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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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The worst flaw in the health care bill says the Economist is that "fee for service" and doctors billing for each test done continues as before.The whole idea of medical services based on medical necessity and value for money has been left out of the billsin Congress. Alan Meltzer also pointed this out in his discussion of the deficits and debt over the next decade; that the 25% reduction in medical expenditures does not look anywhere closer to reality, worsening the deficits. This is also the view expressed in the discussion of health care reform in the November 2, 2009, issue of Business Week. Never mind said BW that the doctors and hospitals account for one third of medical expenditures and there is waste in Medicare spending. Congress said BW has made no changes in the "fee-for-service" system of medical care that has inflated medical costs, by paying doctors for the volume of services delivered and not the quality of services delivered.

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Former Senator Jim DeMint lays out his reasoning for the Republican fight to defund ObamaCare, as the healthcare legislation is now called by Republicans. He points to problems with the legislation with issues about how much the added entitlements will cost in the future( more than the $250 billion by 2023 estimate of CBO insists DeMint based on the general lowballing of projections), and higher premiums for the young and elderly on exchanges. He says the 2012 elections were fought on economic issues not ObamaCare, and that the public he has met in visits to different states as president of the Heritage Foundation continues to be skeptical about ObamaCare. He sees the correct role of the Opposition party to point out the deficiencies in the law and call for corrections in the path for healthcare.

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Janet Yellen Fed chairwoman, says many obstacles still exist for women in the workforce. Bringing more women into the workforce will increase the productive capacity of the American economy. The increasing participation of women in the workforce was factor in the growth and prosperity of America by the middle of the 20th century. In a speech sharing her personal narrative at Brown University, her alma mater, she described how other nations had passed the U.S. in women's participation in the workforce, and how it remains stalled at 75% for women either working or looking for work. Her speech was at a conference "125 Years of Women at Brown." The U.S. is now 17th among 22 developed nations in participation of women in workforce, mostly because of government and business policies that relate to paid maternity leave, affordable child care, and flexible work schedules.

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The basic outlines of new health care legislation takes shape as Senators Dodd and Kenedy come up with a plan that scales down subsidies to low-income people to buy insurance. Attached to their revised outline is a budget office analysis thatprojects the plan costing $611 billion over 10 years and with expected changes from the Senate Finance Committee would cover 97 percent of all Americans. And earlier plan received much criticism because the Congressional Budget Office estimated its cost at $1 trillion over 10 years and left 37 million Americans uninsured. In addition there is the revised Medicaid expansions for aid to the poor that would add a couple of humndred billion dollars to the total tab. The administration's goal is to keep the cost down to $1 trillion over 10 years. The legislation as it stands includes the public option which is designed to control insurance costs. Mr. Obama said this week that "the public option would keep insurance companies honest." Employer mandated insurance is part of the Kennedy-Dodd legislation proposal. Employers with 25 or more workerswould have to provide coverage or pay the government an annual fee of $750 for each full-time worker and $375 for each part-time worker. The government pays the startup costs for the public insurance option as a loan to be repaid, and premiums would make the option self-sufficient....

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Automobile parts imports into the U.S. have increased from $89 billion in 2008 to $138 billion in 2014, up from only $31.7 billion in 1990. In a huge shift in wages with increasing global competition wages at an American Axle plant in Michigan at $10 an hour are about what Target stores and Wal-mart pay for retail workers. An new generation of workers in manufacturing are seeing a shift from being in the middle class during their parents generation to lower class, with this downward pressure on wages as parts are manufactured in places such as Mexico and China.

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Kenneth Rogoff, Harvard University economist, author of the well researched book on the 2008 financial crisis, "This Time Is Different," gives his thoughts on the economic prospects for the U.S under the new Trump administration. He says 4% GDP growth and 3% inflation is possible temporarily for a while with stimulus policies, less regulation, and increased private investment. After 8 years of not investing in much needed infrastructure because of concerns about the deficit, the timing is right for such investments, especially as the economic effects of the crisis of 2008 gradually fade.  This is about taking advantage of ultra low interest rates to invest in infrastructure. He says it helps that Trump policies are pro-business. He sees drawbacks as the stimulus program adds a 25% increase with extra debt, adding $5 trillion over 10 years, but adds that for many years Nobel prize winning economist Krugman and others have said that there is good reason to increase borrowing to invest, and this is now being tried. Inflation remains an uncertainty- if there are large quantities of underutilized and unemployed resources it would raise prices less than its effect to increase output. The reverse would apply if the U.S. economy is closer to full capacity. One factor that would help- increasing confidence for business and increasing investment. Against this what he calls optimistic view or spin, is the idea of mistakes under a Trump administration, errors made and a degree of incompetence which he says is a real possibility. Overall his view is that some risks are appropriate now, and from his deep study of financial crises sees the slow growth of the last 8 years a result of a financial crisis that now begins to fade, creating the possibility of higher growth under prudent policies.  ...

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Alan Blinder, a professor of economics and public affairs at Princeton University, looks at explanations for low productivity growth since 2010, and points to the most likely reason- the lack of technological progress with the kind of impact that the personal computer and other innovations had in the period 1995-2005. Facebook, Google, Amazon and Apple tech innovation has more impact on consumers than on the industrial economy and production. Lower investment since 2010 with the financial crisis could have added to this, but to a smaller degree, says Blinder. Blinder even points to some hours of work being taken up by workers using Facebook, Twitter and other similiar services. The notion strange to Silicon Valley is supported that tech progress, dynamism and entrepreneurship may have actually declined to some extent. Intel's Andy Grove, no stranger to early innovations supported this notion around 2008, saying he saw less innovation of the type he was familiar with, more refinements than breakthroughs by startups in Silicon Valley. Grove was critical of the decline in manufacturing in the U.S., which is likely to have hurt productivity growth....

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With firms cautious about hiring the number of temporary workers is increasing. About one fourth of new jobs created in the second quarter of 2012 in the U.S. were for temporary workers. In June 2012 of the 80,000 jobs created a third were for temporary workers. About 8 million Americans work part-time. This is an increase of half a million since March 2012 for people unable to find a full time job. The number of full time workers has declined by 700,000 since March 2012, and self employed workers have increased by 381,000 since March 2012. This gives the picture of a labor market with employers unwilling to commit and hiring temps, using overtime to meet demand.

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"China's Superbank," by Henry Sanderson and Michael Forsythe looks at the rise of China Development Bank to provide insights into the two decade real estate boom in China, and the trillions of dollars in loans made by state owned banks to finance China's state owned industries and infrastructure development. The authors say these loans based on land owned by the state, improved with roads and other infrastructure and then sold to industry, have helped finance China's urbanization and industrial development. But it has also created problems including eviction of farmers from the land by local government authorites increasing inequality, led to misallocation of capital on bad projects, and an unsustainable model of development focussed on state owned companies. A major side effect of this is not covered in the book. This is the impact of crowding out of credit for private industry in China, with privately owned business having to pay higher rates in the underground loan market or lacking financing. A major focus of the report "China: 2030" by the World Bank and China's official think tank Development Research Center is on reversing this development to come up with a sustainable development model. The report was supported by World Bank chief Zoellick and China's new prime minister Li Keqiang. "The Great Rebalancing," by Pettis, a finance professor at Beijing University, looks at the other side of the financing of China's boom- the low interest rates on savings for China's consumer. This reduces household incomes and reduces purchasing power as the interest rates are lower than the rate of inflation. Lower value of China's currency also reduces the purchasing power for China's consumers. Estimates show the low interest rates cost China's workers and consumers somewhere in the range of 3 to 8% of GDP annually in bank deposit income. This money is funnelled through the banking system to make more loans for infrastructure and growth at the state owned companies, concentrating exraordinary level of financing in one direction. As a result the consumption share of GDP in China has actually fallen in the two decades of hyper development. This is about 34% compared to 50-55% for other Asian economies....

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China's new foreign policy team under the Jinping-Keqiang administration. Foreign minister Yang Jiechi, becomes state councilor, and senior official on the team. The new foreign minister Wang Yi, was China's ambassador to Japan 2004-2007. The new ambassador to the U.S. is Cui Tiankai, a diplomat who graduated from the Johns Hopkins School of Advanced International Studies in the U.S. Cui was ambassador to Japan 2007-2009. Managing the China-Japan and China-U.S. relationships is critical for China because China depends on U.S. and Japanese companies for investment and new technology, for continued economic progress. The relationship has been affected by the territorial disputes with Japan in the East China Sea. Germany as an advanced technology manufacturer and commodity exporters Australia, Canada, Argentina and Brazil depend on the Chinese market for exports, creating an interwoven economic dynamic that is likely to be the dominant factor in relations. This is also the perception of Li Keqiang who told a press conference in Beijing that the competition with the U.S. has been overemphasized, that he "does not believe conflicts between great powers are inevitable." Foreign affairs remains subordinate to domestic policy and priorities in China, as China tackles the problem of reorienting its economy to give an important place to the private sector and consumers. Itself not an easy task, as prime minister Keqiang pointed out at his first press conference: "Talking the talk is not as good as walking the walk." One of Keqiang's main allies in this effort is Robert Zoellick, former president of the World Bank, who helped put together with China's DRC, the report "China: 2030," outlining these priorities....

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This essay in the Economist magazine points out the special nature of the 2017 presidential election in France with the rejection of establishment candidates- Manuel Valls, Sarkozy, Juppe, and now Fillon. Fillon and Valls were prime ministers under Sarkozy and Hollande, from the Republican and Socialist parties respectively. With unemployment high in the areas outside the major cities their is a surge in support in these areas for the National Front. Emmanuel Macron, former Economy minister in the Hollande government, is the only candidate leading Marie Le Pen at this time. In a second round of voting he has to bring in centre right supporters and centre left voters and moderate voters, and appeal enough to working class voters, young unemployed people, offering hope for a better future to win this election against Le Pen. Economist magazine research shows support highest for Le Pen outside major cities in outlying areas, and for Macron in the major cities. There is also an education divide as seen in the U.S. election and Brexit referendum with less educated voters preferring the nationalist sentiment, church support sentiment fostered by the National Front.  ...

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The stark differences in the policy positions of the two major parties in the U.S. seen emerging in the television debates. Trump vocal on immigration calling for large deportations. Sanders and Clinton vocal on the struggles of the middle class and white working class.

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Attorney General Sessions says the driver of the car who drove into protesters could be prosecuted in a number of ways including for a hate crime. The protest was against a white supremacist rally in Charlottesville. A car driven by 20 year old James Alex Fields drove into protesters injuring 19 and killing one woman. The local charges being made are for hit and run, malicious wounding, and the Justice Department is conducting its own probe. The comments by Sessions contrasted with the statement blaming both sides by president Trump, which led to strong criticism in the media and by the business community.

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The WSJ/Vistage U.S. Small Business Confidence Index ends 2013 at a new high of 108.4 reflecting optimism of small business owners. The Index for 2013 shows a sharp drop by November 2012 to about 82 followed by a sharp increase for Dec. 2013 to about 94, and a similiar pattern is observed as it declines to about 95 in October 2013 and increases to 108.4 in December 2013. The sequester and deadlock in talks by Nov. 2012, and the government shutdown and its resolution by Dec. 2013 are likely causes. The Dec. 2013 Ryan-Murray budget agreement points the way out of political uncertainty that Vanguard CEO McNabb pointed to as a primary obstacle to investment and growth. This may be the strongest indicator of what lies ahead for 2014- 52% of 937 small business owners surveyed online in the Index in Dec. 2013, say the economy has improved in 2013, an increase from 36% in 2012. And 38% say they expect conditions to be still better in 2014, from the prior years 27%. Small business owners polled have sales less than $20 million and fewer than 500 employees. They are the main engine for growth in employment. Loten cites small business owners in construction and other industries who have increased hiring and expect to see a significant improvement in 2014. One owner who represents the pattern taken by small business, cut back employees by 2010, and held back on investment till 2012, increased investment in 2013 and is now expanding. Availability of credit with improved bottom lines and banks more willing to lend will be another positive in 2014-2015....

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A strong U.S. jobs report in July with 255,000 new jobs, unemployment at 4.9%, provides positive sentiment going forward. The Federal Reserve is likely to be wary of raising rates because businesses are hiring but are not making the investments needed to spur economic growth, which remains at about 1%. The labor force participation rate is now at 62.8%. The measure of unemployment and underemployment shows a better picture of how different age groups are faring including the 25-54 years age group- this is at 9.7% in July 2016, it was 9.6% in June 2016. This measure shows those working part time because they cannot find a full time job. The market today is stronger for those with the right job skills, but not across the spectrum for all Americans, only setting the stage for further progress and increasing investment as confidence improves.

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On one hand Chinese environmental officials are aware of the pollution problems in Beijing and Shanghai and other cities. Levels of nitrogen dioxide in Beijing exceed the WHO clean air guidelines by 78%. On the other hand the newly emerging middle class is seeking car ownership, and the local government officials need growth in the car industry to show good GNP and GDP growth numbers on which their performance is judged. Beijing and Shanghai and Anhui province local governments are part owners of some auto companies. About 416,000 people are employed in the Shanghai area auto industry alone and the auto industry in Shanghai pays about 900 millon dollars in taxes, according to government figures. At seven cars per 1000 population car sales are just beginning to take off. And with China's population its clearly not going to be possible to have the same level of ownership as in the US. The same is true for India. This would increase by many times the current demand for crude oil and increase emissions to the point of creating a disaster. And even today because of lax enforcement, and older models on the road, about 40% of vehicles in Beijing have no pollution controls and the other 60% have varying degrees of pollution controls. Experts say changes to the subsidized oil price policy, refineries that produce cleaner gasoline, policies to build more mass transit which has lagged behind in China as car sales took off (and probably more GNP impact from car plants than mass transit which act as inducement for local officials), and stricter fuel efficiency and auto emissions standards are needed....