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Samuelson points to the risks to the American economic growth from excessive health care costs. This is hurting take home pay and shows up in consumer spending. It is hurting government spending in other areas such as needed infrastructure spending and efforts to reduce the deficit. This hurts private capital investment to create jobs because of lower demand from constricted consumer spending. The U.S. budget has as its largest single expense 27% on health care compared to 20% on defense the next largest expense, with growth in health care spending taking this to one third of the budget in coming years. Without addressing health care, says Samuelson, the Supercommitte in Congress even if successful at deficit reduction will basically have failed to do its job, and it did not have the time, resources or conviction to do this. According to a new study from the Organization for Economic Cooperation and Development (OECD), U.S. healthcare spending per person is $7,960 per person in 2009. This compares with Norway $5,352, Britain $3,487, France $3, 978, an OECD average of $3,233. Life expectancy in the U.S. is 78.2 years, compared to Japan 83 years, OECD average of 79.5 years. Chile and the Czech Republic have life expectancy equal to the U.S. Except for cancer care where the five year survival rate is 89.3% in the U.S. and the OECD average is 83.5%, the U.S. lags far behind in much needed critical areas such as diabetes and asthma. Rates of emergency hospitalization for asthma are 3 times that in France and 6 times that in Germany and Italy. The U.S. has fewer doctors per thousand population and higher cost per medical procedure- with more frequent use of the costliest procedures- creating a supply shortage that induces higher prices, and less preventive and early action care through physician visits. The number of practicing U.S. doctors is 2.4 per thousand population in the U.S. compared to 3.1 per thousand for the OECD average; and number of annual doctor consultations 3.9 per capita in the U.S. versus 6.5 for the OECD average. Appendectomy cost $7,962 in the U.S., $5,004 in Canada and $2,943 in Germany. Coronary angioplasty cost $14,378 in the U.S., compared to $9,296 in Sweden, and $7,027 in France. Knee replacement cost $14,946 in the U.S., $12,424 in France, and $9,910 in Canada. Knee replacements, angioplasties and MRI exams are twice as common in the U.S. compared to the OECD countries. ...

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Tom Keene of Blomberg BusinessWeek talks to a panel of experts about the future prospects for the US and the global economy. The discussion was spurred by Carmen Reinhart's paper at the central banker's Jackson Hole, Wyoming, conference. This paper forecasts high unemployment, low housing prices and very low growth in the US upto 2017. Shiller, Calomiris, Orszag, Kaufman and Bill Gross are part of this panel. Shiller's to do list main item is to get help to local and state governments by restoring general revenue sharing arrangements. Gross would focus on jobs that can hold up in a competitive economy, and put back some of the production that is taking place in the developing countries back into the developed countries, as part of a rebalancing; through a currency realignment. Kaufman would like to see a capital expenditure program by the US government, including infrastructure and education. Calomiris would like to see a setup of a new Republican Congresss to set the stage for post 2012 efforts. Calomiris favors cutting entitlements, cutting payroll taxes, but is not clear how this would help lower the deficit. Orszag points to feedback from business leaders suggesting a lowering of payroll taxes will not spur hiring, as the real reason for not hiring was low 1-2 % expected growth. Shiller, Kaufman and Gross see government efforts as realistically needed in the current situation....

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Republican vice presidential candidate Paul Ryan's early years in Washington D.C. working for Senator Robert Kasten as an intern and on his staff, at Empower America for Jack Kemp and in other jobs.

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Feldstein's thoughts in April 2009, on Treasury's Public-Private Investment Plan. First, he says this plan will only remove $500 billion of impaired assets. The banks he says now own $3 billion of residential mortgages, $1.5 trillion of corporate real-estate loans, and $1 trillion of consumer debt. Not all of this is impaired but the banks will have to sell much more than $500 billion to regain confidence in their solvency. And with one third of all residential mortgages exceeding the value of the houses, and thie many homeowners under water, likely to default, the negative feedback loop of foreclosures begetting falling prices begetting foreclosures, threatens the whole effort to shore up the defences. If no workable solution is executed quickly to prevent this then even larger pools of mortgage debt will be impaired irretrievably. Feldstein suggests that the Obama administration seriously look at his plan suggested in March 2008 to provide government loans at low rates of interest like 1- 2% for 20% of the principal amount of the mortgage and then reduce the mortgage principal by 20%, thus keeping millions of homeowners above water. But this needs to be done quickly. All voluntary efforts have failed and have become asmokescreen for banks and lobbying groups with support from Congress to make it appear that this problem is being addressed. Thirdly Feldstein says that if banks sell these impaired mortgage assets at a loss- say 40-60 cents on the dollar on the upside with government and the FDIC picking up alot of the risk and financing for private investors under the new plan- they will now have to show the loss whereas they could have previously shown these assets at unrealistic price levels but still not taking losses. This might push banks into insolvency, so banks will need more injection of capital by the government to make this possible. What are the risks in this situation? Without an effective plan to prevent the negative feedback loop of foreclosure waves and falling houseprices, the quantity of impaired assets will simply grow larger. In effect even if some private investors take out some of the impaired assets from the banking system, it is possible that a new set of assets equal to or larger than these assets that are taken out are added to impaired assets in the banking system as house prices fall steeply from new foreclosures. That only means the economy is in the same hole as before, or in a slightly larger one, even with all the well intentioned steps. At some point the private enterprise argument has to be seen in the correct light. It is not that there is any argument that private enterprise can function better or far superior, it is only that the banks as private enterprises are in such an enormously stressed situation that the bank executive's cannot execute a way out of this mess. ...

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Questions about the true cost of the Obama health care legislation and the assumption that the legislation cuts the deficit by billions of dollars. This WSJ editorial says one has to look at this closely, and not merely look at CBO projections, which may be based in a certain context and not reflect the true costs, especially because many accounting gimmicks and use of numbers to present a particular picture is taking place. The information this editorial cites is that: it uses 10 years of taxes to fund six years of subsidies, Social Security and Medicare revenues are double-counted to the tune of $398 billion, a new program funding long-tem care frontloads taxes but backloads spending, and the assumption of an automatic 25% cut to physician payments that Congress is unwilling to authorize. Rep. Rand Paul has tried to present an alternative view which needs to be studied just as closely, because of the enormous impact of a jump in spending at a time when the public finances are fragile. WSJ also cites the work of Richard Foster, the chief Medicare actuary, as an alternate perspective of how things could turn out, Doug Holtz-Eakin, and Eugene Steuerle. It calls for common sense in evaluating programs, entitlements, defense or other government spending. They not only cost money, but costs escalate over time as history has shown over decades, till they eventually are discovered to be not affordable unless the middle class is willing to dig deeper into its finances to pay for them. Alternate perspectives from a range of informed opinion, Howard Dean, Martin Feldstein, and the head of Harvard's Medical School show that the issue needs to be looked at closely and carefully and cannot be something in which CBO numbers can be trusted to tell the whole story. Especially when common sense, history, and informed opinion across a spectrum of thought advises caution, and fragile public finances also suggest caution. Howard Dean, former Governor of Vermont, says the health care bill is not real reform, and may do more harm than good. He says in a Washington Post article, December 17, 2009, the Obama health care bill does not insert competition into insurance markets, does not significantly reduce costs, and does not improve the delivery and use of health services. It was he says done with a political calculus and crafted for votes not real reform. Jeffrey S. Flier, Dean of the Harvard Medical School, gave the Obama health reform bill an "F" grade, saying in a Nov 18, 2009, WSJ article, that it was disingenuous to call this reform, Congress and the White House were simply deceiving the public. He said the bill will accelerate US health care spending, postpone most of the major health care problems, expecially the ones that drive cost, including the "fee for service" system and delivery of health care. He says in his discussions with economists and other health care leaders the opinion was unanimous that the bill will accelerate health care spending. He cites Massachusetts as an example, where access to care was expanded under the same dysfunctional system, and spending went up, and it doesn't work. Feldstein, who in early 2008 suggested proactive solutions to the mortgage debt crisis which were never adopted, says that the Obama health care law means higher taxes in the long run to pay for the $1 trillion cost of health care for the uninsured group over 10 years. Feldstein says that the Obama plan is to cut Medicare to cut spending, and will reduce the amount of medical services, as reduced spending comes from fewer services, not reducing payments to providers. And he asks if the cost reductions are weighted too heavily towards reduced services and not reduced payments to providers ,would this result in large cuts to services to affect the quality of healthcare for the 85% of the American people who are accustomed to a different pattern of healthcare. ...

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Information provided by experts suggest that the government plans including the public-private partnership with $1 trillion committment to absorb the bad assets in financial institutions, offered as a general solution without specifics by Treasury Secretary Geithner, will be inadequate to cope with the growing bad debt. Nouriel Roubini at New York University says his analysis suggests that the USA financial institutions are already insolvent. The bad debts of banks he says now surpass bank assets. Roubini has been ahead of the curve in his estimates in 2008, and is respected for his prescient remarks about growing credit problems. In his latest report he says that total losses by American financial institutions and the fall in market value of the assets they hold will reach $3.6 trillion , up from his previous estimate of $2 trillion. Of the total he says American banks face half of this or $1.8 trillion, with the rest borne by other financial institutions in the United States and abroad. Mr Posen an economist at the Peterson Institute agrees. He says the liabilities of of American financial institutions far exceed their assets. The only qualification of this says Posen is whether this should be seen as a temporary panic, or whether the economic climate will improve and the value of bank assets recover from depressed values. Raghuram Rajan, of the University of Chicago graduate business school, agrees that if the banks had to sell these assets today at distressed prices then they are insolvent, but if there are calmer times say in ayear or so and values recover then banks may get anew lease on life. So much of this depends on market psychology, market confidence and the economic climate improving. The only problem here is that as happened in 2007 and 2008, the recognition, awareness and action has fallen behind the speed and accelerating manner of the downturn. The Bush administration, Congress, and the American public support, have all been lacking in providing the vigorous action needed, compared to the speed with which the crisis hit in the October 2008 to January 2009 period. The transition between administrations added to this effect. The total lack of any Republican support for the Obama administration's effort continues this effect. Now the Geithner plan with few specifics for a public private partnership for tackling the bad debt, and the lack of action on a bad bank solution with government takeover of certain banks as needed, continues this pattern. The constricted credit meanwhile continues to hit business with an additional hit from dropping sales, leading to layoffs across all industries, which simply worsens the housing crisis and growing foreclosures. So all across the spectrum government action is at worst very late as in the slow response to foreclosures, where the $50 billion proposed now should have come in early 2008, and the banks halting foreclosures and modification efforts proposed now should have come in early 2008 as proposed by Bair and Feldstein. And at best government is just catching up to the credit crisis as with the Fed and FDIC efforts to contain and stabilize it, with inconsistent results and the collapse of some financial institutions like Lehman Brothers. The lack of consensus in Congress and the inexperience of the new administration, means more valuable time will be lost in crafting an effective response in the manner of the bad bank solution. What all this means is that the overall response in 2009 as in 2008 will also lag behind, and the opportunity for a decisive solution is slipping away even as the cost of that solution is climbing, putting it further and further beyond reach. See the link to Hiroko Tabuchi's article titled In Japan's stagnant decade, Cautuonary Tale for America, February 12, 2009, NYT. Tabuchi touches on just this point, that the American experience in 2007-2009 is just like that in Japan where the response lagged the problem in strength and effectiveness till 2003, after years of wasted effort....

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China's fiscal 2014 budget plans laid out at the March 2014 NPC meeting show an increase in the budget deficit by 12.5% to 1.35 trillion yuan ($221 billion). The deficit will be about 2.1% of inflation adjusted GDP, according to the Finance Ministry.

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The leaders of Republicans and Democrats, Senate Majority Leader Mitch McConnell, Speaker Boehner, Minority Leader Nancy Pelosi, and Minority leader Harry Reid, reached a budget compromise with the White House in October 2015 after long closed door negotiations, following years of deadlock in previous years. The compromise lifts sequester spending caps agreed to previously in a previous settlement of differences, and lifts the budget ceiling till March 2017. Speaker Boehner said it was time to "clean out the barn," as he did this over the opposition of Senators Rand Paul and Ted Cruz from the right wing of his party who opposed his efforts to compromise with Democrats. On October 28, 2015, the House of Representatives passed the two year budget agreement 266-167, and the following day Speaker Boehner passed on the Speaker's position to Rep. Paul Ryan of Wisconsin. On Oct. 29, 2015, the Senate voted 64-35 to pass the budget compromise agreement. The agreement increases discretionary spending by $80 billion over 2 years, giving half to defense spending with the increase in military threats overseas, and the other half to domestic spending programs. The domestic spending goes to limit premium increases for some Medicare Part B beneficiaries, and a prevents a 20% across the board cut to Social Security Disability Insurance benefits, set for 2016. This removes the uncertainty posed by threats of a showdown on the budget ceiling and threat of defunding Planned Parenthood posed by right wing Republicans in Congress, which were bad for the economy at a time when the U.S. and Europe faces increasing threats overseas. Without a budget agreement the U.S. Treasury Department would have seen its borrrowing authority expire on Nov. 3, 2015....

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At the end of the 2012 Communist Party Congress in Beijing, Xi Jinping assumes the post of chief of the Communist Party of China. He also assumes the post of head of the Central Military Commission, which makes him head of the armed forces of China. Li Keqiang, the incoming prime minister, is the only member of the party Politburo Standing Committee selected by current president Hu Jintao. Jinping is supported by Jiang Zemin, former president. Four of the other five members are older party leaders placed in these positions by former president Jiang Zemin, who succeeded Deng Xiaoping and started China's three decade long modernization. The seven member Standing Committee governs China by consensus. This will limit the room for change, especially as the other five members are in their mid 60-s and favor the status quo. Xi Jinping is 59, Li Keqiang is 57. Xi becomes president in the spring of 2013, and Li becomes prime minister to run the government ministries. The optimism for Li who is the best educated of China's leaders, holding a doctorate in economics from Peking University, and an early interest in constitutional law, is restrained by the institutional arrrangements that favor the status quo. Some experts in China see the new leaders likely to make major changes only if confronted by a crisis. In his live television acceptance speech Xi focussed on China's "rejuvenation," with improvements in the party bureaucracy, tackling corruption, and improving the lives of ordinary people, for better schooling, jobs, incomes, health care, better housing conditions, social security and the environment. From the rush to modernize and build infrastructure attention is now shifting to creating better conditions for the Chinese people....

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The gridlock in Congress and the housing crisis could postpone an overhaul of Fannie Mae and Freddie Mac for another two years. The housing crisis of 2008 has created a situation in which 9 out of 10 housing loans are guaranteed by Fannie and Freddie. The two agencies were created to buy mortgages from the banks, freeing the banks to make more loans. Fannie and Freddie gurantee the loans and then sell them to investors as securities, a process that lowers borrowing costs and makes 30 year mortgages more easily available to homeowners. The Obama administration and the Democrats want to continue some form of government guarantee, and continue government support for the 30 year fixed mortgage. The Republicans oppose any government guarantee because of the losses imposed on taxpayers by the way these agencies operated in the past, with the government guarantees providing the wrong kind of incentives in a housing market prone to bubbles. The fragility of housing markets means anything that raises borrowing costs could put downward pressure on housing prices. As a result the restructuring of the two housing agencies is in limbo. Republicans who want aggressive changes may wait for housing markets to stabilize, making the overhaul a multiyear process. Meanwhile the US Treasury has promised to inject unlimited sums into the mortgage giants through 2012 and nearly $300 billion after that, so that Fannie and Freddie have positive net worth and not go into receivership. The total cost to taxpayers beyond the $134 billion already incurred, is additional capital injection of $146 billion (for a total of $280 billion), because of further problems in the housing market in future years, and another $400 billion to adequately capitalize the entities that replace Fannie and Freddie, according to Standard and Poor's estimates....

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For the 1st quarter 2009, finance industry spent $104.7 million to lobby Congress and the administration, down 8% from the prior year, according to WSJ analysis of data collected by the Center for Responsive Politics. The health-care industry spent $127.1 million for lbbying, up by 12%. Lobbying can affect legislation in ways that can be for either good or bad in the public interest. Since 1990 the financial industry has spent $2.2 billion in political contributions to lawmakers, more than any other industry tracked by the Center for Responsive Poltics. Since 1998, the earliest available data, the finance industry has also been the highest spender on lobbying activities , with spending on lobbying lawmakers at $3.6 billion. Its significant that the financial industry landscape has been changed, the higher risktaking by banks enabled, and the reduced regulatory activity environment advanced by heavy lobbying. The banking industry lobbied for the 1999 repeal of the Glass-Steagall Act, a1933 law that kept banks out of the securities business. That effort led by Citicorp, J.P. Morgan,Bankers Trust took 20 years, many tries and more than $300 million in lobbying funds according to the WSJ. The Mortgage Bankers Association with a 10 story headquarters in Washington D.C. has 114 staffers, and SIFMA the Securities Industry and Financial Markets Association has 120 staffers and 14 people in its lobbying group. As a sign of how all this lobbying is viewed across the country, Rep, Barney Frank, chairman of the House Financial Services Committtee, frankly told Mr. Courson, the President of the Mortgage Bankers Association, "everybody hates you, and now they're starting to hate me for hanging out with you," a remark Courson recited at a meeting....

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Instead of "ring fencing" bad loans one bank at a time, which is what is being done for Bank of America and Citigroup by the government , Bair, Bernanke and others favor something like the Resolution Trust Corporation, which would contain all bad assets of banks. Bair in an interview said she would like to see them priced at what they would get in today's market, meaning that the steep discounts issue would be faced squarely. What this will need is a lot of government money to restore confidence so that investors are willing to put their private money in the banks. And Senator Schumer says he is hearing the number of $1 trillion or more. This would let banks take these bad assets off their balance sheets, like they did with the Brady bonds for bad Latin American assets and with the Resolution Trust Corporation for bad assets in the savings and loan crisis. It was the original intent of TARP but two things happened, first the pricing of these assets was in limbo, with nobody willing to say how steep the discount should be. The auction process proposed was a vague and shaky one. Second, things deteriorated so quickly that it became urgent to instead do bank recapitalizations for $250 billion. Now the same issue has to be addressed directly by another administration with control of Congress, so that the big bucks funding of $1 trillion can be possible to do. Something like a separate institution that holds all bad bank assets. And the government taking on a big part of the burden, and with it some ownership of the banks that hopefully could payback some of this $ 1 trillion....

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Whats the breakdown of costs for Detroit's Three Auto Companies. The following infomation is from documents submitted by Ford Motor Company to Congress. Detroit Auto Companies Foreign Makes like Toyota Hourly cost Hourly cost Hourly wage for workers $29 $26 (Toyota Kentucky plant) Holidays and Vacation pay & pay for Detroit laid off workers $14 $9 Cost of Health Care and Pensions for $16 Toyota has only 300 retired retired workers workers Overall cost $71 $49 The biggest difference is in the cost of paying laid off workers, jobs banks, and in the cost of paying the health care and retirement pensions of retired workers. And for GM there are about 1 million of them, (96,000 active workers, 497,000 retired workers and also the dependents of retired workers) costing GM $4.8 billion on health care. At $1500 per car for GM costs on health care vs. $200 per car for health care costs at Toyota. The difference is $1300. If this is factored in to the profitability of small cars then the field is skewed one way. On a $23,000 car that is a 5% margin right there for adiffernce of $1100 in health care costs. If this is the way profit is calculated on small cars with this health care differential factored in then there is always a muddleheaded tendency to product he bigger cars and trucks because they can absorb this differential better. But it doesn't make sense that this should dictate how the business is run. And it could lead to serious mistakes which appears to be the situation at the Detroit companies, the way they went into the downturn right into 2008 with a product mix that was going to be hit hardest by a change in customer preferences. ...

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Smaller biotech firms typically have products in the development stage and are not making money. Now they are facing increasing financial hardship. Even in good times except for a few names like Genentech and Amgen, the others are struggling. They have a hard time raising money, and its coming at a higher price, 90% of equity instead of 50% like before for 5 or 10 or 20 million dollars. Older shareholders are diluted with new capital raised. And some are selling out. Others are going into bankruptcy liquidation, after wrenching periods of firing most of the staff. Even blue chip firms like Helicos of Cambridge, Massachusetts, which went public in 2007, and has backing of advisors like Steven Chu, the Nobel Prize laureate, are in trouble; with its DNA reader designed to produce custom tailored cancer treatments at $1 million a piece. It has not booked a sale, faces competition from a reader developed by two companies, Roche and Illumina of San Diego. It almost ran out of cash last year. Helicos shares $18 last year, are at 54 cents. According to Burrill and Company, a venture capital concern, 100 of the publicly traded biotechs this year may be lost as companies fail or get taken over. 120 of the 360 publicly traded biotechs have less than 6 months cash left, compared with 12 a year ago, says Burrill. Already 10 have declared bankruptcy according to Biotechnology Industry Organization. BIO is asking Congress to step in and for the government through the National Institutes of Health to provide matches for private investment in small startups with promising treatments. All this is happening as companies are spending large sums for mergers like the Pfizer Wyeth merger. ...

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Questions abound about Steven Chu, is he a scientist who handled administrative positions, like being vice chairman of the Physics department at Stanford, and head of the Berkeley Lawrence Livermore Laboratory, with its $600 million budget and 400 staff? Or is he something more with the stuff to get things done to remake the way America makes and uses energy? Because running the Energy Department means running a place with 114,000 employees and a budget that has doubled under the Obama administration. And he has to disperse $39 billion in Stimulus money without it being wasted. And the priorities are just as big and important- ending America's dependence on fossil fuels, rebuilding the nation's electrical grid, and addressing climate change. WIth so much to be done, answering questions in Congress and handling the media may not be the hardest part, even though its the stuff that he likes the least. Its making things happen with the right investments in place for the new technologies that would help break the dependence on fossil fuels, and address climate change. Right now he has no Deputy secretary. He has brought in Matt Rogers an energy expert at McKinsey & Company. Matt and Chu's brother Morgan provide insights into his character. Says Matt Chu is kind and nice but he is not patient. He likes to see things move muuch quicker than things are done around the Energy Department. Chu himself talks about this. He says the bureaucracy in Washington is a place where Newton's law of motion does not work. Once things are set in motion you have to apply force or the bureaucratic atmosphere gets it derailed and it stops. His brother Morgan points to Chu's inclination to challenge established dogma. ...

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The G-20 summit in April had as its achievement the $1 trillion that would go to aid for emerging countries and other countries in need. But this number may not be what it appears to be and should be seen with care. Prof. Eswar Prasad, former division chief for China at the IMF, and now Professor at Cornell University, says there is double counting in the numbers, and a lot of the money has not yet been committed. With trade financing only a quarter of the $250 billion is fresh cash, the rest is trade financing that is rolled over every 6 months. For the Special Drawing Rights issuance of $250 billion, a kind of virutal currency that is set by a basket of real currencies like the dollar and the euro, the IMF will issue SDR's to all 185 of its members. This is not cash but a form of credit, against which a country can borrow. The Obama administration that came up with this idea thinks it will create $15 to $20 billion in additional credit for the poorest countries. For this to happen the US has to lend out its special drawing rights to poor countries, and this requires congressional approval. Of the $500 billion in direct commitments, Dr Prasad says less than half has been commited by Japan, the EU, Canada and Norway. China says it will put in $40 billion probably by buying bonds issued by the IMF. The US contribution of $100 billion has to be authorized by Congress. Even with the US contribution Prasad sees a shortfall of $145 billion of the $500 billion in donations. And the Saudis, the Indians will require a bigger say in the IMF to contribute some of this. ...

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Lou Jiwei chairman of China Investment Corporation met with Treasury officials in Washington to give reassurances that China's sovereign wealth fund would invest as a portfolio investor and be a good citizen when it comes to investing in the USA. He reiterated the pledge by Chinese Premier Wen Jiabao that the Chinese government would not interfere in the operations of the fund, and that the fund would have its own corporate governance structure. He also met with officials of the IMF who are drawing up a code of "best practices" for sovereign wealth funds. Following the Chinese experience with the Unocal deal and the experience of Dubai in a deal to buy a company that manages USA ports, both deals falling apart on concerns in the media and Congress, the Chinese and the Persian Gulf sovereign funds have become more savy and aware of these concerns and tried to handle them better. They also point out that in the case of the financial institutions caught in the US mortgage securities crisis, it is these companies like Morgan Stanley and Citigroup that have come to them, to China, to Persian Gulf countries and to Singapore and other countries, asking them to invest for small stakes in the companies. Their line goes like this- if you have second thoughts about our investment we will invest elsewhere in other countries. Another facet of this is that these portfolio investments are spread out between many different countries sovereign wealth funds, and the possible influence is small in management decisions. China Investment Corporation has $200 billion in assets. Lou says that only a third would be invested to buy foreign assets, about $70 billion. The other two thirds would be used to support China's three large commercial bank balance sheets. ...