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One in six dollars generated by the U.S. economy goes to pay for health care, almost twice the average for rich countries. It hurts America in many ways; by being a burden on the taxpayer when it comes to Medicare and Medicaid paying for the poor and the elderly, on companies being one reason GM went bankrupt, it eats up federal and state budgets, rising costs make any form of future coverage for all unsustainable, and it robs other priorities such as infrastructure building and other national scale investments. The Economist says that if it had to design a system from scratch, it would go for a system based mostly around publicly funded health care. For the uninsured the solution of an employer mandate is now well accepted, so this is not an issue. What is an issue is how to make the new system affordable? Here the Economist says that whether in stages or in one move, the tax deductability of employer paid health insurance, which is costing the U.S. government $250 billion ayear, has to go. It is necessary to remove this deduction, and its something all interests involved will have to swallow, as other savings are smaller and will not be adequate. The deductability of insurance makes the true cost of insurance transparent, so it supports gold plated insurance. This does not make cost control the pressing priority it needs to be. So the deducatability of employer paid health insurance hurts both ways. The other necessary action is in the area of moving out of the current culture where most doctors work on a fee-for-service basis, where the more tests they prescribe or procedures they perform the greater their incomes. This acts as a perverse incentive, and has aruinous effect in mushrooming health care costs in America. Cutting back on unnecessary tests and procedures, and prescriptions , would save 10% to 30% of health costs says the Economist. And it says this has been proven with the Mayo Clinic in Minnesota and Kaiser Permanente in California showing that cutting back doesn't hurt care and outcomes., so much so that cutting back would occur along with improved outcomes. But Americans with employer paid insurance just take things for granted as its not much out of pocket expense for them. THis creates the lack of a force for controlling costs even as employers are shouldering abigger and bigger burden, and the employee who thinks he is doing fine actually is seeing more of his salary dollars going to pay for his health insurance. In a way the consumers of health care are stuck with the perception that they are not somehow paying for these mushrooming costs and too manytests, procedures and prescriptions. This perception leads them a false sense of comfort with the system they are in, and a fear of something new fanned by the medical lobbies, that any change will impact users negatively. This makes the whole discussion on health care or the process of finding solutions to become an exericize in which terms like "rationing" and "choice" play a distorting role. ...

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Relations between Germany and the U.S. improve in the last year of the Obama administration. The low point is the NSA spying scandal. By 2015 with the Ukraine crisis and the refugee crisis, the U.S. and Germany develop closer relations. In April 2016 U.S. president Obama visits the Hannover trade fair and meets German chancellor Merkel, following a trip to Britian where he expresses support for Britain's membership in the EUropean Union. The U.S. general election campaign with less engagement of the U.S. in the world preferred by candidates Trump and Sanders, the Brexit vote in Britain, also creates a new environment and makes clear the need to support closer ties in an interconnected world.

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As exports and manufacturing decline, China is continuing to maintain high rates of fixed asset investment with the focus now away from factory construction to infastructure like roads, bridges and rails. The National BUreau of Statistics reported that urban fixed asset investment expanded 26.5% in Jan-Feb 2009, compared to 26.1% growth rate for 2008. Fixed asset investment was 42% of GDP in 2008, according to JP Morgan strategist Jing Ulrich. Now it could go up higher to 45%. China's growth has been off-balance say experts, now it is becoming even more so. As long as factory construction as fixed asset investment a lot of new jobs were being created in the manufacturing sector, now these jobs are not being created. China's small and mid sized companies that generated about half of the 4.42 trillion GDP, like GenTech of Mr Yu profiled in the other linked article in WSJ, and which created 90% of the new jobs, are now contracting. With smaller private consumption, and the efforts to improve the safety net and provide universal medical care inadequate and coming late, domestic demand will not help balance the economy and boost manufacturing. Private consumption is only 35% of GDP in China, a much lower percentage than India. The comparable figures for the US are 71%, UK 64%, Australia, Canada, France, Germany and Japan 57%. The balance is now heavily skewed towards government spending. Investment spending from HongKong and Taiwan, the home bases of industrialists with made for export industries inceased investment by 1% in Jan-Feb of 2009 from the year earlier, compared to 17% growth in all of 2008. And foriegn funded companies have comparable figures of 2% for Jan-Feb 2009 compared to 15% growth in all of 2008. Real estate investment growth also fell to 1% for Jan-Feb 2009 compared to 21% for all of 2008. In short the other pillars of growth in housing, and investments from Hong Kong, Taiwan and the West are declining. ...

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Consumer spending boom is over and when you look at the detail in the government numbers on spending consumer spending is already declining. So the idea that consumer stocks like P&G, J&J and Coca Cola and Kimberly Clark will hold up better than other stocks is a mirage. Just this week the idea that stocks of companies doing a lot of business overseas and in infrastructure will hold up better turned out to be an illusion as GE fell by 12% in one day, April 11, 2008, because of earnings shortfalls in its finance units as a result of the new climate in the credit and financial markets. Consumers spent heavily. If consumer spending had continued the trends from the 1990's then it would have gone up $3 trillion less today. It would have been 70% ratio of household debt to GDP, right now its close to 97% of GDP. Some of this $3 trillion estimate of Business Week economist Mandel using Fed data will be what the American consumer will be dealing with as he reduces spending in the years ahead. According to OECD data the ratio of household liabilities to disposable income (charts P11 of BW, April 21, 2008) is close to 1.0 in France and Germany which is contrary to what one would expect considering the more conservative spending there especially Germany, exceeds 1.0 in Japan, and far exceeds 1.0 in the US, and in Canada aabout 1.3, with the highest ratio in Britain at a whopping 1.7, using a ballpark view of the charts. This suggests that Britain is way off the charts in spending, see the link to this so expect spending to be hit hardest in Britain and with financial services being a bigger part of the GDP and the economy in Britain expect higher unemployment in Britain than the rest of Europe....

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Alan Blinder, a professor of economics and public affairs at Princeton University, looks at explanations for low productivity growth since 2010, and points to the most likely reason- the lack of technological progress with the kind of impact that the personal computer and other innovations had in the period 1995-2005. Facebook, Google, Amazon and Apple tech innovation has more impact on consumers than on the industrial economy and production. Lower investment since 2010 with the financial crisis could have added to this, but to a smaller degree, says Blinder. Blinder even points to some hours of work being taken up by workers using Facebook, Twitter and other similiar services. The notion strange to Silicon Valley is supported that tech progress, dynamism and entrepreneurship may have actually declined to some extent. Intel's Andy Grove, no stranger to early innovations supported this notion around 2008, saying he saw less innovation of the type he was familiar with, more refinements than breakthroughs by startups in Silicon Valley. Grove was critical of the decline in manufacturing in the U.S., which is likely to have hurt productivity growth....

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This exceptional report by Chulov in the Guardian shows the changes in the war in Iraq and Syria in 2015-2016 since the downing of a Russian jet by Turkey in late 2015. It says that the Syrian government's future was uncertain in late 2015 with Turkish support for rebel forces in the north. During this period Russia curtailed trade and tourism relations with Turkey, and improved relations with the Kurds. Russia intervened in northern Syria directly to prevent a collapse of Syrian government forces in the north. Kurdish forces were already controlling large parts of the Syrian territory adjoining Turkey, and Turkey was concerned about the support to Kurds within Turkey from Kurds in Syria and a historical movement for  Kurdish independence. In April 2016 Russia made a move to win Turkish support by saying it would support the territorial integrity of Syria, so that no support would be given to the Kurds. As the U.S. consistently supported the Kurds in the fight against ISIS, Turkey under prime minister Erdogan changed its policy of support for rebel forces in Syria to focus on what it perceived as the threat fom Kudish control of the region at its Syrian borders. Rebel forces were told to focus not on the Syrian government forces but on ISIS, leading to withdrawal of support in Aleppo. What remains now of the war in Syria and Iraq is Iranian influence in Iraq, the Russian influence from support of the Syrian government in Damascus, and for the first time U.S. ground forces in the north with 900 troops supported by artillery on the side of the Kurds. The next stage in the war to take ISIS controlled Raqqa is being negotiated between Russia, Turkey and the U.S., according to this report.  ...

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Belgium's justice and interior ministers acknowledge the error in not taking action after being alerted by Turkish authorites of Islamic radicals suspected to be a serious terrorist threat. Turkey's president raised this issue in the media about the Belgian officials failure to act on a Turkish request to take into custody a radical arrested in Turkey for trying to enter Syria. The individual was one of two brothers who were suicide bombers in the attack at the Brussels airport and subway in March 2016.

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Scott Anderson of the NYT provides an indepth look at the Arab World and its fragmentation through the eyes of five people from each part of the Arab world- Egyptian, Kurd, Syrian, Iraqi and Jordanian. He says the countries that fell apart are precisely the ones that were formed by the British and the French, and Italy, following the defeat of the Ottoman Empire  using divide and rule policies- Britain in Iraq, France in Syria, and Italy in Libya- without much thought given to setting up viable nation states. This is why Iraq has a Sunni-Shia divide, Syria has similar divisions, and Libya with a largely tribal based structure, never really held together after the colonial powers left, and were held together only by strong dictators. Today's problems trace back to these historical events. This is complicated by the largely young demographic and restlessness of the people for change coupled with problems of underdevelopment in education, tribal loyalties, religious loyalties, and lack of political and social structures that could keep the countries together as change and transition to democratic processes took place. The role of the military further complicated matters in Egypt. Even Iran experienced these divisions because of the intervention of the great powers including Russia in Iran since 1900, leading to swings between liberal governments, foreign power supported governments, and a swing back to religious leadership as at present. This is one view of the region, others are presented by Ramadan (Oxford),  Bernard Lewis (Princeton), and leaders in Qatar and Emirates, other experts, some of whom point to the failure in leadership and the elites to find solutions to the problems of underdevelopment, in education, health, infrastructure, and aspirations for a voice in their governance. As the same divisions left by colonial powers affected Asia- in India, China, and Korea, but a larger vision of progress prevailed through crises and difficulties.        ...

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Italy's prime minister, Mario Monti, a senior EU official before becoming prime minister, has the credibility and credentials to bring the French and German sides together on a new plan forward for the European Union, says Steven Pearlstein of the Washington Post. In this report from Rome, where leaders of Italy, Spain, France and Germany are meeting to discuss solutions Pearlstein describes the solutions Monti is putting forward. The European Investment Fund would be built up so that it has funding of about $175 billion or 1% of Europe's GDP to finance truly productivity and growth enhancing projects of innovative small and medium sized business in transportation, energy, education and environmental sectors. These companies have suffered shortages of capital as banks pulled bank from lending. It is the inadequate private investment that is causing the greatest damage in this crisis and $175 billion is at the low end of the amount needed in this crisis. Other steps Monti is pushing forward- for immediate steps to tackle the crisis deposit insurance to prevent a run on banks is essential for European banks. This would come with a eurozone regulatory authority that would have the powers to regulate European banks. The European Financial Stability Facility would be the "sovereign buyer of last resort," under Monti's proposal. Eurobonds come up as a key part of the solution. This is not because German and French taxpayers would be required to finance economies of Spain and Italy. As was shown by the U.S. Troubled Asset Relief Program (TARP) a well designed program could pay for itself. This would include the EU financial authority taking up stakes in the banks getting help and closing banks that are insolvent. The key point is that if properly executed and executed in a timely and appropriate way this does not have to cost French and German taxpayers- the important thing being to support the eurozone economies before the situation deteriorates. Borrowing at 6% for Spain and Italy will only put the situation out of control as deficits rise rapidly. The concessions for tighter regulation of European banking systems, reducing risk in banking, setting up adequate reserves, closing poorly run banks, and ceding powers to a European Financial Authority that can make the final decisions, are the steps that would have to go with these arrangements. Sound financial management requires that the kind of banking risks taken in the speculative bubbles in Spain, the lack of transparency and credibility in banking estimates of bad loans in the system, and the glossing over the problems at Bankia, would have to be addressed in solutions through regulation by a credible European Financial Authority to convince skeptical German public opinion that financial accounts are conducted in a proper manner....

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Lawrence Katz, Harvard labor economist, talks to Friedman about the jobs crisis in the U.S.. Katz identifies three jobs crises occurring at the same time today. One is the drop in the demand for goods and services that resulted from the longer term effects of the financial crisis of 2008, with rising foreclosures, weak housing markets, bad debt on the balance sheets of banks, and interest rates at close to zero reducing the scope of action by the Federal Reserve bank. The second, is the widespread long term unemployment with workers dropping out of the labor market. The third, is the nature of new factories and hiring. Work in new factories is done through increased automation, information technology and fewer workers. As a result job creation is a fraction of what it was in the past. Not mentioned here is the shrinking of the public sector under the strain of budget deficits for local, state and federal government. This leads to the question of how America will create jobs in the future. Katz believes the answer is creating more "hubs," networked urban areas like Austin, Silicon Valley, and Raleigh-Durham, by bringing together universities, high-tech manufacturers, software providers, and startup companies, to cooperate in creating new products that enhance people's lives worldwide. This has to be done by the private sector and government working together to build the infrastructure and make the investments in education, training of workers, and equipment for new job creation....

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In his plain talk on Syria Trump said the primary message to Russia was: "You should have peace in Syria; its enough." This is the message foreign minister Tillerson is delivering in Moscow. He described the Russian support for the Syrian government as: "I think it's very bad for Russia, I think it's very bad for mankind, it's very bad for this world." He also described Chinese president Xi Jinping's response at a state dinner during dessert when Trump told him about the U.S. missile attack on Syrian airfield, as expressing the sentiment that it was OK considering the chemical attacks by the Syrian government on civilians and children. The closest any president gets to the plain talk given by Trump is during the period of the Cold War when Truman also had this kind of plain talking style to deliver the message that needed to be heard.

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Since 2011 democracy protests Tunisia's unemployment rate has increased from 13% to 18%, with an estimated 750,000 people unemployed. About one third of the unemployed are college graduates. By 2015 about 100,000 new college graduates will be looking for jobs each year. Tunisia's economy contracted 1.8% in 2011 with a 30% drop in tourists, according to the World Bank, which predicts 2.2% growth in GDP in 2012 and 4.6% by 2014. The democracy struggle in the Middle East started in Tunisia and demographics in Tunisia are similiar to that of the rest of the Middle East, with a surging number of young people and college graduates looking for jobs.