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Elizabeth Rosenthal looks at Obamacare's contribution to cost containment in 2013-2014. Rosenthal says its is a kind of delicate maneuvring at the edges, because serious work needs to be done. The fee-for-service and many of the drivers for increases in medical costs, the old system of pricing, are still in place. In 20 years at the current rate and after Obamacare health care will still take 25% of the U.S. budget if nothing is done. Healthcare costs are about half that of the U.S. in some of the advanced European countries. She calls Obamacare a trickle down theory of cost containment becaue it leaves most of the drivers for cost increase in place and works at the margins. Princeton economist Uwe Reinhardt calls it an ugly patch on a somewhat ugly system. Rosenthal cites the armies of consultants anticipating every move to reduce prices, and working on "strategic billing'' to increase revenues for hospitals and doctors. For those who say the prices are now up more slowly than in the past, Michael Chernew of the Harvard Medical School, has this to say- its like a diet, reminding us that that we haven't even lost weight, just gaining weight slower than before. ...

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Goldfarb says everyone is focussed on the "fiscal cliff," yet there are other issues which when put together could lead to a drop of 1 percentage point in growth and add a million people to the jobless. The temporary payroll tax cut for 160 million workers was setup in Dec. 2010. The payroll tax which funds Social Security is 4.2% since then, down from 6.2%, adding about $1000 for the average family to spend. The unemployment insurance benefits which expire for millions of people will also have an impact. As will the $60 billion in spending cuts on domestic and defense spending under an agreement made in the summer of 2012.

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The London based think tank Open Europe says the exposure from Greece puts the ECB's balance sheet at risk. A small 4.25% drop in the value of the ECB's asset holdings could wipe out the whole capital base of the ECB, according to Open Europe. The ECB holds at present 75 billion euros of Portuguese, Greek and Irish bonds on its balance sheet. In the last 12 months the ECB has increased its capital base to 10 billion euros. The decision to buy Spanish and Italian bonds increases the risk. The ECB loses money if the borrowing bank goes bankrupt or the collateral of the borrowing bank loses value. During the negotiations for the eurozone debt deal in July 2011, the ECB obtained guarantees from eurozone governments for the collateral it holds from Greece. This increases the need for the European Financial Stability Facility to take on the role of buying bonds of troubled eurozone countries.

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Castilla-La Mancha includes the region around Toledo, Spain. It has an unemployment rate of 27% for the 1st quarter of 2012, up 5.4% from 2011, faster than the increase of 3.1% to 24.4% for Spain. Estimates from the University Carlos III in Madrid show economic growth contracting with GDP decline at 3.1% annual rate by the end of June 2012 for Castilla La Mancha. Part of the problem was the lack of credible accounts by the previous administration. Unpaid bills to suppliers were not included in the accounts for the region. When Maria Dolores de Cospedal of the Partido Popular became the president in May 2011, these unpaid bills were discovered and led to the doubling of the region's budget deficit to 7.3% for 2011. Cospedal sees the austerity cuts she is making as a long term approach to preserve education and healthcare. In an interview with Sara Schaeffer Munoz of the WSJ she says reducing debt is the first priority, so that interest rate premiums on borrowing can be brought down. Debt for Castilla was 17.2% of GDP in 2011, according to the Bank of Spain, it was 16.6% in the first quarter of 2012, among the highest of Spain's regions Ms. Cospedal says she wants growth too, but insists that Spain cannot get growth as long as it is sinking in debt. Moody's Investors Service says Ms. Cospedal is strict in executing the budget- a new second hospital slated to be built for 150 million euros in Cuenca with population 56,000 was cancelled and other cuts are proceeding- and Moody's did not include Castilla in the downgrades of 7 Spanish regions in June 2012. ...

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As David Ignatius points out in his trip to China, the China of post 2010 is a lot of things depending on who you talk to in China- cocky, scared, anxious. He comes away perplexed by the range of questions that come up in his mind. The wealth of the coastal cities is stunning, and at the same time as the leaders insist China is still a poor country with deep regional imbalances, and what is less mentioned, the rising inequality in society. How to pull it all together to make possible a transition to development that is evened out across all regions and sections of society and to allow freedom of expression, is a challenge for the new leadership of Xi Jinping in 2011.

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Simon Denyer talks to experts in China in this remarkable piece about the risks to China's own forward development for the economy and society of adopting the so called Putin Way. Particularly when Mr. Putin himself may have second thoughts about as it offers so little and risks so much- actions in Ukraine reduce trade, much needed foreign investment and technology leading to slow growth. This is because technologically advanced societies and economies in a globally interdependent economy need to remain open and vibrant. Mr. Putin's failure to transform Russia's economy from overdependence on commodity exports, while risking development further for relatively insignificant gains on the fringes of its borders, reduces his own development scorecard from a B in the first term to a C in the second. Russia and China have large rural population with low incomes, and the risk is that these emerging markets will fall into the "middle income trap" reaching a certain level and then stagnating, with the additional burden of an an aging population. The irony is that Mr. Putin was elected with the help of this rural population outside the big cities specifically to preserve and expand economic gains made in the first term not erode these economic gains....

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U.S. Senate majority leader Mitch McConnell tells the Washington Post in an exclusive interview that the dynamics surrounding the Trans Pacific Agreement pushed by president Obama have changed. He sees little prospect of it passing Congress before president Obama leaves office, and says it will be up to the next president to take it up after Obama leaves office in Jan. 2017. McConnell said that there is a lot of pushback all over the place. The Republican frontrunners Trump and Cruz both oppose the TPP, and all Democratic candidates including Hillary Clinton oppose it. In addition tobacco interests in McConnell's home state of Kentucky and pharmaceutical interests backing Senator Orrin Hatch, the Republican Finance chairman also oppose aspects of the negotiated deal. Labor unions, the automobile industry, environmental groups, and public interest groups, have strongly opposed provisions of the TPP that hurt workers and the public interest from the beginning, making it a risky proposition for Congressmen coming up for reelection in 2016. The divergence between the Republican establishment and the presidential front runners Trump and Cruz also have diluted support in Congress on the Republican side, making it a no win proposition....

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The NYT editorial in April 2013 supporting a cautious response in Syria as it reports the use of chemical weapons by the Assad government.

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Russia's leading business paper Vedemosti summed up the situation on Dec. 17, 2014, in its editorial- "This is a very dangerous situation; we are separated from a fully fledged run on the banks by just a few days..If the currency market is not reassured right now, the banking system will require large external support." Warning signs were evident at a banking conference in Moscow in October 2014 when the Economy minister, the central bank head Nabiullina, and the head of the largest bank Sberbank, German Gref, expressed skepticism about the economic policies and the risks involved. Not until Dec. 17, was a decisive response evident and the risks of a collapsing ruble openly addressed with economic actions by the Putin administration. A collapsing ruble would have repercussions on the global financial markets and slowing global economy, increasing potential geopolitical risk, and adding to risk of contagion for other emerging markets, which was reflected in the nervousness of global financial markets on Dec 15-16, 2014....

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Krugman points out that the federal tax rate for the top 1% is 34% in 2013, according to the Congressional Budget Office, because president Obama let the high end Bush tax cuts to expire. It is the number to remember says Krugman- 34. In 2008 the figure was 28.2. Under Hillary Clinton the average tax rate for the top 1% would go up by 3.4 percentage points, according to the Tax Policy Center. Some of this would help pay for the tution plan to provide access to the middle class to public universities. Under populist Trump, Krugman points to the elimination of the inheritance tax and tax rates going down substantially, and no such programs to promote the upward mobility that everyone is talking about, and no way to pay for a big infrastructure building effort for growth and jobs- upward mobility that is the focus of every candidate's election campaign including Sanders, Trump in appealing to older white working class families, Clinton, Ryan, Bush, and others in both parties.   ...

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Public sentiment shifts sharply against free trade in the March 2016 Michigan primary for the U.S. presidential election, with candidates saying trade agreements do not take into account the interests of American manufacturing workers making large gains. Between 1999 and 2010 public sentiment shifted against trade agreements for all age, education and income groups. A study by Autor, Hanson and Dorn showed loss of 5.6 million jobs in the last decade and large trade deficits, and demonstrated the effect by counties in the U.S. most hurt by trade policies.

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Gen. Martin Dempsey took a cautious approach to U.S. involvement in Afghanistan and Syria. He did not approve of the way Gen. McChrystal expanded U.S. involvement in Afghanistan, and the hasty manner in which the Iraqi army was trained under his predecessors leading to some commanders being appointed who later became members of sectarian death squads. Under his command the U.S. limited its role in Afghanistan and Iraq and handed more responsibility to local forces. Gen. Dunford who succeeded Dempsey as chairman Joint Chiefs of Staff for the U.S. follows the cautious approach set by Dempsey. Dempsey's approach extends to what he believes is an Heisenberg effect in physics where when you you observe or touch something it changes the way it functions and operates. For critics such as Senator McCain, who served in Vietnam as a pilot, if Dempsey did not want to intervene in some country, he could invent the reasons not to get involved. President Obama exceeded the caution exercized by Dempsey, leading to a situation where the U.S. after hasty action under a Republican president seemed to lurch in the opposite direction under his Democratic successor by not taking action where U.S. presence was needed, followed by a corrective course to make up for this....

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Amar Bhide touches on the unpredictable consequences of devaluations while commenting on the supposed benefit of a country having its own currency vs a currency such as the euro. The euro takes away the advatantage of devaluing the national currency as a way to regain competitiveness. Bhide points out that devaluations hurt the elderly on fixed incomes and low wage workers. Protections have to be put in place for the sections of the population that are badly affected. Large union negotiated wage increases can also reduce the benefits of devaluation in terms of regaining competitiveness.

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Gillespie lists the myths and describes the reality about Ron Paul. Ron Paul is not a "top tier" candidate- with many Republican candidates assuming top tier status and fizzling out this has become a term that has lost meaning. Paul is a doctrinaire libertarian- he has positions similiar to libertarians but also has his own views on immigration and abortion. His views on the U.S. central bank, the Federal Reserve, such as "ending the Fed" are crazy- actually Ron Paul's legislation on auditing the Fed is gaining credibility, and Fed policy is viewed skeptically by both the Tea party and Occupy movement, as well as some in the Federal Reserve such as Kansas City Fed chairman, Thomas Hoenig, and respected economists such as Alan Meltzer of Carnegie-Mellon University.Ron Paul is anti-military- Paul has support from servicemen in the military and raised more money from them than any other candidate including Obama. Ron Paul has youth support because he is against the war on drugs- the war on drugs has not worked that well and new approaches are needed. His support among youth comes from a believing that individuals are better at making the right decisions, his idealism, and his faith in making the U.S. a better place. ...

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Former U.S. president Bush says the U.S. has an important role as a beacon of freedom, human rights and democracy in the world. The U.S. should not shrink from the challenges in the name of a false and temporary stability, and flexibility should not mean ambiguity, difficulties should not mean shrugging away from America's role. Patience, creativity and active American leadership are needed. The Bush administration supported the struggles of people in central Europe and in other countries. This is from a speech Bush gave at the Bush Institute, Southern Methodist University in Dallas, a year into the Arab Spring. A speech that was giving voice to the aspirations of people in the Arab world.

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There are similarities in the Republican and Democratic party platforms in 2016. One area of agreement is in the reinstatement of Glass Steagall Act. That legislation made in the Depression period to separate commercial banking from investment banking was changed  when president Clinton made changes in a deal with Senators Phil Gramm and Jim Leach in 1999. The too big to fail problems of banks and the problems of investment banks during the 2008 financial crisis are attributed to the lack of Glass Steagall protections for financial stability and safety. The result is that in the post 2016 environment banks can expect a tougher regulatory environment. Another are is in trade where both parties are expected to take tougher positions to protect U.S. interests. The Republican platform calls for "better negotiated trade agreemets that put America first."

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The head of Italy's statistics agency Istat, Enrico Giovannini, says Italy's manufacturing sector has performed quite well, and the problem is with the services sector, in lagging sectors such as transport, communications, tourism, retail and social services. The manufacturing sector is only one sixth of the economy. He says productivity is poor and there is lack of investment in human capital and information technology for the services sector. IT's contribution to growth in Italy's labor productivity is the lowest in Europe, according to the European Investment Bank. Italy's total efficiency gains declined one half percentage point from 1995-2005. Retail and tourism sectors lack the needed productivity gains. This means actions taken by prime minister Monti to change labor laws and related changes will not be enough to generate confidence in the economy and economic growth. Giovannini says investment in human capital and productivity is badly needed, and shifting education and training to where there are new job opportunities....

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A study by Prof. Peter Petri of Brandeis University, shows the Trans Pacific Trade Agreement boosting economic output in the U.S. by about 0.4% by 2025 or $77 billion. Winners are biologic drugs which get long term patent protection, tech firms and software engineering services. Losers are the Detroit auto industry with higher auto parts imports, light manufacturing, and some heavy manufacturing sectors. Prof. Douglas Irwin of Dartmouth College and other experts say it is not clear how U.S. consumers and businesses will benefit. The import duties as a percentage of total imports are now at about 1.4%. Experts say about 4/5ths of the benefits of TPP for the U.S. are from opening up trade in services and new rules for investment and commerce. TPP includes Pacific countries Canada, Australia, New Zealand, Chile, Mexico, Malaysia, Singapore, Vietnam, and Japan. Issues are environmental rules, worker protection and standards, agricultural imports in sensitive countries such as Canada and Japan, affordable drugs in poor countries....

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Inozemtsev of the Institute of Post-Industrial Studies in Moscow, asks the question wht if the Russian economy shows no growth in 2017, and 2015-2016 become the beginning of a serious downturn. If oil prices remain low for an extended period as now looks likely with factors such as shale oil technologies, Iranian oil, and Saudi policy, playing an increasingly long term role, Russia could face some of the problems former finance minister, Alexei Kudrin, other business leaders including head of Sberbank, warned about. A major problem that Inozemtsev points to is the change in the business climate for foreign investment in 2012-2016 as the Russian economy looks more inward, and the departure of many foreign companies. During the period 2000-2008, a major boost to the economy came from foreign investment which brought with it management and technological improvements. No emerging market country, including China, can have a bright future without access to new technologies and investments from foreign investment. The current period starting in 2009 stands in sharp contrast to the earlier period with the Russian economy lacking the boost from foreign investment, facing capital outflows, and international conflicts creating a long term effect on oil prices. Russia needed time to move its economy away from commodity dependence through technological improvements and investment, yet this does not appear to be happening, raising serious questions....

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Gen. Keane and Pletka say action by the U.S. is needed in 2013 to render ineffective the airdefense system and runways used by warplanes of the Assad regime. They emphasize that the U.S. has the technology and capacity to do this even with the Russian systems added in Syria. The lack of a U.S. response in the face of the Assad regime's attacks on civilian populations and use of chemical weapons, the support to the U.S. from the Arab world and Turkey, and the huge refugee problems in Jordan and Turkey, say Keane and Pletka, will lead to creating a worse situation than the relatively small risks of destroying the runways for Assad's warplanes and the airdefense system.

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The faltering approach on Syria of the Obama administration and the events that lead to the decision on June 13, 2013, to provide arms to the opposition forces.

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France's president Hollande says about Greece during a visit by Greek prime minister, Antonis Samaras, that the Greek government must move forward with economic reforms, "while making sure that it is tolerable for the population." He also said he was "saluting the Greek people for their painful efforts of the last two and a half years." Samaras says in an intervew: "Greece is like a swimmer who is underwater for a long distance and needs to come up from time to time for some air, we need to be able to take a breath."