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Just one scheme by a Dallas doctor, Dr. Jacques Roy, cost Medicare $350 million over 5 years. HHS data analysis showed Dr. Roy approved 500 times the number of patients normally approved per physician for home health care services- he approved 5000 instead of 100. A case in 2011 resulted in charges against 115 doctors, nurses and company managers, in 9 cities leading to $240 million in false billings.

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No country benefited more than first Japan and then South Korea till 2000, and now China till 2022 from the trade and sharing of industrial technology enabled by the American backed system of trade and industry. Walter Russell Mead says in WSJ that China has chosen to challenge the system through which it developed into an industrialized nation with the US running huge trade deficits, sharing its technology and letting Chinese manufacturing displace American local manufacturing. China is seen as challenging the system. Yet what has happened is that this process of displacing American manufacturing and industry was not sustainable anyway and continued for a decade longer than it would otherwise have lasted because American industry could not easily reverse a course it had set of setting up manufacturing in China, once that manufacturing base had already been transferred from the US to China and American companies had grown accustomed to a new state of affairs of making overseas in China. Not much thought was given to how American workers would react to that situation as companies and industries making that transfer made independent decisions. This led to the election of Trump with wins in midwestern states that had suffered from loss of manufacturing communities.  The Trump tariffs on Chinese goods and the Biden administration lining up completely behind American workers and families for the first time for Democrats has sent the signal to China that it finds the situation of China's dominance in the trade system unacceptable. The document of "China 2030" of the Chinese Government with planned dominance in key sectors and industries was met with alarm across America in all parties. The paradox of Apple as a key sector in Chinese manufacturing and the largest American company is the result of policies pursued by America without realizing the true cost of shipping manufacturing out of the country. That process is now being reversed with change of management starting at Intel Corp. and other companies to bring the manufacturing base back to the US. This policy is being resolutely pursued by the US and will speed up following the pandemic which has further demonstrated how much of a mistake the policy of sending out manufacturing in critical areas such as health could be. This is the reality behind the rhetoric and verbal exchange between China and the US. With the rapid growth of Chinese manufacturing countries such as India were put in a difficult situation  as this was preventing the local industrial base developing in India with Chinese imports in the same way as it had damaged that of the US and the EU. Worse it led to the use of US and European technology in China's defense industrial base including aviation and other sectors that threatened India's borders with repeated Chinese incursions in the Himalayas, from the Pakistan western Himalayas to Ladakh and the eastern Himalayan mountains. That situation existed long before the Trump and Biden administration and the Modi administration called for a return to America of its industrial manufacturing base and its technological leadership. Both the Bush and Obama administrations and the Indian Congress administrations failed to realize the dangers of letting the US, European and Indian industrial base wither. India is not just a country but a culture that extends from the Himalayas all the way across Bangladesh to the Indonesian islands which shares a common cultural history of Buddhism and the Vedanta. This is a region that has a population of about 2 billion people. In a larger sense the cultural history extends to  Vietnam and Japan with its Buddhist culture whose origins go back to India, and also of China itself. In the larger sense this is a population of close to 3 billion people. The economic development of this region and learning from the parliamentary traditions and scientific discoveries of the modern period since 1700 is a task for both the US, Europe and the people of the region.   ...

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In a Washington Post-ABC News poll conducted June 2-5, Republican presidential candidate Romney receives more support than President Obama. Among all Americans Romney and Obama receive 47% each, among registered voters Romney leads 49% to 46%. Independent voters gave Romney 50% to 43% for Obama. The poll shows Obama is being viewed with increasing skepticism because of the economy. By 2 to 1, Americans say the U.S. economy is on the wrong track, and 9 in 10 see the economy as doing poorly. The poll also show a significant shift to Republicans being seen favorably for running the economy, 45% now see Republicans as being better able to tackle the economy, a 11 point increase from a March poll.

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Nouriel Roubini says nationalization is the right solution. Similiar to action taken in Sweden, where the government nationalized the banks, and then after fixing them privatized the banks. He thinks about six months from now would be good timing, as most of the banks will be insolvent by then. The government does not have the risk of disturbing other solvent banks, if at that time it just moved in and nationalized the banks. Obama has cover, because already Republicans like Graham are endorsing nationalization as an option. And Republicans would prefer nationalization over putting in trillions of dollars into banks, and letting good dollars go in after bad. Roubini says that between guarantees, liquidity support and capitalization, the government has provided between $7 trillion to $9 trillion to help the financial system. Defacto the government is already controlling a big chunk of the banking system he says. This would just make it official. Another reason for doing this, is that the earlier solution of taking one failed bank or financial institution and merging it with another, as was done for Merrill, Countrywide, Bear Stearns, WaMu, is like merging two zombie banks. The result is not a stronger institution but one that is just as weak as before. In his picturesque language he says its like having two drunks trying to keep each other standing. He would like to see the big bank split into three or four pieces, creating a number of regional or national banks that are stronger. Because nationalization has become the N-word he says, it could be referred to as temporary receivership. Has Roubini been more prescient than others? No, says Roubini, a number of other people got it right. Robert Shiller on the housing bubble, Steve Roach on asset and consumption bubbles, Ken Rogoff on global imbalances in the current account deficit. He says he put the dots together and gave a more fleshed out picture. This interview was conducted by a fellow Professor of Roubini's at the Stern School of Business of New York University, Tunku Varadarajan. What about Greenspan? I think he says, a belief in market economics led to an excessive ideological belief that there are no market failures and no issues of distortions of incentives. "Central banks were created to provide financial stability. Greenspan forgot this, and it was a mistake. I think there were ideological blinders, taking Ayn Rand's view of the world to an extreme." Did the media play its proper role as this situation developed with all its inherent dangers, asks Varadarajan. In the bubble years everybody became a cheerleader, and the media became a cheerleader. The tough questions were not asked, and there was a failure there says Roubini. They failed in one of the duties of good journalism. The Masters of the Universe were on the cover, the imperial CEO, private equity, and others, no one asked how is it that this guy is producing such high returns each year, is it because he is so smart, or because he is taking on so much risk that he may face bankruptcy in two years? ...

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Important year end reveiw of the oil price forecasting work of so many anlaysts and where they failed . The IEA and the US Enery Dpt forecast have year after year underestimated this pirce by over 20%. Analysts change the price forecasts within a couple of weeks based on changing information and assumptions. Of all this the Saudi Arabian forecasts have ben within 12 % of what has actually ocurred according to a study by Ronald Berger Strategy Consultants of Muich, Germany. And whats their forecast for 2008. By extrapolating from the Saudi budget and the assumptions, used such as giving a wide margin to avoid a deficit in the budget if oil prices undershot by a wide margin, one gets $75 for US benchmark crude. Forecast by experts are in the neighborhood of $80 average for the whole year 2008. Goldman recently revised theirs upwards from $85 average for 2008 to $95 within a 4 week period. How good is the Goldman forecast. No one really knows. Lehman has a forecast of $84 average for 2008 and bases it on the opacity of the market because no one knows what OPEC will do with supply and China does not provide good information on demand. So basically anlysts are adding an uncertainty premium to the price of oil. And this is especially so because as the Chief Economist at IEA says global space capacity is so thin and any event can influence price. Last year the rhetoric about Irans nuclear intentions was enough to stir up the price, as were other smaller events disrupting supplies. But the Iranian situation has since cooled down and diplomatic solutions are in the works. So what to expect in 2008 in the way of political uncertainty. Iraq, Iran, Palestine, Lebanon have all seen a cool off in the ast couple of years and the Bush administration rhetoric has become outmoded as has other rhetoric from Iran so that does'nt look like it will stir up oil prices in 2008. Still there will be some uncertainty premium about supply from OPEC and demand from China and India. And demand from the Middle Eastern oil producing countries themselves as well as the increasing demand in India and China will mean that lower demand in the US because of a recession will still mean an increase in global demand over 2007 of 1.5 million barrrels a day over 2007's 85 million barrels a day. What will change the dynamics of this situation is the government mandated fuel economy for all vehicles on the road with Europe more aggressive in this area under the pressures of global warming. If this impacts India, China and Russia as these fuel saving technologies are transferrred there overall consumption should see an impact. Europe's targets are only 4 years away for 2012. And the environment may cause China to bring in newer technologies that both contribute to improving environment and conserving energy. Because China's environmental record is almost catastrophic one could see some of this happen much sooner than expected after the Olympics in 2008. All that might change the way the world looks at oil and its use, and all energy sources and their use. ...

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Business Week's Chad Terhune points out that the health reform bill that passed Congress will do little to restrain the overbilling by pharmaceutical companies, medical device and equipment makers. Chad cites numbers from the U.S. Health and Human Services Department that shows $47 billion in Medicare spending went to dubious claims in the year ending Sept 30, 2009. This is 10% of the $440 billion Medicare program. And 10% of the Medicaid program also goes to dubious claims. Consider then that Congres allocated $10 million annual increase to fight fraud. A suit filed by a former Siemens manager at the federal court in Philadelphia states that Siemens routinely overbilled the Veterans Affairs Department and other governmental agencies by humndreds of millions of dollars for MRI and CT scan machines.

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Long term changes in voting patterns, with voters shifting allegiance to third parties in larger numbers led to the need for a coailtion government. The Liberals with 23% of the votes won 57 seats. In this election 35% of the vote went to third parties, the highest proportion since 1918, and these patterns are seen as likely to remain. Far smaller number of seats now are close Tory and Labor contested elections, and the Conservatives win their constituencies with large majorities, as a result some of the Tory votes does not register in the way of seats. With a seven point lead over Labor Margaret Thatcher won an overall majority of 44, now Cameron struggled all the way and fell short.

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The public option as anecessary step for effective cost control in healthcare in the USA. The potential for higher healthcare costs in the future gutting the whole effort to provide universal health care if there isn't the money to pay for it. Which means that if the public option brings costs down its anessential part of any healthcare program that is sustainable years from now. Krugman calls for audacity from the President.

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Senate Finance Committee chairman says Senate Democrats have found ways to reduce the cost of the health care plan from $1.6 trillion to $1 trillion. A tax on some employer provided health benefits, cuts in Medicare and Medicaid spending, employers helping to pay the cost of health insurance for low-income workers, and limiting the eligibility for subsidies to households with incomes at 3 times the poverty level or $66,150, instead of 4 times the poverty level. Also a reduction in the plan to give tax credits to small businesses to help them buy insurance. And expansion of Medicad would be delayed to 2013.

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The American Medical Association came out against the public option in President Obama's health care reform plan. The outpouring of comments on this article show that public opinion today seriously questions the actions of the AMA, and think that this is not in the best interests of the nation. Its the kind of outpouring of criticism that GM's old management received from readers fed up with the management of the Detroit automakers, before the GM bankruptcy. Out of the 26 most read or recommended comments on this article shown on the link to the article in the NYT, 25 were strongly critical of the AMA's position on health care, none were in favor, and one was critical of the insurance companies. The 25 that were strongly critical had a total of reader recommends of 6539 readers when they were totalled up for all 25 comments. Some of these comments were strongly critical and explained at length why. Some were from doctors who disassociated themselves from the AMA. One suggested that the American College of Physicians also represented doctors, and the AMA represented only one group of mostly older doctors who are against any change. The financial crisis and the election of a new President, the changes in the country since the last failed reform effort in 1993, the new mood of the country as it changes to its more frugal past, a new generation of doctors and a new generation of young people coming to the fore, all may mean that things are no longer the same, and actually very different. Are the people running the AMA, like the people who were running GM a short time ago, not able to see how they are perceived by the public? ...

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To overcome resistance on Capitol Hill Obama takes his proposals for health care to the states and back to the grassroots support that got him elected. He will hold atown hall meeting in Virginia on health care. Obama advisor Axelrod says the main thing is to show what widespread support Obama's proposals have across the country. As ameans to this Obama's main political group Organizing for America will swing into action in the weeks ahead.Obama is talking to governors, Democrat Christine Gregoire of Washington, and Republican Michael ROunds of SOuth Dakota,

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The Institute of Medicine releases areport of the 100 health topics that should get high priority, as the Obama adinistration proceeds with a plan to $1.1 billion to compare the effectivenesss of treatments. Some of these areas for research are prostate cancer treatments, a surgical procedure called ablation, and others.

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The NYT editorial says budget reconciliation should kick in if by a certain date in the fall bipartisan agreement is not reached. With budget reconciliation, the term for a expedited processs, health care legislation can pass by a simple majority vote. NYT says bipartisan agreement is a good thing, but more important is effective health care reform. And there is little evidence of Republican cooperation so far on any issue.

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WSJ's CEO council advocates a goal of 10% electric cars by 2020 and upto 50% of the fleet by 2030. Other top priorities of the CEO's from Google, Intel, Time-Warner, Fedex and other companies at a recent 1 day conference were obesity, a stimulus program in excess of $300 billion, and restarting the Doha round of talks for global trade.

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With 10.3 million workers unemployed according to the Bureau of Labor Statistics, and this includes 2.8 million added this year so far in 2008. Most of the people who lost their jobs also lost their health benefits. This increases the urgency for the Obama administration to come up with action in the health care area as the ranks of the uninsured will grow in 2009.