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Public opinion in the district of Steve King, a Republican in the House of Representatives favoring defunding of Obamacare healthcare law.

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All sides joined the President at the White House, as part of his consensus building efforts, and to get aseat at the table in restructuring health care. The insurers and health care providers, including technology providers, all committed to cutting the cost of health care. New social insurance programs to cover 45 million uninsured Americans, and to make health care affordable for businesses and individuals, will be unworkable at currently projected rate of increase in health care costs of 6.2% a year for the next decade. The industry promised to reduce that by 1.5% through voluntary efforts, even though there is skepticism about whether they will deliver. The insurers are against a government sponsored health plan fearing it will drive them out of business. Insurers and health care providers are lobbying against the cuts in their Medicare payments, and insurers are fighting Obama's cuts to their private Medicare Advantage plans by a total of $176 billion over 10 years. Doctors are fighting a 21% cut in their Medicare fees scheduled to take place in January 2010. Pharmacuetical companies and makers of medical devices are concerned that new products will have to pass a cost-benefit test before being approved for coverage under Medicare. Its just that they all see the continued rise in costs as somehow unsustainable, especially in the current economic crisis, and share the feeling with business and the rest of the country that the system is broken. At the same time like the banks and bank executives, health care companies and their executives go on lobbying aggressively and doing things the old way, which raises questions about how well these systems that are broken can be put on the right path....

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Providing health insurance to the roughly 50 million people that are uninsured costs some $120 billion ayear. This will hae to be paid for through limiting the tax deduction on employer provided health insurance (something Obama campaigned against), or cost reduction in the bloated cost structure for health care in the country. But the same health care providers who committed to cost reduction in arecent conference at the White House are lobbying against some measures that reduce cost.

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Questions being addressed to get health care to the uninsured and to all Americans at an affordable level.

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David Stockman, director of the Office of Management and Budget under Reagan, is interviewed by Tom Keene. Stockman says the US has $52 trillion of debt on a $14.5 trillion economy, a ratio of 3.6 times GDP. Historically, before 1980, it has been around 1.6. This debtification of the US, he says, is the major problem facing the US today. Stockman sees little or no economic growth in the next 5 to 10 years, as debt reduction progresses.

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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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Cold weather dampened U.S. economic growth in the 4th quarter, with the initial reading of 3.2% seasonally adjusted annual growth in GDP revised to a reading of 2.4% by the Commerce Department. Projections by economists are for even lower growth of 2% in the 1st quarter from the cold weather, which was the worst in 35 years for some parts of the north and midwestern U.S. Consumer spending adjusted for inflation increased by 2.6%, and the savings rate dropped by one percentage point from the average of the last 3 years to 4.5%. Government spending and investment declined by 12.8%, as efforts to reduce the deficit continued. Offsetting this, and the bright spot here was more business investment on equipment, software and buldings of 7.3%, and exports up by 9.4%. GDP in the 4th quarter was up 2.5% from the prior year and unemployment rate was 6.6% in Jan 2014. Overall assessment was cautiously optimistic for the U.S. economy at the beginning of the sixth year following the global financial crisis of 2008....

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Paul Peterson, a professor who heads the Program on Education Policy at Harvard, says that public school education has not done as well as private or charter school education. In two areas character or values, and school discipline, public schools lag far behind private schools or charter schools. Private schools score 59% and 46% in these two areas, public schools lag far behind at 21% and 17%, in the 2016 Education Next Survey, says Peterson. He says by appointing Betsy DeVos as Education Secretary, the Trump administration sees the need to think how public schools can benefit from improvement in these areas.

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Lim Chow Kiat, chief investment officer of GIC Pte. Ltd, Singapore's sovereign wealth fund, says he sees returns on financial assets in developed markets being much lower in future years, including possible negative returns, because of a sharp runup in recent years and changing monetary policy. He sees more opportunities in emerging markets because of younger populations and opportunities from overhauls to economic structures and behaviour. He says he will still look for opportunties in developed country companies that have significant international expansion. GIC invested $1 billion in Indian online retailer Flipkart recently, $680 million in Bank of the Philippine Island, and $1.3 billion in the Time Warner Center building in New York along with Abu Dhabi Investment Authority.

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Howard Dean, former Governor of Vermont, where Dean helped set up health care improvements, says the bill currently in Congress for health care reform does not deserve to be called reform and may do more harm than good. He points out that it does not insert competition into insurance markets, does not significantly lower costs, and does not improve the delivery and use of health care services. And few Americans will see any benefits till 2014, by which time premiums will have increased significantly. He sees insurance companies as winers in this bill, and the American taxpayer about to be fleeced with a bailout in a situation that dwarfs even AIG. One of his keen criticisms is already apparent to the public in this health care bill, that clear thinking has been thrown out in favor of compromise and political calculus, and by political moves the bill has been stripped of real reform , the end result being a bill crafted for votes and not to reform health care. It also then sets an irreversible course of how future healthcare reform is done, doing more harm in the future. ...

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As remedies for the $1.6 trillion federal budget deficit for 2010, which says Hubbard threatens to compromise Americas economic future, set agggressive targets for reducing discretionary spending limiting growth to 2%. Hubbard also wants to see 1% reduction in projected entitlement spending growth for Social Security and Medicare. This can be done progressively, he says, by lowering the growth in spending for middle and upper income households and strengthening the safey net for lower income people. And third he would have a broad based consumption tax to pay for added social spending. Hubbard was adviser to president George W. Bush and is Dean at Columbia Business School.

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How diagnostic tests in portable toolskits, that patients can use themselves, are being developed at low cost in developing countries like China. This creates the kind of care appropriate for poor countries, where patients need something they can afford, and something that does not require repeat visits to doctors offices or clinics. Ustar Biotechnologies is a Chinese startup, that says it has the technology, costs that the founder says "no one can compete with," and affordable prices for poor countries. The sales of such diagnostic test portable devices or kits is expected to soar in coming years. Quimin You, the inventor and founder of Ustar, graduated in North America and worked with multinationals. His proposals for cheap diagnostic technologies were turned down by multinationals, who in their narrow focus saw these thechnologies undermining their existing products. Now Qimin is back in China with a startup that will do this.

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The Congressional Budget Office's Elmendorf says without spending cuts in payments to doctors and hospitals and other providers, providing coverage to the unisured will put the nation deeper into debt. Popular measures such as increasing preventative care, expanding medical records and rewarding doctors for choosing treatments that improve cost and quality have potential but its not proven how much the savings from this would be. The administration and the White House Budget Director, Peter Orszag, say they are in agreement with the CBO that something needs to be done to seriously reduce costs, reducing payments for Medicare and Medicaid to doctors and hospitals, and making other changes.

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In 2017 Facebook noticed a drop in user engagement- fewer comments, fewer posts, and less sharing. To address this Facebook made a change in its algorithm, which is a bunch of mathematical equations which determine what you see in the newsfeed. The result says this WSJ Facebook Investigation was to make Facebook an angrier place, a place where divisive comments were being posted, and sensational or exaggerated comments were being shared. This increased the level of divisiveness in the US during the early period of the Trump administration. As America looks back on this time- the issues related to migration across its southern border that are still alive today and on which there is now a consensus across Democrats and Republicans on returning migrants. The issues related to the urban-rural divide that many presidents preceding Trump and Biden had chosen to ignore, and which the Tech community showed little interest in. The divide also across educational lines with college educated splitting away from people lacking college education just as costs of college had soared. All these issues were out in the open and instead of having an educated debate these algorithms never intended for solving social problems actually made them worse.  It is now in the interest of both Republicans and Democrats to take a hard look at what went wrong and restore the civility and dialogue that marked American experience across all ages and income groups, and remove the overstated influence of such algorithm based apps. The WSJ Facebook Investigation is a way to restore the traditional media's true place in the national dialogue and push back against the insidious and dangerous influence of algorithm based news feeds such as this one.  Outrage Algortihms may be good for a few people and a few in tech  business in California and in capital markets in New York, yet they are bad for America and the American people as a whole, bad for the vast landscape of America and the vast majority of the American people. Mindless infatuation with pictures of young adults leads to a mindless and dangerous result in mental health, bad effects on women, illusions about what is right living, and increasing divisiveness in America.  ...