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Ruchir Sharma, head of emerging markets at Morgan Stanley Investment Management, provides insights into the economc problems facing Brazil in 2016. He points out that 41% of Brazil's GDP goes into public spending by local, regional and national government, crowding out private investment. The tax burden is high at 35% of GDP. And under the Rousseff administration budget discipline has been lacking. Compared to the Lula government running consistent surplus Ms. Rousseff ran a deficit of 10% of GDP. With a large welfare state, the budget has rigidities, says Sharma, with public pensions increasing since 2000 from 3% to 7% of GDP, and heavy state spending tending to push interest rates up and increase borrowing costs. Retirement age is 54 and 52 for men and women respectively, and pensioners get 90% of salary, compared to 60% in advanced countries. The decline in commodity prices has hit Brazil hard because 67% of exports are from commodities such as soyabeans in 2016 compared to 46% in 2000. Manufacturing accounts for only 11% of the economy. As long as high commodity prices supported the lavish welfare and public spending Rousseff's popularity remained high at 60% as recently as 2013. The collapse of commodity prices has hurt the economy leading to growth of negative 3.5% in GDP. Rousseff's popularity hit a low of 11% as public protests over poor public services, were followed by a series of corruption scandals. Even if impeachment led to new leadership the problems are deep rooted, with neglect of education, healthcare, public services, and manufacturing industries, and heavy public spending no longer supported by high commodity prices. Some of the problems existed in the boom years of the Lula administration, only covered up by the commodities boom cycle, and becoming evident in the down cycle of the Rousseff years. ...

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See the piece on GE's Energy Gusher in Ahead of the Tape. As GE's financial services business led to earnings shortfall and 13% drop in its share price on April 11, investors may be overlooking the strong position of GE in energy businesses like turbines, nuclear energy, and in oil and gas. GE's overeseas sales went up by 23% in 2007 driven by 23% gain in its energy centric infrastructure business. Additional note is that GE is in the healthcare business and in green environmental business which should see growth even in a recession. And the financial services business may see further trimming after the earnings shortfall, so that GE is well positioned for the future.

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This editorial in the WSJ describes the sharp increase in premiums under the Affordable Care Act of president Obama. The average premium increase is about 24.2% according to a Barclay's analysis, and as high as 43.9% in states such as Illinois. Bill Clinton calls it the craziest thing with small business affected, and some premiums doubling. Of the 17 million people in the individual market eight million buy without subsidies. One in five enrollees cannot qualify for subsidies. Democrats say subsidies are too small. Hillary Clinton has proposed to have a Medicare "buy-in" for people ages 55-65, and a "public option" government run plan. Republicans want to rewrite the law. But this depends on which party wins the Senate, with the election in Missouri giving Democrats an opportunity to maintain a Senate majority.

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US president Biden proposes to reduce the US deficit by $2 trillion by increasing taxes on American households worth more than $100 million that would apply to their earned income, and their unrealized gains on liquid assets like stocks. Biden also plans quadrupling the tax on stock buybacks by companies, a tax approved in the Inflation Reduction Act of 2021. The deficit in 2023 will be about $1.4 trillion and rise to about $2 trillion, so that Biden's plan is to practically eliminate the  large deficit if the Republicans come on board. Republicans prefer cuts in spending. US companies have engaged in a dramatic increase in stock buybacks in recent years leading to calls for increasing the tax on stock buybacks. Biden says even high income households will not see an increase in their taxes, only the wealthiest households with over $100 million who have benefited vastly through the Reagan type policies of the last two decades. These households with over $100 million in assets will not be affected in the same way as students, workers, and middle income households are affected in shouldering a large part of the burden of these Reagan type policies that did not adequately fund education, healthcare, and manufacturing in communities across America. This was a period when Democrats in Congress awed by Reagan type policies failed to vigorously oppose policy that increased the US deficit and burden on households for health costs by not allowing Medicare to negotiate prices with pharmaceutical companies. A senior AARP official says that when we talk about the Biden Inflation Reduction Act of 2021 the key component is the Medicare price negotiation with companies that is now law. Why Republicans and Democrats before Mr. Biden allowed such a gross distortion for two decades since 2001 that burdened ordinary  working Americans while neglecting American manufacturing, till Mr. Biden assumed the presidency, says much about the policies of the last two decades and how it has affected ordinary working families. Shriveling factory towns and creating much distress in these communities with these distortions that are a legacy of Reagan type laissez faire policies that government should do little. The result of these policies is that manufacturing is concentrated in only one country for the whole supply chain something that would never have happened with a thoughtful policy planning process. India and Vietnam are only today seen as alternatives for the supply chain in 2023 when policies were in place in these countries since 2014 for the supply chain to be distributed in a way that would be a win-win situation for all countries, avoiding the national security threats of today with overconcentration of manufacturing in China. This has not benefited China or the US because of the rancor and tension it has created. It was the fall of the Berlin Wall that created some of this awe for Reagan, when looking at it objectively it was nothing more than a course correction in Europe after the Hungarian revolution suppressed in 1956, Czech in 1968. It had little to do with what policies the US should pursue for workers and families, just as the war in Ukraine today remains another course correction in a different direction in Europe, and does not affect domestic policy in the US to build a better society for workers and families that Mr. Biden is doing. ...

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Pemex (Petroleos Mexicanos) CEO Emilio Lozoya is fired and replaced by Gonzalez Anaya, a close friend of finance minister Videgaray, as the company experiences a liquidity crisis by Jan. 2016. Anaya is known for cost cutting as head of Mexico's government healthcare institute. This report in the WSJ cites a Pemex official who says at one point in Jan 2016 Pemex was down to $8 million in cash. Under Lozoya Pemex failed to introduce financial discipline ahead of collapsing oil prices. Anaya is expected to cut spending by 19% or $5.8 billion. Mexico's governemt made a capital injection into Pemex of $4.2 billion to pay debts to suppliers, and offered tax relief of $2.8 billion. Pemex output is down to 2.2 million barrels a day in March 2016, decline of 4.5%. Pemex cuts will come in putting off exploraion spending of $800 million in one field in the Gulf of Mexico and paying less to rent oil platforms.

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Samuelson points to the risks to the American economic growth from excessive health care costs. This is hurting take home pay and shows up in consumer spending. It is hurting government spending in other areas such as needed infrastructure spending and efforts to reduce the deficit. This hurts private capital investment to create jobs because of lower demand from constricted consumer spending. The U.S. budget has as its largest single expense 27% on health care compared to 20% on defense the next largest expense, with growth in health care spending taking this to one third of the budget in coming years. Without addressing health care, says Samuelson, the Supercommitte in Congress even if successful at deficit reduction will basically have failed to do its job, and it did not have the time, resources or conviction to do this. According to a new study from the Organization for Economic Cooperation and Development (OECD), U.S. healthcare spending per person is $7,960 per person in 2009. This compares with Norway $5,352, Britain $3,487, France $3, 978, an OECD average of $3,233. Life expectancy in the U.S. is 78.2 years, compared to Japan 83 years, OECD average of 79.5 years. Chile and the Czech Republic have life expectancy equal to the U.S. Except for cancer care where the five year survival rate is 89.3% in the U.S. and the OECD average is 83.5%, the U.S. lags far behind in much needed critical areas such as diabetes and asthma. Rates of emergency hospitalization for asthma are 3 times that in France and 6 times that in Germany and Italy. The U.S. has fewer doctors per thousand population and higher cost per medical procedure- with more frequent use of the costliest procedures- creating a supply shortage that induces higher prices, and less preventive and early action care through physician visits. The number of practicing U.S. doctors is 2.4 per thousand population in the U.S. compared to 3.1 per thousand for the OECD average; and number of annual doctor consultations 3.9 per capita in the U.S. versus 6.5 for the OECD average. Appendectomy cost $7,962 in the U.S., $5,004 in Canada and $2,943 in Germany. Coronary angioplasty cost $14,378 in the U.S., compared to $9,296 in Sweden, and $7,027 in France. Knee replacement cost $14,946 in the U.S., $12,424 in France, and $9,910 in Canada. Knee replacements, angioplasties and MRI exams are twice as common in the U.S. compared to the OECD countries. ...

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About 4.2 million Americans will be 65 years old in 2024, and for the next six years about 4 million will be added to the 65 plus population each year making the 2030 population of 65 plus larger by about 24 million people. As America ages it will need more young people to do many jobs in healthcare, care for the elderly, in agriculture and transport. This is what we are seeing in Japan and even a country highly protective of its own culture has a policy of admitting immigrants from Vietnam and other countries to meet worker shortages. Claire Ansberry looks at the 65 plus population today and compares it to 35 years ago and finds it is more oriented to exercise, health, and has more accumulated wealth. About 20% of people over 65 years work today compared to 15% 35 years ago, says Pew Research, and of these working 65 year olds two thirds are working full time compared to half in 1987. They are wealthier having median net worth of $410,000 today compared to $282,000 in 2010 much of the 45% gain made in the last 2 years from rising house prices and stock investments. Those over 75 years have a 13% gain. Overall the wealth is significantly higher today. ...

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Brazil held the Olympics and the World Soccer Cup, building new stadiums and living off the boom in oil and metals prices under previous governments. Today not only is there a lack of funding for infrastructure, healthcare, education and transportation.   This is now leading to lack of investment in healthcare services in a shocking way. The first full blown epidemic of yellow fever is hitting Brazil's cities of Rio de Janeiro and Sao Paulo. Officials fear that it will spread in an area that has 23 million people if it hits the slums where A.aegyoti mosquitoes are to be found in swarms. Rio and Sao Paulo are trying to tackle it by vaccinating 23 million people. Yellow fever kills about 3-8% of people affected. The economic crisis with lack of funds, and the political crisis that has affected Brazil with corruption scandals has led to a delayed response, according to experts at UCLA infectious disease center.  The disease is traced to loggers and monkeys in the Amazon region which usually remains contained in that region. SInce 2016 the lack of a strong official response has led to the crisis where monkeys carry it a mile a day all the way south to the Rio and Sao Paulo region. A effective government response would have included the use of media to educate people on the need for vaccination for all except newborns and pregnant mothers. Instead social media Facebook and You Tube spread the idea that the vaccination was dangerous, anti vaccine persons who normally got no audience trashed the vaccine. So that today public health authorites have to deal with this problem. The vaccination is highly effective and invented in the 1930's, was not started till November 2016, even though the spread southward from the Amazon region started in 2016. In fact says Dr Marquez, an expert at the University of Pittsburgh, only one in 100,000 gets a reaction and one in a million dies. He says compared to this 6% of 30 million people in the region affected could lose their lives, or  2 million deaths. ...

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The NASDAQ index reached 5000 by April 2015, a level reached in the stock market boom in 2000. Yet investment strategists who were wary of the stock market in the period before the 2000-2002 collapse of the market see this market differently. The NASDAQ itself is not what it was in 2000, with the 2015 NASDAQ component stocks being different for the most part, and the healthcare and other sectors better represented in the index. Only three of the stocks in the top ten in 2000 are in the top ten today, including Microsoft. The S&P 500 trades in April 2015 at 18.5 times its company earnings for the past 12 months, compared to an historical average of 15.5, according to research firm Bespoke. A big part of the difference today is the investment climate of low inflation, which gives the U.S. Federal Reserve flexibility in raising rates. Low rates make bonds with lower yields less attractive, and increase the present value of future earnings. The yield of the 10 year U.S. Treasury was 1.917% on April 25, 2015. In April 2000 it was 6%, and in mid 2007 it was 5.3% before the financial crisis in the two periods. James Paulsen, chief investment strategist at Wells Capital Management oversees $347 billion in fund investments. He also was wary of the U.S. stock market in 1999, yet he does not see the similiar kind of risks today, and sees a long term bullish trend. The scenario he envisages is more of a pause or temporary decline. Paulsen has shifted money to European markets, as U.S. stocks are becoming more expensive relative to their European counterparts, a strategy that is being followed by other money managers since 2014. Higher price volatility is seen in the markets in 2015, with the S&P 500 up 2.9% for the first four months of 2015, and the Dow up 1.4%. ...

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This article in the NYT provides a look at the features of the Republican House Health Care Plan- Both the Affordable Health Care Act and the House Plan provide incentives for buying insurance- the ACA bases these incentives on income levels whereas the House Plan does not provide additional help for low incomes or elderly. Incomes at $20,000 would see a loss greater than  $2000 under the House Plan and as many of the elderly poor living in high cost areas may not have the resources to make up for this loss of subisidies they may forgo buying insurance or have insurance coverage that protects only in a limited way. President Trump has given assurances that all will be covered. For people with incomes of $50,000 or $75000 the loss of $2000 subisidies would also have some impact. At larger incomes or the well to do the subsidies are not handed out under either plan. Under the ACA the emphasis was on income levels and high cost insurance areas the subsidies were greater, under the House Plan the subisidies would be higher for the elderly compared to the young but very low income levels are not given additional help.     ...

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Brooks says no to the current health reform bill as most experts say it does little to control the bulging healthcare cost curve which will take it from 17% of GDP to 22% and beyond. He goes over the pros and cons. Passing this gets little done for health care reform in a fundamental way that is so badly needed today. Says Brooks the system today is rotten to the bone with opaque pricing and insane incentives, with consumers insulated from the costs of their decisions, this won't change with the current health care bill. In fact he says according to the chief actuary for Medicare it will cause health care spending to grow faster. At this rate we will be giving more money to insurance companies and programs that have great social value like expanded preschool and other needs that America has will be shoved aside. In coming years as the population of America ages there will be growing needs for health care. With no increase in supply, and the perverse incentives still in place, prices will continue to grow rapidly without the focus on efficiencies that is badly needed. Brooks points out that its not the politics is the chief obstacle to reform as most people say, but the reverse is the truth, unless one gets the fundamental incentives right politics will be terrible forever. ...

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Bernie Sanders is reelected Senator from Vermont, as one of the oldest and most senior members of the US Congress in history. He will be 89 at the end of his fourth term in the US Senate. At 83 years he is the most resilient and active Senator in the US. Bernie Sanders support was key for president Biden's election in 2020. “It should come as no great surprise that a Democratic party which has abandoned working-class people would find that the working class has abandoned them,” Sanders said. “First, it was the white working class, and now it is Latino and Black workers as well. While the Democratic leadership defends the status quo, the American people are angry and want change. And they’re right. “Today, while the very rich are doing phenomenally well, 60% of Americans live paycheck to paycheck and we have more income and wealth inequality than ever before. Unbelievably, real, inflation-accounted-for weekly wages for the average American worker are actually lower now than they were 50 years ago. “Today, despite an explosion in technology and worker productivity, many young people will have a worse standard of living than their parents. And many of them worry that Artificial Intelligence and robotics will make a bad situation even worse. “Today, despite spending far more per capita than other countries, we remain the only wealthy nation not to guarantee healthcare to all as a human right and we pay, by far, the highest prices in the world for prescription drugs. We, alone among major countries, cannot even guarantee paid family and medical leave.” ...

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Interview with Gerard Kleisterlee, retiring CEO of Philips Electronics. Kleisterlee led the effort to focus on emerging markets where sales of health care, lighting and consumer products are accelerating. Second quarter sales in emerging markets went up 29% for 2010 over the prior year, and now are 34% of total Philips sales. As part of this strategy Philips is increasing its staff and research divisions in China, to capture part of the $125 billion that China plans to spend on healthcare in the next 3 years. Kleisterlee talks about local competitors in emerging markets who are trying to get a regional or global presence. How Philips is increasing local responsibility, and how it is designing, engineering and manufacturing products specifically aimed at local markets in emerging market countries- as away to compete effectively in these markets. He also points out that it is no longer sufficient to be in the major cities, Philips has to move into smaller cities and into the rural areas to increase sales. He sees consolidation opportunities in Asia where the lighting manufacturing is still fragmented. Responding to a question about Philips still being too old, too male, and too Dutch, Kleisterlee agrees that it is too male and too Dutch for his comfort. Women are a bigger part of his health-care team, but not that much progress in other areas of the company. And he would like to see more local leaders in emerging markets. He sees consumer behaviour changing in one respect- there is an increasing consciousness among buyers for value, and not just for low price points, but at all price points....

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John Cochrane, professor at the Booth School of Business, University of Chicago points to the simple truths about U.S. healthcare- out of control pricing because of the pathologies created by previous laws and regulations. He points out that costs are high in healthcare because regulations keep them high. Supply of new doctors is controlled because Congress and the AMA made it that way with a cap on residency programs and AMA opposing the expansion of medical schools. In a system of open competition new hospitals and health care businesses would challenge old ones which is not happening in a regulated market with regulations working to limit competition for the firms already in the business and with the influence to limit competition. Insurance costs for major expenses in an open and deregulated competitive market without the regulations would be so much lower than todays costs that its likely we would not even need a mandate such as the one the Obama healthcare law imposes.

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According to the General Accountability Office inquiry, 28 drug products had price increases over 100% in 2000, in 2008 71 drug products had such large increases. Medicines like Adderall for attention deficit disorder, Inderal for chest pain, Sumycin for infections were in the list of 416 brand name drug products where makers or distributors raised prices at least once by 100% or more for period 2000-2008. As large pharmaceutical companies sold their marginally profitable drug products or small selling products to smaller companies, these smaller companies would immediately increase prices to recover the money they paid to the large pharmaceutical companies. 26 of the brand name products saw prices raised 10 fold. A third of the drugs with large price increases treat depression and disorders of the central nervous system.

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WSJ's Monica Langley provides an exceptional report with a close look at the first woman CEO at a large corporation in the cusp of great change. IBM CEO Ginni Rometty is remaking IBM by moving out of existing businesses and shifting to new growth areas such as analytics, cloud computing, new R&D advances. She sees her job as building the IBM of the future, and this includes divestments and phasing out of some businesses, acquisitions, and building some businesses such as the Watson Heath Care business from scratch. In some fast growing areas such as cloud computing this means competing with other established competitors, Amazon, Google, and Microsoft. Rometty's job is tough because of the size of IBM with 380,000 people in 170 countries, a culture that lacks the agilityof younger companies, and the older businesses which continue to slow IBM's progress, and where divestments reduce revenues. IBM sales are down for 12 consecutive quarters from the year earlier quarter. IBM's share price is down about 10% since Rometty became CEO in Jan. 2012, resulting in investor dissatisfaction with results. Rometty's goal is for 40% of IBM's revenues to come from corporate markets in analytics, cloud computing, cybersecurity, social networking, and mobile technologies, increasing it from 27% of about $93 billion in sales in 2014, and 15% of $105 billion in sales in 2013. Sold off and divested are low end servers, IBM's chip maker, and other hardware businesses. It is so extensive that whats left of the mainframe business is focussed on new technologies for mobile. Rometty setup a partnership with Apple for the corporate mobile market, and started Watson Health as a new venture in analytics for healthcare using its Watson Computer technology. Rometty grew up in Chicago, one of 3 daughters raised by a single mom, who says she was taught to be "fearless" by her mother. She graduated from Northwestern University with majors in electrical engineering and computer science, joining IBM as a systems engineer in 1981. She carries a backpack, school size notebooks, on her frequent trips to see customers in person and is constantly prodding employees at IBM to go faster. Rometty has a passion for scuba diving in her spare time and always carries the gear with her. Christine Lagarde at the IMF is one of the few women heading large organizations that have the same level of energy. Lagarde's passion is swimming having competed in sychronized swimming, and both Rometty and Lagarde describe the loss of a parent in different ways as a significant impact in their life. ...