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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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A 35 year old Engineering professor from Texas who studies how transportation systems propagate infectious diseases and her 2 graduate students from China started and since January maintain the database of coronavirus confirmed cases and deaths. This is one of the widely used databases, also used by public health officials in the U.S. The database was started with a hunch from one of Lauren Gardner's students from China Ensheng Dong who comes from Shanxi province, north of Wuhan. A geography and mapping specialist he had studied in the U.S. since 2012, and spent many hours inputting data by hand following his classes. This WSJ report says the website was built in 1 day and was launched on January 22, when the coronavirus cases were practically nonexistent in the rest of the world and were concentrated in the Wuhan area. This report says behind the data reported in the media everyday is a complicated supply chain filled with challenges that come with data, what is reported, underreported and with what assumptions it is reported. Dr. Gardner says she is dealing with so much data on her dashboard, 4000 points of data, that its hard enough to pull all the data scraped together from different sources, its impossible for her to check the assumptions behind the data for consistency and trying to figure out facts underlying the data.  One of the ways the virus developed in the rest of the world is the surprise with which it caught western countries and then the rest of the world. As a result something that the government authorites would do such as the Centres of Disease Control is being done in a totally ad hoc manner. The U.S. government uses the University of Washington Health Metrics database, and in turn the University of Washington Health Metrics database takes some of the data from the John Hopkins database. Because a complacent population in the western countries were relying on numbers counted as cases to know how serious this epidemic was or whether there was an epidemic, the significance of data count from China assumed a signifcance far out of proportion to what it might normally be. This was because the western countries in Europe and America never encountered an epidemic of this kind in living memory, the last one forgotten from 1917 hundred years ago. Researchers in Gottingen University study in Germany conducted analysis of data in studies of cases published in Lancet Journal and found that only 6% of cases were being shown- that a much larger part of the population was infected. A researcher at Princeton University Ramanan Laxminarayan says countries tend to delay reporting until a problem becomes certain, because telling others comes with economic costs such as a rapid drop in trade and travel. Yet he says early warning systems are key to prevention. Early warning from the different publicly available data bases was not possible for many reasons. Relying on such ad hoc data was hazardous considering that as the NYT reported recently when there was the first confirmed detected case reported in New York there were already 10,000 persons estimated to be undetected. James Glanz and Benedict Carey, say in the NYT.com on May 7, that hidden outbreaks spread through U.S. cities far earlier than Americans knew, estimates show, which makes the publicly available databases giving a false sense of security, and not acting as an early warning because of the inadequacy of the resources for this task for individual researchers to handle. Not depending on  hurriedly put together databases with inadequate resources and having an independent sense of what the danger was as German chancellor Merkel described it in her first coronavirus address in March, was a better early warning signal than the databases in retrospect. And this too had come late. The reason is that the response had to be fast, very fast, and public perceptions had to be shaped quickly about the magnitude and speed of enormous proportions of the coronavirus, so that actions could be shaped quickly and executed quickly to stop it in its tracks.    ...

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Bernie Sanders tells his supporters at the Democratic National Convention in Philadelphia that "immediately right now, we have got to defeat Donald Trump, and we have got to elect Hillary Clinton and Tim Kaine." He says this campaign was not about just electing a president but about transforming the country. And for this he was planning to back about 100 candidates with similiar thinking across the U.S. He called on supporters to continue the campaign for social, economic, racial and environmental justice. Voters for Sanders were offended by the information shown in DNC email leaks of the bias against Sanders shown by DNC chair Debbie Wasserman Schultz, who has since resigned.

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China expands the trading range of the yuan to 1%. The yuan is set by the People's Bank of China, China's central bank, at 6.2879 yuan per U.S. dollar on March 14, 2012 or 15 to 16 U.S. cents to the yuan. The yuan rate is set daily by the PBOC, called the parity rate, and was previously allowed to trade in a 0.5% trading range.

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The largest U.S. bank holding companies, including Bank of America, J.P. Morgan Chase and Citigroup, and two foreign banks Deutsche Bank and Barclays PLC must submit initial plans for "living wills" by July 1, 2012. The Dodd-Frank legislation requires financial firms to develop plans that lay out how they could be liquidated if they went under in a crisis. This legislation gives the FDIC and other regulators the power to seize and dismantle a failing financial firm, to help mitigate the problems of "too-big-to-fail" firms. The FDIC and U.S. regulators lacked such powers at the time of the collapse of Lehman Brothers in 2008. The FDIC and the U.S. Fed co-wrote the living will rule for "comprehensive and coordinated resolution planning." In all, 124 banks, including 100 foreign banks with U.S. affiliates, which have over $50 billion in assets worldwide, must submit plans and update on a regular basis. Smaller banks will have the deadline extended to December 2013.

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In a sign of the low returns in the past year for pension funds, the 896,000 California teacher retirement pension fund CALSTRS, shows returns for year ending June 30, 2016, at 1.3%. Half of the holdings of CALSTRS are in U.S. and global stocks with returns of negative 2.3%. Real estate provided return of 11% but overall the returns were low. Over 10 years the returns of CALSTRS are now at 5.6%. The California Public Employees Retirement System (CALPERS), says its returns on its investments were 0.6% for the past year. With large retirement obligations pension funds in the U.S. face real challenges in this low return environment. Private equity investments of CALSTRS had returns of 2.9%, also lagging behind.

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With so much coverage of other aspects of China,  to really understand China and Xi Jinping one has to understand the rural urban situation in China. Xi's long experience as a teenager in the cultural revolution of Mao was in rural areas, the 8 years he spent there till the age of 22, as this report by James Areddy with help of Yijun, Cheng and Qi aptly shows. It traces the shift and mass migration to cities starting with Deng's modernization drive in 1979. This shift of labor to city and town factories as the U.S. and Europe shifted factories and production to China is the story of our times. How it has both helped and hurt China and how it has become the dominant issue of our times, and a lesson for India in the middle of its own modernization and shift of labor to cities. It has helped China modernize with the shift during 1979 to 2016 and run into a road block with president Trump leading a movement in the U.S. of people most hurt by the outsourcing of factories and production to China. It was not meant to be this way. Yet the shift also led to ripping up the fabric of communities and towns with loss of factories across America over three decades. Because China is a large country the impact was huge decade after decade, leading to a backlash against lost jobs in the U.S. and in Europe.  Xi Jinping has romantic view of rural China as he spent 7 years in Shanxi province rural areas during the cultural revolution under Mao. During this period he toiled as part of farm labor alongside villagers which allowed him to get to know villagers and farmers in the countryside well, and formed his view of the world around him. As it is described in a description of the man in Chinese sources- "He arrived at the village as a slightly lost teenager and left as a 22 year old man determined to do something for the people."  China's system separated migrants from city dwellers not  giving same rights to better education, to schools and housing, and official documents separating the two, city dwellers and migrant populations from rural areas. As a result as China modernized and population shifted -shown here in excellent graphic charts over four decades- in 1979 from about 80% in rural areas and 20% in urban the shift goes to 50-50 by 2001. Today it is 40-60 with 60% in rural areas but a population of 40% suffering from severe inequalities and  low incomes. So that GDP per capita of $10,000 for China is deceiving. The real incomes in average disposable income is about $4300 in urban and $1700 in rural area, according to National Bureau of Statistics. High school education is hard enough to get in rural areas, medical care is very basic and the $1700 would hardly get a room in low income housing in a large town in China, says premier Li Keqiang. Keqiang did his masters thesis on urbanization and has studied this shift from his college days. Just as in Gandhi's India, Mao's China is the story of the villages, with 128,000 villages for 600 million people in Mr. Xi Jinping's anti-poverty drive. Hong Kong other issues have to be understood in the context of these concerns of China's leadership today- the sense that strong central leadership alone can keep the country together and bring a decent life to the people in the villages and in the countryside outside the cities.  Modernization of cities still set in the context of China's vast rural population and essential to its full uplift and progress. Xi has allocated $80 billion each year to bring roads, schools, medical facilities, and other amenities including electricity and modern heating. The idea now is to shift people back to the villages, find opportunities for jobs and livelihoods in farming, tourism with guesthouse facilities, and other occupations in the villages. The villages are being turned into attractive places to live one by one in this party drive and providing new enthusiasm and support for the party's efforts. India can learn from this experience in China. The western nations of the U.S. and Europe can no longer and will no longer undertake the wholesale shift of factories with loss of jobs to China or India to offer the prospect of bringing these countries to the kind of urbanization and overall prosperity of small nations like Japan and South Korea, which are a tiny fraction of the population of China and India+ Pakistan + Bangladesh. As a result China is changing strategy now with a return to some aspects of the informal economy in Chengdu with street peddlers and tiny retail, and return of migrants back to better built and improved villages in the countryside. A better life than in cities is possible this view says for people from these rural areas, if the rural areas are given modern facilities and construction and resources are allocated, job creation locally tackled. The villages can offer better air quality, better quality of life where villagers who earlier migrated to cities with ownership of land, when they are modernized with better roads and have better facilities for education, housing and healthcare, better amenities. The new approach is to strike a good balance for urbanization, by modernizing and investing in villages and small towns, so that cities can cope and overall life can be better than with mass migration and wholesale urbanization. It is also a balance that works well for the U.S. and Europe which can redirect manufacturing to their home regions as part of a better distributed and balanced supply chain than the one that was unwittingly built over the last three decades.    ...

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The U.S. effort to protect the sea lanes in the straits of Hormuz as the Iranian backed Houthi rebels advance into the southern port city of Aden in Yemen. This involves support of Saudi airstrikes in Yemen and control of airspace over Yemen. In Iraq the U.S. makes airstrikes to support Iranian backed Shiite militias near Tikrit. The lack of a coherent policy and years of inaction by the Obama administration in the Middle East leads the U.S. into a situation where it is drawn into airstrikes on both sides of the Middle Eastern sectarian Sunni-Shiite conflict.

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The U.S. Federal Reserve announced on Dec. 13, 2016, that it would increase its benchmark short term interest rate by 0.25 percentage point, to between 0.50% and 0.75%. The increase will also be reflected in business and household borrowing costs. The Fed also announced its intention to make 0.75% percentage point increase in 2017, possibly in 3 quarter percentage point moves. The Fed's forecast is for the fed-funds rate to reach 2.1% at the end of 2018, and 2.9% at the end of 2019. The Fed's policy is based on a sense of strong labor market with unemployment falling, and says it is based on discussion at a 2 day meeting, and "in view of realized and expected labor-market conditions and inflation." This reflects a view that there is now not that much slack in the labor market, that further improvements could trigger higher inflation. Fed forecasts for inflation are for it to increase from 1.5% in 2016 to 1.9% in 2017 and to the target of 2% in 2018. The unemployment rate of 4.6% in 2016 is forecast to go to 4.5% in 2017 and remain at that level till 2019. Economic growth is forecast at a median annual rate of 1.9% in 2016, 2.1% in 2017, only a slight improvement from last forecast in Sept. 2016. Support for chairwoman Yellen's policy decision was unanimous. See the link on views of NYT's Binyamin Applebaum and Neil Irwin on how Fed rate policy and economic growth under the Trump administration is likely to play out, and Ian Talley's report on impact on exports with a stronger dollar in WSJ. These views also are in line with the Fed's forecasts and policy decision as they reflect the concerns of the Fed about inflation, and also reflect the Fed's view that growth will be close to 2% in 2017-2019, and not the 3-4% stated by Trump and Treasury Secretary Mnuchin. Fed rate policies to keep inflation at about 2% tend to counter stimulus spending by the Trump administration and effect of tax cuts. The size of the stimulus and the tax cuts are also likely to be much smaller than stated because of Republican concerns about the deficit in the U.S. Congress, according to these views. The stronger dollar also has the paradoxical effect of making trade gains more difficult while increasing trade friction in tougher bargaining supported by Trump, making the higher growth targets harder to reach.   ...

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Asymptomatic people infected by coronavirus are acting as spreaders of the coronaavirus making it more essential than ever that everyone wear masks. This is a widely accepted practice in Asia- wearing masks to prevent others from getting a virus. This now needs badly to become the practice in the U.S. and Europe. The longer it is delayed the worse the crisis can get and the longer it takes to eradicate it. Even low grade cotton masks are useful as is the practice in Asian countries. It is now part of the new guidelines of the Centers for Disease Control in the U.S. This needs to be adopted as safe practice everywhere.

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John Lipsky, a deputy managing director of the IMF from the U.S., gives reasons why the U.S. should support IMF reforms that increase representation of emerging market countries in the G-20. Lipsky was at the IMF 2006-2011.

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The Guardian sends its reporters along with UN special envoy on poverty Australian Prof. Alston as he spends two weeks in the world's richest country looking at poverty in urban areas.  They look at some of the 55,000 homeless people in Los Angeles, homelessness exacerbated by the tech boom in California that has sent housing costs skyrocketing. LA saw homeless people increase by 25% in 2017. The safety net is not being reinforced as the Trump administration cuts many social safety net programs. Next they visit the Tenderloin district in San Francisco where homeless people can be found at St Boniface Church sleeping in the pews. As the Guardian points out the cuts to social programs disproportionately hurt people of color who make up 39% of the homeless in the U.S. This report looks at the incongruity between the tax cuts that are likely to hurt poor whites who supported the Trump administration, as well as hurt the social protections that are part of today's democracies across the western world. This is most evident when one looks at the European Union. They were put in there in Europe for a reason- fairness is good for all classes, and most of all it protects democracies. Authoritarian regimes arise out of social dislocation from wars, or from lack of social protections and ineptitude of elites. Which is why a Lincoln or a Theodore Roosevelt from the Republican party supported fairness and social protections as much as FDR and Truman from the Democratic Party. The view expressed in this report in the Guardian is that the U.S. may have moved in the wrong direction under the Reagan and Clinton administrations creating the "me first" culture that prevails in the U.S. today. ...

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Daniel Altman's proposal for a tax on wealth over $1 million. He makes the case for taxing wealth not incomes to reduce inequality as this is where the situation in terms of inequality has worsened for the U.S. in recent decades. To support this proposal Altman cites the change in the U.S. Ginni coefficient, which measures inequality. The Ginni coefficient is anumber from 0 to 100 which goes up with higher income inequality. From the late 70's to the 1990's, the Cnesus Bureau showed this to be in the low 40's. By 1992 the Ginni coefficient went up to the mid-70's, according to the Federal Reserve data. It increased to about 80 in 2010. In 1992 the top 10% in the U.S. population controlled 20 times the wealth of the bottom 50%. By 2010 this figure triples to 65 times. and the graduated income tax even if it redistributes a small share of the wealth does little to affect the trend of wealth extremes from building up and threatening the social fabric of America, reducing mobility and opportunities for the bottom 50% to unprecedented levels since the 1950's. ...

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In a massive intervention last week and again this week the Bank of England cut interest rates from 0.25% to 0.1% and launched a 200 billion pound program to buy UK government bonds and corporate bonds to support the economy and business. Investors sold UK government debt for short term cash holdings and invested in U.S. currency holdings as the safest asset they could find, as the economic effects of the coronavirus epidemic hit capital markets. Andrew Bailey, the Governor of the Bank of England stated that it was the government's job of preventing temporary "dislocation" becoming permanent economic "destruction." Business failures are expected as a result of the coronavirus impact and also layoffs resulting in a temporary jump in unemployment. The government needs to take steps to mitigate these effects in the UK as is being done in the U.S. by the Trump administration with $1 trillion in direct assistance to business and people affected by the crisis. ...

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The current trade disputes and negotiations between the European Union and the U.S. are leading to European carmakers looking again at their supply chains to come up with ways of increasing manufacturing autos in the U.S. Daimler CEO Zetsche says Mercedes Benz will increase engine manufacturing in the U.S. BMW CEO Kruger says the USMCA agreement as the new NAFTA is called, will accelerate investments in manufacturing in the U.S.- more U.S. production for the U.S. market.

The USMCA require at least 75% of car's value built in the U.S. up from 62%. Also 40-45% of the car has to be made at wages of at least $16 per hour. The cap for cars made in Canada and Mexico and exported to the U.S. is 5.2 million with 4.1 million currently shipped into the U.S. Any cars over this or not qualifying with the rules pay a tariff of 2.5%.

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This view from the Editorial Board comes as Republicans in Congress geared up for a legislative victory decided to ignore the expert opinion of the Joint Committee on Taxation and polls showing a majority of Americans disapprove of the tax law. It says a "corrosive partisanship" that is affecting the nation has led to this decision. Not an informed consensus necessary to make real and lasting changes to the tax laws that increase growth without disrupting hard won gains in social cohesion after World War II.  Republicans pushed through a trillion and half dollars in tax cuts in the law that reduces the corporate tax rate to 21% from 35%, and cut taxes in 2019 by 51 times ($51,400) for the top 1% of incomes compared to ($1000) for middle class families earning less than $100,000 (Tax Policy Center). The Joint Committee on Taxation estimates it will add $1 trillion to the U.S. deficit as only $500 billion is expected in increase in government revenues over a decade from additional economic growth. This is supported by evidence from countries such as Britain that implemented this type of corporate tax cut without generating much economic growth, says Greg Ip in the Wall Street Journal. The "victory" then comes at a high cost says the Washington Post- in years to come programs to help the growing lower middle class and working class will be subject to cuts and taxes will have to rise to balance budgets.   ...

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Speaker Boehner's difficulties getting Republican votes in the U.S. House of Representatives. 151 Congressmen and majority leader Cantor voted against the McConnell-Biden fiscal cliff agreement of Jan. 1, 2013.

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Republicans and Democrats decided to tackle the U.S. fiscal cliff in several steps. The first step for the Bush tax cuts to be extended to single earners with income under $400,000, and couples earning under $450,000 was part of the agreement reached Jan. 1, 2013. Republicans see this as protecting small business owners who generate jobs in the U.S. economy. Democrats see this as progress in taxing the wealthy to reduce spending cuts in other programs. As expected the deal was reached between Senate colleagues Republican Mitch McConnell and former Democratic senator and Vice President Joe Biden, as rapport is missing in the relationship between Speaker Boehner and president Obama. The $110 fiscal cliff spending cuts on entitlements and defence will be postponed for 2 months till early March under the deal. Debt ceiling will not be raised and negotiations will be needed again by the end of Feb. 2013 to raise the debt ceiling. By March 27, 2013 short term funding measures lapse. Republicans see accepting tax cuts on the wealthy as a way to remove this issue in future negotiations to focus on spending cuts needed to improve U.S. finances. ...

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U.S. president Obama's chief of staff and former deputy national security advisor, Denis McDonough, meets with Peter Altmaier, Chancellor Merkel's chief of staff, and Gunter Heiss, head of Directorate-General 6 of Germany's Federal Intelligence Service in July 2014. The meeting was part of an effort to improve U.S.-German relations following the problems created by NSA spying in Germany. This meeting took place following the shooting of a Malaysian airline flight over Ukraine and the call for stronger western sanctions on Russia. U.S. president Obama sought to convey to Merkel the importance he placed on German-U.S. relations after Obama failed to make a serious effort to soothe tensions with Germany over spying revelations.

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Are high prices for pharmaceutical products and healthcare services putting a severe burden on U.S. finances and defunding education, infrastructure, R&D in new technologies, which provide the underpinnings for future U.S. competitiveness? Yes say experts. In 2009 Americans per person cost of healthcare was $7,960. By comparison Canada was $4,808, Germany $4,218, and France $3,978. And without necessary efforts for educating people about caring for health and preventive care, the health conditions of Americans are no better than these countries, and poorer in some dimensions. Klein says deficits would not be a problem for the U.S. if prices for pharmaceutical products and healthcare services in the U.S. were similiar to that of the largest developing countries. Experts say the Obama healthcare law simply postponed the addressing of this problem.

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Bayer AG CEO Marijn Dekkers talks to the Journal's Geoffrey Rogow about the company's pharmaceuticals business and job retention. Dekkers says profits are reduced by the tight budgets of European governments and the pressure on pricing. He cites the 16% mandatory rebate in Germany on prescriptions. For Bayer diversification through the chemicals business offers a way to handle the ups and downs in the pharmaceuical business with patent expiration. He is not interested in acquisitions because of the high premium involved and the difficulty of recovering this for investors. Bayer like other drug companies has extensive operations in China. Bayer is training salespersons in top and second tier Chinese cities. It has a program to train 10,000 physicians in rural areas of China working with the local government. Dekkers makes an interesting point about jobs and job retention in the U.S. He says a lot of jobs were outsourced in the 1990's and its difficult to bring them back. Germany has done a better job with job retention with "kurzarbeit" and other programs working in partnership with industry. In his view this could have been managed better in the U.S. with active programs such as this in the last two decades....

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The U.S. Congress passed free-trade agreements with South Korea, Colombia, and Panama, in October 2011. The deals are expected to increase U.S. exports by $13 billion, including $11 billion to S. Korea.