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Tyler Cowen, Professor of Economics at George Mason University, points out some basic truths about health care as it is practiced today in the USA, and healthcare spending as it stands today. He questions whether starting out with extra spending plans to provide coverage to all will help solve the basic problems facing American health care. Too many tests and diagnostic procedures used by doctors is not aproblem that will be solved by spending more money to cover everyone. And government taking on more spending to cover all will not address all the other major shortcomings of the American way of practicing medicine, like prescribing a battery of tests, that tend to drive up costs, to just mention one of the problems. And it will not address any of the shortcomings in the way Americans take care of their health, diet, exercize and healthy lifestyles. THese are critical to get good health outcomes for the people, and which combined with careful spending of dollars where it will provide the greatest benefit, is the only way the health care solutions can be found....

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McGurn of the WSJ looks at the Gallup study on Trump supporters showing that they are older and white, but not more likely to come from communities adversely affected by trade competition. The study shows intergenerational mobility, health prospects, and relative racial isolation, more likely blue collar workers, as being key features, yet more likely to be employed or self-employed. Of this cultural angst, and lack of intergenerational mobility, poor health prospects, are critical findings. McGurn sees them as the people who feel left behind, and says the nation needs to look at them not as "losers" but to address the problems of intergenerational mobility in the U.S. following the election. Theresa May, the new prime minister of Britain has described the "burning injustice" in her first speech when taking office, in a reference to people who suffered under the 7 years of austerity programs in the Cameron years, people from similar groups who face a situation where their children's prospects are no better or worse than their own. ...

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As president Jinping begins a second five year term his focus is on the small communities like Chashan, only a 6 hour drive from Beijing, that were neglected in the rush to industrialization. He has vowed to get rid of poverty in China by 2020. About 43 million people live in rural communities that have mostly older people and live on 95 cents a day. There is another challenge say experts which is the much larger popuation that lives in rural and urban areas- including urban migrants without property and residence rights- who live on less than $5.50 per day, $165 a month, according to the World Bank. This is about 1070 yuan per month, or in Indian rupees for a comparison with India- which was at a similar stage of development in 1990- of Rs 10,000 per month. About 40% of China's population or 560 million people are in this group. With a rapidly aging society as a result of the earlier one child policy, China faces the risk of not advancing from the level of a middle income country, in the way that South Korea and Japan have moved to levels similar to Western Europe and the U.S. As China's growth level slows and with an aging society this remains a major challenge. As this report shows there is great pressure on local officials to eliminate the poverty level of people living below $30 or about 200 yuan a month, as targets are set at local levels and corruption weakens the effort. There is concern at the lack of an effort to improve the living conditions of the 200 million rural migrants living in cities, who under China's "hukou" system are not considered residents and are not getting education and health benefits. ...

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Pakistan's economic delegation meets Christine Lagarde, head of the IMF, at the IMF and World Bank Annual meeting in Bali, Indonesia. Lagarde calls for transparency in accounting and complete understanding of Pakistan's debt. IMF delegation will visit Islamabad to discuss terms for a loan. The previous government of Mr. Sharif came under criticism for not providing transparency on Pakistan's total debt. There is concern about debt trap diplomacy in loans from China, as loans may exceed the country's ability to repay and the interest rate terms are not seen as favorable to Pakistan. The Sharif government is criticized for not negotiating better terms for loans from China. Pakistan faces $8 billion debt load in 2018, with first payments to China under Belt and Road Initiative of $1 billion due in 2019. Pakistan's total foreign exchange reserves fell to a low of $8.4 billion, according to the central bank. Pakistan is seeking $12 billion in IMF assistance, but experts say more will be needed to bridge the financial gap. The Pakistan rupee dropped by 10% during this week in October 2018, down to 137 rupees for a U.S. dollar. The new government of prime minister Imran Khan took office in August 2018 after election promises to bring transparency to Pakistan's debt situation. Promises were also made to improve low income housing and meet needs of poor and low income public. Imran Khan opened a public housing project to build 5 million new homes. IMF terms could restrict the money available for badly needed housing and other social projects.  Pakistan's small tax base with a small percentage of the population paying taxes, also restricts the ability of the government to fund social welfare projects and infrastructure. It makes the country more dependent on outside assistance and loans. India has moved to expand its tax base, and is implementing GST tax reforms to increase the tax revenues available to fund infrastructure, health, education and housing. The war in Yemen has complicated other sources of funding traditionally accessed by Pakistan from Saudi Arabia and the UAE. The financing gap is estimated by experts to be $20 billion, with the IMF assistance sought of $12 billion falling short of the financial needs. ...

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Alan Blinder calls for something better than Social Darwinism to tackle the problem of foreclosures in the U.S. economy. Martin Feldstein has made the same call repeatedly. Homeowners under water need help from the government to avoid foreclosures. Rising foreclosures reduce the chances of a recovery in housing markets and U.S. economic recovery.

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Remarks by president Biden in Accokeep, Maryland, at the International Union of Operating Engineers Local 77, April 19, 2023 outlining his vision for American workers and for its economy. "I am pro-union because union workers are the best workers in the world. Not a joke. That's the God's truth. That is the God's truth. You are the best in the world. It's better  for them to hire you, because you get the job done, you get it done on time, and ultimately it costs them less when they hire you." "So I've said many times Wall Street didn't build America. The middle class built America. And unions built the middle class. That's a fact. Unions. One of the reasons I ran for president was to rebuild the backbone, the backbone of this country, the middle class, to grow the economy from the middle out and the bottom up, not from the top down. Because when the middle class does well the poor have a ladder up and the wealthy do very well still. And we middle class can get a shot. We do well as well." "And that's in clear contrast to my friends on the other side of the aisle these days. DIdn't used to be. Did'nt used to be, but it is now. For decades they've said the best way to grow the economy is from the top down- trickle-down economics. Well, growing up, I didn't see a whole hell of a lot trickle down on our three-bedroom house with four kids at our dad's kitchen table. You know what, Trickle-Down did'nt work for us, and it did'nt work for a long time." "And by the way it's not just what's been with MAGA Republicans. For the last three, four decades we have been losing ground. And you know- it's hollowed out the middle class, you know rewarding wealth, not work; rewarding companies moving overseas because they get cheaper labor. Look at all- a lot of you know- and maybe you come from neighborhoods and small towns, like Scranton, Pennsylvania, where I come from, or Claymont, Delaware- where there used to be a lot of pride, because we had businesses, we had factories that were working, operating. In Scranton, and Claymont, there were 4500 steelworkers. There are none today. And not only do you lose jobs, you lose a sense of pride, lose a sense of who are you. You begin to wonder. Does anybody see me? I mean it sincerely." ...

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The Gulf economies are not managing their wealth that much better this time. There is more money in the hands of private companies compared to the last boom but the investments in Saudi Arabia to create 6 or 7 cities in the desert and the huge construction boom pose questions about what is the best way to allocate capital for countries like Saudi Arabia, which have larger population than some Abu Dhabi or Dubai for instance. Are many aluminium plants and other similiar investments and building cities in the desert the best way to allocate capital resources to provide for the needs of a growing population in Saudi Arabia, especially as high prices of oil may not last more than a couple of years if conservation and energy efficiency really take hold and there is a global softening in growth after the rapid pace of the last decade? Interestingly some of the wealth that is being spread through imported labor to neighboring countries is not doing enough because of the Gulf countries exchange rate with the US dollar and the link to US monetary policies which create looser monetary policy just when inflation is picking up. With higher inflation and the fixed exchange rates of Gulf countries the inflation eats into the sm all earnings of foreign labor from South Asian countries and elewhere and money repatriated home brings less rupees or home currencies. In addition to all the waste and these distortions in the way wealth is shared with neighboring countries who send in labor, there is also the way this creates distortions in global finance. Mentioned here is the example of how in the last boom in petro economies of the Gulf the recycled petrodollars were loaned out to niave latin american borrowers whose countries borrowed more capital than they could possibly absorb or afford and ended up with a lost decade of growth when it became impossible to support so much overseas debt. The current boom for oil producing countries is already being cited as the cause of the huge global liquidity, that made for the availbility of cheap capital and kept interest rates too low for too long, leading to too much risk taking and taking on off too much debt by homeowners and companies in the USA. ...

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A sense of entitlement and hold on power can be seen throughout Africa. A lack of the kind of education that creates an ethic of responsibility for the educated and ruling classes, an honest civil service, and experience with and development of democratic institutions with their own checks and balances, account for some of the principal reasons for this failure in government. Even in South Africa, which has experienced several elections and is on the path to gaining experience in democratic government, Jacob Zuma and the African National Congress display some of these tendencies of entitlement to power.

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Michael Barbaro describes how Romney reflected on his loss for the Republican nomination and worked hard to get things right in 2012. Romney does not see himself in the way voters did in 2008- as uncaring, emotionally detached, and somehow not authentic.

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As health care markets are slowing in western countries and price pressures are increasing Phillips is moving aggressively in emerging market countries like Brazil and India. It s market share in emerging market countries is 18.5% and it wants to push this upto 25%. And health care is becoming more important to Phillips as it scales back from consumer electronics. To understand and meet the different needs of these countries Phillips is acquiring local companies and redesigning its products so that they meet basic functions at a much lower price than the same product sold in western countries.

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Mayo Clinics 18 month long effort with 400 health policy experts working on the panel has a set of recommendations for the Presidential candidates. It suggests a private system with private insurance companies offering many options and nobody can be turned down. Those least able to afford it would get government help, individuals would pay for the insurance with some help from employers. Since once insured its not dependent on employer its permanent, changing a job would make no difference at all. Interestingly most of the panel experts cited here from Verizon, the Heritage Foundation and others all agree that the present system is coming to a close and a new one has to replace it with coverage for all Americans and a privately based system with contributions made by society and government, by all individuals, and also by employers. Mayo's study, the breadth of the number of experts participating (400 experts), the length of time to understand and come up recommendations (18 months), the respect the institution has among all sectors and groups, should give the consensus view of experts in the US, so that any future health plans do not simply get derailed by partisan opinion, controversy and lobbying....

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Figures on costs for the uninsured and total spending on health care by researches at George Mason University.

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The National Association of Realtors reports that sales of previously owned homes dropped by 27.2% from June, to seasonally adjusted annual rate of 3.83 million homes. House prices gained ameasure of stability in 2009, after dropping since 2006. Now that measure of stability may be lost as house prices weaken. The expiry of a home-buyer tax credit was expected to dampen sales but not by this much. Paul Dales of Capital Economics expects a further drop of 5% in house prices. Combine this with sluggish consumer spending and prospects of deflation in 2011, a weak Obama administration HAMP homeowner relief program, fading stimulus and the likelihood of no further stimulus because of deficit fears; and the picture shows serious problems. The underlying picture of housing is not changing. One in four homeowners with mortgages owe more than their house is worth. Banks are handling over 5 million loans that are delinquent, if these loans are modified or short sales are permitted by banks, there would be support for housing prices. HAMP has failed in this regard, see the link to this....

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Plastic use has increased with the tripling in parcels delivered in the last 4 years, up to 64 billion parcels. As much as 93% of the growth in trash in major cities in China in 2018 comes from this one source- an astonishing 850,000 tons of plastic waste in 2018 from the e-commerce and delivery sector. Food deliveries and Alibaba online deliveries add to plastic waste. The government is cracking down with new rules from the Environment Ministry. By the end of 2020 non biodegradable plastic bags will largely be banned from cities, and single use straws banned in restaurants across China.  This ban will extend to all cities and towns by 2022 and to markets selling fresh produce by 2025. Restaurants will have to cut use of plastic by 30% by 2025. In 2018 China stopped taking imports of plastic waste. China is beginning to realize the costs of letting single use plastic grow. The last regulation was in 2008 banning the giving of free plastic bags at retail markets and banning production of super thin bags. It has taken the sudden jump in use in package delivery and in food delivery for the government to finally act. Experts say China uses too much plastic. India has taken strong action against single use plastic in 2019 under the leadership of prime minister Modi. ...

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A state wide ban on single use plastic bags goes into effect in New York state March 1, 2020. This is part of a global push to get rid of single use plastic bags that pollute the environment, end up in waterways, rivers, on trees and landfills. Some clues are offered here on why store owners still used plastic bags, and why large grocery chains still use plastic. The plastic bags cost much less than paper bags. Here one small store owner says 100,000 plastic bags cost him $2000, the same number of paper bags $15,000. New York state uses 23 million single use plastic bags a year. A public education campaign is underway. New York city requires stores to charge 5 cents per paper bag, with 3 cents going to an environmental fund and 2 cents to a the local government. Astonishingly for a large city in a developed country this report shows a Moroccan immigrant saying that it is already popular in her home country Morocco where the ban on single use plastic bags has reduced litter. Americans are not used to carrying reusable bags to the grocery store in the way Germans or people in other countries are. ...