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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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Comparative effectiveness research will be conducted to evaluate what is the best treatment for any ailment or disease or health problem under the $1.1 billion allocated for this in the Stimulus Plan. What are the alternative methods of treatment, what is the effectiveness of each treatment, what are the comparative costs and so on. Is it better to treat neck pain with surgery or acombination ofphysical therapy, exercize and medications? If there is ablockage of arteries in the lower leg and leg pain, how does drugs and watchful waiting compare with surgery? For chronic heart failure how does home monitoring of blood pressure and weight and exercise in addition to medications provide an alternative route as opposed to just medications. Dr Fisher of Dartmouth Medical School cites these as examples of questions that can be asked in comparitive effectiveness research. The money will be available to the Health and Human Services Department and will be used over several years. About 15 federal employees will form a council to coordinate the research and advise President Obama and Congress on how to use the money. In 2007 the US spent $2.2 trillion, or 16% of GDP, on health care, and the Congressional Budget Office says it will grow to 25% of GDP at the rate its growing by 2025 if left to its own devices. ...

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Of the people asked the question "what issue do you see as the most important for health care" 44% in a NBC/WSJ poll said they considered Cost as the biggest issue, and 37% said that they considered the Uninsured as the biggest issue, 11% said quality of care was the biggest issue. The President is focussing on cost as he develops the health care plan. He is also saying that to provide health care for all and cover the uninsured without controlling costs would break the bank. Another thing that the White House shows it has learned from previous failed attempts, is that it is doing this with an open Health Care Forum with participation of different sides in the health care discussion. Clinton's effort in 1993 ran into problems because it was developed secretively, and without much discussion, and little effort to get different people's views. The previous attempt also waited too long after the election, and this time the President is moving quickly when he enjoys large popular support. Its also true now that there is serious concern especially in this downturn of what a threat spiralling costs of health care are becoming to the future prosperity of the American people. This time the leaders in Congress are setting an aggressive schedule to get health care palns legislation on the floor by June and get a floor vote in August 2009....

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Dirk Kurbjuweit of Spiegel says Merkel needs to show strong leadership to overcome the challenges with the rise of right wing populists in the U.S., Britain and France. He points to the leadership shown in the latter part of Kohl's term in office to promote German reunification after the fall of the Berlin Wall. The challenges include talking to the German people directly in a convincing way, and meeting the day to day challenges of life for the people with investments in education, health care, infrastructure so that people see real significant improvement. It is even necessary to reorder priorities such as the shift from nuclear energy so that this challenge is met. It is not enough to hope that more Christian Democrats turn out to vote than Social Democrats, that the fifth of Germans who feel the economy is not working for them and feel threatened by immigration see real changes being made to address their concerns.

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In a new WSJ/NBC New poll, conducted July 24-27, 2009, 42% called the Obama health plan a bad idea, and 36% called it a good idea. In mid June the poll showed Americans evenly divided on this question. It reflects rising anxiety over the costs of the health plan and what it will do to the deficit, and also shows public anxiety about the ways in which Obama and Congress are reaching compromises to pay for it and to control costs. Added to this are the anxieties raised about government involvement in healthcare and medical decisions about care. Noteworthy are two differing pieces of evidence. In the WSJ/NBC News poll, only two in ten people thought the quality of their own care would improve, only 15% of those with private insurance thought that it would improve the quality of their care. And 4 in ten people thought quality of care would get worse, and 45% of those with private insurance thought quality of care would get worse. By focussing on the cost of health care, the administration seems to have ignored or missed the concerns of people about the quality of care if government focussed on cutting costs. These concerns are real as a vast majority of the public, or about 85% of the people, as Martin Feldstein points out in a recent Washington Post column, are insured. The question is what cost would they be willing to pay for the admittedly worthy cause of insuring the uninsured? And even with the unisured, it seems likely with the current Obama reform plan that immigrants and other people may still remain uninsured, at least for some time. Would a huge burden of $1 trillion make this worthwhile, and is there some better way to do this without the prospect of higher taxes further down the road to pay for this. These are points Feldstein makes. The other piece of evidence is that at the same time that there are reservations about what is coming out of Congress today, there is general support for making constructive changes to healthcare. The WSJ poll showed 56% of respondents favoring the basic ideas in the reforms being considered in Congress, with 38% opposing it....

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Dan Maffei won his Congressional seat from an incumbent Republican from Syracuse. Others of the 35 first term Congressmen represent a rural, small town and suburban areas like Maffei. And they are not about to lose their seats after tough congressional campaigns, they say, by voting the wrong way on health care reform. As one from Maryland put it he is not willing to foloow the lead just to follow the lead. These are the Congressmen that Steny Hoyer, Rep. from Maryland, who leads the Democrats in the House, wants to give more time as this is what they wanted. And these Congressmen are making themselves heard and making changes in the health care legislation where they disagreed.

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The employment to population ratio in August 2011 was 58.2%, down from 62.7% in December 2007, according to the Labor Department. For men the ratio is 63.6%, down from 69.4% in 2007 when the recession began. About one percentage point of this is a result of a surge of retirements during this recession period.

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Public opposition in the summer of 2012 to the restarting of nuclear plants by prime minister Noda. A huge rally was held in central Tokyo with about 100,000 protesters.

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There is cramped space for renters and limited supply of housing space per capita in Shanghai, China. After a decade of hyper building China still lacks affordable housing space. The residential space per capita in Shanghai is only 183 square feet or 17 square metres per person- about the size of a small room. And estimates by GK Dragonomics Research show one third of China's 225 million households lack kitchens and plumbing. At the same time housing is increasingly unaffordable for the middle class. Government restrictions on price increases reflect growing concern with the fact that the average Shanghai residential home sold for about $276,000 in 2011, even though annual per capita income in Shanghai is about $13,000. Prices for homes in Shanghai increased 2.6 times in 5 years, according to the Shanghai Urban Real Estate Surveyors Company. With the slowdown in construction developers are working through inventories, and more homes were sold than built in 2012, compared to about 1.5 units built for every unit sold in 2011. ...

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Porter cites research by Andrew Berg and Jonathan Ostry of the IMF, which shows the strong connections between having a vibrant middle class, lower inequality and the sustainability of economic growth. In countries with higher inequality growth comes in spurts which fizzle out, and there are sharp contractions. Having good income distribution is important according to Berg and Ostry, if the process of economic growth is to be sustained. This logic is also supported by the need for a strong middle class for consumer spending, to provide the demand that supports growth.

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China's ginni coefficient at 0.5, has changed from 0.3 several decades ago, according to Li Shi at Beijing Normal University. A level above 0.4 is considered socially destabilizing. 150 million migrant workers from rural areas are denied access to benefits such as health care, education and pensions which are provided to urban residents. Migrant incomes are also affected by rising food prices. Estimates of per capita income are $935 a year for rural areas, up 13% in 2010, and $2,965 in urban areas, up 10 % in 2010. An economist at the National Economic Research Institute in Beijing says the income gap is understated because the incomes of families in the higher end are understated.

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Research figures show corporate insiders are not buying into the rally in the U.S. stock market in Feb. 2012.

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The growing number of women in their 40's who are childless, one person homes, "child-free" adults, higher rates of divorce, are not limited just to Western Europe, the U.S. and Japan. This is spreading rapidly in lower income countries in the Arab world and Asia also. In Europe the progress is relentless. With divorce rates higher and fewer women marrying, the probability of a women of reproductive age getting married in Belgium is about 40%, and divorce at about 50%, according to Eurostat. So that the probability of women getting married and staying married is about 20%. This is true of other European countries also. There is a huge increase in "child-free' adults, men and women choosing voluntarily to not have children. The proportion of childless women in their 40's is highest in Berlin and Hamburg, nearly 33%, about 25% in Italy, and 20% in Sweden. One person homes are increasing in Western Europe, with about 32% in Europe and 45% in Denmark, not from aging alone as in Denmark as many as twice the number of one person homes are under age 65 than over 65. The UN population Division's "World Marraige Data 2012," shows that places like Morocco, Libya, and other parts of the Arab world are also experiencing these trends, with income and schooling levels much lower than in Europe and the U.S. These trends are now worldwide and affecting traditionally conservative societies like China....

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Krugman says the TPP is no big deal because most of the trade in that region is free, protectionism is way down. He cites a recent report on American import restraints by the International Trade Commission putting their total cost at 0.01% of GDP.

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By acquiring Vodafone Japan Softbank CEO Son brought competition to the industry and challenged the duopoly of DocoMo and KDD telecom providers. After acquiring Sprint Son is taking a hands on approach to shakeup management at the company, which has lagged behind T-Mobile in building its subscriber base. After years of losses Sprint now faces the prospect of a complete makeover from the old way of doing things. Sprint is based in Overland, Kansas. Son says Sprint is like Japanese lords in feudal Japan who controlled everything in their lands, and said Sprint is a Kansas Daimyo. Masayoshi Son has asked executives to fire all the ad agencies and start over, at one point asking executives if they were stupid. Son has established shadow offices at San Carlos, California to monitor weekly progress at Sprint.