...

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A partnership between rivals and the movement towards the 2016 U.S. elections.

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The language and tone of the leaders says something about what is likely to be the outcome of the G20 summit. Its a first for significant participation, as countries as diverse as Russia, China, India, Indonesia, Saudi Arabia, and the Netherlands are represented. The credible positions of both sides, the US, UK and Japan, and the European side of France, Germany and the Czech Republic, well presented, provide for some serious discussion and negotiations. France's Sarkozy and Germany's Merkel want to see a global regulator that would reach inside the borders of the US with stricter regulation. Sarkozy calls this "nonnegotiable." And he said that he would reject an agreement that puts off stringent new regulations on banks, tax havens, and hedge funds. He said "the compromise has to come from all countries around the world." US President Obama said that if there is going to be renewed growth it can't just be the US as the engine, everybody is going to have to pick up the pace," at the same time saying that the US had to be concerned about its own deficits. The fact is that the US stimulus will mostly help a severely impacted domestic economy recover with social safey net payments to local and state governments and unemployment insurance, as well as targeted investments in infrastructure, education, energy and health care. It will not mean anywhere near the kinds of imports the US made from other countries, especially China. And Obama made that clear when he said the US will never return to that situation, where the US had become a "voracious consumer market." For the Germans the major market for their middle companies is China, and China has its own stimulus spending on infrastructure spending, which should provide for continued imports of machinery from Germany at a much lower level. Thus Germany and France see a strong tendency to call the source of the crisis and repeat that call till the US listens, and refer to the failure of free market capitalism in its unregulated form. And to insist on fixing it through a global regulator with strict and systemwide rules. So you hear this in Merkel's words, "the foundation for this finacial architecture must be laid now, that is why we seem to be so tough." While the vivacious Sarkozy talks of compromise, and a US gesture in regulation in return for Franc's gesture of joining NATO, the mild mannered Merkel is clear and focussed about her concern. She rejects the idea of linking stimulus spending demands of the Anglo-Americans with the Franco-German demands for global systemwide regulation. "This is not a bargaining chip," she says. The media may mistakenly report lack of consensus as a failure of the summit. But in the long run in the presence of good positions on both sides, it could lead to some tough negotiations even if continued at another meeting. And result in something serious, credible and lasting in its impact, rather than something that was easy and did not in Andy Grove's useful words involve "constructive confrontation." ...

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Jon Stewart's farewell on "The Daily Show," on August 6, 2015- the first show appeared in 1999- ended on the day the first Republican presidential debate was put on by Fox News. A year after Jon Stewart started his show he made his mark on television by creating a new genre- comedy that informs people. "Indecision 2000" was a new show that covered the 2000 U.S. presidential election ending with the small number of paper ballots in Florida determining the election. A whole generation of young people grew up watching his show which provided some of the bold vigilance so essential for a effective democracy, including coverage of the 2009 financial crisis. It included a show in which the host of the CNBC show "Mad Money" was told boldly that it was disingenuous that the crisis caught everybody on Wall Street by surprise, when informed people knew about the bad mortgages that were being wildly securitized. This was handled with the subtle humor that continued the conversation in an intelligent way, so typical of Jon Stewart. He is also remarkable for helping so many of his colleagues make a mark, including Stephen Colbert, which amplified his influence on discourse in American society. It included questionning those who benefitted from the intelligent debate with humor that Jon Stewart engaged in- president Obama was asked why the homeowners got so little help compared to the banks involved in the faulty mortgages, as a question of fairness. Veterans from the Iraq war were welcomed to see how the show was developed and get training. Stewart defused anger and channelled it into constructive discourse in American society, during 2 wars, a global financial crisis, and 4 presidential elections- "with malice towards none, with charity for all"- he will be sorely missed....

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Pete Domenici of the Domenici-Rivlin deficit reduction commission and Sam Nunn are part of the initiative- Strengthening America- Our Children's Future. Other members of this initiative are Warren Rudman and Evan Bayh. Here they provide ideas on how to address the fiscal cliff of automatic cuts in spending that are approaching at year end under an agreement between Republicans and Democrats in Congress. The agreement was designed to offer the worst outcome for Republicans (huge cuts in defense spending) and worst outcome for Democrats (cuts in entitlemnt spending) as a last ditch effort to force the two parties to come to an agreement on deficit reduction. It comes after president Obama failed to accept the Simpson-Bowles deficit reduction commission proposals as a basis for working out a plan and as Republicans in Congress were dead set on avoiding any tax increases. In a recent WSJ editorial praising the CEO statement of 80 U.S. CEO's- organized by the Fix the Debt initiative inspired by Simpson and Bowles- the Journal called the CEO's support for tax increases encouraging and was critical of Republican "deadenders" who flatly opposed any tax increases. Domenici and Rivlin say kicking the can down the road again as Congress has a tendency to do is not the answer and a vigorous effort by responsible members of Congress is needed to come up with deficit reduction using the proposals of Simpson-Bowles commission and Domenici-Rivlin commission. This will end the uncertainty plaguing business confidence that is leading to decline in business investment- decline of 1.3% in the 3rd quarter of 2012- and a weakening of economic recovery. To this end Domenici and Nunn have brought together 35 members of Congress to push forward and held four public forums with experts including hearing from John Taylor, Martin Feldstein and Larry Summers....

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The Obama idea is to use the need for investment and the need to create jobs constructively by turning it into an opportunity. The opportunity arises from the need for several things that the government is also best equipped to provide or is uniquely equiped to provide. Such things as first rate broadband access across the country, putting in asmart electric grid, putting in the new energy infrastructure of windmills, solar panels, energy efficient appliances and energy efficient heating and cooling systems. Such things as mass transit, work on schools, sewer systems, dams and public utilities, roads and bridges, in the state of the art infrastructure building that is needed. All these things create jobs and create a sustainable advantage for a 21st century economy in which US companies will compete with companies from other countries. It includes such things as education and making it possible for kids to go to college and investing in education. Two concerns are present from conservative economists about this investment on a large scale from $500 billion upwards. One is the large deficit and public spending which crowds out investment by the private sector. In this case with the danger presented by an economic crisis arises a unique opportunity for government to do the right thing if it grasps it correctly and do as President Eisenhower did in building the interstate highway system at a cost of $128 billion according to governemnt estimates in 1991. Would the private sector be crowded out? In these circumtances faced today many companies including the largest ones are faced with great uncertainties and a precarious existence, and with a climate of fear and disappearing credit are not likely to come forward with these investments, so the danger is not in crowding out but in the risk that no such investments will be made at all. The second concern is that a lot of this money is either wasted or each dollar is not spent efficiently. Obama in response to this concern says he will have new spending rules, and measuring the progress for investments made by the number of jobs created, energy saved and American competitive position in the world. As an indication of the jobs created for each dollar spent the nation's governors have $136 billion in road bridge, water and other projects in which the money can be put to immediate use. Their estimate is that each 1 billion dollars spent would create 40,000 jobs. The estimate is from the nation's governors who met with Obama in the 1st week of December 2008. Local and regional transit systems have $8 billion in additional projects that can begin immediately like buying hybrid buses ans expanding light rail systems. ...

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Jac Welch gives Obama an A for leadership. Mind you he says he doesn't agree with all the President's policies. He is talking about leadership. He scores Obama in four areas, Vision and Team Building, Speed and Authenticity, and he finds him at an A in all areas and gets an A in authenticity with alittle help from Michelle with her warmth and personality. There are 2 more traits on which the test is still going on he says, that of resilience and the wherewithal to champion unpopular causes.