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Susan Jaccoby brings up a major issue facing healthcare in America from personal experience. A third of the Medicare budget, she says, goes to the last year of life, and a third of this goes to the care in the last month. At the same time public opinion polls show Americans see the problem being too much medical intervention rather than too little. Especially when there is no hope except to prolong life for the patient with an highly deteriorated qulaity of life for a few months or a year, doing no service to the patient or future generations who may see their basic services cut when they most need it as a result of the unaffordable spiralling cost of Medicare. A Pew Research Center poll in 2006, shows 22 percent say a doctor should not always make efforts to save a sick person's life, and 70 percent believe that patients should be allowed to die in some situations, when it only prolongs life for a few months for instance and patients live in pain. The problem only gets worse in future years as an estimated 8.5 million Americans are expected to be over 85 years in 2030 with these same choices facing patients, their families, Medicare and the country....

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What the French take for granted today- 99% of the French people are covered by national health care- started when Charles De Gaulle faced rising scial discontent in the postwar period, and accepted a demand for worker protections. During the postwar period Frenchmen are paying higher taxes, but in the first 30 years because French salaries were growing fast this was not noticeable. With slow growth and rising healthcare costs its getting harder to increase these tax deductions for overall social security, which have reached one third of apaycheck at the low end, say for ataxi driver in Marseilles. So you have the government running deficits of $15 billion in 2004, even after increasing co-payments for routine care and doctors visits. Experts say this could reach $40 billion in 2010 and $90 billion in 2020. In 2007 health care cost the government $300 billion, or 11 % of GDP, (OECD numbers) and the bureaucracy and rules are getting more complicated. This 11% is well below what Americans pay for asystem that leaves out about 50 million people. France ranked 8th on the OECD list in cost per capita, the US at the top. And the French life expectancy is higher at 80.98 vs. 78.11 for the USA, higher by about 3 years. For this cost the system is cost effective according to the OECD. And the French find the American debate abouthealthcare public option "altogether surreal", as the newspaper Le Monde put it. To keep the system in viable form the government is increasing copayments, such as the decrease in reimbursements from 80% to 65% for routine care and doctors visits in 2004. As aresult the deficit dropped to $6 billion in 2008. ut the global economic crisis and rising unemployment has made this grow to estimated $13 billion for 2009. Measures under consideration: increasing hospitalization copayments to $28 a day from $22. To fill this substantial gap for routine care and other costs the French system has private insurance companies called mutuals that offer different policies. Which is where the Fench notion for equal treatment in health care gets distorted because different people can have different coverage. The French though compare their system to the British system and say theirs is not as nationalized as it appears and the Brisih one is much more so. The French system though supervised by the government is different from government run health care as in Britain. French people are free to choose their own doctor who is often a private practitioner. ...

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Why polluting industries and colluding local government officials who are judged on the rate of economic growth achieved have come together and become entrenched to thepoint where its hard for the central government to implement pollution control measures. Deng's response to a sluggish socialist bureaucracy was to give power to local government officals to promote growth and to be judged on that basis. The environmental ministry and the environmental protection departments are very small and lack the resources to control these industries. And NGO's and the informed public and citizens are powerless to demand change as they are seen by the government as risking social stability by risking growth. After the East Asian crisis China anticipating a slowing down in competition with recovering Asian economies pushed harder for more economic growth. As a result production of steel set new records and the addition of power generating capacity each year surpassed the total power generation of countries like Britain and France.But this power generation does not use the modern technology available as it is costlier and takes longer to build. So a lot of short run decisions are being made in the interests of growth. An effort to introduce Green GDP backed by President Hu Jintao was dropped after it ran into a lot of resistance. Using this about 3 points of GDP were deducted from the 10% growth as environmental cost. This was based on modest environmental costs estimates and did not take into account the entire cost of pollution to health and the environment. China's own environmental experts think that Western estimates of environmental costs are if anything on the conservative side as they are based on models used in the west and conditions in China have little precedent in the scale and range of environmental degradation. Coal is burned to produce two thirds of the energy and uses older technology for power generation, it is a big polluter of the environment. And the modest energy efficiency goals set by the central government are not being met as a result China is already expected to be consuming as much energy in 2010 as it was expected by its own planners to be consuming in 2020. To informed outsiders it appears that the polutting process is systemic in its nature and only political change that allows people who are suffering the worst effects of this pollution to make their voice heard, can lead to reversing the trends that have been set in place from the Deng period of economic change that started in the 80's. ...

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Anil Ambani's Reliance Communication's is being investigated in India's Telecom scandal.The shares of his public companies have fallen by 50% or $17.9 billion since August 2009, according to an estimate by Bloomberg. A report by Kotak Securities Ltd, says Reliance Communications reported higher revenue numbers to investors than it showed to telecom regulators. This has led to a government audit of Reliance Commmunications. The market value of his publicly traded companies fell on Feb 9, 2010, by $2.9 billion, when an Indian accountants association questioned Reliance's finances that day. Total debt of Reliance Commnications, Reliance Power and Reliance Infrastructure Ltd, is $10 billon larger than cash and equivalents according to Bloomberg.

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Kaushik Basu, economist at Cornell University, and Chief Economist at the World Bank, says the U.S. Federal Reserve should consider the current low labor participation rate and low inflation in its rate policy setting decisions in 2015. Basu points out that in the recent past unemployment has gone below the current 5.5% without increasing the risks of inflation. He cites the period from July 1997 to August 2001 when inflation was below 5%, and at some points below 4%, yet inflation in 2002 was close to 2%. The large number of discouraged workers in this economic cycle has placed the unemployment rate below what it really is, says Basu.

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India's Supreme Court ruled that Vodafone PLC does not owe $2.2 billion in taxes on the acquisition of a majority stake in Hutchison Essar Ltd. The Indian tax authorites were directed to return 25 billion rupees ($500 million) which Vodafone had deposited. With declining foreign investment in India and a lower growth rate of about 7%, this tax case had assumed larger significance. The Supreme Court decision emphasized that taxing Vodafone "would amount to imposing capital punishment for capital investment." Vodafone had difficulties in its Indian operations- a $3.4 billion impairment charge in May 2010 because of strong competition. Vodafone is estimated to have invested $26 billion in India since 2007, and in the fiscal year ending March 2011 showed only $115 million in profit on sales of $3.86 billion.

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U.S. auto sales increased by 7.5% in October 2011. Chrysler sales were up 27% in October. Its Jeep vehicles had the best sales performance in 5 years. Jeep sales were up 25% and Ram pickup sales were up 21%. Ford Motor Company sales were up 6.2%, and GM sales were up 1.7%. Sales of Ford's F- series pickup trucks were up 7% and sales of Escape sport utility vehicles were up 30%. Lincoln sales declined 11%. For GM the Cruze small car and the Equinox crossover sales were up, while Buick sales were down 7% and Cadillac 12%. Because of limited vehicle supplies Honda and Toyota showed decline in sales by 1% and 7.9% respectively. The annualized seasonally adjusted selling rate in October was 13.26 million vehicles. Reasons given for the pickup in auto sales by analysts are that buyers had held off buying in 2009 and 2010 and are now back in the market as their vehicles show signs of aging. Hyundai sales were up 23%, VW's up 39.6% and Mercedes-Benz's sales up 28%.

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U.S. president Trump announces withdrawal from the Paris climate change accords, saying the U.S. will consider re-entering the agreement  or coming up with a new deal. He said "I was elected to represent Pittsburgh, not Paris." Trump said he was concerned about the environment, and avoided saying climate change scientific evidence was not correct. He based his concerns on the idea that China and India were getting an unfair financial advantage over the U.S. The U.S. had pledged under the Paris accords to reduce greenhouse gas emissions by 28% from 2005 levels by 2025. The WSJ's Stokols and Ballhaus point out that president Trump had the option because of the nonbinding agreements committing nations to a broader goal of reducing emissions to combat temperature change of of 3.6 degrees F, to have modified emissions targets and still remained in the Paris accords. For Trump the motivation may have rested more on politics to shore up support in the Republican party which has largely opposed climate change targets.  ...

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This objective look at the situation of Black Americans comes from a American -Jamaican. Educated in the West Indies and in Britain, Patterson is able to bring another perspective to look what has happened and what is the way forward. Here he is interviewed by the Harvard Gazette. Patterson is a professor of sociology at Harvard. A separate Saturday Essay by Orlando Patterson appears in the Wall Street Journal on June 6, 2020. Patterson points out that the big problem is de-ghettoization is not happening. Progress is not about integration first, it is about successful de-ghettoization taking place first, says Patterson.  And here he faults white liberals for not putting their money where their mouth is. For this to happen black families have to be able to move into suburbs. Strict zoning laws and limits to building moderately priced housing in some of the most liberal parts of the country keep out families wanting to move to the suburbs.  It is the social contact even side by side in suburbs with a leap in quality of housing and neighborhoods, schools, that can change people's own perceptions of themselves and their interactions with the communities around them. A lot of whites Patterson says have liberal views but when it comes down to making the concessions needed to make black lives better they are not willing to do that.   Patterson offers his own experience in Britain walking down a street in Cambridge. He lived on Trowbridge Street. He enjoyed walking through the Cambridge Rindge and Latin School. And while walking he observed the easy interaction of black kids and white kids, and realized how different this was from the 1960's and 1970's. Having this sort of interaction comes from a more integrated setting, so that people grow up not having that awkwardness or lacking social contact.      ...

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The Oxford vaccine is showing promising results and is expected to be authorized for use by December 2020. The vaccine being developed in partnership with Astra Zeneca PLC for marketing and Serum Institute of India for mass manufacturing is shown to be proven 90% effective in preventing infections in clinical trials. The partners say there were no serous safety events and the vaccine has proven 62% to 90% effective with an average of 70%.  This vaccine is significant because it is being developed with this partnership not seeking profits from this venture, providing it at cost and keeping the price to about $4 a dose compared to competitors Moderna and Pfizer whose vaccine is expected to be at $24 a dose. The Oxford vaccine also uses existing technology for vaccines and manufacturing is being done in India with the world's top manufacturer of vaccines. By using existing technology unlike the Pfizer and Moderna technology Oxford has taken an approach that could prove to be unique by minimizing side effects for vaccines that are being developed with such speed. By not requiring refrigeration at very low temperatures the vaccine makes itself ready for immediate and widespread uses all over the world. By use in its home country India with its large population Oxford vaccine can gain even wider acceptance because of India's long experience in pharmaceutical technology and manufacturing. Of particular interest is the study of 23,000 participants showing that the 90% effective dosage is one that only requires half a dose for the first shot. This say scientists is because the vaccine first dose prepares the body for a more powerful second dose and creates the maximum effect. This means the vaccine can be used for more doses than 2 full doses. It can be stored in a fridge making it easy to use in many countries. The full study will have 60,000 participants spread across U.S. Britain, Brazil South Africa and India. ...

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Michael Barnier leads the negotiating team for the EU as it begins negotiations with Britain on Brexit. He is a former foreign minister of France and former EU commissioner, giving him the necessary skills and experience. Yet as he meets with the Affairs of the European Committee in the German parliament, even Barnier is not clear how the negotiations will be conducted. Only that the issues relating to disentangling the closely interwoven economies of the EU and Britain relate to nationals of the EU and Britain in each others region, the common 20,000 legally binding regulations, and the price tag for Britain to pay of 60 billion euros. The leading German in the negotiating team is Gunther Oettinger, a former EU budget commissioner, and he tells Der Spiegel that the bill may be even higher than that number. The figure will be arrived at by taking into account the obligations of Britain and applying this to assets. The obligations include the money owed to the EU budget, share of medium term budget planning to 2020, share of pension payments to EU civil servants. The British take a different view and do not understand why they have to pay this amount when they are exiting. The British want to see their future relationship on trade and access to the EU markets discussed early, but the EU position is just the opposite, first exit negotiations to be completed by September 2018, then other discussions on trade. March 29, 2019 is the date set for Britain to be no longer a member of the EU. Yet even the sequence of issues has not been set and the sides could not be further apart than they are now. Each side looking at its situation domestically with elections in the EU in 2017, and May facing the added challenge of Scotland threatening to leave the UK. ...

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It seems like good common sense -surely studies come later that masks can cut coronavirus cases by 40%- as Texas is learning the hard way. As coronavirus cases jump in Texas the governor makes wearing face coverings or masks mandatory in the state. Texas recorded over 8000 cases in a single day on July 3, 2020. "wearing a face covering will help us to keep Texas open for business." As a grim warning to Texans he said "we are now at a point where the virus is spreading so fast there is little margin for error." As the virus cases surged Mr. Abbott, the governor of Texas, ordered all bars shut and cut restaurant capacity by 75% last week and reversed step taken to open the economy. Another lesson learned the hard way when it seems like common sense- consider that on June 20 as reported in the WSJ a staggering 500,000 people went to bars in Los Angeles county the day after bars reopened. It is this type of activity that makes Dr. Fauci, say cases could reach 100,000 a day in the U.S. Infection rates are now increasing in 40 of 50 states with the southern states, western states doing badly.  A lot of it was plain common sense. A German study shows a 40% reduction of coronavirus cases when masks or face coverings are worn. For those arguing for the reopening so that economic hurt is mitigated there is even more reason to wear masks as it makes it possible to get back to work by following strict social distancing and mask guidelines. Everything in life is about adapting and making small changes for the larger good. Younger people have badly failed to show fellow feeling with lack of following social distancing guidelines on beaches and gatherings leading to the numbers now showing that people 18-34 are now equally at risk. ...

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Canadian tar sands oil production from Alberta faces increasing competition from production by Bakken oil fields in N. Dakota. The increasing production from Bakken fields in the U.S. and the lack of pipeline space to bring oil from Alberta to the U.S. is putting the more costly projects on hold. The costlier projects have costs of about $100 a barrel with crude prices dropping below $90 in the U.S. Projects using steam to get bitumen to the surface are viable at $50 a barrel, other projects that require mining the bitumen to make synthetic crude have costs upwards of $100 a barrel. Costs are rising quickly with the cost of geoscientists going up 14.5% in 2012 and salaries over 200,000. Production workers make $35-$39 an hour and can make about $170,000 a year. The boom has pushed costs higher each year. Suncor Energy, the largst producer, is reviewing the viability of large planned multibillion upgrading and mining projects and cutting capital spending in 2012 by 11%. By 2020 oil sands output is forecast to double from the 2011 figure of 1.6 million barrels a day, according to the Canadian Association of Petroleum Producers. In 2012 about 50% of production is from the costlier mining operations....

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The terms of the debt restructuring deal with the bond swap in Greece become clear on March 9, 2012. In the deal with private bondholders -using collective action clauses to force remaining bondholders into the deal- about 96% of the 206 billion euros of Greece's bonds will be exchanged. Private bondholders held out throughout most of 2011, delaying the inevitable as Greece's economic situation became increasingly hopeless. This created a logjam with the German government, which insisted on serious private sector participation and bondholder haircut as the cost of poor lending decisions of the French, German and other European banks that made loans to Greece out of proportion of the ability of Greece to payback loans. Charles Dallara of the Institute of International Finance, negotiating for European banks, offered a 10% average loss on the bonds in July 2009. It was not until German Chancellor Merkel told Dallara at a late night meeting on October 27, 2011: "this is my last offer," for a 50% loss on the face value of the bonds, was agreement reached. The Greek debt swap that now takes place will give private bondholders a loss of 53.5% from the face value of 200 billion euros of bonds that they hold. The new Greek bonds issued in place of the old bonds include short-term bonds issued by the eurozone rescue fund at 15% of the face value of the old bonds, and a series of Greek bonds with maturity ranging from 11-30 years valued at 31.5% of the face value of old bonds. That even this 53.5% bondholder loss will not be adequate, as Greece's economy looks irretrievably damaged as it spirals downwards, is shown by the value of these bonds already trading in a hypothetical "gray market." The new 30 year bond is quoted at 17 cents and the 11 year bond at 22 cents. The questions remain about the stalling by the banks in taking the losses earlier- was this the wisest move considering the losses beyond Greece as the eurozone economy as a whole has suffered from the prolonged negotiations stretching through 2011, lurching from one crisis to the next? Even if the stalling was designed to give time for banks to repair their balance sheets, was this the best strategy, considering the damage inflicted on European economic growth. John Taylor of Stanford points out that the European banks delayed the unavoidable serious debt restructuring for too long, when insolvency was the real issue not illiquidity, and exaggerated the effect of contagion from the beginning- in John Taylor, WSJ, 2/22/2012, A Better Grecian Bailout. And John Cochrane of the University of Chicago, points out that French and German governments if they bailout French and German banks should do so openly and frankly rather than cover this up as bailouts of countries, because this would lead to serious questions about the poor lending decisions of the European banks and government supervision of the banks- in Cochrane, WSJ, 12/2/2010, 'Contagion' and other Euro Myths. As early as Feb. 2010, Cochrane was suggesting the forced exchange of new bonds with long debt maturities for exisiting bonds with short debt maturities, as short term debt was the major issue here. ...

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This report in the WSJ from Singapore says Chinese authorites are asking local governments to prepare for the potential downfall of housing developer Evergrande which was built on ever growing debt. This was described as getting ready for a possible storm in the event there is a disorderly collapse. Beijing is unwilling to bail out the developer. For years the Chinese government has discouraged speculative investment in housing saying "housing is for living not for speculation." This had little effect on housing developers and housing prices in China making housing smaller and smaller in size and beyond the reach of average households.

To get some idea of the magnitude of Evergrande's expansion it has 800 projects in progress spread over 200 cities in China. It is unable to complete many of these projects, now that it is unable to pay contractors and suppliers.

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Places like Rapid City, South Dakota, and Topeka, Kansas, where people are choosing to live because of the affordability of homes. Average 30 year mortgage jumped from 3.1% at the end of 2021 to 5.0% by April 2022. High housing prices in coastal and mountain region cities and remote work flexibility are reordering where people choose to live. Rapid City, South Dakota is near the Wyoming border, here you are in what was once the Wild West of Teddy Roosevelt, a western wilderness found in an 8 hour drive to Grand Teton National Park. Nearby to this 145,000 population city are Mount Rushmore and the Black Hills mountain range.

Other cities that are getting attention from younger buyers are Santa Cruz, California, Santa Rosa, California. These are smaller towns of less than 600,000 population with outdoor recreation opportunities and small city feel, and are also attractive to retirees.

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Inflation slows to 3.2% for October 2023, and decelerates from 3.7% in the prior month. Moderate energy prices contributed, so did lower used car prices and lower airline fares. It is also broad based decline which makes it sustainable. Biden says- "I am fighting every single day for lowering costs to hardworking families." It reduces the pressure on the Fed to raise interest rates further. Inflation in food, bakery products and fruits and vegetables was 0.2 percent and apartment rental at 0.5 percent, electricity at 0.3% making it truly broadbased. This points to major progress on inflation, that adds to gains in low unemployment that have not been seen for decades. Wage gains for workers after the UAW agreement are spreading to other companies and industries which provides cost of living relief for workers and families across the 51 states for 2024. Lowering inflation and increasing suppressed wages is the way out of the cost of living crisis facing Americans. ...

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The U.S. trade dispute with China takes a new turn after tit for tat tariffs, with the U.S. president Trump claiming that China was interfering in the U.S. midterm elections. This plays into the narrative in China that the U.S. does not want to see China's ascent as a global power. President Trump and Trade Representative Lighthizer have singled out "Made In China 2025," China's plans for tech leadership as a serious issue for the U.S. President Trump made his claim in a speech at the United Nations, saying that he was "the first president ever to challenge China on trade."

Many of China's tariffs on U.S. exports are targeted at agricultural products such as soyabeans and corn in heavily pro-Trump states, and in rural areas where the Republican party has a significant base. 

 

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The climate change bill that passed the House 219 to 212. When the program begins in 2012 the estimated prie of apermit to emit aton of carbon dioxide will be about $13. This is projected to rise steadily as emission limits come down, but there is aprovision to prevent a surge in costs. In the early years of the program amajority of permits will be given out free to keep costs down. The Congressional Budget Office estimate is that an average American household will pay $175 ayear more in energy costs by 2020 as aresult of this bill, while the poorst households will recveive a rebate to lower their energy costs by $40. WHile the bill has been watered down form its original, the fact remains that this is the first climate change bill America has passed in decades. It is welcomed by Chancellor Merkel and the Germans who want to see the USA as akey negotiator in future talk on global warming.

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A large blackout leaves Venezuela's capital Caracas and parts of the country in complete darkness. The blackout was the result of problems at the El Guri hydroelectric dam in eastern Venezuela. Venezuela's power grid has deteriorated rapidly from lack of investment, corruption leading to siphoning off of funds for investment in new turbines and technology, and mismanagement with the power company run by people with little experience in power generation. Initially Electricidad de Caracas was  bought by AES Corporation in the U.S. in 2000, then nationalized by president Hugo Chavez in 2007. The lack of investment is also a result of policies that subsidize power making it practically free, just as in the case of gasoline. 70% of Venezuela's electricity comes from El Guri hydroelectric dam. Hyper inflation estimated at an astounding 1 million percent is ruining Venezuela's economy leading to 3 million refugees into neighboring Colombia and other countries. ...

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Spending a minimum of 250,000 euros on a house in Greece gets an investor a five year renewable visa. Chinese investors seeking a European base are buying or constructing homes in Athens, and the islands of Santorini and Corfu. This is reviving the residential building market in Greece after years of bailouts by the European Central Bank. Chinese middle class investors see the presence of Chinese companies such as Cosco which owns part of the port of Piraeus as a sign it is safe to invest in Greece. Property prices dropped 40% in 2010. In 2018 prices went up by 2% and building permits by 10%, according to the Bank of Greece. Real estate investment was up 20% in 2018 with Chinese investment companies buying into whole apartment blocks in Athens to draw investors.

Greece had a record 33 million tourists in 2018. A 320 billion euros bailout ended in 2018. 

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Barney Roney Analysis of England's 3-0 defeat in three matches in Australia in December 2025. Roney writes in the BBC Analysis that there was a basic lack of tension and discipline, of not doing the homework needed and not recognizing the need for homework when playing a side like Australia. Australia without Cummins, Smith and other injured players- made it work with Mitchell Starc and Travis Head in the bowling and batting attack. Roney does not fault Stokes as much as he does McCallum the coach of the England team. Other reports show Stokes and the England cricket team spending time at the beach for days that suggested a lack of discipline. England did not trust the process it trusted the captain's instincts and brave comments, Australia trusted the process and this helped it improve as the game went on even without key players. 

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Wal-mart has a$10 promotion for the top 10 books coming out in November, and it is selling 200 bestsellers for 50% off of their list price on Wal-mart.com. Amazon responded by matching this price.

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The automobile market in the U.S. showed strong sales for Chrysler, Ford and GM in November 2011. As a result automakers expect to sell 12.7 million vehicles in 2011, 10% higher than 2010. The average age of vehicles in the U.S. is 11 years, and this is leading to more buyers coming into showrooms. Some of this demand was for prickup trucks and SUV's. Ford Explorer sales tripled from the prior year. Ford sold 26% more trucks and 9% less cars compared to the prior year November sales. Sales of Jeeps went up 50%. GM sold 31% more pickup trucks. In the past sales of trucks and SUV's slumped with rising fuel prices and a slower economy.

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The 2012 Camry, is very much like the 2011 Camry, other than the Entune multimedia system in the dashboard. The big difference is in the price. Toyota has dropped the price on the 2012 Camry- the 4 cylider XLE starts at 25,535, about $2000 lower than the 2011 price, the LE Hybrid with 41 mpg fuel economy, starts at $26,750, and the V6 XLE is about $30,000. It offers quieter ride and dependable quality, but it lacks the new technological advances such as turbocharged motors, direct fuel injection, stop-start systems, and lithium battteries on new hybrids, features on the new Ford Fusion models. Ford, GM, Hyundai and VW are all competing with newly designed models. With the fierce competition it is difficult not to see Toyota struggling with the same problems Ford faced when it failed to innovate with the old Ford Taurus model two decades earlier.