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Italy's debt sustainability analysis shows how critical it is to improve prospects for growth and competitiveness and avoiding any lowering of growth from current forecasts. Equally critical is lowering of borrowing rates. And vital to setting the right tone for this is the future of the Monti government and nature and committment of the new government after spring 2013 elections.

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The startling truth about health "reforms," - they won't control spending, and without that the whole system of health care will rapidly become unaffordable and unsustainable. Obama's Council of Economic Advisors points out in new report that since 1975 annual health spending per person, adjusted for inflation has grown 2.1 percentage points faster than overall economic growth per person. At this rate health spending which was 5% of the GDP in 1960, and is 18% of GDP today, would grow to 40% of GDP in 2040. Medicare and Medicaid would increase from 6% of GDP now to 15% in 2040, or equal to three fourths of federal spending. Employer paid insurance premiums for families which grew 85% in inflation adjusted terms from 1996 to $11,941 in 2006, would increase to $25,200 by 2025 and $45,000 in 2040. This would force employers to reduce take home pay. Samuelson says the uncontrolled health spending is singlehandedly determining national priorities, reducing discretionary income, raising taxes, widening budget deficits and squeezing other government programs, while it is producing large amount of waste in medical spending. See the link to Prof. Tyler Cowen of George Mason University in NYT, 6/14/ 2009, who cites the habit of doctors to write many expensive tests as one of the prime culprits in the wasteful spending. And in the process it delivers higher cost for lower overall quality of health for the American people. This at a time when many European countries provide live examples of doing it in a better way- lower cost, better health. The serious problem with the Obama health reforms says Samuelson is that it talks about restraining spending but may end up increasing spending. Its talk about controlling spending he says is good intentions, but based more on hopeful thinking, public realtions and risks becoming cosmetic reform. Because to really control spending will require coming to grips with its fundamental cause- hospitals and doctors are paid mostly on a fee-for-service basis and reimbursed by insurance, private or governmental. Such a system encourages doctors and hospitals to provide more services, expensive tests, favors heavy use of expensive medical technologies to increase profits, and for patients to expect them. Samuelson puts his finger on the root of the problem - there is no incentive and every disincentive for all the players in this game , doctors, hospitals and patients to seek reform of this system. For doctors and hospitals the hope would be that this cosmetic "reform" would leave the system basically unchanged, and patients to continue with a lifestyle and expectations that do not not acknowledge the fact that a lot of healthcare does not come from spending but from preventative care, education, good eating and exercize habits, and healthy lifestyles. And the uninsured are no exception, they would simply start consuming the expensive care for lower quality of overall health like everyone else. With this kind of situation confronting us, the views of Samuelson, and Professor Tyler Cowen of George Mason University, as welll as a growing chorus of informed public opinion on this subject, is that insuring the uninsured is a good idea, but doing it within the bounds of the present system, can only increase the costs. And too much is at risk, to rely on what Samuelson calls a scattershot of measures to control costs made up by Congress such as "evidence -based guidelines," "electronic record-keeping," "bundled payments to hospitals, to give the illusion of progress that won't make a serious difference. A sweeping restructuring of health care is needed, that would overhaul "fee-for-service" payment and reduce the fragmentation of care. It will also need what has not even be touched on adequately in the debate. This is the massive need for education in the schools about nutrition, eating, exercize, healthy lifestyles. It would also require opinion leaders in each field from sports and other fields to lead by example and with constant public presence, the media, and companies to form a partnership with private institutions to change existing eating habits and lifestyles that encourage obesity, smoking, fast food eating habits, large portions in restaurants....

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IMF Managing Director, Christine Lagarde says Greece should have 2 more years to achieve the deficit targets. Speaking at a news conference during the annual meeting of the IMF in Tokyo in Oct 2012, Lagarde said: "it is sometimes better, given circumstances.. to have a bit more time... This is what we advocated for Portugal, it's what we advocated for Spain, and it's what we are advocating for Greece, where I have said repeatedly that an additional two years was necessary for the country to actually face the fiscal consolidation program that is considered." A two year extension would add an estimated 20 billion euros to the financing cost for Greece, at the same it improves the chances for growth and means having a program that is more likely to work.

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John Bolton looks at the continual dithering behaviour of the U.S. president in the Middle East- Iran, Libya, Syria, Iraq in sequence- and provides some insights into the president's behaviour. He says it comes from Obama's distrust of the U.S. role in the world as a positive factor, and a deterministic view of the "arc of history" bending towards outcomes he finds ideologically acceptable. This coincides with a different public perception of America's role in the world, not so much of mistrust and skepticism, as of indifference and focus back on domestic issues following the event of the first war in Iraq and of the 2008-2009 financial crisis. The two are different in nature as the public including women may not share the ideological frame of mind of the president that the U.S. is not overall a serious positive factor in the world through the presidencies of TR, Wilson, FDR, Truman, Ike, to Kennedy, Reagan and Clinton, from the Russo-Japanese war, through the First and Second World War, the Berlin Airlift and the Korean War, to the Balkan conflict. Bolton writes at a time when the two perceptions are about to diverge as the U.S. returns to its normal role of positive and constructive engagement with the world....

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Krugman questions whether the assumptions behind the austerity policies are true- that they would inspire confidence in economic recovery, or that in the absence of austerity policies borrowing costs would go through the roof. The recent events in Holland with the collapse of the government in the Netherlands- when a party leader supporting the government said he did not want to hurt pensioners in the Netherlands just to satisfy German opinion- and the mood in France with economic anxiety vote going to Marie Le Pen and Francois Hollande in the first round of presidential elections, shows that very little confidence has been created. High unemployment and economic anxiety are leading to a reappraisal of austerity cuts that depress the economy and reduce tax revenues, but Krugman says no changes are taking place to correct these policies. This is true for Spain with its high unemployment, and Britain which now has two quarters of negative growth.

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The rapidly changing demographics as the U.S. becomes more of a multicultural society. For the first time minority babies formed a majority in 2011 with 50.4% of new babies, according to the Census Bureau. The median age of the non-Hispanic White population is 42 compared to 28 for Hispanics. Hispanics are right at the child bearing age. This also raises the issue of how the U.S. will educate the minority population. Today 13% of Hispanics have college degrees, 18% of Blacks and 31% of Whites. High school graduation rates in places like New York City for Hispanics are lagging far behind other groups. The economic downturn after the 2008 financial crisis has worsened the educational prospects for Hispanics and other minorities. The education of minority children is essential to improve the competitiveness of the U.S. in a global economy, as the educational levels in emerging markets accelerates with more opportunities.

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An internal IMF document that estimates Europe's banks are short of capital by $273 billion. IMF managing director, Christine Lagarde, tries to downplay the report by saying this is not from a stress test that the IMF conducts. In August, Lagarde, called for an "urgent recapitalization" of European banks. As France's finance minister, Lagarde, steadfastly insisted French banks were well capitalized. France worked hard to prevent requirements for significant capital reserves under the Basel III rules. The higher capital requirements were supported by the U.S.. Simon Johnson said in his blog, that as long as European banks had inadequate capital to act as a buffer against losses, European countries had no safe route for restructuring their debts.

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Experts in the U.S. say the U.S. made a mistake in not supporting the idea of a new financial institution to meet the urgent needs of development and infrastructure financing of Asia's developing countries. India, Australia, S. Korea, Britain, Germany, France and Italy are joining as founding members in 2015. China has offered leadership in providing resources for the new bank. Jane Perlez says China is looking for the best talent worldwide to help write the charter for the bank and to run it. It is a project pushed forward by China's president Jinping, and was discussed at the 2013 G-20 meeeting in Moscow as a critical part of the agenda. Laurence Brahm, who supported Chinese premier Zhu Rongji in 2001 for entry into the WTO, says it is natural for China to look for ways to use its extra capacity in steel, concrete and pipes to build projects in other parts of Asia, which would mutually benefit China and the region. Paul Haenle of the Carnegie-Tsinghua Center in Beijing, says the U.S. lack of support is shortsighted, as the existing U.S. sponsored institutions World Bank and the Asian Development Bank are sorely lacking the resources to deal with the huge infrastructure challenges in Asia. China's Finance Ministry is looking for the best talent worldwide to write the charter and run the bank. Natalie Lichtenstein, a lawyer with 30 years experience working at the World Bank will write the bank's founding charter. ...

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David Brooks of the NYT comments on the Hillary Clinton interview by Goldberg in the Atlantic magazine, where she criticized U.S. president Obama for a weak foreign policy and failure to act in Syria. Brooks says Obama's failure to act in the robust manner Clinton is advocating only leads Obama into situations where he is forced to act later as the situation deteriorates with more serious consequences for the U.S. By not acting in a timely manner the U.S. may be forced into greater involvement later, which makes Obama's "don't do stupid stuff" less of a sound idea than it appears. As Clinton points out not leading to better decisions in the same manner as the Bush-Cheney jingoistic policy making.

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Spain and Italy's 10 year government bonds yield declined to 3.2% in April 2014, compared to 2.68% on U.S. 10 year government bonds and 1.56% for German 10 year bonds. This is a far cry from the dark days of 2012 when these yields for Italy and Spain hovered at 7-8%. Italian bonds reached a peak in Nov. 2011 of 7.408% and yields declined to 3.221% on April 8, 2014, according to Tradeweb. Spain's bonds reached a peak of 7.637% in July 2012 and declined to 3.204% on April 8, 2014.

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International Atomic Energy Agency (IAEA) chief, Yukiya Amano, answers questions in a closed door 90 minute meeting with the U.S. Senate Foreign Relations Committee. The IAEA chief says he cannot disclose details of his investigation into Iran's earlier weapons activities, or the agency's agreement with Iran for the inspection of nuclear facilities. Senator Corker who heads the committee said most senators left the meeting with greater concerns about the inspection process. The IAEA chief cited as reasons for the secrecy, independence of the agency, and what he called "a legal obligation" to protect confidential information. Senator Barroso described the process as one in which an NFL player or athlete is asked to mail in his own urine sample. Of particular concern to senators is the Parchin site where testing ocurred in the early 2000's, which Amano has said Iran is trying to sanitize, and which is not part of this agreement. Iran has not agreed to IAEA requests to interview a Iranian scientist Mr. Fakhrizadeh or other top Iranian military officers and nuclear scientists as part of its probe into past Iranian nuclear activities, Yukiya Amano told the WSJ in an intervew. ...

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The warning light is again on for Greece in the beginning of 2012, as the rapidly deteriorating economy makes a 50% loss by private creditors insufficient to help it meet repayment or refinancing of bonds coming due in 2012. Additional funds will be needed from EU countries unwilling to do this. 14.5 billion euros in Greek bonds come due on March 20, 2012. Greece also faces a public increasingly resistant to austerity cuts. A vountary exchage of existing Greek bonds by private creditors for new bonds at 50% face value and maturing over a longer period will be done under English law. This will be harder to change in the future. Most of the existing bonds were issued under Greek law which can be altered by Greece's parliament.

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The European Banking Authority has worked on an exam for European banks since October 2011- separate from earlier stress tests- to determine the capital shortfall at banks arising from potential losses on bank holdings of sovereign debt. The EBA says banks in the eurozone will have to come up with 114.7 billion euros in new capital by June 2012, to meet reserve capital requirements for core Tier 1 ratio of 9%. The EBA looked at bank holdings of European government bonds as of Sept. 30, 2011. Loss rates for government bonds were applied at current market prices for the debt, and banks that fell short of the Tier 1 capital ratio of 9% were identified. This is different from the stress tests in that the stress tests were designed for banks to withstand deteriorating economic conditions, where a range of losses were applied to test for resilience. Spain and Italy have capital shortfalls of 26.2 billion euros and 15.4 billion euros respectively. Germany has a capital shortfall of 13.1 billion euros, France 7.3 billion euros, Portugal 6.9 billion euros, Belgium 6.3 billion euros. Banks have till January 2012 to show how they will come up with new capital. EBA officials will ask banks to do this without restricting lending. Germany's Commerzbank has a 5.3 billion euros capital shortfall, and may need government funds. Italy's UniCredit SpA plans to make a 7.5 billion euro share offering to its existing investors which will address most of its 8 billion euro shortfall. Spain's Banco Santander is divesting assets in Brazil, Colombia and Chile to meet a 15.3 billion euros shortfall. France's BNP Paribas and Societe Generale have shortfalls of 1.5 billion euros and 2.1 billion euros, which they plan to meet by selling billions of euros of assets....