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U.S. Fed chairwoman Janet Yellen, says the Fed will be prepared to respond to the "twists and turns" in the recovering U.S. economy in 2014-2015. In many ways Yellen finds the recovery "disappointingly slow and consistent expectations for a pickup in growth dashed over a number of years." She sees the labor market behaving in "some perplexing ways and showing patterns that are novel." The high rate of long term unemployed is an abiding concern and Yellen says a healthy job market is "more than 2 years away." This clarifies remarks made at her first press conference, which were interpreted to mean the Fed would raise rates in a much shorter time frame. U.S. stock markets responded favorably to her remarks after declines and volatility over several weeks following the previous press conference.

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The Economist cites the Dartmouth Atlas Project which shows differences in cost across the country for health outcomes and spending involving Medicare. It cost $5000 per person in Salem, Oregon in 2006, $8000 in San Francisco, and more than $16,000 in Miami, with outcomes for health tending to be better in places where the costs were lower. This is one of the statistics that Peter Orszag of the Congressional Budget Office uses to come up with his estimate of 30% waste in health care spending in the United States. Prof. Skinner at Dartmouth and Prof. Garber at Stanford point out that of most health systems around the world the American system is "uniquely inefficient" and wasteful. The Economist cites information that the American system is twice as costly per person for healthcare than the Swedish system, and that it costs twice as much in Minnesota as in Miami. A poll done for the Economist shows 52% of the people in the UA are dissatified with the quality of care, 40% think the system needs fundamental change, and 29% think that it should be fundamentally rebuilt. The lack of uniform coverage is also causing turmoil in the system. About 49 million are uninsured, and a quarter or more are able to buy insurance and do not buy it because it is so costly, has exclusions and coverage is inadequate. But these people also end up in the emergency rooms along with the indigent costing the whole system tens of billion of dollars for costly late interventions that could have been avoided with preventive care early on. With the economic crisis and rise in joblessness, the dire condition of state and local budgets, the situation has probably drastically worsened, and the system near breakdown. ...

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Dipti Deshpande writes in the Economic Times that how India's economy recovers depends a lot on how well the government tackles the problems of vaccine supplies, vaccination staff and incentives for vaccination to the public, vaccination logistics, and vaccination skepticism. Vaccination plays a large role in the reduction of fear and permits resumption of normal activity as seen in the US, UK and France. Government education of the public on vaccine safety should be conducted on an organized basis across the country starting now for the gaol of vaccinating the entire population by December 2021. In the 200 days remaining in 2021 the government would have to administer over 1000 million doses or at the rate of 5 million doses a day just for the single dose population, with the second dose meaning additional supplies and logistical effort, organized health staffing, all to be organized.  The thrust of this article is that the economy and especially laggard sectors such as services would gain a fully powered recovery if the problems of vaccine supplies and vaccination drives are resolved early with preparation, lessons learned, and proactive action all taking place immediately. The period after the decline in cases to below 50,000 a day which is fast approaching for India is one that needs to be used to take deep yogic breaths, and prepare the Indian mind for the next challenge for government and nation.   ...

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This story in the NYT describes how the flawed effort to pass the Republican healthcare bill or repeal the Affordable Care Act passed under president Obama failed after another effort. Many developments killed it. In the end the president lost interest, especially when he saw Republican Senator Rand Paul of Kentucky go on talk shows on the weekend before its collapse to complain about the bill. Senator Collins of Maine was exasperated by the way the bill was being rushed through Congress, and she voiced her strong opinions about this by talking to people back home in Maine and sharing her conversations with the media. The bill pushed by Senator McConnell, the Republican leader in the Senate, imposed annual caps on Medicaid spending. And did this without any discussion, shutting out committee debate, any public discussion, or formal drafting. Once this process was set in motion in this way the Republican Senators formed camps. Senator Grassley of Iowa and Jerry Moran of Kansas, normally conservative moved to the moderate side. Moran held a town hall meeting covered in the NYT, where older people voiced their concerns. Most of the patient advocacy groups, the hospital groups such as the American Hospital Association, and other medical groups also opposed it.  After Senator McCain of Arizona said he could not return following a surgery in Phoenix, Senators Lee and Moran announced their opposition. With this the bill's support crumbled including any effort to repeal the Affordable Care Act.  ...

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There are about 181,000 homeless in California one third of the total in the US. This $6.4 billion bond issuance for borrowing funds was approved by just over 50% of the vote. It will go to create more affordable housing so badly needed in California's out of control housing prices. People tended to think nothing works and out of apathy did not vote. But the scale of the problem required effort at the state level or federal level with funding in the tens of billions of dollars for affordable housing. This is the first time that this has happened even though Silicon Valley and capital markets have wasted hundreds of billions of dollars in dubious companies and projects that have contributed little to the standard of living and ease of living of the American people, including essential infrastructure and health, education services. The dilapidated and crumbling infrastructure, of subways, streets and bridges in New York City is another aspect of the same problem of serious, serious lack of affordable housing in California. It also creates the kind of class divisions in society that FDR-Truman-Kennedy sought to remove since the 1930's. ...

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The slow growth on spending in services is affecting economic recovery in the U.S. in 2011-2012. Spending on discretionary services since the second quarter of 2009- other than housing and health care- is up 2.8% according to Wall Street Journal analysis of Commerce Department data. This is affecting gym memberships, eating out, air travel, and other postponable purchases. By comparison spending on consumer goods is holding up better. Spending on goods was up 9.1% in the same period. This shows up in sales of autos, flat screen televisions, and other electronics. Alan Krueger, chairman of the President's Council of Economic Advisors, says services account for about half of GDP, and over half of jobs, and points to the lack of growth in discretionary services.

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Uber and Lyft, ride-hailing apps are adding to the traffic in downtown areas of major cities in the U.S. It is getting worse to the point where cities are looking for ways to ease the congestion in downtown areas of Chicago, San Francisco, New York, New fees are being enacted in these cities on Uber and Lyft, and regulators are also considering fees. The problem is that ride sharing apps customers prefer not to pool or share rides as the ride sharing apps said they would to prevent congestion. Another problem is that Uber and Lyft are actually pulling people away from buses, subways and walking creating new waves of congestion and poor utilization of public transportation designed to ease travel for most of the post war period. Worse they are not supporting healthy living because it is harder to walk on traffic congested streets and some people become lazy and just grab a ride rather than walk a short distance or walk to public transportation. Another issue is that an estimated 40% of the time the Uber and Lyft drivers in major cities cruise around for fares without passengers. San Francisco county officials have found in a study that over 60% of the slowdown of traffic speeds in San Francisco between 2010 and 2016 was due to the introduction of ride hailing apps. In Chicago, the policy director in the mayor's office says there is exponential growth in traffic congestion from these ride hailing apps.  A December report by the California Air Resources Board found that ride- hailing cars are driving with no passengers 39% of the time, and New York city estimates cruising at 41%. Mr. Schaller, a New York City official who has studied this issue says surveys in many cities show about 60% of riders in Uber and Lyft would have walked, biked or taken public transit or stayed home if a ride hail car was'nt available. More and more so called disruption by Silicon Valley in the interest of rapid and chaotic growth is looking like a bad thing, says this report in the WSJ, creating a whole new set of problems. What is not even understood here is the vast misallocation of resources, the billions of dollars that could have improved public transportation, bike paths and other means of getting around, improvements in cities downtowns to make them friendlier and with new park spaces with those dollars invested there instead of in ride hailing apps.   ...

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Healthcare, climate change, pensions and social benefits, are three issues uppermost in the minds of German voters. Three million new young voters most of them only about 2 years old when Merkel started 16 years in office, look for change. They are well informed and for these young voters climate change is the most important issue. DW.com shows three voters and how they plan to vote. One voter has cast a mail in ballot for The Greens party. The second voter will vote for the Greens. Both because of climate change concerns. The third voter Thurid says her mother is a geriatric nurse and is not vaccinated. She is vaccinated but had talks with her mother and understands her worries about vaccination. She will vote for the Free Democrats because they oppose compulsory vaccination. The three leading parties for young voters are the Greens party, the Free Democrats, followed by the Social Democrats all in the range of 16-18% of support. The Greens have sent out 2 million brochures to voters. Out of 60 million voters in a German population of 80  million, 3 million is only 5% of the vote. What makes a difference is that it is consistent with the general direction of voters young and old, all looking for change in Germany as the CDU party attracts only about 20% or one fifth of German voters. Social Democrats Scholz is way ahead of Christian Democrats Laschet in how voters view each candidate. Will German voters be well informed enough to make a decision based on their desire for change after 16 years of Merkel or will the CDU bringing back in the last days of the campaign the old fears that the communist Left party would somehow find its way into the government using the Greens as a way in- this is a question for German voters. In1994 during the Cold War with Soviets Kohl used this to keep the Social Democrats out and Greens out and formed a coalition with the FDP. Yet today Merkel has grown close to both Russia and China and away from the Western alliance in a way that was unimaginable under Adenauer who helped build the new Federal Republic of Germany after the war. Merkel refuses to even immediately accept a call from a new US president Biden, American president who is closest in style and temperament to Harry Truman who faced off the Soviets in Berlin in 1948.  The FDP opposes a wealth tax or any form of taxes in which the wealthier pay a fair share of what is needed to build crumbling infrastructure in Germany neglected in the Merkel years. In Germany social and economic disparities have grown during the pandemic with poverty increasing during the pandemic as has happened throughout Europe and the world. The US is already committing to increase taxes for the upper incomes. This is where voters have a choice- do nothing with infrastructure, health or climate change or do something by increasing taxes. The choice is now before the German people.  With this question comes a choice for western civilization, with the recent election in the US, and two elections in Germany and then France. Will it look with optimism to the future or will it huddle up in a deeply cautious and slightly pessimistic view of the world that is embedded in Angela Merkel's cautious vision that ended up only responding to crises- some self inflicted as in migration policy, and even self inflicted in tackling euro problems created in the euro currency's faulty design. In fiscal policy as in migration policy Merkel has reversed her position- by supporting European solidarity. Will Germans vote for optimism or never ending caution? Are lessons learned?     ...

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European Union countries, Britain and the US face the risk of a resurgence of coronavirus through the Delta variant and other variants. The Delta variant detected in India is 40% to 80% more transmissible than the Alpha variant detected in the UK, with the Alpha variant 50% more transmissible than the original coronavirus that originated in Wuhan.    Virologists in Italy feel they are flying blind at this time because of the lack of genetic sequencing in Italy, Spain, France and across most European Union countries. The UK has done genetic sequencing on 27% of recent covid positive tests. The figure drops to 1% for Italy and is tiny for most of the EU countries including Spain and France. Without genetic sequencing it is hard to predict and take steps. Another problem in the EU is that the southern economies Spain, Portugal, Greece, Italy, Croatia are dependent on summer tourism for the economy. The UK economy can handle a delay to a full opening for 6 weeks without serious impact to the economy, says WSJ. Southern European economies can afford only short delays to full reopening. Croatia acted as a door to spread of coronavirus into central Europe when Germans and Austrians went to vacation spots in Croatia in summer 2020. This situation could be happening again in 2020 with British and other tourists visiting vacation areas in Portugal, and Germans visiting Greece and other summer tourism spots. Portugal's national health institute says the Delta variant represents 60% of new cases in the area around Lisbon based on early data. The government of Portugal is facing criticism for letting a Champions League soccer final to take place in Porto, Portugal between two English teams. Thousands of English fans watched the game at the stadium. Other problems are in relaxing of mask rules in France and Italy, last week in France and in the coming week in Italy. French nightclubs open July 9 without mask requirement. Germany is maintaining some social distancing measures and this includes mandating medical masks in closed public spaces and on public transport. Half of French, Italians, Germans are vaccinated and quarter fully vaccinated. Yet the gaps of unvaccinated people is large enough to cause serious concern of another wave. The relaxation of mask rules- the entire stadium in Budapest was packed for a recent game between Hungary and Italy for a soccer Euro 2021 game with no masks to be seen. Stadiums played a key role for the spread of the original coronavirus in Italy with a game in Bergamo, Italy, in the area near Milan. All this makes health officials concerned about the risks of still another wave of the coronavirus.   ...

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US Congressman Darrell Issa, incoming chairman of the House Oversight and Government Reform Committee, says he will look at saving much of the $125 billion dollars of waste and fraud in the Medicare system. What he described as money going out to Medicare recipients that don't exist for procedures that did not happen and other wasted dollars in the Medicare system. He describes this as money that doesn't get one person health care in Medicare.

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Alan Blinder, Princeton University professor and former vice chairman of the Federal Reserve, says the biggest reason for the growing deficit in the years out to 2040 is because of increases in health care spending. Its not that there is runaway spending in other areas. He cites CBO projections that show other costs stable relative to GDP from 2015 to 2035 and declining. This is why healthcare spending is at the heart of the problem. And why tackling the deficit has a lot to do with reducing healthcare cost increases.

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From the country of "Feierabend" the much appreciated German term for cutting off the workday to do something else like biking or running which is very healthy way of living during the pandemic and everyday, come more German expressions which tell us  more about how to live.  "Na Wie Lauft's" is the German expression most people learn because it means "how are you running", and shows people you care about them. Here DW.com, looks at other German expressions with wonderful pictures of people and scenery in Germany to accompany each expression that has a soothing, calming effect on all. The meanings are given by DW.com, the German national broadcaster which also helps people learn German. "Die Dinge Laufen Lassen," is another German expression that has a Zen nature and is one that one take comfort in for its calming effect. It means "let things run their course, and everything will be alright in the end." "Noch in den Kinderschuhen stecken It means things are only in the early stages, beginning to develop, unfold, the ball is only beginning to roll. With it goes "Laufen Learnen" which means you have to walk before you can run. "Lugen Haben Kurze Beine" means "Lies have short legs." It suggests walking or running. It says you won't get far with lying, you won't get ahead with it, somebody will see through you. "Auf dem Ruder laufen" means to lose control of an oar while rowing a boat to stay on course. It also means hang tight and things will right themselves eventually. And to go with this is the German expression about learning the procedure or techniques for getting the work whatever it is done correctly. Wie est der Ablauf" how will things run, what is the procedure for doing it? Positive expressions from the images of running or walking at the time of the pandemic when this can have a soothing and calming effect.   ...

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Francesco Guerrera of the WSJ interviews Sergio Ermotti, CEO of Swiss bank UBS, and Andrea Orcel, the head of UBS investment bank. He asks Ermotti why the drastic restructuring at UBS, especially the downscaling of its investment banking operation. Ermotti says its because it was time to stop throwing money away on activity that did not cover the bank's cost of capital and the unhappiness of shareholders with the way UBS was operating. The string of bad news from UBS with legal settlements, trading scandals and huge losses have created a special situation at UBS which required drastic action. UBS was able to take the action also because of its successful wealth management business, which will become the core of its future business. Other banks such as Goldman Sachs and Morgan Stanley with large fixed income, currency and commodity (FICC) businesses, get more of their earnings from this unit and are less likely to follow UBS.

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The inflated costs for spinal surgeries at some hospitals in California. How surgeons, doctors, consultants, distributors and hospitals operated in a flawed system to make revenue gains through overbilling, and focus on increasing the number of surgeries performed.

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Vaccine mandates are becoming a favored action as companies and governments see the dangers of rapid spread of highly transmissible delta variant. Following the action by the French government to make vaccinations mandatory for all healthcare workers, and require health pass passe sanitaire showing one is fully vaccinated at restaurants, cafes, and trains, more governments are taking up this action. This is supported by French premier Castex showing that 97% of the 18000 average daily cases in France this week, up 150% from prior week, are from unvaccinated people. Similar situation prevails in the US making it critical that governments take action early, and not miss the right time for such action.

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The Editorial Board of the WSJ questions the lack of debate on the frequent lockdowns and the quashing by public health officials Fauci and Collins of an alternative point of view on lockdowns. That point of view by epidemiologists at three universities Oxford, Harvard and Stanford favored a policy of "focused protection" of high risk populations instead of snap response of blanket lockdowns. It cites statement by Dr. Fauci that people who criticize him are "really criticizing science, because I represent science. That's dangerous." And questions the idea that one man can by himself represent science, saying scientific debate over pandemic policy was and still is in the public interest. In some ways the Biden administration has adopted some of these ideas on a new pandemic policy that does respond with focused and selective lockdowns. Today shuttered businesses, lost livelihoods, untreated illnesses, mental illness, isolation effects are all taken into account in decisions throughout the US, and other countries in Europe, in Asia and the rest of the world. Some of the emails mentioned in this WSJ editorial were in October 2020 at the height of the first wave and second waves before the vaccination drive in 2021, when the fear of the coronavirus was the dominant response. Yet a spirited public scientific debate could have prevented some of the rancor and division that has led to high vaccine resistance in the US with fully vaccinated stalling at about 62% of the American population at the beginning of 2022. It did'nt have to be that way. America could have done a lot better with sincere scientific and public debate. ...

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In a new WSJ/NBC New poll, conducted July 24-27, 2009, 42% called the Obama health plan a bad idea, and 36% called it a good idea. In mid June the poll showed Americans evenly divided on this question. It reflects rising anxiety over the costs of the health plan and what it will do to the deficit, and also shows public anxiety about the ways in which Obama and Congress are reaching compromises to pay for it and to control costs. Added to this are the anxieties raised about government involvement in healthcare and medical decisions about care. Noteworthy are two differing pieces of evidence. In the WSJ/NBC News poll, only two in ten people thought the quality of their own care would improve, only 15% of those with private insurance thought that it would improve the quality of their care. And 4 in ten people thought quality of care would get worse, and 45% of those with private insurance thought quality of care would get worse. By focussing on the cost of health care, the administration seems to have ignored or missed the concerns of people about the quality of care if government focussed on cutting costs. These concerns are real as a vast majority of the public, or about 85% of the people, as Martin Feldstein points out in a recent Washington Post column, are insured. The question is what cost would they be willing to pay for the admittedly worthy cause of insuring the uninsured? And even with the unisured, it seems likely with the current Obama reform plan that immigrants and other people may still remain uninsured, at least for some time. Would a huge burden of $1 trillion make this worthwhile, and is there some better way to do this without the prospect of higher taxes further down the road to pay for this. These are points Feldstein makes. The other piece of evidence is that at the same time that there are reservations about what is coming out of Congress today, there is general support for making constructive changes to healthcare. The WSJ poll showed 56% of respondents favoring the basic ideas in the reforms being considered in Congress, with 38% opposing it....

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The Senate FInance Committee's $829 billion bill, would cut by $113 billion money for America's Health Insurance Plans over ten years, specifically Medicare Advantage, reducing insurer profits. The AHIP is responding with aad campaign to seniors to fight this setting up aconfrontation with the Obama adminsitration.

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This report from Germany in DW.com says Germany tried to build a softer relationship with Russia during the leadership of Adenauer of CDU and  Brandt of SPD. This continued under Schmidt and Schroeder. Under Merkel of CDU the emotional aspect of the relationship as Russia retreated from Bolshevism and Soviet Union collapsed was lost. Little attention was paid to East Germany and to how the fall of the Soviet Union had affected Russia negatively,and became purely focused on German industry and trade with cheap Russian gas supplies. Even as Germany did not invest in shared burden for defense with the US, and Germany under Merkel increased dependence on Russian gas supplies to 55% with the Nordstream gas pipeline from Russia, and shut down nuclear energy.  As a result the emotional or mental health aspect of the relationship with Russia of Germany was lost under Merkel. The focus on purely financial aspect of things has been proved wrong both for the economy as physical infrastructure was neglected under Merkel and social infrastructure such as child care and other social aspects of society were sorely neglected. A new broader framework that needs to be built will have to keep this in mind.  All the hard work and good intentions of the Adenauer and Brandt years has been lost with the short sighted basis of relations based purely on finance and trade under Merkel's leadership. This happened also in the US relationship with China with the relations based purely on finance and trade under Clinton, Bush, Obama proving to be too fragile as they did not protect other social aspects within the two countries as inequality widened and whole segments of society were neglected.  ...

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Alexandra Stevenson provides this insightful glimpse into a highly inflated property market. Microflats in Hong Kong of 275 square feet, smaller than a bedroom, sell for $722,000. Smaller flats of 165 square feet are planned by developers. Since 2003 property prices are up 300% in Hong Kong. Experts see another fall in prices similiar to the one in 2003 during the Asian financial crisis. Mainland Chinese investing in Hong Kong flats have never experienced a collapse in prices. Hong Kong mortgage rates are low, about 2%. Experts see a rise in U.S. interest rates affecting buyers, as Hong Kong interest rates are tied to U.S. interest rates. With low rates on savings accounts, savings are going into an highly inflated unsustainable property market. One estimate shows 41% of household wealth in China is tied up in the property market. A downturn in prices could lead to a large decline in consumer spending. Nicholas Lardy of the Peterson Institute of International Economics sees China not immune to the kind of housing price collapse that hit the U.S., Spain and other countries in the last decade....

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Doctors face a 21% cut in the amount of Medicare payments for treating seniors having Medicare, though this cut will be delayed till 2011 under legislation in Congress. This issue goes back to 1997, when a budget law set spending targets, and stated that if they were exceeded formulas to reduce doctors payments would go into effect. The formulas seriously cut into doctor payments by Medicare in 2002, so the formula was put off. The result of this is that the cuts based on the formula now amount to 21%. The cuts are not expected to go through, but at the same time Congress has an headache on its hands with the growing deficit. In the Senate there is opposition to a $120 billion bill to extend long term unemployment benefits which lapsed in June 2010, for tax breaks, and other expenses. Senators want to pare down the bill's price tag, as $80 billon of this is unfunded and will be added to the budget deficit. For a primary care doctor in Washington state, Medicare pays about $95 compared to private insurers payment of $129, and a plan for state workers that pays $140....

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Einer Elhauge, professsor of law and founding director of the Petrie-Flom Center in Health Law Policy at Harvard University, says there are limits to Congressional powers under the Commerce clause such as enacting a law requiring Americans to eat broccoli. If the health care law required all Americans to subject themselves to health care this would be the case. But the law only requires all to buy insurance so that insurance can cover the costs of healthcare for all. He points to the "necessary and proper clause" as also authorizing the health care mandate. That clause gives Congress the power to pass laws that are "rationally related" to execution of constitutional powers, such as criminalizing the interference with mail, on the basis of the constitutional power to setup post offices. In this case the health care law mandate is related to the constitutional power to regulate premiums and prohibit rejecting the sick, says Elhauge.

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In a factory the size of 5 football fields located in Gurnee, Illinois, Abbott Labs makes its BinaxNow Covid-19 home tests. Abbott turned out 1 billion tests in 2021 and at one point had 80% of the market. Along with Pfizer vaccine, BinaxNow Home covid-19 tests are a dominant product during the pandemic. Abbott generated a fifth of its $43 billion in revenue from these home tests. Abbott faced several hurdles along the way. It gained when the US government authorized it to make the test. Yet after vaccination took off by mid 2021 the demand for tests declined and Abbott nearly idled its giant factory in Gurnee. Delta and Omicron variants led to a sudden reversal and surge in demand. Abbott developed its test based on an existing design it used in the US for flu tests, by a company it inherited by acquisition called Binax. To do that test one sends a swab up the nose, add that sample and a liquid mixture to a rectangular paper card, and close the card shut. The liquid then travels up the paper strip, revealing one or two pink lines, one for negative, two for positive. This is done in 15 minutes and the simple design described as a lollipop shape, put Abbott far ahead of competitors. The US FDA authorized Becton Dickinson and Quidel to make the tests before it authorized Abbott, but these rival companies had a poor and complex design. The Trump administration gave Abbott a $760 million contract to buy 150 million tests for distribution to health departments, long termcare facilities, nursing homes, and schools. And by October 2020 Abbott was already making 50 million tests a month. When it comes to distribution Abbott tapped into its pharmacy connections for baby products such as Similac baby formula. This gave it an advantage over Quidel and others who also lacked the manufacturing knowhow for large scale ramp up. The BinaxNow in pharmacies was sold at $24 for a box of two tests, while government paid $5 for one test. Abbott says it makes $ 7 per single consumer test. Yet there was one problem waiting to hit Abbott in 2021- demand dried up as the vaccination campaign took off. In fact the plant manager, Mr. Rodriguez, planned to move to another job inside Abbott as production declined. Then came the Delta variant and he was asked to ramp up production again. With Omicron demand soared. The Biden administration committed $3 billion to help boost test production and asked Kroger and Walmart to sell over the counter tests at cost for 3 months. Abbott had to lure workers from Amazon at $25 an hour for the Gurnee plant expansion. What was learned by the government and Abbott from this experience? The US government now looks for ideas in meeting demand volatility, supply challenges and production needs,. Sustaining production capacity is important for future virus flareups- a new government-industry partnership is required for maintaining test making infrastructure. With government help Abbott plans now to keep the facility at Gurnee operating indefinitely. ...