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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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This Journal editorial cites the regulatory burdens imposed on small and medium sized businesses in Italy that discourage hiring and innovation. Prime minister Mario Monti's efforts to reduce these burdens and change labor laws in Italy.

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Reports that the family and relatives of China's prime minister Wen Jiabao have accumulated assets worth about $2.7 billion.

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Full face veils for women are now a topic in the immigration debate in Germany. Interior Minister Thomas de Maiziere now favors a ban on full face veils, agreeing with state level party members of the Christian Democratic Union. CDU interior ministers are now in agreement to come up with legislation to require that people show their faces where necessary "for living together in our society." Maziere says the Social Democrats SPD party agrees with much of this agreement, called the Berlin declaration. Chancellor Merkel told news group RND that she understands and accepts that "a fully covered woman has little chance of integrating in Germany." Some CDU officials such as state premier of Hesse, Volker Bouffier, say its all about liberating women, because he thinks it simply isn't true that this is what a woman wants. Other CDU leaders interior ministers in Berlin and Mecklenburg, Henkel and Caffier, say dual citizenship needs to be abolished. The Berlin Declaration put off this issue by requiring a report on this by 2019, on whether it helps integration. The Berlin Declaration calls for 15,000 additional police officers, though the association BDK of police officers says this is not enough. ...

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The current economic expansion in the U.S. in April 2014 is at 58 months from the beginning of recovery in 2009. In this exceptional account Josh Zombrun of WSJ compares the current expansion to previous expansions since 1950, with the views of experts such as Stan Hall of the NBER committee, which studies turning points. This expansion is forecast to go for 90 months into 2016 by the U.S. Federal Reserve, and 102 months into 2017 by the CBO. Sooner or later, says Stan Hall, some adverse unpredictable event takes place that ends the expansion. So far the expansion has been slow and protracted, as predicted by economists Reinhart and Rogoff from previous financial crises in the last century, giving it room to grow as corporate earnings continue to improve. Fed chairwoman's sense of slack in the economy also provides room for employment and incomes to grow in the later stages of the expansion. This is good news for the emerging market economies such as India and China, and for the European Union, faced with slowing growth. So how does this expansion compare with earlier ones. The expansion of the 1991-2001 of the tech boom was 120 months, 1961-1969 of the Sixties 106 months, 1982-1990 of the Reagan era 92 months. The controversial one on shaky foundations is the recent housing boom 2001-2007 of 73 months ending in a huge bust with the 2008 financial crisis. The shorter expansions are the 1975-1980 Post-Vietnam one for 58 months, and the 1970-1973 spurt before the OPEC price surge. Figures are from the NBER, CBO and the Federal Reserve's Summary of Economic Projections....

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White, Thomson and Blumenstein interview Russian President Medvedev. Medvedev says he is very conscious of what is happening to the EU and its fiscal affairs, and to the euro, in this intervew. He sees Russia's future as a European country closely related to the future of the EU and its member countries, especially how the EU countries do as they adopt austerity measures and cut spending.

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Economists are calling this a "wage-less" recovery in the U.S. With unemployment at 8.8%, wage pressures are weak. Average hourly earnings were flat in March 2011. The annualized growth of average hourly earnings for the last 5 months is 1%, according to Gluskin Sheff chief economist Rosenberg. After accounting for higher inflation, real wages are actually falling.

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Friedman reviews Acemoglu and Robinson's new book, "Why Nations Fail." Acemoglu says that nations fail when wealth and opportunities are concentrated in the hands of few people, that a condition for societies to succeed is to create opportunities for more people. For this to happen it is important to create inclusive political and economic institutions. This is an important insight, but for Western society this is an insight as old as Adam Smith when he pointed out the importance of this aspect of western societies after the feudal period in his "Wealth of Nations." For Smith it was the failure to create inclusive societies that led to the gradual unravelling of societies in the river valleys of the Yangste and the Ganges, in China and India, of increasing poverty and the gradual disappearance of what constituted the middle class in India and China. Chapter 8 titled "Of Wages and Labor" in the "Wealth of Nations" makes specific reference to this.

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Detail about Tata's $2500 car. What it looks like- a jelly bean small in front, larger in the back for aerodynamics, 30-35 horsepower, with bearings good for 45 mph, top speed 75 mph, trunk in front to hold a briefcase and battery, rear mounted engine with continuous variable transmission, a hollowed out steering wheel shaft, engine designed by Bosch 600 to 660 cubic centimetres 35 hp. Tata CEO, Ratan Tata, says in a interview the car will do far better on emissions than today's low end cars, and that the emissions standards were much easier to meet than the crash and safety tests, because of the lightness of the vehicle. Todays lower emissions standards in developing countries makes it easier by not having to use more expensive technologies. Electronic sourcing and internet auctions are used by Tata to a greater degree, 30-40 % of parts sourced this way compared to 10-15% by other larger carmakers. This helps meet the aggressive cost target. On the safety isssue its interesting to note that most of the people buying this car will be millions of motorcycle families and individuals (typically a couple of people can ride an Indian motorcycle). They may be safer in a light car than on a motorcycle. This has to be seen in the particular context of India. Renault-Nissan used the experience of lowcost car engineering techniques and secrets from its Logan car made in Romania and transferred it to its other models. Tata started with a clean sheet of paper, asked the quesion what they really had to have and was there some other way. It was Ratan Tata's dream to build a car in 1 lakh or 100,000 rupees or about $2500. The project had all out backing and tested Indian engineers ingenuity. The Tata effort will be studied by carmakers from around the world. Bosch does not underestimate the value of this business, as the car will target a market of hundreds of millions of people in India and China and developing countries. Ariba a supplier to Toyota, and BMW a supplier to Tata, helped Tata buy parts through electronic sourcing. China's Cherry Automobile company, another pioneer, had an Austrian firm help it design its engine for its small car. Tata worked with German company Bosch on the engine. And both must have used cutting edge technology but with a different goals and specifications to achieve unique tasks....

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Syriza party's young leader Alexis Tsipras retains popularity even as Greece accepts the third bailout program from the EU with conditions for pension reform and tax changes. He now says some of the pension reforms were necessary even in the absence of the bailout conditions, saying it is not normal for someone to retire at age 45 or 50. He also says that he is fighting tax evasion so that the rich pay their share of taxes. The mainstream parties have lost confidence because the programs did not ensure a equitable sharing of tax and other measures, and more of the burden falling on the poor. In contrast to Portugal where the tax burden is shared more equitably, more of the burden in Greece has fallen on the poor and less affluent.

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Speaking to Cadena Sur, a Spanish radio network, EU Commission Vice President, Joaquin Alumnia said the EC will have plans to monitor the restructuring of each bank that gets EU funds. He said: "Whoever gives money never gives it for free. There will be people coming to Spain to make sure the money will be properly used."

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The U.S. National Security Agency is going through four separate reviews- one by a White House internal review team, by the Review Group for Intelligence and Communications Technology setup by president Obama in August 2013, by the Privacy and Civil Liberties Oversight Board setup in 2004, and by the Senate Intelligence Committee. Sources say the head of the agency Gen. Alexander offered to resign but this was not accepted because it would be seen as a win for Snowden. Proposals being considered are having a civilian head the agency, setting up a process where a determination is made balancing the potential value of the information with any political implications. Decisionmakers at the NSA are trained to be apolitical in collecting intelligence making it difficult for them to make such determinations. The recording of conversations on Merkel's mobile phone was made at the request of the State Department. Mr Ledgett, a senior NSA official says there are 36,000 pages of "requirements" or intelligence requests from all parts of the U.S. government, including State, Defense, and Commerce. What to do with such requests and how to assess them will now be important questions for NSA. One of the risks of the NSA revelations is that individual countries will impose restrictions on the internet to protect information leading to a fragmentation of the Worldwide Web. U.S. relations with Iran have remained stuck in the original atmosphere of the period under U.S. president Carter in the late seventies with the Islamic revolution with the most recent president Ahmadinejad being one of the activists from that period, the isolation and sanctions have also created a siege mentality in the Islamic republic. The U.S. and the world has changed since that period after over three decades. The Obama administration sees an opportunity to gradually resolve the Iranian nuclear crisis by relaxing tensions and giving small wins to moderates in Iran like Mr Rouhani. Rouhani may see a way out for Iran's isolation and falling behind other countries in the region in developing its oil resources and economy. The moves also helps to reduce new sectarian tensions in the Middle East as the different countries take sides in the Syria....

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The health care system is designed to encourage procedure based specialist practices and discourages the patient understanding education and monitoring that occurs with a well designed preventive family physician practice. As a result a patient only spends 30 minutes ayear on average with family physician compared to one hour in other developed nations. In the USA there has been a steady decline in the level and quality and extent of family care and the close one on one rapport with well trained family physicians who enjoyed their work and understood their patients and kept up with their health conditions and provided good and regular advice on these conditions. There is no money in this care as a result first you provide an environment where a whole range of medical conditions can flourish and expand, and then you hit them with a whole series of tests to rule out specific medical conditions. It is a perfect way to expand the testing and let testing flourish, so it would appear that if someone had wanted to start with a goal of letting testing proliferate unhindered then this would be the perfect way to design it. ...

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John Taylor looks one step ahead of the March 2012 Greece bailout and sets up the most plausible scenario for the future. He says the risks of contagion were always exaggerated from the beginning- a planned default or restructuring of debt such as happened in Argentina in 2001, does not have the contagion risks associated with a chaotic and unplanned default as in Russia in 1998. Predicability in policy makes a huge difference, says Taylor. The European banks which stood to lose from writedowns exaggerated the fears of contagion- a process that always occurs for people who are adversely affected by writedowns- resulting in top officials in the European Union delaying the unavoidable serious restructuring. It was not until Chancellor Merkel handed Charles Dallara, who negotiated for the European banks, a note stating a demand for 50% bondholder writedown, on October 27, 2011, at EU headquarters in Brussels, did any serious writedown of debt begin. Merkel told Dallara: "this is my last offer." The July 2011 summit by contrast had only a 10% bondholder writedown in the agreement, when insolvency not illiquidity was the real issue. Walker Forelle and Meichtry, give a detailed account of what happened in the Wall Street Journal, Dec. 30, 2011. The important thing for Greece, says Taylor, is for what the IMF calls "growth enhancing structural reforms" - greater reliance on private markets, incentives, rule of law. He says this bailout won't work because IMF growth forecasts do not reflect the rapid shrinking of the Greek economy. Antonis Samaras, leader of the major opposition party, is in favor of pro-growth measures and has stated his desire to change the agreement. The 130 billion euro bailout provides 90 billion euros for recapitalizing Greece's banks, and financing the budget. This puts Greece in a situation where the political leaders win voter support by discarding the conditions from the Northern EU nations and come with a plan that is better suited for Greece. The EU in this scenario would cut off further bailout funds to Greece. Taylor sees this as the better outcome for Greece than the current situation, which leaves Greece no hope for growth, and also for the EU by getting out of bailouts that have little prospect of working. It would be difficult but doable for Greece says Taylor, because interest payments would be low and Greek banks would be recapitalized after the current March 2012 bailout. ...

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Darren Woods of Exxon gives the view of many in business in the U.S. when he says of the Paris climate change accords of 2015- "We need a framework like that to address the threat of climate change." GE's CEO Immelt says a decision to leave the Paris accords "is not going to change one thing we do for energy efficiency, and I think all business is going to feel the same way." Most utilities including AEP see the political changes in government as coming and going, making it important to base their long term strategies on the economics and the general trends worldwide. Only support for the move to leave is coming from some coal companies and the steel industry, a small fraction of the overall industry in the U.S. Not mentioned here is the moves worldwide, by China motivated by health and pollution concerns to shift away from coal after disastrous pollution effects seen in China, and the decades old effort in Germany that has made the country self sufficient in renewable energy through use of solar and wind energy. India has set aggressive targets for renewables energy and is likely to join this long term trend as the economics shift in favor of wind and solar, especially when the health costs are counted in.   ...

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Condoleeza Rice, former U.S. Secretary of State, who insisted on meeting opposition leaders in Cairo during the Mubarak regime (in Condoleeza Rice, Washington Post, 2/16/2010, The Future of a Democratic Egypt), reflects on the situation after parliamentary and presidential elections in Russia in March 2012. She says that the growing middle class in Russia seeks respect and participation in how Russia is to be governed. She thinks Russia's dependence on oil and commodities for revenues fosters a climate of corruption and it should move faster in the direction of diversifying its economy. Russian entry in the World Trade Organization, fostering a climate for Russian engineers and scientists to work inside Russia and start new companies, and building U.S. and European business and private ties with Russia's public and private sectors, should be promoted to help the Russian economy diversify. Resetting Russian relations or depending on the U.S. government to come up with solutions appears to be the wrong answer, Rice points out, because resetting is still based on internal politics in Russia. ...

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Ian Talley provides this excellent account of how this drop in oil prices is likely to add to economic growth in major world economies, removing any ambiguity about the positive effect on the global economy. West Texas Intermediate crude dropped to about $65 from $105 between June and December 2014. The IMF estimates growth in 2015 will increase from 3.1% to 3.5% largely because of the lowering in energy costs. JP Morgan Chase economists see an addition of 0.7% points in global growth in the first half of 2015. ECB president Draghi sees the lower oil prices as an unambiguous positive. Estimates from Rhodium Group show major oil importing countries seeing import bills cut by $500 billion if prices remain low for 6-8 months, with $90 billion going into the U.S. economy. IMF estimate is that only 20% of the drop in oil prices is from lower demand, about 80% from higher fuel efficiency, increased supply using new technologies, decisions by OPEC to lower oil price, increases in supply. Based on estimates by the Rhodium Group, IEA and the IMF, the extra money flowing into the economies of the U.S., Asia and Western Europe from reduced oil import bills, as measured in percentage of GDP is: the U.S. 0.5%, Germany 0.8%, Japan 1.2%, China 0.8%, India 1.8%, South Korea 2.4%. Italy and France and other oil importing countries benefit. The impact comes at a time when Japan, China, India and eurozone economies badly needed a boost after significant slowdown in growth in 2014. It could not have come at a better time and because it is technologically driven as in the case of highly fuel efficient automobiles and new oil exploration technologies, a self sustaining process. The corresponding impact for oil exporters is: Russia -4.7%, Nigeria -5.4%, Venezuela -10.2%....