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'Showrooming' is hurting big retailers with large stores such as Best Buy, Target and Wal-Mart, which are taking their own actions to reduce the impact.

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President Biden called for corporations to pay their fair share of taxes so that investments can be made in vital needs of the nation-US infrastructure, education and health, transport, public services. The NYT looks at companies where profits are shifted overseas to reduce taxes. In this case NYT looks into an investigation into shifting of profits to a Swiss subsidiary to avoid billions of dollars in income taxes. 

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On the way the majority of people in China's rural areas live, and how their lives have worsened with the market system. A lack of democracy makes it harder for them to get a fair allocation of resources. Lack of press freedoms and no constraints on authorites at the provincial and county levels makes the situation even worse.The support systems for health, education have collapsed in the rural areas. Even though life was drab in the Maoist period, basics such as health care and education were free or nearly free. Efforts are to throw more money at the problem are being made. The government has allocated an higher amount of 340 billion yuan or $42 billion for agricultural development and rural services. But as the Economist points out the money is only about an additional $7 per person for the 800 million in the countryside. A large part of the problem is that the lower levels of the government are run incompetently. The lack of democracy means that these officials are not accountable to the people they govern. No effort has been made to make these officials accountable by having elections at the township, county and provincial level. The Communist party is placing all its hopes of keeping a monopoly of power on its ability to spend and manage its way. The Economist's prediction is that this will fail because only democracy can bring the kind of accountability that is needed in the rural areas. ...

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JP Morgan Chase will modify the terms of $70 billion in mortgages for borrowers who are behind in their payments or expected to be. This covers 400,000 borrowers. The focus is especially on a type of loan structured so that the monthly payment increases, and Chase inherited $54 billion of such loans with the takeover of Washington Mutual in September 2008. Some of these loans are called options adjustable rate mortgages where borrowers can make payments that don't even cover the interest costs, resulting in increasing the loan balance. Chase will replace the options ARM's with fixed rate loans.In taking over WaMU, Chase had a large exposure to the California housing market. WIth WaMu CHase ended up with $16 billion of subprime mortgages. The mortgages that Chase will modify for this plan with affordable payments make up 4.7% of the home loans it owns or are serviced by Chase's EMC Mortgage Corporation. So this is a good start but a lot remains to be done. Chase's Scharf who heads the retail division said that Chase had heard loud and clear what the thought leaders in the country are saying, and wanted to provide leadership on this issue to the whole industry as it does'nt make sense to wait. About 7.3 million American homeowners are expected to default on their mortgages from 2008 to 2010, and about 4.3 million homeowners lose their homes, according to Moody's Economy.com. While opinion leaders like FDIC's Sheila Bair and Reagan adviser Martin Feldstein have called for government help to prevent foreclosures from the early months of 2008,and FDIC has considered about 40% of current monthly payments the affordable amount for loan modification in IndyMac FDIC modifications, neither the Bush administration, banks or companies in the mortgage industry have taken any leadership on this issue. And now Scharf says it makes no sense to wait, in effect a signal to other banks to do the same. Scharf also said the stronger you are the more easier it makes to take these decisions suggesting that the $25 billion in government funds it received helped it reach this decision on this plan, which makes a lot of sense for the banks because foreclosures are the worst way to recover money with bad consequences for all parties and disastrous for the US and global economy....

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Muhammad Azhar Ali, factory manager for National Foods plant near Karanchi, Pakistan, describes what it is like running a manufacturing operation in Pakistan. National Foods is the largest manufacturer of pickles and other spice products in Pakistan. A big problem is the lack of security and terrorism. This remains a constant cause of anxiety for business people in Pakistan. Its like being in a war zone says the National Foods chairman Abdul Majeed. Another major problem is lack of reliable electricity supplies. Supply of electricity is only one third of national demand in Pakistan. Larger companies such as Lucky Cement generate their own electricity, with Lucky Cement producing 150 megawatts from its plants. Smaller companies like National Foods rely on diesel generators. To conserve electricity many factory, floor office and bathroom lights are turned off. For workers the lack of electric supplies and high inflation affect lives in many ways. National Foods has a weighing department and assesses workers picked up from many parts of Karanchi to see if they are fit for work or are unduly stressed from poor living conditions. This is a side of Pakistani life that is rarely touched on-the daily lives of workers and managers. Ali works harder than other production managers in other countries because of the power shortages and lack of security. He would like to devote time to increase productivity and be more like other production managers. The war with the Taliban has cost Pakistan $68 billion in destroyed infrastructure, security costs, lost foreign investment according to one estimate. ...

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DW.com looks at what it means for first Finland, and then Sweden joining NATO. For Finland the invasion of Ukraine where people speak Russian and have close cultural ties comes as a reminder of past history. Under the treaties that ended the war with Napoleon in 1815 after the Congress of Vienna, Finland was given to Russia and Norway wrested from Denmark was given to Sweden. Jens Stoltenberg now head of NATO is a former prime minister of Norway. Russia invaded Finland in 1940, and Germany invaded Norway during that war. As a result there are historical reasons why 62% of Finns support joining NATO.  What this means for NATO- This means NATO's border with Russia will double from 1300 to 2600 kilometres. Finland would be different alone compared to being part of the NATO alliance. For NATO this means 280,000 Finns in its army if mobilized under Finland's compulsory military service would be added to defending the border. Finland already is training with US equipment and training since 2015 and is in a joint defense plan with NATO. Sweden's situation is quite different. It has benefitted from neutrality and never been occupied by any power in the 500 years of European wars for balance of power in the region. In the last 200 years Sweden has acted as a neutral state and stayed out of 2 world wars and other conflicts. For Sweden to join NATO it has to change this historical neutrality and has to be convinced that the invasion of Ukraine and the immense destruction in Ukraine with over 4 million refugees mostly women and children is an event that has changed everything. If Sweden were to join NATO not much could be expected for ground forces as Sweden has a small army. Sweden also has no land border with Russia. Sweden is on the Baltic Sea which is also a border for Russia. Sweden does bring 100 modern fighter aircraft and 8 modern submarines that would secure the Baltic Sea.  If one or both countries were to join NATO this would happen by June and both countries would join NATO immediately after 30 NATO member countries approve this.  ...

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Rehma Malik, Interior Minister of Pakistan, admits in a rare statement that militants were entrenched in the southern part of Punjab province, the most populated province of Pakistan. This happened as two mosques in Lahore were attacked. This showed that the problems are deep in the heart of the country. This complicates the situation in Afghanistan, as all the problems faced by the USA in that country somehow come back to Pakistan.

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The situation in Boise, Idaho. Home to many electronics and high tech companies like Micron Technology, Boise has weathered many downturns with unemployment rates well below the national average. This time things are not looking at all like previous downturns, as the unemployment rate in Boise climbed to 6% from 2.7%- it has already approached the national average of 6.7%, and is climbing. This suggests that high tech is also being affected seriously. Unemployment is expected to reach 8% in 2010, about the same as the national average forecast according to Moody's Economy.com. Goldman Sachs forecast is for the 2009 savings rate to be between 6% to 10% by 2009. Families like the Capps and Muirs that have young children or children in teenage years, are now serious savers, as profiled in this description. Down to getting their meat from a calf grown on a family farm in the Rocky mountain region where Boise is located, cutting their own wood in the mountains, buying 11 dozen eggs and freezing the insides of the eggs, buying on deals like $8 winter coats at Old Navy's store, bulk purchases of sugar and staples, growing and canning vegetables, handcrotcheting hats and scarfs for sale on Craigslist and local bazaars. All this from Mrs and Mr Muir including starting a Moneysavers Club, an email group of 30 people. The Muirs are a young family with their first child 5 years ago, who have stable employment, with Mr Muir working as a grape researcher for the state Dept of Agriculture, and his wife a dental assistant. But having taken 2 mortgages to buy their $144,000 home because they could not afford the 20% down payment. The wife's 401K of $3000 going for insulation and fence , and the husband's 401 K savings down to $13,000- reduced to half by the stock market. Suggesting poor decisions on housing debt with low savings for a couple in their thirties. The Capp couple in its forties has also low savings, having $40,000 in student loans, and credit card debt of $11,000 just paid off by using the $10,000 severance package for Mr Capp. The Capps are economizing on everything from skiing to using washable rags instead of paper towels. He worked as a field service engineer for Electroglass, a semiconductor equipment manufacturer based in San Jose which fired two thirds of its field service engineers, including Capp. They also used a $25,000 line of credit on their home to buy a used Toyota 4Runner. Considering their economizing skills, their responding to the downturn by paring down debt as quickly as possible, the information of Mrs Muir's skills at saving, the Capps continuing to use their 253,000 miles Toyota Corolla- these are families that were not crazy spenders, but just families that did not take saving seriously. The Capps made $65,000 from Mr Capps salary and $10,000 from Mrs Capps work at a mental health clinic (after getting a BS in psychology), yet their $2700 in savings suggests no effort was made to save for a rainy day. What this saving and economizing means is that restaurants are closing in large numbers in Boise. Retail stores, including electronics and clothing, are shuttering, All this is leading to higher unemployment, leading to saving measures like those used by the Capps and the Muirs. Meanwhile the numbers for savings accounts at Home Federal Bancorp in Boise, Idaho, a $725 million bank with 15 area branches, shows savings accounts up 26% in December from the previous year. And says the banks consumer banking head, the balances are increasing even as the unemployment rate is going up. Which suggests that Rodriguez and Goldman Sachs may be right (seee link) that the savings rate may reach 10%, and even higher, from what is happening in Boise. Views on currency valuation and the dollar as indicated in the analysis of the article about Rodriguez /Grantham/Scheiff, WSJ, January 2, 2009, may have to be separated from the analysis of what is happening in savings, as the weakening of the dollar relates also to the weakening of other economies and currencies. This steep upturn in saving is likely to affect Chinese exports severely and the Chinese economy. This also affect the German economy, as China imports less from Germany, especially its midsized manufacturers. See links. What is happening on saving, on the other hand, is very real, and happening before our very eyes....

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Just before the general elections of Feb 24-25 in Italy, the centre left PD party of Luigi Bersani sees its 12 point lead over the coalition of Silvio Berlusconi go down to 6 points. Former EU commissioner and prime minister in 2012, Mario Monti, has 14 points. The maverick Five Star Movement of comedian Beppe Grillo has the support of younger voters looking for a break from the past in Italian politics with 15 points. Italy's election rules automatically gives the coalition with the largest number of votes a 55% majority in the lower house of parliament. In the Senate a similiar rule gives a majority on a regional basis. For the eurozone the best outcome is for a Bersani win. Bersani looks to the Monti coaliton, which has the support of Italy's business community, for credibility and backing. The Economist provides an insight into how Italy lost competitiveness and income per capita stagnated in Italy in the last two decades. The dynamism of the sixties and seventies is missing, Italy's infrastructure is old and needs to be modernized, the productivity growth is negligible, and application of new technologies for productivity in many sectors is lagging. Political mismanagement under Berlusconi and other administrations before him has led to an entrenched stagnation and Italy badly needs to get out of this. Italy and Portugal are the only two countries with a lower per capita real income in 2013 compared to 1999, when the euro was launched. Unit labor costs have risen, and productivity has declined in the last two decades leading to lost competitiveness. The inability to resort to devaluations, and the lagging application of technology in many sectors, has increased the lack of competitiveness, with the economy becoming dependent on higher public spending, higher public debt. The result is higher unemployment at 11% and youth unemployment at 36%, infrastructure that is old and badly needs modernizing. Foreign investment is small, and the cost of doing business higher, including electricity rates 50% higher than the European average, R&D spending low, all of which need to be reversed for Italy to grow. But there is hope. The Economist cites an OECD report that shows the Monti government's reforms in regulatory, labor-markets, product-markets, can generate 4 points of GDP growth in the next decade. An IMF report of Jan 2013 looks at proposed reforms in energy, transport, professional services, judicial system and public services and more labor-market improvements, with the larger impact when done in combination, could add 5.7% to GDP growth in 5 years, and 10.7% in 10 years. Adding changes to taxation and shifting public spending towards investment for growth increases the figure to 21.9%....

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Kevin Maurer looks back at 15 years of covering Afghanistan since 2004, and asks was it worth it.  The conflict has cost 145,000 lives for the U.S. period of the war alone. Not counting the war in which the Russians were involved in the decade before the U.S. involvement. In fact the Russian involvement in Afghanistan was costly enough to hasten the collapse of the Soviet Union and bring Gorbachev to power to unwind the war and make the changes that led to the collapse of the Berlin Wall.  2400 U.S. servicemen dead and 20,000 Americans wounded. The cost to the U.S. is $737 billion for this war, according to a report in 2018 from Brown University's Costs of War Project. Just as the Soviet Union showed the damage from this war the U.S. has seen the cost of this war and foreign entanglement in another war that started accidentally with international interventions in the Iran-Iraq region as a cost that was borne with consequences. This includes the neglect of infrastructure and the damage to the middle class prosperity built up in the 1950's and 1960's after the Second World War. The U.S. got into this war with 9/11 attacks on New York City. By 2010 what began as a war fought by a few Special Operations teams turned into a war with troop levels reaching 100,000. Presidents Bush and Obama both failed to end the war by winning it. In 2014 finally combat operations stopped and American troops mainly conducted anti-terrorism operations and trained Afghan forces. In recent years the war has gradually disappeared from the national discussion in the U.S. and is barely talked about. President Trump wants to end the war even if it means talking to the Taliban and negotiations directly with the Taliban are ongoing.  One result of this war is the aversion to costly international entanglements and the highly unpopular nature of the conflicts. There are serious costs of the conflict in terms of neglected domestic priorities including infrastructure, loss of U.S. technological edge in key industries, and the competition from China, an the investments in health, education, services that were not made, the increase in inequalities and the diminishing of the middle class. The global financial crisis of 2008, the result of faulty banking, added an economic dimension through the loss of middle class savings in the U.S., worsening the financial situation of the middle class in the U.S.    ...

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John Cochrane, professor at the Booth School of Business, University of Chicago points to the simple truths about U.S. healthcare- out of control pricing because of the pathologies created by previous laws and regulations. He points out that costs are high in healthcare because regulations keep them high. Supply of new doctors is controlled because Congress and the AMA made it that way with a cap on residency programs and AMA opposing the expansion of medical schools. In a system of open competition new hospitals and health care businesses would challenge old ones which is not happening in a regulated market with regulations working to limit competition for the firms already in the business and with the influence to limit competition. Insurance costs for major expenses in an open and deregulated competitive market without the regulations would be so much lower than todays costs that its likely we would not even need a mandate such as the one the Obama healthcare law imposes.

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As the pandemic continues to spread and numbers grow with reopening of the economy the question remains -what can we learn from other countries positive experience in controlling spread? Here the Times provides the example of German contact tracing- chancellor Merkel has emphasized that a lot depends on "total" contact tracing, and contact tracing "above all else." Germany's experience is that even if you don't get everything right, you make an honest effort with everything you've got and do it early it makes a real difference. Some of the offices across Germany are stretched and short of staff but they have been working since the beginning of March, sometimes in the early days 7 days a week. Only 33% or one third of the offices throughout Germany for contact tracing have the required 5 person team for every 20,000 people, and 35% are overstretched or at their limit, according to one survey. No apps, just a low tech effort with people from the state administrations who were not working during lockdown trying doing something else, or volunteers. Mainly using the phone, talking to people and tracing the contact chain of people testing positive. Putting this information on the computer with a central database.  The Berlin office has 115 workers and has tracked down every one of 666 virus cases it was given. Because of privacy concerns at the Munich office sometimes even the patient's name is not given and office staff have to locate the name and the person. It requires dedication, flexibility and above all resilience, says Harold Rau, the deputy Mayor of the Cologne office, cited in this Times report. The doctor alerts the local office with a test result. The office calls the person and finds out who he has been in contact with for the last 14 days. Then the people who were in contact with are grouped based on the directness of contact, face to face, so on. These people are asked to quarantine for 14 days, sometimes with the rest of their household. They get daily call to find out how their doing for symptoms. The effort goes back to Robert Koch in the 1892 cholera epidemic in Hamburg. Robert Koch, microbe hunter in Germany, was called in after the epidemic spread from Moscow. It devastated Moscow and Tokyo, but Hamburg suffered far less about 8605 deaths as a result of the contact tracing and strict closing off quarantining of affected chains after isolating them, closing off affected parts of the city. Bit by bit the cholera epidemics sparks were put out before turning into flames, says Koch. In the current pandemic Germany has suffered 8241 deaths and 178,000 confirmed cases. So far this is in line with the cholera epidemic in Hamburg 1892, and this for all of Germany. And it is not just affluent nations that can do this. where there is a will there is a way. In Kerala state in southwestern India, similar efforts have worked to limit spread  with even better results than Germany. ...

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A senior military oficer, Admiral Fallon head of the Central Command overseeing both wars in Iraq and Afghanistan questions US policy towards Iran in major differences with President Bush. Its a bit strange though as Defense Secretary Gates points out that US policy towards Iran changed towards diplomatic pressure and political moves as opposed to a possible military action after the new intelligence report that questioned earlier reports of Iran moving towards nuclear weapons itself a result of vigorous debate and questioning in the intelligence department. So why would this result in public differences when the Bush administration has already changed both its rhetoric and its policy posture towards Iran? The Admiral is near retirement after 40 years of service, and may not have authorized the article in Esquire magazine or been aware that the journalistic world would turn this over the internet into a public spat with President Bush.

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Two weeks after his election Donald Trump says the U.S. will not join the Trans Pacific Trade Agreement during his term in office. Barack Obama took seven years to negotiate the trade agreement which was opposed by trade unions, the auto industry and was unpopular in the midwestern U.S. because of the impact of trade in hollowing out the manufacturing sector. Here Frank Sieren of the DW.com points out that the agreement was not really about trade, as most of the gains of trade had already been realized according to experts. It was part of the "pivot to Asia" to maintain American dominance in the region, says Sieren. After China pulled together some Asian and European countries into its trade agreement, the Regional Comprehensive Economic Partnership (RCEP), the U.S. pushed for TPP as a counterweight to the China sponsored trade zone. China says it will try to integrate the countries in TPP into the trade zone it has sponsored. President Trump has said that the U.S. is better off negotiating agreements with each country and not getting into multilateral trade agreements. He fought the election campaign on the basis of the opposition to TPP and trade agreements that unfairly hurt American workers. This could have provided the 110,000 margin of victory in the states suffering from the hollowing out in manufacturing such as Michigan, Wisconsin, Ohio and Pennsylvania. A similar hollowing out in Ontario favored Justin Trudeau's Liberals against the Conservatives in Canada's election. ...

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Many African countries have high growth rates but this can be misleading. Much of the wealth is generated from drilling or mining for resources. There is no transparency about the wealth generated and its use, with much of the wealth siphoned off to go to the ruling elites. Even the thriving private sectors can give the false impression of progress, when they are cartels of firms run for the benefit of the ruling party and its cronies. Independent media is purchased by the ruling elites and the information is one sided, concealing the imbalanced development and widening gaps between the wealthy and the vast majority of poor. When investments are made they show a stark reality of years of neglect of education and healthcare. Angola has built 24 new hospitals with oil revenues, but has only 1500 doctors for a population of 18 million. Much of Nigeria's electricity supply comes from small generators as the government electricity system has seen underinvestment for years. State owned firms are "privatised" in Nigeria by giving them to cronies of the government in power. These countries lack a honest civil service, an ethic of responsibility in the educated and ruling classes, institutions of democracy with checks and balances, and independent media. The anti colonialist movements in African countries have failed to deliver on education, democratic institutions, and building a prosperous middle class in most of Africa with a few exceptions. Both military and civilian leaders have failed to relinquish power once in control, with the rare exceptions....

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Athenahealth, a provider of software for physicians, is intervewed by Jon Kamp about the efforts to promote digitization in physician's offices.

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What is the Muslim Brotherhood in Egypt and what does it mean for the US in the current protests? The Muslim Brotherhood was started in Egypt in 1928, in the colonial days, by an imam and schoolteacher named Hassan al-Banna. The intent was to act as a grassroots organization to promote the reform of Egyptian society through a greater adherence to Islam, by preaching and social services. Scott Shane talks with Reidel of the Brookings Institution and Shadi Hamid, director of research at the Brookings Quatar Center about the Brotherhood and Israel. Reidel was the Egypt desk officer at the CIA when Mubarak came to power in 1981, and is an experienced observer of the Muslim world at Brookings. Reidel says if we want democracy in Egypt, the Muslim Brotherhood is going to be a big part of this, and we should be engaging and talking to them now. Hamid responds to a question about terrorism by pointing out that the Al Quaeda hates the Brotherhood and the Brotherhood hates Al Quaeda, that for counterterrorism engaging with the Brotherhood would be helpful to the US. On Israel, Hamid says years of accomodation to the real world has brought a knowledge that the Brotherhood has to live in the real world and the geopolitics of the Middle East. Carrie Wickham, a political scientist at Emory University, is author of "Mobilizing Islam," a 2002 book on Egypt and the Muslim Brotherhood. Carrie says it was analogous to evangelical Christians and their goal of sharing the word of God, but Banna also referred to Jihad as a struggle against colonialism and Zionism. Some leaders such as Sayyid Qutb, who was imprisoned by the Egyptian government and executed in 1966, advocated violent jihad, but after the 1970's the Brotherhoods formally renounced violence as a means of achieving power. In 1984 the Brotherhood reached another point in its evolution when it competed in parliamentary elections. And estimates of its actual support begin at about 20% of the electorate. Another development is the relative youthfulness of the April 6th and other movements in Egypt, where two thirds of the people are under 30 years age. The Muslim Brotherhood leaders are much older and hesitated to join the popular movement in its early stages. On the question of the Brotherhood's future evolution and winning a large role in a future government, Carrie says that a system of checks and balances has to be established to ensure that the Brotherhood operates as a democratic party committed to the democratic process. The Wall Street Journal in an editorial on February 4, 2011, emphasizes the need for institutional checks and balances. Carrie says rewriting the constitution and electoral process to ensure that this happens and no one party can take abslute control is crucial. ...

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British prime minister Theresa May makes a bid for working class votes in the 2017 election, just as the Labor party under Jeremy Corbyn announces its own manifesto seeking working class votes. May has proposed increasing the minimum wage to 60% of median earnings by 2020, and increased funding for the National Health Service by 8 billion pounds over 5 years. Corporate taxes will be reduced from 19 to 17% compared to Labor Party raising it to 26% under Corbyn's manifesto. Some of the Labor Party's supporters in the north of Britain are leaving the party because of dissatisfaction with Labor's leadership.

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President Goodluck Jonathan as "Mr. Clean" aroused many of the same hopes now aroused by the election of Buhari as president of Nigeria. Under Goodluck Jonathan Nigeria's foreign reserves declined from $50 billion to $33 billion, and there is $1 billion in the sovereign wealth fund. About $20 billion in pilfering of state funds was reported by the Central Bank of Nigeria, but no action was taken by Jonathan. Indians may pride themselves on a better performance, yet prime minister Singh of India, seen as "Mr. Clean," allowed auctioning of telecom licenses in the second term, that had to be cancelled because of corruption. Throughout emerging markets not just in oil producing countries, poverty remains entrenched, because funds that should go into infrastructure and services are misused, which creates a disincentive for foreign investment, further adding to the problems in these countries. India and Nigeria are the two fastest growing countries in the planet, and the unspoken fear is that the demographic dividend with so many young people will be wasted by corrupt and inefficient management of the economy and resources of the two countries. The time lost in the last years of the Singh administration and the four years of the Jonathan administration will never be regained, the hopes of millions of young people are dashed again and again, and the goodwill of Europe and the U.S. eager to participate with the latest technologies in the development of the two countries, as they have done in China, is wasted....

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The Saudis fear a blowback from a military push by the US against the Taliban. Pakistan sees a push by the USA leading to Taliban concentrating in the Baluchistan part of Pakistan.

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Modifications proposed for Agnipath recruitment to the Indian armed services include full healthcare benefits and pension benefits for the scheme. The government has presented a fact vs. myth explanation to provide a clear understanding of the intent of the scheme to reflect a younger population and integrated India without the regimental bias towards caste and region present since British times. Job security is always a concern in India. The better technically trained and better financed Agniveer recruit would have more opportunities for education and training after 4 years and become an attractive asset for the private and public sector. A program of this kind was the GI Bill in the US that Franklin Roosevelt signed in 1944 and the Veteran Act of 2008 that continued educational benefits for free college. These programs have resulted in benefit of great value to the US economy and to the military veterans who used these benefits. In India's fast growth period after 2025 the Indian economy would be 50% larger and be easily able to take in these graduates from the armed services with technical training and advanced courses just as the US economy did decades ago. During the days following the pandemic there is a sense of pessimism in some sections and the government can enhance the package with added pension benefits and healthcare and still keep the financial aspects in good shape. ...

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Walk in clinics at drug stores like CVS and stores like Walmart now have the cooperation of hospitals. Hospitals are now affiliated with 25 Walmart clinics. THe Cleveland Clinic has lent its name and backup services to a number of CVS clinics in northeastern Ohio. And the Mayo Clinic is operaing ne Express care clinic at asupermarke in Rochester, Minnesota, and asecond one at ashopping mall. This helps clear emergency rooms of people seeking bsic medical care as for astrep throat or flu. About one thousand clincs are operating in the US at drugstores, supermarkets and big stores since the idea took root 4 years ago. Wal-Mart has partnered with hopitals like the Christus Medical Group in Texas, Aurora Health System in Wisconsin and COxHealth in Missouri to setup clinics. Mayo did so after employees and patients said they wanted more convenient treatment for minor medical problems, so there may be a need here that as not been met. The lower costs at these centers compared to primary care doctors offices or emergency rooms make it possible for them to price lower and meet the needs of the 45 million or so uninsured people in the US, numbers growing as jobless rate increases. They are typically staffed by nurse practitioers or physicians asistants. Dr Herman at Mayo Clinic, who supervises its retail store clinics, says rather than fight this trend primary care doctors should learn from it, and work with hospitals around the country to offer more convenient locations and consumer friendly office hours, including periods of walk-in care with no appointment....

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Jay Powell, a former US Treasury official, now a scholar at the Bipartisan Policy Center, says the fears of budget problems in US states are survivable, even though they will be difficult and painful. He does not see widespread defaults, the way Meredith Whitney has predicted. Kenneth Rogoff of Harvard University, says a major default would cause serious macro-economic dislocations. It would have impact beyond the US, in the European economies with serious budget problems such as Greece, Portugal and Spain. Analysts cite the following reasons why a widespread debt default by states and local governments is unlikely. Municipal bonds are held mostly by individuals, who own about two thirds of US municipal bonds, directly or through mutual funds. Most state and local government debt is long term, and does not rely on short term borrowing the way a Lehman Brothers did in the recent financial crisis. The states can raise revenues, as Illinois did recently. With the economy improving state tax revenues were up 6.9% in the fourth quarter of 2010, compared to a year earlier, according to preliminary data from the Nelson Rockefeller Institute of Government, Albany, New York. That said, the following reasons show that life will be difficult and painful for states and local governments. State budget gaps total at least $125 billion, as they look to the coming fiscal year, according to the Center on Budget and Policy Priorities. And no federal help is in the works, as it was in 2009. Far less of newly issued muni-bonds are insured today - 6% compared to 57% in 2005- according to the Bank of America Merrill Lynch. Insurers are still recovering from losses in the recent financial crisis. A massive supply of new bonds has depressed the market just as Dec 31 expiration of a federal program, Build America Bonds, which provided help to states that were borrowing. Investors withdrew $23.6 billion from muni-bonds mutual funds since November, 2010. Moody's Investor's service has listed the states that will need to issue bonds to fund current operations. California will borrow billions to cover cash flow needs, and Illinois is considering an $8.75 billion 'debt restructuring bond' to pay past due bills, and a $3.75 billon bond for contributions to its pension system. Because banks have only 1.3% of assets in muni-bonds any defaults will not affect their ability to lend. But the impact will be felt in the US economy and overseas. In the event there was a default, some analysts believe the federal government would find it hard to say no when the federal government said yes to AIG....