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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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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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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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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....

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Department of Education invites controversy because of diversity programs and "transgender" as culture ignoring health risks. Established by president Jimmy Carter in 1979. Education in the US is run at the state level by each American state administration compared to UK where it is done at the national government level. It has one of the smallest budgets of any agency at 4%, Transportation is 1.7%, Agriculture 3.0%. Most of its work is overseeing $120 billion of federal grants and programs for public education through high school. It supports districts with low income students with $18 billion aid. Head Start program supporting 883,000 low income pre school children in 2022 gets federal aid from Department of Health and Human Services. National School Lunch Act of 1946 by Harry Truman is not affected as it is run by states,  federal aid comes from Department of Agriculture to 20+ million children. Republicans oppose spending about $1 billion to support Diversity program DEI initiatives and support for "cirtical race theory." There is opposition to "transgender." Britain's NHS had a commission look into transgender and says it poses health risks to children and young people. It also adds to anxiety of parents. Republicans are 53 -47 in majority in Senate- to scrap the agency Republicans need 60 votes in the Senate. The likely option is that they will pass a bill putting many of the functions in other agencies reducing its impact- between HHS, Treasury and Interior agencies. ...

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The party congress of the Communist party does not look like its going to lead to any changes in the system, only to make sure it runs better by getting public input through pollsters on public officials, and on web sites on new legislation. The pollster, including a firm, Horizon Group, describes his role as working out a mechanism for people to express themselves as there is very real frustration in society. Websites airing public opinion helped introduce nondiscriminatory clauses in the new employment legislation. But otherwise there is actually a tightening of the control of dissent, as the party is worried that once it starts it will get out of control and jeopardize the economic progress However this leaves the future quite uncertain as there is still not enough room for airing the very real frustrations and concerns such as for the environment, health and services, the prevailing corruption, and the problems in the countryside of the poorer regions in the interior of the country. These concerns are being pushed into the future. For instance without a free press its hard to air corruption cases, as in India. Only two of the several thousand petitions under the system of letters and complaints xinfang are resolved. About 12 million are received each year by the government. Because of the obsession with tight control many activists end up in prison even though the causes such as the environment are popular. Like the activist who called attention to the Lake Tai pollution, and the rural blind activist mentioned who argued on behalf of women that were forced into late term abortions. Here the government actually stepped in to announce plans to cleanup Lake Tai, but the system continues its inexorable push to drive out any dissent even if it does not relate to political issues. This may be one of the severe distortions of the present system. ...

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The growth of China's economy is likely to have a slight or no effect on growth in the US. Some estimates even show negative impact on the US if China's growth pushes up oil prices. Growth in China will come mainly from consumption spending and growth in services. This consumption spending may not not last beyond the first half of the year, according to one estimate. Even the more optimistic estimates such as Oxford Economics show the impact on global growth of growth in China of 5% to be not much more than 0.2%.

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Pakistan prime minister Nawas Sharif's friendly overtures to India. The need for improved trade and economic relations with India to improve Pakistan's economy and fears that the military and intelligence services or extremist groups could torpedo these efforts.

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A health care practitioner says the real problem is the high cost of medical care in the U.S. when compared to other countries. She points out that the Obama bill in 2008 did not take effective steps to bring down the cost of health care before enacting legislation to cover the uninsured, leading to higher premiums for the middle class. The link between healthcare and profits is seen as the main problem. 

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This article in the NYT explains why the loss of jobs particularly in the auto industry to Mexico, with the experience of NAFTA passed by president Bill Clinton, has caused widespread opposition to the TPP trade agreement proposed by president Obama. Both Hillary Clinton and Donald Trump in 2016 oppose the TPP.

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In an effort to create a single market India's Modi administration is replacing the multiple federal and state taxes with a single Goods and Service Tax. The bill passed India's parliament on June 30, 2017. It should increase GDP growth by 2%. The taxes are in 4 categories 5%, 12%,18% and 28% depending on the goods and services. Vegetables, some food items and milk are exempted.

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With unemployment at 11% and inflation at 9%, public finances in Rio de Janeiro state dire to the point of delaying payments to public servants,including police and teachers, and corruption scandals affecting most politicians and parties, the mood in Brazil at the time of the Olympics is one of anger and indifference. Ordinary Brazilians feel that the $12 billion spent on the Olympics could have been better spent on education, health care and improving basic public services such as the bus system. The decision to host the Olympics was made by the Lula government at the height of the commodities boom. With the collapse of commodities prices and the debt run up by the federal and local government Brazil faces a contracting economy- a 3.8% drop in GDP in 2015- and rising unemployment, increasing inflation, the climate is very different in 2016.

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Compared to 2008 Hillary Clinton is now very clear that she will stand up for woman's issues openly- "it is about no ceilings, no limits, for any of us." About playing the women's card she says "deal me in." One of the paradoxes of this election season is that white women registered voters 35 to 64 years of age have shown less enthusiasm for Hillary, around 34-36 percent in polls such as the NBC-WSJ poll. Interestingly the figure climbs to 66 percent for ages 18-34, and to 56 percent for ages over 64, for all women. Experts attribute this to the fact that women over 35 are facing fewer barriers than the women over 64 who remember the hard won battles for women's rights when it was hard for women to get a credit card or run for office, or be promoted in business. Traditional career choices were being teachers or nurses. A lot has changed in the last 20 years, and this has left some women who are no longer facing such barriers turning to other issues to choose their candidate such as happened in their enthusiasm for Bernie Sanders. Overall for all women registered voters  Hillary gets 52 percent support, Trump 37 percent, according to a July 2016 NBC/WSJ poll.   ...

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Upward mobility in China was weak and income growth for average workers sluggish during the years before the coronavirus outbreak. In this sense China is similar to the U.S. and Europe where upward mobility gains after the second world war were lost in the last 30 years partly from the loss of manufacturing to China. It is much worse now as the effects of the coronavirus lead to drops of as much as a third in income for ordinary workers. Lower income workers, the vast majority of Chinese numbering hundreds of millions now suffer from lost work or diminished wages. Small businesses cannot afford to pay the salaries paid before and as workers dip into savings or increase borrowing the retail spending is taking a hit. As a result economists see a vicious cycle of lower spending and lower incomes for the hundreds of millions of ordinary workers in construction and smaller businesses. Some small businesses could just close down because of weak demand affecting the economy over the long term. Before the coronavirus China went over three decades from being a Communist country with relatively equal distribution of wealth but lack of growth and technological development to a capitalist country with the structure of state control of the economy from the Communist period. The result is that 1% of the people control 33% of the wealth and the bottom 25% having 1% of the wealth, according to a 2015 Peking University study. China's president Xi Jinping, head of the Communist party, tried to reverse some of these trends by attacking corruption and making changes that began the task of reversing decades of unequal distribution of wealth under state sponsored capitalist growth. Investments were made in rural medical care, infrastructure and basic services. This did not have much impact because much of the pattern of growth over three decades continues including the housing bubble.  With coronavirus the trend is set for even more unequal distribution of wealth as many workers at the bottom half of the population in incomes either lose work, or see drop in incomes as businesses that hire them struggle from shoe factories to other retail business. Reports of informal economy and street markets in Chengdu in western China and bringing this part of the economy back by the state are effort to get people work in other ways. Researchers estimate that China's bottom 60% of household in incomes lost about $200 billion in income in the first half of 2020. In May premier Li Keqiang said 600 million people in China earn only about $140 a month. Many who lost income or jobs do not have support from the government as China lacks a program of comprehensive unemployment insurance as in Europe and the U.S. to help people get over bad times. 300 million migrant workers are particularly vulnerable to loss of income and dipping into savings.   ...

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Admiral Mullen accused Pakistan's ISI intelligence agency of supporting the Haqqani terrorist group's attack on the U.S embassy in Kabul in September 2011. The flaring up of serious problems in the U.S.- Pakistan relationship. American patience with the double terror game in Pakistan appears to be disappearing with this call in a Journal editorial for the U.S. to clear the Haqqani bases in Pakistan.

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The European Union’s total defense spending increased by 30% from 2021 to 2024, to 326 billion euro or $341 billion. That is 1.9% of the EU’s GDP it's economic output, according to European Defense Agency. It is still short of 2%.  Britain will ramp up defense spending all the way up to 3% in 2027. Britain is short of defense equipment with transfers to Ukraine and with much of the defense budget going to maintain a nuclear deterrent. This leaves less for other defense needs. This report says most of the procurement for defense equipment goes to countries outside Europe.The Kiel Institute says 80% comes from outside EU. It is not mere shortage of funds it is the severe bottleneck from lack of defense manufacturing industry  that is putting Germany, France and UK in a situation where they are too dependent on the US. It takes years to build this capacity. Russia built it up during 3 years of war by going to a wartime economy and it now produces 4 times the ammunition Europe produces. The US did the same to match and exceed Russian capabilities and capacity, Europe lagged behind with unwillingness of Macron and of Scholz in particular to switch funds from needs in transport, infrastructure to defense. The debt brake Merkel to stop debt based infrastructure investment is what ails Germany. It has had two pernicious effects it created the AfD's surge by lowering economic growth and investment in public needs - housing, transport, public services. It worsened the SPD and CDU performance by not investing in security with no policies to return crime committing refugees to their home countries. A combination of aid and other assistance, diplomacy, secured the cooperation of countries to take them back. A strong display of action on removing refugees committing any offenses would have lessened the number of terrorism incidents. ...