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Th cost of cancer drugs Avastin and Erbitux and the need for putting life savings at risk for a few months of treatment create tension among families, doctors and treatment providers. A course of Avastin could run $56,000 and take 90 days for reimbursement by meicare or pricate insurance, and a 20% co-pay comes to $11,200.

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Meet Victor Brown, one of the remaining 450 workers at Buick City, GM's sprawling plants in Flint, where in the 1980's 27,000 workers built GM cars. Victor Brown of Clio, Michigan, and O.C. Cooper do not want to leave, and have repeatedly turned down buyout offers from GM preferring to stay with GM even if it enters bankruptcy, and take their chances. Since 2006, GM has persuaded 60,000 of its hourly employees- about half of the total hourly workforce at GM in the USA- to take cash buyouts and leave. Cooper says, this is the only life he knows, he is 64, a machine operator at Flint North, a run down engine plant in Flint, Michigan. Every day for the 42 years he has worked here, he gets up, washes up, and drives to the plant. He can't imagine anything else. If he leaves he will give up $60,000, for apension half that amount, with no guarantee that its secure after a GM bankruptcy. Victor Brown is 55, a repairman with 36 years at GM, he is divorced and putting a son through college. A year ago he and others turned down a buyout offer for $62,500 to retire with all benefits, now this is down to $20,000, and a car voucher for $25,000. GM needs an additional 21,000 jobs to be cut and closing of 13 plants in its latest restructuring under help and supervision from the Obama administration. ...

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The current economic expansion in the U.S. in April 2014 is at 58 months from the beginning of recovery in 2009. In this exceptional account Josh Zombrun of WSJ compares the current expansion to previous expansions since 1950, with the views of experts such as Stan Hall of the NBER committee, which studies turning points. This expansion is forecast to go for 90 months into 2016 by the U.S. Federal Reserve, and 102 months into 2017 by the CBO. Sooner or later, says Stan Hall, some adverse unpredictable event takes place that ends the expansion. So far the expansion has been slow and protracted, as predicted by economists Reinhart and Rogoff from previous financial crises in the last century, giving it room to grow as corporate earnings continue to improve. Fed chairwoman's sense of slack in the economy also provides room for employment and incomes to grow in the later stages of the expansion. This is good news for the emerging market economies such as India and China, and for the European Union, faced with slowing growth. So how does this expansion compare with earlier ones. The expansion of the 1991-2001 of the tech boom was 120 months, 1961-1969 of the Sixties 106 months, 1982-1990 of the Reagan era 92 months. The controversial one on shaky foundations is the recent housing boom 2001-2007 of 73 months ending in a huge bust with the 2008 financial crisis. The shorter expansions are the 1975-1980 Post-Vietnam one for 58 months, and the 1970-1973 spurt before the OPEC price surge. Figures are from the NBER, CBO and the Federal Reserve's Summary of Economic Projections....

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The impact of foreclosure in one Detroit neighborhood called Boston-Edison, where Henry Ford once lived and how the residents who have a neighborhood association going back many years to the 1920's are coping. The human consequences of foreclosures for a neighborhood. How could either side win, the lenders or the borrowers in a foreclosure situation and the need for the government to step in and bring some sense to the whole thing before it sinks both and blights towns and neighborhoods across America. One home bought for $179,000 in April 2006 was sold in the Boston-Edison area for guess how much, $6,500. Which shows that by the time thieves who for the copper and metal mining of these homes can destroy tens of thousands of dollars in value in minutes, and the deterioration of the neighborhood with crime and boarded up looks, and the very presence of foreclosures on each street destroys enormous amounts of value so that in this case the bank and its lenders got how much, less than $6500 or less than 4% of its original price. Repeated all across America this just does not make sense. Just as it never made sense for those who benefitted from the housing boom to say that subprime lending was a good thing because it brought home ownership to the less well off. Only lending that is at rates that are reasonable and considers the borrowers true finances, and on ethical and fair terms can be good lending and only government regulation designed to be easily enforceable and keeps lenders responsible, can ensure that this happens, as a free market is not good for this sort of thing. And this is all the more true for lending to those who are less well of because their ability to screen these contracts and their wording is not adequate and their own understanding of their finances inadequate. Barclay's Capital estimates that there are 811,000 bank owned homes in the USA, up from 129,000 in 2006, and predicts that it will grow by 60% before peaking in late 2009. ...

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The costs benefits and savings in a patient focussed practice. The new models of thes practices that are emerging such as amonthly payment of $54-129 per patient to the doctor and insurance only to cover hospitalization and catastrophic illness. The satisfaction of patients who avoid crowded doctors waiting rooms and avoid having to limit their questions. and get in and out quickly. The satisfaction doctors derive fom not having to rush through the day's schedule. The reduction in emergency care visits as patients better m=nderstand and manage their medical conditions.

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Republican governors hold governorships in 30 states in the U.S. They have a different perspective on the expansion of Medicaid envisaged in the healthcare law, as long term funding for the expansion is uncertain. With the deficit reduction planned in negotiations between president Obama and the Republican controlled House the outlook for money going to state funding is precarious.

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Romney emphasizes that he supports some of the popular parts of the Obama Healthcare Law such as coverage for people with pre-existing conditions. He tells voters he got everybody in his state insured. He also says there will not be a huge cut in taxes that would worsen the deficit. He would close loopholes and deductions to offset any deductions as shown by his advisor Harvard economist Martin Feldstein. The idea is to get a message across that will resonate with women, minorities, the middle class, workers, and business- the 100%, something he is able to do with some credibility having come from Massachusetts, a liberal state in the eastern United States.

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China's new prime minister Li Keqiang makes his first foreign trip with a trade delegation for talks with Indian representatives and business leaders, showing the importance he places on India. India offers China's companies access to large opportunties in infrastructure development, and China can benefit from India in the area of information technology and pharmaceuticals. Trade is envisioned as expanding from $70 billion in 2012 to $100 billion by 2015, and expanding rapidly as the two economies grow. Economic contacts also would provide an anchor for future relations as China faces difficulties in its relations with Japan, and S. E. Asian countries, and a U.S. wary of China's capabilities. This was pointed out in the joint statement. Li Keqiang also emphasized this in an editorial page article in India's daily newspaper, the Hindu, saying India and China have "to work hand in hand," to promote Asia as "an anchor for world peace." A peaceful India-China trade and economic relationship opens the way for investment and participation in development by China alongside Japan, Germany, France, UK and the U.S. in India, as the next major source for global economic growth. This also serves to defuse Asian tensions as both economies grow, and increased contacts between cities in India and China with the twining of cities program launched in the meetings. India can use China's capabilities in infrastructure development, the two countries share the need for information sharing on lowcost solutions in healthcare, in managing urbanization, and solutions for clean water in rural areas, and use of IT solutions in development, where much remains to be accomplished through cooperation. Some of these themes are the focus of Li Keqiang in his efforts for urbanization in China. ...

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Leonhardt says that there is little reason to think that the flatter rates are better always. With the need to finance Medicare and health care for all, the government can use the extra dollars from taxing the very wealthy, the very rich in different tax brackets. The top bracket in 2008 started at 357,000, and you paid 35% whether you made 400,000, or $4 million, or $40 million. So basically the upper middle class was lumped in with the extremely wealthy. And considering the cost of college tutions for 2 or 3 kids, the upper middle class is only middle class. It makes sense not to lump the two together. Considering that there has been a lot of wealth accumulated at the the very high end, it would also reduce inequality, generate tax revenues for health care, and not have much effect in the incentives for generating economic growth. It is something he says the Obama adminisstration may and should consider.

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Inflation was a little above the eurozone average of 0.7% for Jan. 2014 in Germany and below the average in Portugal, Spain, and Ireland.

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The economic crisis in the Russian city of Yaroslavl, 150 miles northeast of Moscow on the Volga river. Auto sales are down 30% and the city's diesel engine making plant is down to working only 3 days aweek. Many of the other factories and plants here are laying off people and are also on 3 days a week. Cafes and bars in the city are empty and people are filling job search centers.

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This review of Acemoglu and Robinson in the MIT News is relevant to the situation faced today. The two professors at MIT and University of Chicago, have provided two books relevant to today's crises, the first "When Nations Fail" in 2012 about the need for inclusive nations, and the second "The Narrow Corridor" about the importance of the role of individual and society in sustaining democracy. Their point in the first book "When Nations Fail" in 2012 coming after the financial crisis caused by banking excesses stated that the nations fail when they are not inclusive.  In practice it is about " the system being rigged" to favor some groups as the Republican party and Mr. Trump say has happened. The banks and lobbyists, pharmaceutical industry and lobbyists, tech industry and lobbyists, leading to a system where individual and society are pushed into a corner. Social theorist and economists fail to look at things in practice such as profit seeking behaviours and unethical behaviour that goes unchecked, which continued after the financial crisis into the election of 2016, with charges of rigged systems.  This week Germany's DW.com oped pages covered New York with the statement that treatment in New York costs $15,000 for coronavirus infection illness yet many New York residents in the worst affected neighborhoods would find a $500 expense difficult to bear. Early closing of schools to control infection rate was resisted by Mayor De Blasio of New York because many parents depended on schools for lunches for their kids. The situation had been allowed to deteriorate to that level.  In their second book the MIT authors are saying that the role of the individual and society are important to check that of the state (for example if it is perceived as being rigged by the influence of lobbying of legislators and politicians as the Republican party and Mr. Trump have maintained). It is only when it is checked and there is some tension is there the possibility of democracy and democratic processes, say the two MIT authors. In the absence of this the states and elites of politicians and business interests supporting the leaders and their common behaviours, become a perpetual state, in effect a one party rule of two parties with similar behaviours and interests in the state. A situation that allowed the outshoring of American manufacturing and European manufacturing to China including critical infrastructure, essential infrastructure over 2 decades even over the protests of Mr. Lighthizer since 2010. As the twin crises evolved in Europe of austerity policies after banking excesses in Europe, and the migration crisis of migrants coming from North Africa and the wars in the Middle East, a similar situation began to develop in Europe as the political elites entrenched in Germany, France, and Spain faced new voices. The tensions that arose were constructive bringing in the role of society and individual that the MIT authors say are so necessary for the narrow corridor of democratic process to function. New parties emerged in France with Macron's La Republique En Marche, Podemos and Ciudadanos in Spain, and in Germany with the SPD and CDU shrinking till the revival of Merkel for her handling of the pandemic. Coming from an intuitive way born from experience in East Germany, Germany's recent president Joachim Gauck, civil rights activist  came up with the same ideas. He is a Lutheran pastor in former East Germany who struggled against the government of the German Democratic Republic (former communist East Germany) for a role for individual and society against the state. We profiled and quoted him in "The Way Forward"  column in Lyrarc.com. Gauck's point was that  having diverse groups in the conversation is important, not excluding others from outside in the conversation is important. Gauck called  debate "the oxygen of democracy,"  that needed to be maintained.  Genuine democratic process is hard to sustain, it happens only when the role of individual and society is given prominence, so that only a narrow corridor exists for democracy, a narrow space in which can be sustained only if the effort is there, the goodwill is there, and the grace of Divine Providence.  It is fragile and it is critical to sustain.   In this sense the sometimes heated debate in the U.S. and Europe, Asia and Latin America about words such as- austerity, community, solidarity, migration, New York Mayor De Blasio's choice between school lunches and infections, about infrastructure, pharmaceutical prices, infrastructure, outshoring, jobs sent overseas, manufacturing locally, made in USA or made in India or made in France, Atmannirbhar Bharat, misallocation of capital starving health and public services, are all relevant and essential for democracy. This includes the discussion to avoid use of the military in protests in American cities in the middle of a pandemic which just crossed the 2 million mark in cases in the U.S., that was taken up by Defense Secretary Esper. In it lies the hope for democracy and many voices. Der Spiegel recent look at the pandemic how it happened in China, closes with the line- you need more than one voice in society. A constant reminder that many voices be heard, counseling patience, but also that wise choices be made with divine providence.           ...

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Mr Leung, the highly unpopular Chief Executive of Hong Kong, and target of protesters demanding his resignation and universal suffrage in 2017 as originally promised, is a reserved man who does not interact much with the public. His secondary scholing was at Kings School in Hong Kong followed by studies at Hong Kong Polytechnic for a higher diploma in building surveying. He then studied valuation and estate management at Bristol Polytechnic in Britain graduating in 1977. He was a surveyor by training and worked in this field to help China open up its property markets in the 1980's. By 30 he was made head of the JLW real estate firm's Hong Kong branch, and in 1993 formed his own firm DTZ Debenham. Throughout his life he has worked for or had close ties to the authorites in Beijing in the property field, and has little political experience. In 1985 he was elected to the Hong Kong Basic Law Consultative Committee, and later became its Secretary General. This was followed by a position in the Chinese government as a member of the National Standing Committee of the Chinese People's Political Consultative Conference till 2012. His first political campaign in 2012 was itself of a limited nature because he only had to win support from members of a 1200 member pro-China, pro-business Executive Council that currently approves nominees and elects the Chief Executive. Albert Ho, one of three candidates in 2012, says Leung was completely insulated from political pressures, political give and take, and uses a "greenhouse" comparison to describe this isolation from the public. His progressive credentials for providing affordable housing involve ideas to open up housing development in territories near Hong Kong appear to be merely election period ideas. The large gaps between rich and poor, or rich and a struggling middle class in Hong Kong- becoming sharply accentuated in China to the point where China is probably one of the most unequal societies similiar to Brazil- are also keenly present in Hong Kong. How much part this plays in the protests is not clear in media reports, though the "Occupy Central" name for one of the protest groups suggests a connection to social issues as well. Protestors may see democratically elected chief executives as more responsive to voter concerns including social, income, housing and other issues, in sharp contrast to more than 1200 well heeled business executives who have prospered greatly in China's boom years. China's national leadership under Jinping and LiKeqiang appeared to sense this income divide as they focussed on extragavant displays of wealth in the transition, but may still have failed to grasp how big that gap has become and how the political processes of rigid control cannot keep up with the times even with the best of intentions. Especially when growth slows and the problems of the boom years such as hyperinflation in property prices and pollution remain unsolved. Bloomberg quietly let the Occupy Wall Sreet protests fizzle out clearing protestors at times, yet voters could peacefully elect Mr. Blasio as Mayor of New York in response, a level to which Beijing's political system has not evolved and to which Hong Kong offers both a challenge and an opportunity. As one protester quoted in the NYT put it- "we are not the enemy, we are the people."...

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Krugman looks at the economies of indusrialized countries in 2014-2015. He points to the errors made by the Riksbank in Sweden to increase interest rates prematurely when a recovery was not on firm ground, ignoring the advice of deputy governor Lars Svensson. Sweden now faces the prospect of little growth and deflationary tendencies. He compares the decision of the ECB to raise rates in 2011 with Japan's decision to prematurely raise rates. The austerity policies in the EU driven by Germany and the lack of political consensus in the U.S., are faulted for making the situation worse when compared to Japan's poor handling of the situation. He says fiscal policy did not do enough in Japan to create growth, in the EU he says austerity policies were actually destructive of growth.

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The commodities boom allowed Brazil under president Lula to commit to heavy state spending, subisidies, protection of favored sectors with large tariffs, that led to inefficiency and high debt. The policies continued under president Rousseff. Corruption scandals in the latter part of the Lula administration led to more populist policies for the Workers Party to stay in power, says Porter. Compared to Mexico and Chile, Brazil and Argentina under presidents Lula and Kirchner moved in the direction to closing up their economies to trade and foreign investment that would make corporate sectors more competitive and less dependent on the state for subsidies and favors. Mexico's economy other than the automobile sector is struggling, as mismanagement also plays a part as with the handling of Pemex and huge capital injections needed. Mindfulness and thoughtfulness is needed in setting policy direction, aware of the risks free of illusions about rosy scenarios, knowing that ideology plays less of a part than exercizing good judgement....

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The Economist points out that China's total debt of government, corporate and households has grown by about 100% of GDP since 2008. The 2009 crisis led to rapid increase in debt. It is now about 250% of GDP, according to the Economist. Slower growth of below 7% risks reducing China's ability to service this debt. About half of this debt is owed by state owned companies and property developers. China can use its sovereign reserves to continue supporting bank and state owned companies. Investor's are pricing bank shares to reflect about 10% of this debt as bad debt even though government estimates are much lower. The reserves provided China time to fix the banking system since 2008, yet the debt keeps growing and China has failed to take strong action in the last 6 years. Complacency is a problem, and the incentives for local governments to continue prior practices that increase debt continue. As Krugman and other experts have pointed out at some point the rules of finance will apply to China as they have for other countries that faced a debt crisis- Japan in the late 1980's, South Korea and other Aisan countries in 1997, and the U.S. in 2008. Even without a crisis through deft managemen and use of reserves China risks zombifying the economy as old loans are backed up by new loans, with the further risk of misallocation of capital or poor use of capital. This lowers productivity of capital and hurts development. With poor statistics such as the figure of 1% of debt being bad debt cited here, the problems of complacency can be magnified, as there is less reason for a strong response....