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Laffer says there is a big gap between the cost of health care and what people actually pay, which keeps cost escalating as there are no pressures from users of services to economize or bring reductions in the prices. But Laffer offers no effective solutions either his patient centred approach to health care reform does not address the problem that employers are paying for health care for the large part and these are not taxed as benefits leaving the employee free to load up on services and ignore the cost, which works just fine for the health care providers who increase revenues and profits- also called cost escalation upto the point now reached where the nation can no longer afford it.

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A report by pharmacy benefits managing company Express Scripts shows a 13% increase in the price of branded drugs in the U.S. from Sept 2011 to Sept 2012. Generic drug prices declined by 22% in this period. The report also shows that growing spending on specialty drugs for cancer, MS and other diseases is a big reason for the increase in prices of branded drugs. This report is from a random sample of six millon Express Scripts members using prescription drug coverage. Prof. Schondelmeyer of the University of Minnesota, who manages the drug benefits program at the university and conducts a similiar price report for AARP, says the potential benefits for these specialty drugs are not that good to justify the high prices.

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Women in senior management positions at GM include Mary Barra, Melissa Howell, Anne Larin, Victor McInnis, Grace Lieblein, Alicia Boler-Davis. Howell is senior vice president of global human resources. Leiblein, vice president for global purchasing. Boler-Davis, senior vice president for global customer experience and quality. Barra is the new CEO in 2014. Here Leiblein describes her decision as chief engineer for large crossover utility vehicles- to leave a gap at the bottom of the left foot rest making room for female drivers wearing a high-heel shoe. Barra says she concentrates on doing a good job and doesn't count the number of women in the room at meetings. Other female managers says women have to put in more than men to be recognized.

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The difficult task ahead for Fiat's Marchionne, trying to reverse Chrysler's decline. Running Opel and Fiat, will take a lot of energy and initiative, and its by no means clear how he is going to go about doing this. Some arithmetic done by analysts shows the value of the Fiat, Opel, Chrysler auto companies, by excluding other non-auto parts of Fiat, and taking out Fiat debt and liabilities estimated at $8 billion euros. And taking that number and Fiat's market cap, the difference gives a value of 5.5 billion euros as what investors ascribe to Fiat Auto and its ambitions. This is just one fourth of the Fiat auto units 2009 revenues of 21.7 billion euros, as estimated by Morgan Stanley.

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A large number of utility companies ( most of the big companies like Duke, AEP, Consolidated Edison, DTE, Edison, PG&E and so on) in the USA are working with General Motors to come up with the whole system for putting electric cars on the road and to work out all the issues relating to electricity recharging of the batteries in the cars. Even though coal is used to generate this electricity it reduces overall emissions as the electric plants burn coal with lower emisssions than the internal combustion engine burns gasoline. Charging the cars at night might be attractive as the utilities might find that this is more efficient for them as they may be able to increase production at power plants with extra capacity.

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AP/NORC poll March 2023 shows 7 out of 10 adults in the US feel that the US is spending too much on development assistance when the budget for USAID is $40 billion. In general Republican administrations prefer foreign aid to be adminstered by the State Department not a separate agency. USAID was setup during the Cold War with the Soviet Union by president John F. Kennedy in 1961. Today it adminsters programs for HIV/Aids and for pandemics, health programs that can be done through the State Department. Attitudes have shifted following the pandemic with 9 out of 10 Republicans opposed to foreign aid through USAID. Some of the criticism is that it funds bureaucrats favorite programs. The actual impact is now uncertain in the developing of an economy. For example Sri Lanka benefits more from aid and development assistance from neighbor India than from programs of USAID as it tackles the current economic crisis following the pandemic. India pulling together the aid through IMF for Sri Lanka, and the investment in energy from India is way more important than the small USAID programs.  ...

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In a effort to improve nutrition for the urban poor in India, the Indira Canteens formed in 2017 have already made substantial progress in Bengaluru (Bangalore). The canteens backed by the state offer subsidized meals, breakfast costing 5 Indian rupees or 7 U.S. cents, lunch and dinner costing 10 rupees or 14 U.S. cents. About 65 million Indians live in urban slums, a highly marginalized group, many migrants from nearby villages who now live in slums that are often near neighborhoods of the affluent and upper middle class. In addition to low income groups, rickshaw cab drivers, and laborers, this program has benefited school and college students who also use the canteens. More than 170 canteens have been set up in Bengaluru in a hub and spoke model with canteens located near colleges and hospitals and supplied from central kitchens nearby. An app gives the menu, nearby locations and takes feedback. It costs the state 16 million euros from a state budget of 26.4 billion euros, and is an imitation of a similar project Amma Canteens in neighboring Tamilnadu state. It reaches 250,000 people a day in Bengaluru. ...

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Galston cites a Federal Reserve Board of Chicago 2014 study showing setbacks for black people in achieving improvement in income status. Even for children born into middle income black families about 55% are expected to fall below middle income status compared to 36% for children of white middle income families. The problem is not just the gap as Galston points out but what it says for the declining income mobility for the white middle class when 36% are likely to see declining status and prospect for the future, and 23% will see no improvement. Overall it shows a lack of income and social mobility for whites and minorities alike compared to the past improvements since the 1960's, not a bright prospect and less hope for the future the way things are, and why so many of the establishment candidates and existing policies are being questioned by voters.

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From Lindau, Germany. A meeting of Nobel Prize winning economists and other economists on a pituresque island in southern Germany. The discussions focus on the widening gap between rich and poor as globalization takes place and the need for governments to redirect some of the wealth to the poorer sections of society. The discussions were on broad themes rather than solutions with the main thrust being that free markets are not always fair and economists should help governments to make them fairer.

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Goggle's Eric Schmidt speaks at the annual meeting of the Newspaper Association of America on the issues raised by Google News use of newspaper content. He says it is unlikely that Google would buy the content behind a pay wall for a subscription and make it available to users for free. Under the current arrangement only AP is paid for content. Newspapers can choose not to be part of the Google Search but choose to get traffic from Google Search to their websites, and from Google News to their websites, which they monetize through advertising. Schmidt provided as one solution publishers creating more personalized news products that could be effectively delivered on the Web, on mobile phones and on the iPad.

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Laura Marshall-Andrews is a GP, a General Practitioner doctor, in Brighton, England, with a different approach to patients and health care. She takes into account the whole patient, the patient's mental condition, putting back some of the things that reduce isolation, increasing feelings of self-worth, bringing more community and nature interactions of a positive nature that can affect the patient's health. In some situations having a doctor who listens and is willing to take the time to talk to and know the patient, and being aware of the patient's whole condition as opposed to fragmented areas based on fields of medicine can make a huge difference. Don't look for a diagnosis, treat the whole person,  says Laura Marshall Andrews in her new book- What Seems To Be The Problem? She believes social prescribing takes a whole load off the National Health Service in Britain. This includes art, photography classes, dance classes, singing classes. A study by the University of Westminster shows the GP visits go down by 30% and emergency A&E visits by 25% with social activity prescribing. Yoga, meditation, gardening, nature walks, are also part of the same activities that can help people improve how they feel and think and bring the sense of peace in their lives that brings better health with it. In the loneliness and isolation, community dislocations and pressures of life in today's cities, all these activities are immensely important to the idea of whole health of the whole person. Dr Andrews says that if you keep a community happy and creative, then you are not going to need a lot of expensive hospital treatments." "Cum Scientia Caritas" the motto of the Royal College of General Practitioners means Science with Caring. ...

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Jeremy Hunt, head of the Health Select Committee and Health Secretary 2012-2018, says Britain needs to take up mass contact tracing as its next national mission. Britain he says has passed 20,000 tests a day for coronavirus. America has passed 150,000 tests a day. Both more than South Korea. What is missing when compared to South Korea and Taiwan is mass contact tracing.  The app TraceTogether is not enough, as it was used by only 20% of Singapore's population. Only South Korea and Taiwan are able to open up the economy, have workplaces and life function close to normal through extensive testing and mass contact tracing, with feet on the ground. This is the only path that has worked with South Korea successfully out of the lockdown. This means "feet on the street." Making these calls requires skills, getting information, getting cooperation, offering guidance, and ensuring people isolate themselves after contact with an infected person. Sometimes it is by phone and sometimes in person wearing full PPE. They need to be sensitive enough in talking to someone feeling ill and to see how home isolation can be achieved, who else the coronavirus infected person or someone in the chain of contacts has been in contact with. Mr. Hunt says no effort should be spared in doing this as the millions of jobs in Britain, of people without work, the economy, and the need for light at the end of the tunnel of lockdowns, requires a way out. A huge task but a lot of impossible tasks are being tackled in the health services. The resources of Britain, every spare civil servant, every administrator not working, every one who can do this, needs to be enlisted to do this. The same task needs to be tackled in America, and in other countries as a national mission. ...

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Surprising as it may sound, India's independence in 1947, did not get the attention one would expect to see for a country with the second largest population in the world. Europe was still recovering from the Second World War and the cancellation of the debt of Italy made the biggest headline in papers such as the Chicago Daily Tribune. Its title was - Mountbatten named new Governor of Hindu India, Punjab riots rage 250 dead. A misperception as Nehru and Sardar Patel were the leaders of independent India, as prime minister and deputy prime minister. In fact the biggest headline in bold was that -Population was up by 9 million with California surpassing Illinois. A Kipling type picture complete with tigers and cobra was put alongside a departing British ship, adding to the ignorance about India.  The Washington Post title was much better- India achieves sovereignty amid wild rejoicing. But it competed with a Soviet threat on the Balkans, Mercury heat wave hitting 96 degrees, and Truman predicted victory in 1948. The New York Times headline was- Two Indian nations emerge on world scene before a map of India. And another headline India and Pakistan become nations, Clashes continue. Alongside were headlines about a price gouging inquiry from president Truman. To this day the coverage has not changed much with the NYT not truly recognizing the aspirations of the Indian people for a standard of living comparable to the western nations, the papers like the Tribune not having any conception of India except in a vague misguided way. And papers such as the Washington Post only somewhat better. None of the western media, much less the BBC, have any conception of the aspirations of the Indian people for a quality of life and the industrial infrastructure that would be comparable or exceed other countries in Europe or that of America.     ...

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President Xi's struggle to bring 43 million people out of extreme poverty in China in 3 years as shown in this BBC video. Xi Jinping's focus is on the people left out in the boom years in which the wealth gap expanded to astounding levels and many were left behind. Communist era society under Mao went for leveling up after the 20's and 30' capitalism under the Nationalists. Then came the Japanese invasion in 1931 and chaos out of which Mao built Communist China by 1947. The years with the Nixon opening in 1971 led to another experiment with capitalism to modernize China under Deng and Jiang Zemin in the 80's and 90's to this day after the experiment under Mao had collapsed by 1976. This led to a fading away of the Communist Party's ethos and reason for existence till its revival under Xi Jinping. For Jinping the efforts to guide China's progress started by Deng appeared to derail with the widening wealth and inequality gaps in China, the sense of corruption and misuse of power at local levels that people could see, and the gradual sense in America that the experiment of outsourcing manufacturing and jobs to China was failing for Americans. From 2013 to 2017 a complete rethinking was underway which shaped Jinping's ideas for the future for China. Some of it may be still underway after the realization that Russia and China had diverging views of the world also, following China's sense that the prolonged war in Ukraine affecting its relations with the European Union does not help a country such as China as a middle income country with large pockets of poverty. Russia was seen as a non colonial power in the Soviet era yet it was a major part of the western colonial powers that suppressed the first revolution for an independent China in 1901.   ...

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Indian Foreign Minister Jaishankar visits Ahmedabad for the introduction of the new Gujarati language edition of his book, The India Way- Strategies for an Uncertain World. At the meeting to take questions on the Gujarati edition at IIM Ahmedabad,  Jaishankar said India is now the fifth largest economy in the world. During the Nehru period it was the 20th largest economy in the world. It now has the capacity to take a leading part in world affairs. In a few years by 2030 India is expected to become the third largest economy in the world. And with its economy integrated into that of the US economy in a way that no other economy has been it will make the US-India economy by far the largest of any economic combination in the world. Because both are English speaking and both are modern democracies, and the traditions of Lincoln and Mohandas Gandhi, of St Paul and the Vedanta with Buddhism deeply rooted in each country. This is the true meaning of the Indo-Pacific. As Jaishankar pointed out in Ahmedabad there is no point in the water that says here is where the Pacific starts- that is the reality. Once you are in the Indian Ocean east of Africa you can travel on the ocean all the way past India to Indonesia, the Japanese Islands and the Hawaiian Islands till you reach the western shores of the United States. For India, the US and Australia, and Japan this is the ocean pathways that they are committed to keep open and with the international rule of law for all nations. In renewable energy, in climate change action, in managing soil and water, in agricultural innovation, and in technologies of all kinds India can now lead the way. Scientific curiosity, learning curve, manufacturing and innovation, education that brings new skills for a large workforce, India can tap into the resources of the world and make its own contributions to this resource for all mankind.  ...

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The relations between the former president Obama and the current president Trump have soured in the first 100 days. Obama lauded activists opposing the travel ban, and Trump sees leaks being conducted for his administration by Obama supporters. Obama was clear from the beginning that he would voice his opinion when it came to systematic discrimination, right to dissent, and deportation of children. Trump's claims that Obama ordered his offices to be wiretapped during the election have caused a rift. Trump took to Twitter to says that Affordable Care Act was "a total disaster," and made it personal by saying "How low has President Obama gone to tap my phones during the very sacred election process. This is Nixon/Watergate. Bad (or sick) guy!" Attorney General Sessions said he will recuse himself from the investigations into Russian efforts to influence the election.

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Amazon is tackling the Indian market by addressing the need of rural shoppers in all parts of India- home to nearly 800 million people. Here WSJ shows how this works with a customer in Dhowachal, in the northeastern state of Assam, who had no access to stores except by travelling for hours to the nearest town.  The customer is a teacher who received an Amazon delivery of pairs of jeans, socks, curtains, glasses and other items. Rural shoppers in India spent about $400 billion in 2017. Barclays estimates Amazon had $7 billion in gross merchandise sales volume in India in 2017, about 2% of what it does worldwide. More than 80% of customers in 2018 are from outside India's largest cities.  To do this Amazon has changed its app to work on cheaper smartphones and patchy cellular networks, added hundreds of thousands of Indian language descriptions of products and videos. It has also opened physical Amazon stores to teach people how to order online. Tens of thousands of distributors were added to deliver packages and take cash or digital payment. Amazon is spending $5 billion in India to set up a logistics network and warehouses, including staff and content development for Amazon Prime. In doing this Amazon has learned from China where Alibaba and other online retailers have grown seven fold by reaching rural areas. Amazon could not compete with Alibaba in China. In India Amazon has no strong local competitors like Alibaba. It is learning how to operate in India. The app offer tips on how to order, no email is needed, only a phone number, machine learning translates all descriptions into Hindi. Icons work well. A digital wallet lets customers without bank accounts or cards to pay or get money back. Amazon is investing aggressively using an advertising campaign and discounts to pass Flipkart which WalMart bought for $16 billion in 2018. Amazon is trying new ideas in India's situation where small stores often closet sized sell a limited number of products often going through multiple middlemen resulting in high prices. Amazon is now enlisting these small stores as package depots in its own unique distribution network. The small store gets an 8-10% commission on sales for helping guide shoppers make a purchase. In Amazon's unique "I Have Space" program 20,000 mom and pop stores in remote areas of India offer to take packages and deliver in neighborhoods for a commission. They get a uniform, a bag and a week of training. Many of these store owners know the addresses in their neighborhood having lived there a long time. The entire effort shows Amazon has adapted its delivery effort, logistics and payment systems to Indian conditions in a well planned way. Compare this to the failed effort by Apple in India, with high management turnover and lack of understanding of Indian conditions and pricing, and no real plan to tackle the Indian market.     ...

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Joanna Stern of the WSJ uses the original iPhone that came out in 2007 for one day in June 2017 and sees how it felt to use the introductory version. The original one worked on a 2G cellular network. It took about a minute for the president's Twitter feed to fully load in the old phone's Safari browser, it now takes 5 seconds. A lot has changed with the smartphone revolution in ten years. Lunch spot search results, Stern points out, might take longer than the time to eat lunch in the Maps App with that old phone. No emojis, predictive text, no Siri, and no third party apps, no Apple Music or Spotify, all that came later. The 2 megapixel camera took decent shots but not without good light. What is useful in Joanna Stern's little experiment is that it makes one reflect on how quickly people forget, how so much is now taken for granted as smartphones change the way people live their lives and interact with technology on a daily basis. Not mentioned here is how common smartphones have become with the Android versions made in China offering so much more for the budgets of ordinary people. And how it has changed the lives of billions of people in China, India, other parts of Asia and Latin America, bringing them into contact with the outside world. What is also interesting in this sense is that what took a huge effort over many years and many disappointments- the idea of a touchscreen that works- shows what an idea and the courage to persist in the face of innumerable hurdles can accomplish. See the link to how  Steve Jobs accomplished this. Daisuke Wakabayashi talked with Apple engineer Greg Christie in his article-"Apple Engineer on iPhone's Birth," Wall Street Journal, March 26, 2014. Christie had worked on a digital personal assistant at Apple in 1996, one that had tried the first touch screen Apple made. The device failed in the market. In 2004, eight years later the touch screen is the idea Jobs had Christie work on again. Many frustrations and obstacles later the first smartphone was developed by 2007. It took 10 years and undaunted effort which is the Apple story under Jobs. ...

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US Universities awakening to the need to reduce costs after making college unaffordable to middle class. NIH says indirect costs are in the range of 60-70% at some elite universities, the proposal would cap this at 15% for all universities for federal funding. The purpose is to reduce administrative costs that are increasing and have universities take a hard look at finances not just increase salaries, hire more and increase prices for students to go to college. The savings generated could be $6.5 billion in this one action alone and some universities need to cut salaries and hire less to bring down their cost structure before a whole generation of young men are deprived of opportunities to go to college. Not everyone can be sent to apprenticeships and not all research needs to be funded. China and India and some European nations will be funding the same research with less. There is a Deepseek moment now not just for AI - for all research.

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During the first days of vaccination drive in India the uptake is lower than expected, below 48% in many states of India. Healthcare workers are coming forward in smaller numbers. The glitches in the app that was used to transmit information is one reason, the other being that not enough information was disclosed about the two vaccines.  On the first day Jan. 16 India vaccinated 200,000 healthcare workers. The target was 300,000. The uptake is lowest in states such as Tamilnadu and Punjab.  One of the reasons for the low uptake is also that India has a lower number of cases, and cases are in decline in India for coronavirus. The first wave peaked on September 13 at over 90,000 and has declined ever since to 13,000 on January 19, 2021. The Indian diet includes vegetables and a large part of the country is vegetarian. Indian diet also includes herbs such as turmeric, ginger and cinnamon, and many others that help build immunity. The lack of cars for large numbers of the population means a lot more exercize walking long distances is essential in daily living. Another factor is that the mandate for masks is strictly followed everywhere. Also helpful is that after independence in 1947 the pharmaceutical industry was built up to serve the large population with prices regulated carefully by the government, enabling steady supply of medicine during the pandemic. ...

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Zhou Xiaochuan, is head of the People's Bank of China since 2002. For a long time Zhou has tried to convince party leaders in China to make financial sector changes. The new leadership of Jinping-Li Keqiang has now adopted most of the road map and priorities drawn up by Xiaochuan. The first is bank deposit insurance, which would especially protect small depositors and provide a basis for new private banks to compete with large state owned banks, creating competition in the financial sector. By supporting creation of privately owned banks impetus could be given to loans to the private sector to rebalance the economy away from state owned banks and state owned enterprises. This is a key goal in the road map drawn up by the think tank Development Research Center (DRC) which has the backing of premier Li Keqiang. Competition from new private banks would let banks compete to offer higher rates to depositors, another goal. In a September article for the Communist Party Seeking Truth magazine, Zhou pointed out the pressing need for " supporting private capital to set up private banks and guide them to position themselves in serving small and micro companies." These new companies especially in tech and information technology fields can be the new drivers for growth in the future as the burst of infrastructure building generated growth slows down. The one area Zhou faces resistance is his idea of opening up China to foreign capital inflows and outflows. Here critics,including younger economists, say this protected China in the Asian financial markets crisis of 1997, and would protect China in the event it faces outflows of the type that are happening in India in 2013 after the U.S. Fed's plan to withdraw from its quantitative easing. Xiaochuan sees the flow of foreign capital as another way for capital to flow to new private companies and balance away from the state owned enterprises, and for China's savers to be able to obtain more attractive returns. Zhou says his plan would include the option for China to reintroduce capial controls in a crisis. As China's debt to GDP ratio is set on a trajectory to approach the levels reached in Japan before its banking crisis there is greater awareness from party leaders about the need for prudence. Xiaochuan has worked with party leader Jinping's key economic advisor Liu He for years, and has the support of He and Jinping for introducing deposit insurance as a top priority. President Jinping and Premier Li Keqiang see the need for Xiaochuan's experience and foresight "as a talent who can be counted on," as the sense of importance of changing the economic structure has deepened in 2013. Mandatory retirement for Xiaochuan at 65 was set aside to give him a third five year term, and his road map long ignored by former premier Wen Biao, is now at the top of China's agenda. ...

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About 15% of black men of working age in the population, and 21% of black women, were employed in the U.S. public sector, according to the population survey. The Labor Department reports 500,000 jobs in the public sector were lost since 2007. This reverses an historical trend of resilience in jobs for the public sector during economic downturns. If population increase since 2007 is figured in there are even fewer jobs considering more jobs might have been added, with estimates as high as 1.8 million. This is bad for black people in the U.S. because many work in public sector jobs driving school buses, in the post office, in the police and in other public services, with black people being 30% more likely than whites to hold a public sector job, and twice that of Hispanics. Thic comes at a time when the black community has seen a devastating impact from the foreclosures and other economic damage that followed the 2008 financial crisis. The result is shown in a study of foreclosures for 2005-2009 at Cornell University showing mostly black and Latino neighborhoods were affected by foreclosures at three times the rates for white neighborhoods. According to Pew Research Center the median white family had net assets of $142,000 compared to $11,000 for the median black family. With median black household income at 60% of that of white households the gap keeps increasing especially with high unemployment in black neighborhoods....

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Kenneth Volpert, head of taxable fixed-income at Vanguard Group in Valley Forge, Pa, says the weak economy and the Fed's easy monetary policy could lead to higher inflation. Inflation bonds strategists at Barclays Capital says the consumer price index after taking out food and energy is running at an annualized rate of 2.5% over the past 6 months and 2.9% over the past 3 months and is expected to go higher. The yield gap between 10 year TIPS and 10 year nominal Treasury notes, was trading at 2.24 percentage points on August 12, 2011 This means investors expect an annualized average rate of inflation of 2.24% in the U.S. over the next decade. This figure has declined from 2.65% in April, it is up from 1.5% in October 2010.

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This editorial from the Times after the New Hampshire Republican primary- in which rival candidates attacked Bain Capital- says that leveraged buyouts by private equity firms like Bain Capital were only one of the causes of the growing income inequality, and by no means the principal cause. And they had little to do with the subprime mortgage crisis that led to the financial crisis and recession in 2008, which aggravated the income inequality. A serious factor was the lowering of wages in manufacturing in competition with lower wage countries in a globalized economy and the decline of good manufacturing jobs over three decades. The increase in low wage jobs in the retail and service sector with the decline in manufacturing did little to arrest the growing gap in wages.

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The IMF currently has $202 billion in basic resources and an additonal $41 billion it can tap in international financial crises, for a total $243 billion, according to IMF documents. Under a G-20 initiative a new lending pool will replace the $41 billion and add about $250 billion of new money. This money will be needed to address the new committments required in the current euro-zone crisis. Seven Europen countries are expected to ratify the lending program with parliamentary approval so that it can be put into place in 2011- Austria, Belgium, Italy, Switzerland, Luxembourg, Norway and Sweden. This will bring the IMF's lending capacity to over $450 billion. The US has approved the increase and is committing about $106 billion, larger than its 17% ownership stake in the IMF.