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The loss of state support in the 1980's resulted in the gradual withering of the health care system in China as individuals bore the brunt of health care costs. Hospitals and clinics shifted to pay as you go system, with the emphasis on prescribing treatment that would boost income including costly tests.

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China's agriculture based on small farms is undergoing a change as the government pushes automated farming and large farms in the face of limited imports from the U.S. China put tariffs on agricultural imports from the U.S. in retaliation for U.S. tariffs on Chinese imports. China's Agriculture Ministry says it will build 254 "strong agricultural industrial towns" as models for the country. President Xi stated on a visit to northeastern province Heilongjiang, that "unilateralism and trade protectionism are rising, forcing us to take the road of self reliance." The yield per hectare in the U.S. for soybeans is about twice that in China. Mechanized farming is limited in China because it would eliminate many jobs in rural areas. As the state has ownership of land and farmers merely use land, farmers are less likely to take risks with large long term investments. It can be risky for farmers to rent their land use rights to others, which would lead to consolidation.  Now a separate "Made in 2025" plan makes upgrading farm machinery and equipment one of the 10 goals. China may lift ban on genetically modified seeds now that ChemChina has acquired Swiss seed company Syngenta. China plans to partner with Asian Development Bank to provide $6 billion of loans, grants and investment to fund a list of development projects in rural areas, to modernize agriculture. WSJ cites a project of consolidation into an 8200 acre farm in Shandong province that  has increased yields 43% by investing in new farm equipment and planting machines, pesticide spraying drones. Scaling up has made this possible.    ...

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The comparison of China with Japan as stress builds up from overexpansion of credit in the banking system. The sharp increase in credit following the 2008 financial crisis has built up stress in China's banking system. Japan went through a period of low growth and insufficient lending by banks. Banks refinanced bad debts to zombie companies in Japan leading to a long period of low growth. China faces a similiar period of low growth after a credit expansion binge.

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Zombrun describes the effect of low interest rates on savings for the bottom half of households in the U.S., the pressure to invest in stocks without the skills and experience of the better educated part of households in the top 20% of households by wealth and income. This resulted in a negative effect, a depletion of savings compared to an increase under a higher interest rates scenario with less pressure to take risks in a volatile stock market. This is the direct cost of the crises in stock and financial markets of 2000 caused by a internet bubble, and the larger crisis of 2008-2009 caused by the bubble in mortgages and housing. The secondary effects of the mortgage price bubble and faulty mortgage securities was in the millions of homeowners who went into foreclosure in 2009-2013, which further depleted wealth and savings of households in the bottom half lacking the experience and skills to navigate this type of housing market. The failure of the Obama administration to stem the foreclosures with practical steps which would have helped not hurt the banking sector, as suggested by FDIC's Sheila Bair and Harvard economist Martin Feldstein in many WSJ op-eds in 2010-2012, added to the erosion of savings and wealth of the bottom half. Minorities in particular were hit hard. A third effect is of communities across America that are feeling the effects of job migration to emerging markets such as China that has been underway as part of the globalization of the last three decades. A fourth effect in the rising cost of education, particularly since 2000, has reduced the opportunities for struggling working class people to enter the middle class and enjoy the higher incomes in precisely the very period when the divergence of incomes between less educated, less killed people and the more educated and better skilled people was taking place. The last two effects were neutral as part of the overall process of emergence of a globalized economy with a premium on more skills and education, requiring action by the government, universities and business for a concerted effort to mitigate in some places the negative effects and enhance in other places the positive effects. The first two effects were man made crises which required managing in constructive and positive ways for the entire American people, taking risks where necessary such as fears about the financial system if foreclosures did not go through. The risks of a long period of extremely low interest rates for savers and the middle as well as working class were poorly understood by the Fed since 2000. A similiar crisis is being faced in Europe with extremely low interest rates. Janet Yellen was only doing the honest thing by acknowledging how far and how different the situation is now compared to the period of three decades following 1945- a question not just of values cherished in America, also of the need for societies to advance through creation of wealth across all sectors of society or regress, as described by Smith in the Wealth of Nations....

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Keith Bradsher describes the life of one family of migrant workers in China struggling to get their ony daughter through college. Wu Yiebing is a worker in coal mining and his wife Cao works on farms nearby. He has managed to send his daughter Wu Caoying to college. She is a sophomore in college but fears for the future because of the lack of opportunities for new college graduates in China. She also feels the heavy burden as the parents spend half their income to get her through college and have no retirement savings. This is typical of many migrant families in China who see education as the only way for the next generation to have better lives than their parents.

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Economist John Spence on advice to the Chinese government to tackle problems of shifting from an export based economy to one more dependent on domestic spending. And managing the shift upscale to sophisticated technologies from basic consumer goods.

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China's GDP growth for the 4th quarter of 2012 was 7.9% over prior year, increasing from 7.4% in the third quarter of 2012, according to the National Bureau of Statistics. GDP growth for 2012 was 7.8%, down from 9.3% in 2011. Growth is stabilizing at 8% which shows China is managing the economy, slowing the growth rate with a smaller stimulus planned in 2013, and working on sustainable growth for the longer term. This is a significant positive as a new leadership takes over in China and sets priorities for stable growth, and improvements in housing and health care.

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China's shadow banking system of trust companies and insurance companies with trust company units and other informal lenders are the fastest growing part of its banking system. Between 2010 and 2012 trust companies and other shadow banks doubled outstanding loans to 36 trillon yuan ($5.8 trillion) or about 69% of China's GDP, according to J.P. Morgan Chase & Co. Hidden debt that is likely to default in this poorly regulated sector is seen as a large risk in the banking system by the central bank and China's government planners. Tightening of credit by the central bank, the People's Bank of China, sent interbank lending rates from 3% to as high as 25% in late June 2013, finally settling on June 24 at 6.64%. China's state owned banks lend to trust companies in this market. Trust companies get additional financing by selling wealth management products promising investors returns of 8-10%. Even with China's high savings rate and large government reserves, the hidden debt and large unknowns about the loans in default, are seen by the central bank as posing risks to the target rate of economic growth of 7.5% if the government has to bailout a significant number of troubled banks. Much of the money funnelled through the trust companies since 2008 has been poorly invested. The trust companies such as Citic and Ping An Trust channel lending to borrowers for projects ranging from steel mills to infrastructure projects, such as highways and property developments that cannot obtain the financing through the large state owned banks. Fitch Ratings estimate is that since the financial crisis of 2009 these loans generated only one third of the economic growth per yuan as they did before 2009. ...

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Orlik reports that the link between China's GDP growth and lending has broken down as credit expansion is accompanied by slowing growth. Slowing credit growth and lowering GDP growth even further is the price China's ecnomic planners are willing to take to forge a new path of sustainable growth, increasing efficiency of investment and increasing domestic consumption. The ratio of China's credit outstanding to GDP has jumped to about 180% in 2012 from 123% in 2008. Rapid expansion of credit is one of the danger signals before a crisis according to the IMF. Turkey and China are facing danger signals according to this IMF danger indicator.

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China's economic planning agency, the National Development and Reform Commission, has approved $156 billion in new infrastructure projects, new subways, highways and other projects in recent weeks. The response is more carefully planned than the stimulus projects in 2009-2010, which are now seen as excessive response creating the prospect of bad loans in the banking system and causing inflation. The stimulus spread over 2 years, 2009 and 2010, was by government's initial estimates about 4 trillion yuan and this does not include additional local government spending as the government encouraged spending. This time the stimulus is about 1 trillion yuan or $158 billion, 2% of GDP, spread over 4 years, with projects going through careful review, according to Nomura economist Zhang Zhiwei. The Chinese government wants to avoid losing gains made in controlling a property bubble and holding down inflation.

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Street protests in Brazilian cities with economic growth slowing to about 1% in 2012 and inflation at about 6%. Street protests in Brazil reflect public disconten over corruption, overspending on the World Cup and Olympics, and lack of good education, health and other public services. Increase in bus fare and police response against small protests using tear gas set off the large scale protests of tens of thousands in Brazilian cities. President Rousseff's sees her popularity ratings drop 8% percentage points from the March level to 57% in June 2013, according to polling firm Datafolha. Ths includes high popularity in poor northern states. Rousseff's popularity in more industrialized southern states declined by 13%, and by 16% among college educated youth.

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The risks that China could be stuck in middle income status- plateauing similiar to countries like Mexico in middle income status- grow as China's remains stuck in a state enterprises driven model of growth at the expense of consumers and savers. Japan reached the level of development China is in today in 1970, Taiwan in 1980 and South Korea in 1990. Progress from now on depends on innovation and developing a more open society as shown in the experience of Japan and South Korea, which requires a shift away from most bank lending and funding investment going to state owned enterprises and towards private enterprises and tech startups. The resulting overbuilding has led to a vast misallocation of resources and starving new private enterprises of the large amounts of capital needed. Porter describes the lower level of rural education which has not kept up with the pace of improvement in urban schools, and which poses problems for the future, including a shortage of skilled workers.

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The private sector ignores health insurance. And state coverage in China is inadequate. More than two thirds of China's 1.3 billion people have no health insurance at all. If you have insurance you still pay up front in cash, if you do not have the cash up front you cannot get a surgery, treatment of any kind or any drugs, even if the insurance will later reimburse you. The Chinese health care system is dysfunctional and in a crisis because of the way it is structured, and the faulty policy incentives. It caps prices for basic drugs and procedures at below market rates, yet it lets hospitals profit from everything else from advanced drugs to sophisticated diagnostic tests. So hospitals invest heavily in technology and expensive testing. and drug sales account for 45% of revenues. And enforcement is lax. Doctors in Shanghai make monthly incomes of about $400, about what a taxi driver makes, so they supplement their income with bonuses earned by prescribing more expensive tests and drugs. There is no utilization review so the state reimburses for whatever the hospitals charge regardless of whether the test was needed or not. So the system is dysfunctional and lurching towards a crisis. In fact heavily burdening the middle class. The private outlays and burden of total health care spending has increased from 20% to 60% of total health care spending from 1978 to 2003, as the the health care system got the same dose of unfetterred capitalism as the rest of the system. The Government's share of total health care spending has dropped sharply. In addition there are design flaws that push expensive care and build in incentives for expensive care at the expense of good medical care. The government recognizes this problem and sees it as athreat to social stability. It has committed to increase spending on healthcare. ...

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The approach of the new Jinping-Keqiang administration to tackle the problem of surging credit growth, with poor quality lending in China's shadow banking system leading to problems of hidden debt and unknown quantity of loans in default. The central bank tightens credit in June 2013 sending a signal to lenders including small and medium sized banks and Trust companies in the shadow banking system that the government will let them default- that they are essentally on their own if they do not follow prudent financial practices.

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China's National Bureau of Statistics made an announcement in Beiijing that 51.27% of the Chinese people now live in urban areas. In 1949 the figure was 10.6%, in 1979 it was 19%. In the space of three decades China has urbanized rapidly. This has brought with it economic growth, infrastructure development and increased employment in the manufacturing sector as new workers moved from rural areas to the cities. With it also come major problems for the country and the leaders of the Communist party led government. Of the 691 million urban residents, 253 million are migrant workers- 37% of urban residents and 19% of the population are in this grey zone described as the "hukou" or household registration system. Under "hukou" these migrants from rural areas cannot access public services in the cities, and have rights to access them in their own villages where they are registered. Integrating these migrant workers who are different than their more affluent and better educated neigbors in the cities so that they become truly a part of the urban areas will remain a huge challenge for China. One of the ways China is addressing this is with the plan to build 36 million units of affordable housing for these migrant workers by 2016. Ever so gradually Chinese officials are relaxing the restrictions on migrant workers- such as Shanghai Mayor Han Zheng's announcement for allowing all migrant workers to rent subsidized housing in the outer parts of Shanghai and committing to "increase the migrant population's involvement in the community affairs, cultural life and show genuine care for them." Food security is another issue as more development on prime agricultural land means less land available for agriculture. Appropriation of agricultural land for industrial use is bringing the country down to the limit of 120 million hectares of agricultural land needed for self sufficiency in food, according to the Land Ministry. At the same time China's leaders want to avoid what the World Bank calls "the middle income trap," where a country reaches a level of modernization and urbanization, and then stalls at that level- the level being around $3000 per capital GDP, which is China's GDP per capita today, according to the National Bureau of Statistics in China. Li Keqiang, who takes over from premier Wen Biao, sees the building of affordable housing for migrant workers as a critical way to continue the urbanization process, and shift the country from its export focus by increasing consumption and the development of industries that support this. A slowing economy dominated by state owned companies focussed on a decelerating export model and an aging but still growing population- NBS says China's overall population was up by 4.8% in 2011 over 2010 and has reached 1.35 billion- presents a tougher set of challenges to the new leadership in China than was faced by the current leadership....

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Moody's Investor's Service downgrades China's credit rating to A1 from Aa3. Moody's predicts a slowdown in growth for China. GDP growth for 1st quarter 2017 was 6.9%. Total debt has grown from 149% of gross domestic product in 2008, to 213% in 2013, and is now 253%, according to JP Morgan. The problem is that ever higher levels of credit have supported growth and more of this is coming from the shadow banking sector. Higher levels of debt in future years from the already high levels will weigh heavily on growth, leading to an eventual slowdown in the economy's growth rate.

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Browne describes the excessive focus on "hard" GDP targets in China and the results in wasteful spending and neglect of other vital indicators of development such as healthcare, education, environment.