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The coronavirus pandemic and the disaster in nursing homes, the chaotic conditions in the first wave, the lack of staff and poor attention to residents during the pandemic, has exposed the major weakness of nursing home care in western countries. Much of this sector is in the hands of private operators seeking a profit.  The staff is paid low wages and lacks the experience and empathy needed for care of older people. During a virus all these factors turn deadly. With some staff sick the other staff is overburdened. If the sick turn up for work they are likely to risk the safety of other staff and the residents. With the incubation period lack of testing there is no way to know. When deaths occur and the nursing homes are sealed from the outside world the deaths happen with no goodbyes as happened in U.S., Britain and Sweden. This has exposed the scandalous and shocking way in which the elderly are treated in today's environment where ridiculous amounts of money are being spent on other things and the the most basic "one's parents" are neglected and allowed to die in horrific manner in a pandemic. The new trend for home care for the elderly is a welcome trend and long overdue as one of the worst aspects of the system in the west is the treatment of elderly parents in nursing homes run for profit. The new technology tools available for monitoring a elderly person at home, and the help of stores such as Best Buy which are serving elderly at home, is making this more and more a choice for the elderly. Even older patients and ones needing significant care can recover and spend time at home in a better environment, a less costly one, as hospital managers and families have learned in 2020. Some hospitals in the U.S. say they never want to go back. That the drive to get every patient home who can be home is the right one for patients and families and for the government paying for the care so that dollars are well spent in quality of care. Home health care companies are working on providing new services for sicker patients recovering at home. Technology helps do better monitoring. Medicare now pays for digital doctor visits and intense hospital type care at home after coronavirus showed this as vitally needed.  Both the Biden and Trump administrations are firmly focused on this issue. Seema Verma as head of Medicare is clear about the need for a national conversation on how we take care of the elderly, of our parents. And Mr. Biden wants to spend $450 billon to make certain that people who need long term care can get the support they need in the home and the community. This report looks at the home health care companies and how they are improving their services. This and telemedicine are two of the major constructive changes coming out of the pandemic, clearing out some of the worst aspects of the old system of living the older years in the western world.  Nothing speaks more about humanity and a human world than the story here of Savanna Hollar, 90 years old and almost blind. She broke her shoulder in August, Her sons decided not to send her to a the rehab facility she went to after a broken hip 3 years earlier. The sons brought her home to recover in the farmhouse near Yadkinville, N.C., where she has lived since 1951. One of her sons himself 63 years says that at a nursing home she would be lonely, scared and afraid to move. The sons hired two people to help her during the day and a rotating system was used for having people help her. At home Mrs. Hollar could enjoy her gray cat, Buddy, her favorite recliner and tomato sandwiches made with produce from her garden. Really, if we can't do this much what good is the U.S.A.? or Britain? or Sweden? or India? ...

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Spain's cabinet announced new changes to labor laws to provide incentives to business to hire. Spain has some of the most restrictive labor laws in Europe and high unemployment. The unemployment rate reached 23% in December 2011, and about half of the people under 26 are unemployed. The cost of downsizing is so high in Spain that Spain's representative on the executive committe of the European Central Bank, Jose Manuel Gonzalez-Paramo, says companies prefer to close rather than downsize. The World Bank has singled out the labor laws as one of the main reasons for Spain's rising unemployment rate. New rules will reduce severance payments to 33 days per year of employment from 45 days. Severance packages will be reduced to a maximum of 24 months from 48 months. To encourage companies to hire permanent workers and depend less on temporary workers the new rules say employers must switch temporary workers to permanent contracts after two instead of three years. As an incentive for companies with a maximum of 50 employees to hire young people the rules give a 3000 euros corporate tax break for each new person hired under age 30. If the hired person was jobless he can still collect 25% of previous unemployment benefits for a limited period with 50% of the unemployment benefits going to the employer. Companies having losses for three consecutive quarters are allowed to pay less in severance payments- only 20 days per year of employment. Companies will now find it easier to leave collective bargaining agreements and make deals with their own staff. Luis Garicano, a professor at the London School of Economics, says this is a good step forward. He finds missing from the new rules subsidies to train young and unemployed people given the high dropout rates in Spanish schools. The government approved the rules by decree, but they will be discussed in the Spanish parliament. The government of prime minister Mariano Rajoy was recently elected with an overwhelming majority in parliament. This makes making major changes different from the process in Italy where a consensus has to be established....

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Russia is excluded for the second year for the G-7 Summit meeting of leaders in Berlin, in June 2015. The exclusion follows Russian intervention in Ukraine.

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Spain's national statistics agency confirmed that the Spanish economy contracted by 0.3% of GDP in the 4th quarter of 2011. The central bank of Spain predicts the economy will contract by 1.5% in 2012 if Spain makes spending cuts to meet the defict target committed by Spain with the EU of 4.4% of GDP. The deficit was 8% of GDP in 2011 and the new Rajoy government announced cuts and tax increases amounting to 1.5% of GDP. A separate IMF report predicts a 1.7% contraction in GDP of Spain in 2012. Opposition party leader Rubalcalba says Spain should renegotiate its deficit target with the EU in the light of the expected contraction. Spain's prime minister Rajoy hinted he would move in this direction.

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Only 23% of meals in America include a vegetable. The number of dinners made at home with a salad dropped to 17% in 2010 compared to 22% in 1994. Salads ordered at restaurants dropped to 5% in 2010 from 10% in 1989, according to NPD research company in its 25th edition of "Eating Patterns in America." The U.S. is going backwards in good eating habits and no enough attention is being paid to this in the debate about cost of health care. Their is a clear connection between good eating habits and health, and while invention and use of the latest research and innovations in health care are lauded, the decline in patterns of healthy living and food habits are receiving less attention.

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Higher inflation in Germany could help rebalance the German economy by increasing imports. German inflation has averaged 1.6% since 1999, compared to 2.0 % for the eurozone. It was 2.3% in December. And after years of wage restraint German unions are increasing the wage demands. IG Metall is looking for a 6.5% wage increase. And interest rates at 1% are quite low for Germany where unemployment is down to 5.5%, according to Eurostat, and employers have to meet higher wage demands. The ECB is aiming at 2% inflation and Germany has a 26% weighting in the calculation of the rate. But as Italy, France and Spain see inflation decline there is room for addditional inflation in Germany before the eurozone goes well above the 2% inflation rate. By freezing wages and improving price competitiveness with German products, other countries could increase exports. Yet the prospects of this making a large difference is limited because German companies are likely to push for wage restraint. The Bundesbank predicts wage increases of 2.4% in 2012. Over time the wage restraint in other eurozone countries and even slightly higher wages in Germany would reverse the trend since 1999 of Germany having much lower inflation, and this could be one of the factors helping in rebalancing....

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This Journal editorial cites the regulatory burdens imposed on small and medium sized businesses in Italy that discourage hiring and innovation. Prime minister Mario Monti's efforts to reduce these burdens and change labor laws in Italy.

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Steven Erlanger describes the mood in France as it faces problems of improving competitiveness in a rapidly moving global economy. A sense that the actions of the Hollande government will not be enough to tackle the need for deeper changes.

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Hoover Institution scholar Fouad Ajami describes in this essay how a more active policy by the Obama administration could have prevented the chaotic situation in the Middle East, the sectarian conflict, the breakup of Syria and Iraq, the increase in terrorism eventually affecting France and the U.S., and the refugee crisis in Europe. This active policy he says would have included- keeping some presence in Iraq, and taking action to prevent the spread of the conflict by restraining regional and foreign powers and terrorism.

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"Defend blue sky and breathe together" says a painting on a brick wall in the coal producing region of Shanxi, northern China. China is finally acting seriously to impose strict environmental rules from the top. Old coal stoves are thrown into a dump as China shifts away from coal stoves to heat homes. So many new homes shifted to natural gas in Shanxi province. population 37 million, that demand overwhelmed natural gas supplies. Results are to be seen in cleaner air in Taiyuan, capital of the province and in Beijing itself.  President Xi's commitment to climate change accord reached in Paris is seen as firm in this report in the NYT. The head of the gas, coal and power markets division of the International Energy Agency, Mr. Peter Fraser, says that even though homes use only 6% of total coal used in China, the effects are disproportionately high because homes do not have any emission reduction mechanisms. Natural gas demand has increased by 16% in 2017 as provincial officials eager to meet the demands issued in Beijing to cut coal emissions even let some homes and schools go without heat in an early winter spell. This extraordinary report shows how in cities in northeastern China the people welcome the change to natural gas and cleaner air. Even in coal country, in cities like Linfen population 4.4 million, the change is seen as people welcome the clean air and officials build natural gas connections to execute the plans issued in Beijing. In Beijing itself Greenpeace estimates show 54% reduction in PM 2.5, harmful particulate matter for breathing by 54%, a startling fact showing Beijing's determination and effectiveness of its actions. Natural gas is more expensive and citizens do not complain in neighboring provinces near Beijing because the state provides adequate subsidies to compensate people. Decrees are being enforced to avoid coal stove use with people knowing they could see action by authorites if reported. Compare this to the problems of crop burning around New Delhi, in Haryana and Punjab provinces, and one can see that centralized control and direction has advantages when used in the right way for a good purpose and supported by people who want to breathe clean air. ...

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Portugal's economy is shrinking. Austerity measures taken in exchange for 78 billion euros from the IMF and the EU under a May, 2011 agreement have reduced the prospects of growth. The ratio of debt to GDP was 107% in May 2011. It is expected to reach 118% in 2013 because the economy is shrinking- even though Portugal will have achieved its targets for reducing the budget deficit. Portugal's finance minister, Vitor Gaspar, a former ECB research director, has reduced the budget deficit by one third by cutting spending, pensions, wages and increasing taxes. GDP fell by 1.5% in 2011 and is expected to decline by 3% in 2012. Even the IMF says in its recent economic review that if growth is lacking the debt of Portugal "would not be sustainable." David Bencek, analyst at the Kiel Institute for the World Economy, says that the Portuguese economy lacks the structure needed to grow, and therefore has debt that is unsustainable. Portugal lacks a manufacturing base and exports, and was just emerging from decades of neglect by military rulers of education and other essential parts of a modern economy when it joined the EU....

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The Gallois Report and France's efforts to improve competitiveness under the Hollande administration.

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The elections in Italy in Feb. 2013 show the centre left coalition headed by Pier Luigi Bersani with 29.6% of the votes in the lower house, the centre right coalition headed by Silvio Berlusconi with 29.2% of the votes, the Five Star Movement headed by Beppe Grillo with 25.6% of the votes, and the Civic Choice headed by Mario Monti with 10.6% of the vote. In the Senate the results show the centre left coalition with 31.6% of the vote, the centre right with 30.7%, the Five Star Movement with 23.8%, and Civic Choice with 9.1%. Election rules in Italy give the party with the highest number of votes for the lower house an automatic majority of 340 of 630 seats. The vote shows voter protest over austerity measures. This benefitted both the centre right and the Five Star Movement and hurt the Civic Choice centrist party of Mario Monti which implemented austerity measures in 2012. The centre left was affected by its role in coming to the aid of Monte de Paschi bank in Siena and failing to mount a strong campaign under Bersani. A majority in both houses is needed to provide a stable coalition government which opens the prospect of new elections. The Five Star Movement emerged as the largest single party. Its support comes from young people, internet based campaigning, and a rejection of the right and left parties from the old order in Italian politics, and offers a new dimension to Italy's political future....

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Martin Feldstein points out why the recent agreement for a "fiscal compact" is no more than an empty statement about fixing the eurozone's finances. In this respect it is no different than the Stability and Growth Pact it replaces, with serious weaknesses. Feldstein cites the weaknesses in the language of the agreement. Each eurozone country is required to limit its"cyclically adjusted" budget deficit to 0.5% of GDP and bring its debt down to 60% of GDP. Compliance will be performed by the European Court of Justice and fines imposed. In practice the questions loom large- for a country like Spain with a 23% unemployment rate, isn't all of the 6% budget deficit cyclical? Again the agreement says deficits are calculated "net of one-off and temporary measures." Under this provision a lot of the stimulus programs would be considered in the category of "one-off." Other language lets eurozone countries frame budgets based on "exceptional circumstances" and "periods of severe economic downturn." Italy has declining economic growth, does it make sense to have a large budget surplus in that situation to lower debt to GDP, and how does that goal relate to "exceptional circumstances."...

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So far the Italian government has already recovered $15 billion for 2011 in its fight against tax evasion. The fight includes an advertising campaign depicting tax evasion as anti-social activity and vigorous enforcement by tax officials and the financial police. Italy has already banned cash transactions to reduce possibilities for evading taxes. This problem is severe in Italy because the underground economy is about 17.5% of GDP. An estimated $150 billion is lost to the Italian treasury from tax evasion. As a result Italy has a chronic budget deficit problem and is not able to make necessary investments in improving competitiveness to keep up with other countries. This may be one of the lasting achievements of the new administration of Mario Monti, along with its efforts to change the way the public thinks about other issues including labor laws that place large burdens on small companies in hiring practices. Italians sense the need to change the way they think about taxes because this is one way to reduce the burden of austerity measures- higher tax revenues could enable lowering taxes. It would also enable investing in improving competitiveness that would the economy grow and provide the jobs to reduce the high unemployment rate among young workers. One of the lasting positive aspects of the eurozone crisis is the change in the way the people and society think about many issues....

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Efforts to change labor laws by Italy's prime minister, Mario Monti.

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The strong showing by National Front leader Marie Le Pen and her focus on the economy in France, and the lack of growth with austerity measures, is likely to change the way the eurozone countries respond to the deficits and German insistence on austerity cuts. Marie Le Pen's economic positions for more government spending to reduce unemployment and provide additional benefits is closer to Socialist candidate Hollande's position. The right wing party in Holland also voiced the same concern recently- that it did not want to hurt Dutch pensioners with austerity cuts- when it refused to support the Dutch government leading to its collapse and new elections.

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The WSJ's Christopher Emsden and Alessandra Galloni's interview with Italy's Labor Minister, Elsa Fornero, after major changes to Italy's labor laws including Article 18. This is a major change for Italy. She describes the problems she faced and how she has tackled them to get the new labor law passed. Fornero will set up a monitoring system to ensure that the law's imprementation takes place smoothly. To make the change Fornero took apart Article 18 to its constituent elements, preserving the anti discrimination aspect and the right to appeal, but allowing employees to be terminated for economic reasons. This puts Italy on an even footing with its europartners Germany and France, and addresses one of the main reasons Italian businesses are loath to hiring new employees. It also addresses the main reason why foreign investment in the Italian economy is so scarce. In achieving this Fornero faced the lack of support from Confindustria, the business association (which does not cease to amaze her), CGIL, the labor unions, and the political class in Italy, with each side wanting to tweak the system to make gains or get special exemptions. Fornero is a pensions expert and economics professor at the University of Turin. Her ministry covers pensions, labor, welfare and equal opportunity policies....