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Rosa Ines Rivera, a cook at the cafeteria for the Y.H. Chan School of Public Health, Harvard University, with 2 small children, describes the protests over the increase by Harvard administration of the premiums charged on health insurance that now take up over 10% of the income. She says she lives in public housing with her parents as she lost her apartment because she is behind on the rent, and now cannot afford to pay the increase in premiums. About 750 workers at Harvard are on strike on this issue. She says dining hall workers want the current pay of $31,193  a year increased to $35,000 to provide a living wage that helps them afford medical care, because of the high cost of living in Boston.  To get some idea of the plight of workers who provide the kind of nutritious meals that a lot of students depend on for healthy living- Rivera says she takes in about $450 a week after taxes, or about $1800, rent is $1150, which leaves $650 for herself and two children for all food, and expenses in Boston. The $4000 in premiums for health insurance would be about 330 per month, leaving her about $320 for food and living expenses with 2 children. Why the need to bring up children in poverty in America, for generation after generation, after putting in a full day of work? ...

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The startling truth about health "reforms," - they won't control spending, and without that the whole system of health care will rapidly become unaffordable and unsustainable. Obama's Council of Economic Advisors points out in new report that since 1975 annual health spending per person, adjusted for inflation has grown 2.1 percentage points faster than overall economic growth per person. At this rate health spending which was 5% of the GDP in 1960, and is 18% of GDP today, would grow to 40% of GDP in 2040. Medicare and Medicaid would increase from 6% of GDP now to 15% in 2040, or equal to three fourths of federal spending. Employer paid insurance premiums for families which grew 85% in inflation adjusted terms from 1996 to $11,941 in 2006, would increase to $25,200 by 2025 and $45,000 in 2040. This would force employers to reduce take home pay. Samuelson says the uncontrolled health spending is singlehandedly determining national priorities, reducing discretionary income, raising taxes, widening budget deficits and squeezing other government programs, while it is producing large amount of waste in medical spending. See the link to Prof. Tyler Cowen of George Mason University in NYT, 6/14/ 2009, who cites the habit of doctors to write many expensive tests as one of the prime culprits in the wasteful spending. And in the process it delivers higher cost for lower overall quality of health for the American people. This at a time when many European countries provide live examples of doing it in a better way- lower cost, better health. The serious problem with the Obama health reforms says Samuelson is that it talks about restraining spending but may end up increasing spending. Its talk about controlling spending he says is good intentions, but based more on hopeful thinking, public realtions and risks becoming cosmetic reform. Because to really control spending will require coming to grips with its fundamental cause- hospitals and doctors are paid mostly on a fee-for-service basis and reimbursed by insurance, private or governmental. Such a system encourages doctors and hospitals to provide more services, expensive tests, favors heavy use of expensive medical technologies to increase profits, and for patients to expect them. Samuelson puts his finger on the root of the problem - there is no incentive and every disincentive for all the players in this game , doctors, hospitals and patients to seek reform of this system. For doctors and hospitals the hope would be that this cosmetic "reform" would leave the system basically unchanged, and patients to continue with a lifestyle and expectations that do not not acknowledge the fact that a lot of healthcare does not come from spending but from preventative care, education, good eating and exercize habits, and healthy lifestyles. And the uninsured are no exception, they would simply start consuming the expensive care for lower quality of overall health like everyone else. With this kind of situation confronting us, the views of Samuelson, and Professor Tyler Cowen of George Mason University, as welll as a growing chorus of informed public opinion on this subject, is that insuring the uninsured is a good idea, but doing it within the bounds of the present system, can only increase the costs. And too much is at risk, to rely on what Samuelson calls a scattershot of measures to control costs made up by Congress such as "evidence -based guidelines," "electronic record-keeping," "bundled payments to hospitals, to give the illusion of progress that won't make a serious difference. A sweeping restructuring of health care is needed, that would overhaul "fee-for-service" payment and reduce the fragmentation of care. It will also need what has not even be touched on adequately in the debate. This is the massive need for education in the schools about nutrition, eating, exercize, healthy lifestyles. It would also require opinion leaders in each field from sports and other fields to lead by example and with constant public presence, the media, and companies to form a partnership with private institutions to change existing eating habits and lifestyles that encourage obesity, smoking, fast food eating habits, large portions in restaurants....

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The toal loans held by the 15 largest banks declined by 2.8% in the second quarter, 2009. More than half of the new loans in April and Maycame from refinancing mortgages and renewing credt to businesses, not new loans, acording to an analysis by the WSJ.

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Some straight talk from Bethany McLean on why Congress which repealed Glass-Steagall and refused to regulate derivatives. She says the Fed and the SEC which did nothing while all the excesses and risky behaviour were playing out on Wall Street should also join Goldman on the hot seat. The Office of Thrift Supervision and the Comptroller of the Currency, she points out actually used their power not to protect but to prevent predatory lending laws. And the ratings agencies signed off with AA ratings for a lot of junk. McLean tells readers Goldman's idea that what is good for Goldman is good for America is downright scary. She is a former Goldman employee who reminds readers that Goldman's 14 principles had integrity right up on the list, something Tourre and other higherups at Goldman simply lost sight of.

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Charlie Rose talks to Paul Ryan, the Republican Congressman from Wisconsin on his "Roadmap for the Future" and a major overhaul of taxes, spending, Medicare and Social Security. He tells Rose, who hosts a news show on Bloomberg TV, that in 2010 he is all by himself looking at the big picture for shaping ideas on economic reform, and still hopes others will join him in this effort.

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Interview with Levinson of Genentech and answers to a wide range of questions about ther drug discovery process at Genentech, the cost of Avastin to treat cancer, the long years taken to develop the drug, the development and pricing of Lucentis for macular degeneration from the basic process of blocking the VEGF protein that helps the macular degeneration develop. The reasons for the pricing of Avastin- $55,000 for one year. And of Lucentis $2000 for one shot and the possible equivalence of Avastin and Lucentis so that doctors can take a small fractional dose of Avastin and use it in a tiny opthalmic syringe for cost of $50. The research budget of $1.86 billion. And the philosophy of Levinson about attracting the best scientists to Genentech by giving them opportunities as he puts it for "doing great science." And his emphasis on making Genentech a great place to work. Genentech was on Fortune's top twenty list 4 years in a row and No 1 in 2007 and No 2 in 2008 behind Google. Can Roche keep this up without Levinson and his team and the culture they have fostered, and the way they have created a great place to work ? ...

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Feldstein points out that Obama economic plans missed the real target, which was on the home front where it came down to addressing the problems of 15 million homeowners under water- with mortgages exceeding the value of their homes- and lack of solutions to deal with the $1.5 trillion in troubled commercial real estate loans. Administration plans really did not help more than a couple of hundred thousand homeowners to reduce their monthly mortgage payments. Getting banks to start lending again by selling impaired loans to nonbank investors, also failed to work, as banks were reluctant to do so and reduce their accounting capital. Health care legislation simply distracted attention from the real problems. See the links to Feldstein's repeated insistence that the new administration (and even during the late stages of the Bush administration) focus on these problems. Health care legislation that passed simply would not control the increase in health care spending, that the public correctly perceived as the real problem if the other health care issues were to be resolved. Instead Obama's health care legislation offered to increase the deficit to unsustainable levels, with no solutions to more pressing home front problems in sight. Feldstein, is one of the most eminent US economists....

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The recent appointment of fast food executive Andrew Puzder as Labor Secretary has caused great concern among union leaders. Puzder supports a $9 minimum wage compared to $15 supported by Democrats. Unions now represent 7% of the labor force, down from a high of 20% during Reagan's time when Reagan appointed a construction company executive as Labor Secretary and cut regulations.  Globalization has thinned the ranks of workers in unions. And the failure of Democratic administrations to stem the shift of factories overseas to China, Mexico and other places, as part of global supply chains focussed on cost, has weakened Democratic support among workers since the period of Bill Clinton. It eroded to the point where Obama won 65% of support among unions and Hillary Clinton won 56% in 2016. Interestingly the Republican Romney gained 33% versus 37% for Trump, showing voters were more inclined to move away from Democrats and only a smaller number willing to support Republicans, but the shift enough to give Republicans a win in 2016 for the presidency. The figures are from a Election Day survey of trade union AFL-CIO, and a larger proportion in midwestern states showed disaffection with policies from Clinton to Obama. In fact Obama spent years promoting another free trade agreement TPP that favored tech more than auto and older industries, just as Bill Clinton had promoted NAFTA, without giving thought to what this was doing to its worker base of support. A similar situation happened with Social Democrats in Germany as a SPD administration moved to the centre and handed Christian Democrats led by Merkel a win in parliamentary elections. As Democrats such as former Labor Secretary Reich, a professor at UC Berkeley who served under Bill Clinton, describe the problems of working class people their is less reflection on the impact of the changes from globalization and how Democrats handled or mishandled it, and more on the politics between the two parties.   ...

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Krugman points to some striking data in a U.S. Federal Reserve study, showing 47% of Americans do not have the money to meet an unexpected expense of $400 without selling something they own or borrowing. The is the 2nd year of this Federal Reserve study. It shows alarming information about the condition of retirement savings- about 30% of nonelderly Americans say they have no retirement savings or pension, and reported going without some kind of medical care because they could not handle the expense. About 25% say they or a family member experienced financial hardship this year.

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Government GDP figures show the GDP shrank by 1.8% in the third quarter of 2016 compared to the same period in 2015, the first such contraction in the economy since 2009. Household consumption was down 3.2%. The sharp decline in the value of the lira by 20% in 2016 makes imports costlier, in an economy dependent on consumption spending and tourism for higher GDP growth. Political uncertainty with instability in Turkey following a crackdown on opposition and media also leads to decline in foreign investment and investment by domestic firms.

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Congressional Budget Office projections show the difficult choices facing the U.S. - tackling the deficit by letting the Bush tax cuts and the payroll tax cuts expire will lead to low growth. The alternative is growth with much higher deficits. GDP growth would be at about 2.3% in this fiscal year if the payroll tax cut is kept till December 2012. In fiscal 2013 if a number of tax cuts are permitted to expire and across the board spending cuts take effect as scheduled GDP growth would decline to 1.1%. Taxes would increase by $465 billion in 2013 over 2012 if tax cuts expire - individuals and companies would pay $2.99 trillion in taxes in fiscal year 2013 in that scenario. Spending cuts would take effect in Jan 2013 for $1.2 trillion over 10 years. The result- " a sharp fiscal contraction" in the words of CBO director Elmendorf. Unemployment would go up to 8.9% in 2012 year end and 9.2% in 2013 yearend from 8.5% today, if no agreement is made to extend tax cuts and block spending cuts. The risk of not taking the debt reduction actions is to let the debt grow to $11 trillion over 10 years, an unsustainable path, compared to about $3.1 trillion over 10 years if tax cuts are permitted to expire and spending cuts take place. This is the tough choice facing America in 2012, and comes when Europe is facing similar tough choices....

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Feldstein says that for the 85% of the people who have healthcare the Obama proposals are not a good deal. The Obama proposals mean higher taxes in the long run to pay for the $1 trillion cost of healthcare for the uninsured group over 10 years. This lower income group has no coverage despite the $300 billion Medicaid program. Feldstein says there surely must be better and less costly ways of getting this lowincome group healthcare. Raising the top income tax rate to 45% from 35%- as a result of letting the Bush tax cuts expire and adding aproposed health surcharge on higher income individuals- would actually lower revenues for the government, as it would change behavior of high income individuals in ways that lower their taxable inome. The result is higher deficits and higher taxes when even without this large deficits are projected for the future. How to slow the rapid growth in healthcare spending? The Obama plan is to cut spending on Medicare. Feldstein sees the govenment's effort aimed at reducing the amount of medical services, as reduced spending comes from fewer services, not reduced payments to providers. Will this result in enough of acost reduction to make the system work. And if the cost reductions are too heavily weighted 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% who are accustomed to a different pattern of healthcare, even though it is structured to allow cost escalation. Feldstein offers no solutions to the problems of cost escalation except to suggest that the Obama plan does not really tackle the cost escalation issues directly with providers, and instead burdens the national finances to an extraordinary degree. And the need for apause and reflection....

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U.S. president Obama called Libya and the policy of not following up on helping establish a stable democratic government in Libya his biggest mistake. Kristof of the NYT says people looking back would say Syria and not establishing safe zones is Obama's biggest mistake. He describes the 470,000 deaths in Syria as a huge tragedy that could have been avoided to a large extent by setting up safe zones. In addition the UN estimates that millions of refugees on a scale similar to the partition of India in 1947 were created.There is bipartisan opinion on this. Kristof cites General Cartwright's opinion in a conversation he had with Cartwright that this should have been done. Others who agree are Madeleine Albright, Bill Clinton's Secretary of State, who spoke at the Democratic Convention about how America helped change her life as a young refugee after Russia's invasion of Czechoslovakia following Prague Spring. Albright says force should be used carefully so as not to aggravate the situation but action taken where needed, something that was done successfully under Bill Clinton in the Bosnian conflict following Serbia's ethnic cleansing policy under Milosevic. Not only that, with the diplomacy of ambassador Holbrooke Clinton was able to negotiate the peace accords that hold till today- a huge achievement.  Kori Schake, director of defense strategy in the George W. Bush White House also agrees. This would have improved U.S. relations with Turkey as this was a key Turkish request. And it would have reduced the dimensions of the refugee crisis in Europe, which has hurt the European Union. The Brexit "No" vote many in Britain have attributed to ads showing refugees in endless numbers streaming across Europe's borders. Similar ads were used in Austria's elections. Kristof points out that Secretary of State Kerry's job of negotiating a peace is difficult in these conditions. Another issue raised by Kristof is the lack of Obama's leadership in helping the refugees in Jordan, Lebanon and Turkey, as he points out only 41% of this is funded. David Miliband former British Foreign Secretary, who heads the International Rescue Committee , says 200,000 Syrian kids are growing up in Lebanon without an education. George Washington counseled against getting involved in the wars on the European continent for a young nation, this advice was not followed in the Reagan and other administrations without showing the carefulness needed before action is taken. As Hillary Clinton has once pointed out the situation has resembled a pendulum swinging in the other direction under president Obama, and former Defense Secretary, Panetta, has expressed similar views. Hillary Clinton and Leon Panetta, Gates, Gen. Jones, served in the first term of the Obama administration, many of these mistakes were made in the second term by president Obama and his White House advisors Dennis McDonough, Valerie Jarrett who clearly lacked the deep foreign policy experience of Hillary Clinton, Leon Panetta (who served under Bill Clinton), and Gates who served under many presidents). ...

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The drug industry which faces the prospect of losing billions of dollars in sales of epilepsy drugs if pharmacists substitute cheaper generics is using the Epilepsy Foundations state affiliates to lobby for legislatio which would make it harder for pharmacists to substitute generics for epilepsy. The FDA does not think generics are any different from the epilepsy drugs that will lose patent protection between 2008-2010.

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There are similarities in the Republican and Democratic party platforms in 2016. One area of agreement is in the reinstatement of Glass Steagall Act. That legislation made in the Depression period to separate commercial banking from investment banking was changed  when president Clinton made changes in a deal with Senators Phil Gramm and Jim Leach in 1999. The too big to fail problems of banks and the problems of investment banks during the 2008 financial crisis are attributed to the lack of Glass Steagall protections for financial stability and safety. The result is that in the post 2016 environment banks can expect a tougher regulatory environment. Another are is in trade where both parties are expected to take tougher positions to protect U.S. interests. The Republican platform calls for "better negotiated trade agreemets that put America first."

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Daily Show host, Jon Stewart, interviews US President Obama. Obama told Stewart that "it was fair" to say that Obama had done his work, in Stewart's words, in "a political manner that has papered over a foundation that is corrupt." Obama says "we got 90% of what we wanted," which reflects a huge gap between how he is seen by people in the U.S., and how he sees his first 2 years in office. Obama's defensive responses, and no efforts to connect with the youthful audience on the Daily Show. Stewart points to the gap between the "audacity" in the rhetoric of Obama, and the "timid" nature of his administration. Stewart made particular reference to the hiring of Larry Summers, a former Clinton administration official, to guide the President on economic policy and the dealings with the banks.

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Did U.S. Treaury Secretary, Timothy Geithner, ignore a key request by President Obama to present plans for the restructuring of Citigroup after the government bailout of Citigroup? Ron Suskind says this is what happened in his book on the Obama administration and how the White House operated to make key decisions. Ron Suskind, intervewed key members of the Obama White House economic policy team, Lawrence Summers, Christina Romer, Peter Orszag. In all Suskind conducted 700 hours of interviews for his new book in Sept 2011: "Confidence Men: Wall Street, Washington and the Education of a President." According to the book, in early 2009 after Obama authorized a series of stress tests for banks he told Geithner to develop a plan for restructuring Citigroup. A month later at a meeting not attended by Geithner Obama raised a question about the status of the plan. He was told by Romer that no restructuring plan had been developed for Citi. Suskind says Geithner disagreed about a plan to restructure Citi and decided to ignore the request. Geithner and the Treasury Department say Obama asked Geithner to develop a backup plan to overhaul banks if the government was forced to keep a big ownership stake in the companies, and "there was fortunately never a need to put them in place." Geithner told Suskind that he doesn't slow-walk the President on any matter. Other aspects of the operation of the economic policy team that Suskind covers are a series of memos from top aide Pete Rouse raising questions that ongoing communication between some members of the economic team and Summers was giving Summers power to shape policy. Summers, Director of the National Economic Council, is shown as trying to keep out the views of Romer and budget director Orszag from reaching the President without going through him. When Orszag gives a private report to the president on the deficit, Summers objects saying that this was immoral. Obama lacked the fresh ideas needed to tackle the problems created by the mortgage and banking crisis of 2008, when he used the Clinton administration economic policy team of the 1990's- Rubin, Bernanke, Summers and Geithner. Fresh approaches were needed two decades after Clinton's election in 1992, and the Bush administration that followed, as many of the problems developed during this period. The similiar embedded thinking was shared during the Clinton and Bush administrations and the economic advisors about dealings with the banking sector, but the situation for deficits, unemployment, housing, and the economy had completely changed requiring fresh approaches. ...