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Medical malpractice works in the worng ways.

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To gauge economic progress and improvement in living standards, instead of GNP alone look at number of indicators. Look at healthcare and education, cleaner skies and cleaner air, water and land. This is what areport commissioned by President Sarkozy of France, done by Siglitz and Amartya Sen, esentially emphasizes. And be careful when you see more cars and gasoline and more driving drive up GDP numbers and growth because this may actually work in the wrong direction, and have unusual negative effects as the SUV buildup and later collapse led to destroying companies and jobs in Michigan and the midwestern USA.

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The views being currently argued in meetings with the President about the war in Afghanistan and Pakistan. Vice President Biden's view: Completely change the goal and strategy. Scale down the military presence. Change the goal from protecting the people from the Taliban- and note that reports on the ground suggest that the people are indifferent and see the Americans and the Taliban as equally bad, with the Americans as foreigners far worse, see Doris Kearns others- to accelerated training of the Afghan forces to fight the Taliban. The focus of US interests would shift to Pakistan. Biden points to the disparity for every $1 spent in Pakistan $30 goes to Afghanistan, and the US real interests lie in Pakistan, not Afghanistan. The US would work with Pakistan to take out Al Quaeda in the border regions. And the proof is that this is working, as Al Quaeda figures have been taken out with Pakistan's help. Counterinsurgency would be replaced by counter terrorism so the US doesn't get bogged down in support of a failing government. The fraud in the recent elections and increasing isolation and loss of support for the Karzai government, supported by unofficial evidence from the ground, make this a serious option, especially as President Obama knows the Karzai government does not merit support and presents a losing proposition. The second view is that of Secretary of State Hillary Clinton- Ike Shelton of Missouri on the Armed Services Committee and Leslie Gelb (see links) share this view- who said in an interview on PBS, "Well Al Quaeda's no longer in Afghanistan. If Afghanistan were taken over by the Taliban, I can't tell you how fast Al Quaeda would be back in Afghanistan." The problem with this view is that the US has only a limited presence in a large mountainous country with the difficult terrain that Afghanistan has, and its not American ground troops that have done the damage in taking out Al Quaeda, its mostly high tech drones. WIth a wider engagement and expanded US ground troops in support of a failing government, that is alleged to have corrupt and narcoltics connections, the popular support would dwindle to the point that the extra troops would not be seen as protecting the population- because how do you protect a people who simply don't care or are suspicious of you? The solution requires some sort of settlement with the Taliban, which guarantees that it not serve as a haven for Al Quaeda. Progress with schools and modernization would have to be, at least in the short run, be given upon the basis of the U.S. coming to terms with what it can and cannot accomplish at an acceptable cost, and the idea of vital interests not lying in Afghanistan but Pakistan. The missing elements in this puzzle would help this strategy, bringing together key countries in South Asia, India and Pakistan, to assume greater joint responsibilities and abandon the entire postindependence. approach to relations. The third view is that presented by Bruce Reidel, who led the Obama administration's strategy review of Afghaistan and Pakistan earlier this year, and is based on pragmatic considerations and the unofficial information on the ground. Reidel puts it this way: "A counterinsurgency can only work if you have a credible and legitimate Afghan partner, and thats in doubt now." And he goes on to say "part of the reason you are seeing a hesitancy to jump deeper into the pool is that thay are looking to see if they can make lemonade out of the lemons we got from the Afghan election." For a complete change in policy and focus Obama would have to admit that he now has different information, and he is willing to admit to have misread the situation during the first 6 months and during the campaign. That is a test of leadership, being able to change after looking at the reality of the situation and digesting it fully. ...

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World leaders meet at the UN for action on climate change, especially Obama and Hu Jintao of China who represent countries that generate 40% of carbon emissions worldwide. Hu set the target for nuclear power at 15% of energy for 2020 from 8% now, and India set atarget of 20% for renewable sources of energy for 2020. President Obama said he saw the need for the developing industrial nations, by which he meant China, India and Brazil, to adopt targets for curbing emissions in any agreement, but Hu Jintao was vague about any specific targets. So the gap remains as the US goes to the Copenhagen talks on climate change in late 2009.

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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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Patterns of decline or increase of foreign born population in the USA by country in 2008 vs. 2007 to gauge how immigration patterns are affected by the global financial crisis. There were over 325,000 fewer people from Mexico and 120,000 more people from India. There are about 38 million foreign born people in the US with 1.6 million from India, and 11 million from Mexico.

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As the American banks were better capitalized before the global financial crisis than the European banks, and they were recapitalized with taxpayer money during the crisis, the Europeans and the French in particular feel that they have alot of catching up to do. Geithner at U.S. Treasury is pushing for higher capital requirements for the banks, with agreement by the end of 2010 and implementation by 2012. The way these new rules work the Europeans feel would put their banks at a disadvantage, because their banks would have to raise more capital and constrain their ability to provide credit to their local economies. Capital requirements for banks were part of the previous arrangement called Basel II, which covered USA and European banks. Basel II capital requirements rules measured capital compared to assets weighted on the basis of how much risk they carried, but this relied on credit rating firms which were discredited in the crisis. On the subject of bonuses the large banks are trying to influence the discussions. As a result the Financial Stability Board, an international advisory committee of financial regulators is going to make its own recommendations....