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The publisher of the Wall Street Journal, Dow Jones & Co., is working to overturn a court injunction that prevents the public from seeing the Medicare billing records of individual doctors. Dow Jones & Co., filed court papers in January 2011, to overturn the court injunction. The American Medical Association has fought to keep secret the amounts of money individual doctors get paid by Medicare. The AMA filed a lawsuit against the government to keep secret these Medicare records, on the grounds of privacy rights, and won a court ruling in 1979. This court ruling still stands. The position of Dow Jones in its efforts to change this situation, is that giving the public access to the records is essential to the monitoring of so large a public expense as Medicare. These records would then be available to state medical boards, nonprofit organizations, universities and newspapers who can act as watchdogs over the $500 billion Medicare program. Such transparency and monitoring is an essential feature for the proper functioning of such programs and to prevent misuse of public money. For a program like Medicare, fraud and waste has enormous implications, as it adds to the spiralling cost of healthcare and to the unsustainable budget deficits. In one of the largest cases so far, the FBI, Justice Department, 700 state, federal and local agents, worked together to charge 114 defendents nationwide with Medicare fraud in February 2011. A senior law enforcemet official says Medicare fraud is so rampant, "there's no way in hell you can prosecute your way out of this problem, no way." He says the the answer is more effective monitoring of the money that goes out. And a key part of that is transparency and public access to how the money in Medicare is spent, what individual doctors and healthcare providers are getting paid by Medicare. The lack of this transparency for a program the size of Medicare can only lead to a lack of monitoring as the Dow Jones suit asserts, and make it difficult for the government to check abuses in the way money goes out. At a time when teachers and public workers and seniors are expected to make their share of the sacrifices to fix the budget deficits, it is incomprehensible that money should then be allowed to go out of the Medicare system through fraud and waste, because of a lack of transparency....

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Detail about Tata's $2500 car. What it looks like- a jelly bean small in front, larger in the back for aerodynamics, 30-35 horsepower, with bearings good for 45 mph, top speed 75 mph, trunk in front to hold a briefcase and battery, rear mounted engine with continuous variable transmission, a hollowed out steering wheel shaft, engine designed by Bosch 600 to 660 cubic centimetres 35 hp. Tata CEO, Ratan Tata, says in a interview the car will do far better on emissions than today's low end cars, and that the emissions standards were much easier to meet than the crash and safety tests, because of the lightness of the vehicle. Todays lower emissions standards in developing countries makes it easier by not having to use more expensive technologies. Electronic sourcing and internet auctions are used by Tata to a greater degree, 30-40 % of parts sourced this way compared to 10-15% by other larger carmakers. This helps meet the aggressive cost target. On the safety isssue its interesting to note that most of the people buying this car will be millions of motorcycle families and individuals (typically a couple of people can ride an Indian motorcycle). They may be safer in a light car than on a motorcycle. This has to be seen in the particular context of India. Renault-Nissan used the experience of lowcost car engineering techniques and secrets from its Logan car made in Romania and transferred it to its other models. Tata started with a clean sheet of paper, asked the quesion what they really had to have and was there some other way. It was Ratan Tata's dream to build a car in 1 lakh or 100,000 rupees or about $2500. The project had all out backing and tested Indian engineers ingenuity. The Tata effort will be studied by carmakers from around the world. Bosch does not underestimate the value of this business, as the car will target a market of hundreds of millions of people in India and China and developing countries. Ariba a supplier to Toyota, and BMW a supplier to Tata, helped Tata buy parts through electronic sourcing. China's Cherry Automobile company, another pioneer, had an Austrian firm help it design its engine for its small car. Tata worked with German company Bosch on the engine. And both must have used cutting edge technology but with a different goals and specifications to achieve unique tasks....

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Petrobras and the discovery 200 miles offfshore of the Tupi field with estimated reserves of 5-8 billion barrels of light crude oil. As Brazil is self sufficient in energy with its own ethanol industry helping substitute ethanol for oil at the pump, it can become a major exporter with this find. However even with Petrobras technology and expertise in offshore drilling its a challenge as the oil is 4.5 miles below the oceans surface, and involves drilling through 7000 feet of water and 17000 feet of sand rock and massive salt layer. Cost could approach $20 billion according to analysts with current inflation in oil drilling rig costs. It involves challenges like building floating liquefied natural gas plants. Gabrielli, the Petrobras CEO thinks Petrobras has the expertise to develop it on its own. If oil majors are given the chance to join in the development the investment terms will be ones that favor Brazil. Gabrielli pointed this out saying that Brazil had already incurred most of the risk in exploration offshore so the oil majors have far less risk and Brazil should invite them only on its own terms if needed. The Tupi field puts Brazil ahead of Canada in oil reserves and in the leagues of China and Nigeria, with new Brazilian reserves at 17.2 billion from the 12.2 billion barrels currently. Brazil has invested in refineries with 2 new refineries coming up in 2010 and 2014 to increase refining capacity by 40%. It is also investing to convert heavy crude oil into diesel and $8.6 billion to reduce sulfur at 11 refineries. The Tupi field will take about 7 years to develop. Similiarly the Kashgan field in the Caspian in Kazakhstan is also in difficult in this case icy and gases filled environment that will take years for a Eni led consortium to develop. When oil does come will the demand situation have changed with new conservation taking hold in the developed world and the cars in developing countries more like the Tata Nano at 54 miles per gallon consuming less gasoline? Even with increase in energy needs of developing countries, improved efficiency and new technology for conservation brought into developing countries could if not significantly reduce, at least moderate demand. To the point where prices drop from $100 a barrel to something more affordable to developing countries....

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Experts say this is the worst economic crisis since the Great Depression and it has gradually accelerated since October 2007 from a gradually unfolding housing crisis into a full blown credit markets crisis with the lack of transparency in mortgage securitization and the loss of confidence in the credit markets as mortgage securities values collapsed. The worst is still ahead as home prices have only fallen to a small extent so far and experts expect another 20% drop in prices this year and 2009. In the face of this crisis Immelt can be faulted for not using caution in his promises to the analyst community but to be so unforgiving for GE shares to fall 13% in one day and calls for breaking up the company or frustration at GE's inability to overcome what were clearly extremely unusual financial and real estate market conditions that may be a first in 40 years, is clearly overdone. Jack Welch who said he would be shocked beyond belief and shoot Immelt if he doesn't make what he promises now is also expressing some of that frustration, but beyond this is the inability to grasp the true extent of the situation in the markets that Welch never experienced first hand as he demanded and got his managers to deliver on results quarter after quarter or be fired for credibility problems ,because Welch's batting averages reflected a stretch of years where there were no crises of the magnitude of what Immelt is facing today. Upon further reflection Welch still stands by Immelt saying that this business about breaking up GE and Immelt's in trouble is crazy. And Immelt is building GE around the growth engines of the next big success stories in the growth engines of the future in Asia and the Middle East and emerging market countries of infrastructure, energy, aviation, health and environment, which would also be supported by the smaller but still significant growth of industrialized countries. And these things take time to put together a collection of winning businesses to be well positioned for future growth. Can GE accelerate sales or are there any shortcuts? Immelt doe not think so. Can he change things in a "severe and protracted" economic downturn as the Fed put it last month? Its beyond even large companies like GE....

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A couple of things can be noted about the burgeoning Chinese market for cars. Most car buyers are first time buyers. But that is to be expected as China started with a small bases of cars to begin with. What is interesting about these first time car buyers is that they ask a lot of questions do their research and are looking for the best car for the money in terms of features, safety, reliability. So its also a sophisticated first time buyer that carmakers are dealing with. This car buyer is also looking at waiting to save enough to buy a better car as far up the ladder as the car buyer can go in terms of features and value in safety, reliability, design, even if this means waiting longer and saving for longer periods.In this sense the Asian car buyer may be different and less bent on instant gratification to get into a 4 wheeled vehicle. What this is doing is putting the domestic manufacturers under a lot of pressure to match the overseas manufacturers. Geely and Cherry the larger domestic makers have to come up with just as good or better a product to get new customers. At this time the overseas makers of cars like the Buick Excelle, the Toyota Camry and the Volkswagen Jetta have the advantage as they are established brnads. Its interesting to compare this with the experience of japan the other large Asian carmarket. In Japan Toyota, Nissan and Honda were the only carmakes available because of trade barriers in the Japanese market in postwar Japan. China is a relatively open market and China's approach seems to be to get the Chinese carmakers to do better in an intensely competitive market as opposed to giving them favorable treatment. Another aspect of this first time car buying in a country where car sales have increased eight fold since 2000 and now exceed sales in the Japanese market, is that this market is abit precarious as the example of the Li family shows. Li Rifu purchased a Geely for $9000 but later after he contracted cancer and had $40,000 in medical bills had to sell the car. China has no social safety net so that if there is a medical or other emergency or crisis in the family there is nothing to fall back on and the family ends up selling the car to pay for expenses....

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Amazing! Just fresh from the foreclosure crisis and as the worst of the foreclosures are taking place between now and 2009 for subprime and other loans homebuilders and home sellers are financing the 3% downpayment required by FHA for loans from the is government agency. What do they hope to accomplish sell homes and have the government foot the bill when these homes also go into foreclosure in a downturn? Already above average default rates for seller assisted down payment programs will make this government agency the Federal Housing Administration ask for a government subsidy for the firtst time in its 74 year history. The FHA will need $1.4 billion next year. FHA estimates that down payments provided by nonprofit groups account for 34% of all 200,000 loans backed by the FHA so far this year, up from 18% in all of 2003, and less than 2% in 2000. And FHA says that borrowers are 2 to 3 times as likely to default on their payments when they receive a down payment from a nonprofit. The reckless manner in which homebuilders are selling these homes is unbelievable, more so in today's difficult economy. See the ads for these homes in this WSJ article and its is shocking. D.R. Horton is advertising 100% financing for 2 and 3 bedroom homes near the beach in Maui, costint $498,000, and a Seattle area builder Quadrant corporation is advertising townhomes for $500 downpayment. Use your coffee budget says a online promotion in the St Louis area! And though the risks are known to housing officials in the government they face a battle from well funded and coaltition of homebuilders, lowincome housing and minority groups. though its hard to understand how a home that ends in foreclosure for a low income group or minortiy group can benefit a minority group. Yet the Black and Hispanic caucus, people in Congress like Maxine Waters and Barney Frank still think it does as they continue to support the lobbying that keeps these kinds of loans going. Two examples given here of a Dick Whitmore and a Gloria Harris one saying it was impossible for him to come up with the $5000 downpayment and the other saying she was living from week to week suggest that they are likely to end up having difficulty making payments. ...

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Axel Weber, former Deutsce Bundesbank president, will becomes the new chairman of UBS bank in 2013.

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About $50 billion of the $170 billion in government money that went to AIG has gone to counterparties that bought credit default swaps from AIG, couterparties like Goldman Sachs, Merrill, Societe Generale, and Calyon another French bank. The Fed has resisted disclosure of these names. If the Fed had not done this insurance experts say some of these banks would have taken hits on their capital cushions, which they keep as reserve against such losses. And they say these banks would have been stretched if that happened. These counterparties were made whole against these losses. Critics ask why these counterparties should not have been compensated with a discount, so that they bore some risk and took a small haircut. But it appears that with the banks in a fragile condition the Fed decided to take this step.

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AIG CEO's own account of what happened at AIG and the bonuses.

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Germany's industrial union IG Metall with about 3.6 million workers is asking for 7 to 8% pay raise for its members. Goldman Sachs Dirk Schumacher says a rule of thumb is that the final deal is about half a high as the initial demand. Last year the demand was for 6.5 raise and the end result was a 4.1% aise in mid 2007 and a 1.7% raise this summer. That deal ends in November. A look at the graphs for last year side by side showing inflation and pay increases from the Federal Statistics Office of Germany shows that even with the pay increases granted the CPI monhly data for Germany or the rate of inflation is running higher than rate of pay raises. The German economy is not doing as well but experts say that it can absorb these moderate pay raises without affecting the attractiveness of exports and affecting demand in Germany. If anything inflation has accelerated compared to last year so for German workers the situation would be more like the status quo or just keeping up with their current situation. ...

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Sarkozy convened a meeting of European leaders in Paris over the weekend but getting concerted action by all members has not been easy, with each country taking its own steps. But there is no question that the credit crisis is hitting Europe hard. Germany guaranteed all customer deposits in banks without limit. It also rescued a big mortgage lender Hypocredit.

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OECD survey on India points to changing labor market regulation that limit the flexibility of firms to reduce labor if they do not need it, or if its not productive, or if other changes are planned. In a growing economy this should not be a fear that large numbers will be unemployed because a growing economy will create new jobs. And an economy like India's will grow far into the future. So the presence of the Communist Party in the coalition government of Manmohan Singh does act as a kind of of limiting factor as their view is shortsighted and does not see the larger picture. The other areas the OECD points to are government intervention in the economy and infrastructure. Infrastructure problems are huge but efforts are underway and gathering momentum because everybody agrees that his is a major major problem and will require lots and lots of investment in the future.

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A trial by Merck and Schering Plough that lasted 2 years with 720 patients in the Netherlands found that while Vytorin helped reduce cholesterol more than Zeta taken alone, the plaques of patients on Vytorin grew twice as fast as the one on Zeta alone. Vytorin is a combination of Zetia and Zocor in a single pill. About 60% of patients take Zetia in the Vytorin form. Zetia by itself reduces cholesterol by 15-20% but its not clear if it reduces the plaque formation in arteries at all. The trial was completed in April 2006 but released now only after articles were written about it in the media. Zetia and Vytorin account for 20% of the overall cholesterol lowering drug market. Its about 70% of Schering's earnings and about 100 million prescriptionhave been filled in US so far. The drugs cost $3 a day. For Merck its reputation after the Vioxx issues would be affected by these results leaving some doubts in the public mind.

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Sony's new smartphone, the Xperia Z2, with new 4-K camera and video technologies is shown in Barcelona. It has a noise cancelling headset and two speakers, a larger brighter 5.2 inch display. Sony also showed a new tablet, the Xperia Z2- slimmer, waterproof, and Sony says the lightest with a 10.1 inch display.

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All the extreme rhetoric on how Project 2025 is going to be adopted under a DJT administration has led to unease that there will be deterioration in the government and society.  Yet it simply may not work that way.   A second objective look at Project 2025 and how it's value to Republicans will be carefully evaluated piece by piece by DJT is needed. Keeping in mind 2026 House and Senate elections, winning broad support for the traditional Republican conservative line of thinking, and maintaining the support of all Republicans in the business, government, media and other sectors.  1. Replacing federal employees with party loyalists. This happens at the top of every agency of the government for every government in the US and Europe after an election for the last century. At today's unemployment level of 4 percent, adult males actually 3.9% and adult females 3.6%, and considering the higher salaries paid in the private sector, the tenuous nature of joining as a party loyalist as the national mood can shift at any time and things change again in 2027; where was the federal government going to find employees to be replaced at mid and lower levels? There is also the situation seen in 1928 when a Republican Hoover victory made Democrat NY Governor Al Smith compel a reluctant Franklin Roosevelt, who was just recovering from polio, to run for NY Governor. By 1931 over 3 years Franklin Roosevelt and Columbia University's Frances Perkins tested programs to stabilize employment in the US, introduce unemployment insurance as a new concept, and a 40 hour week also new, in the entire northeastern + midwestern states, all governors working together. By 1931 in just 3 years Franklin Roosevelt was on the clear path to sweeping victory in 1932 with a tested program to stabilize employment. 2.  The No. 1 goal is to restore the traditional family. It is clear in 2024 that the vast majority of Americans, whites, women as well as men, of all age groups, whites as well as Latinos and Asians, blacks, see that things like transgender "have somehow gone too far." 3. Cultural Literacy is needed for any nation to long survive. This is not even on any platform. Yet knowledge about America's history of settlement of the continent -correcting for treatment of American Indians, blacks, Chinese, Japanese without pointless race controversies- is being rapidly lost, and with it an understanding of America's civic institutions and Constitution, its founders and presidents, and evolution of the nation over the 20th century with the Industrial Revolution. The very terminology that has defined public knowledge about these United States is fast disappearing. It is a cause for unease in the minds of people in rural and urban, conservative and other parts of the political spectrum alike of what will happen to America as this is lost. 4. On immigration  a consensus was reached by president Biden that migrant flow was mishandled and the Lankford legislation offered by Republican leaders accepted by both parties to stop the flow. During his first term president Eisenhower conducted a program of returning illegal migrants to their home countries, Germany is doing this now and the UK's Labor party has made it No. 1 priority to stop migrant smuggling. 5. An effort to increase oil and gas production. This will help bring down the cost of living by reducing energy costs in the US and also helping Europe to do the same. Biden had already accepted the idea of the temporary need to do this to ease cost of living burden on the people of this Nation. The economic cost of wind and solar, are ultimate drivers for expanding renewable energy as major form of climate change action. In the first term of DJT 2016-2020 the lower cost of natural gas made it economical to switch from oil to gas. In the Biden term 2020-2024 all the effort to increase EV's on the road ran into the problem of lack of charging stations. It is possible that spread of charging stations could reverse this in the second term of DJT. It is the private sector and also the local governments that play a big part, climate change action will continue, and new R&D breakthroughs will happen to jump start it again.    ...

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This response by experts on transatlantic relations rejects the other view expressed in Zeit Online that the U.S. under Trump remains estranged from Germany and the EU. These experts from the American Institute for German Contemporary Studies, American German Council, and Centers at John Hopkins and Georgetown for German Studies, reject the view that the Trump administration and Germany are that far apart on many issues as it appears from media coverage.  Foremost it points out that civil society relations are sound and growing. About 50 million Americans trace their descent to Germany, including president Trump, much larger to over half the U.S. population considering European descent. Much larger is the sense of a culturally shared future with the European Union, with the nations of Europe including Germany, France, Italy, Spain, the nations of Eastern Europe, and Britain. The civil society relationships run deep in a way that is hardly affected by the Trump administration. Within the Trump administration the policies to Europe these experts remind the reader, are determined by the "adults" in the administration, who are senior members of the administration. This is a crucial point as Trump administration policy is not determined by the president's liking for tweets as much as by senior cabinet members Tillerson at the State Department, Gen. Mattis at Defense, Kelly at the White House, and senior members of Congress including Senators Corker and other senior committee members. This is why Republican Senator Kay Hutchinson was chosen as Ambassador to NATO. It should be noted in this context of German-EU relations in president Trump's first year that there was a period of German disillusionment with president Obama, exacerbated by the NSA spying on German chancellor Merkel and on the EU delegation to the UN, with president Obama's failure to offer any apology. Relations recovered from that low point. No one suggested that there be a German led decoupling of the EU with America at that low point, or at another low point in German-U.S. relations with the setup of American Pershing II nuclear missiles on German soil under the Reagan administration when there were large scale protests.  The American view that the U.S. should not have to shoulder major responsibilities for defense and foreign relations by itself is not new say these experts, and goes back to earlier administrations before Trump.  The experts argue for an active role by Germany with its partners in Europe for defense and foreign relations, which should not be seen as a result of U.S. pressure, only responding to the situation as it has evolved upto this time. Views on immigration are also changing with effort by the EU and Germany, France, to reduce immigration from the source countries in Africa, and the changing perceptions about uncontrolled immigration in Germany and France, say the authors. A coordinated policy towards Russia  is seen as not having changed. And much as a reset in relations was advocated by Obama in the first year of his first term, the current policy of the Trump administration to work with Russia to lower tensions can be seen in the same way say these experts, and not as a fundamental shift in American policy. The deep relationship of Germany and the EU with China is another positive aspect that will also help the U.S. in framing its own policies towards China. The German-American relationship, and the European Union relationship with the U.S.  is seen as basic to the values and interests of the U.S. and Europe. This relationship is too deep and supported by civil society and Congress, the Republican Party, and the Democratic Party, by large trade relationships, to be affected by temporary differences under any one administration. Even these differences are part of a larger debate that is part of dialogue on issues in a democratic society, sometimes raucous and loud, and could be welcomed and carefully channelled in constructive ways.     ...

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Mr. Rodrigo Maia, the 49 year old son of the former Mayor of Rio De Janeiro, Cesar Maia, is uniting Congressmen from all parties in Brazil's parliament to get things done and restore lost confidence, such as the recently passed pension reform. Brazil's pension system sucks up most of the money in the budget with overly generous benefits, leaving little to pay for essential public services such as sanitation and transportation. Shockingly sanitation has suffered as only 50% of the sewage is treated in Brazil.  Polls show confidence in parliament after corruption scandals and lack of work to help the people of Brazil with essential public services has fallen to an abysmal low of 7%. Only 50% of Brazil's sanitation is treated and the rest flows as untreated sewage and rubbish into the rivers. To bring some sanity to pensions the Brazilian parliament, with the organizing skills of Mr. Maia to bring parties together around the reform, has cut $240 billion over 10 years from pensions and introduced 65 years for men and 62 years for women as minimum retirement age.  Brazil has 33 parties and Mr. Maia's is with the centre right DEM party. How did this happen. This WSJ story says Rodrigo Maia, 49 years, was born in Santiago, Chile in 1970 during the days of Brazilian military dictatorship. His father was in exile in Chile. The election of a  far right figure Jair Bolsonaro who supported the military dictatorships record as president in the recent election was a warning sign for the different parties in Brazil on the centre right and the centre left that corruption scandals and a do-little spirit was wiping out their influence and destoroying their credibility with ordinary Brazilians. The pension cut reform was their response to gain some of the lost goodwill from the Brazilian people. In the past Brazil's members of the Chambers of Deputies were people of power and influence who held positions for long periods and passed on these positions to people in their families or in their close circle. The elections and democratic governments following years of dictatorship brought in a new class from centre right and centre left that mismanaged public finances and excluded new ideas. The Car Wash scandal and scandals at the state petroleum company under Da Silva's Workers Party led to loss of confidence not only in the centre left party government of Da Silva and the Workers Party, but also in a do-little parliament. The large state spending from the government was possible during the commodities boom from China with Brazilian iron ore and other products getting high prices. WIth the collapse of the commodities boom and lower prices the entire system of state spending has unraveled revealing how much generous pension system is damaging the financing of  basic public services.  Corruption is prevalent in many countries in Asia including India but nowhere has the spending on essential public services such as sanitation suffered as in Brazil. And nowhere was parliament and the government able to get away with staging Olympics, World Cup and building many stadiums, handing out generous benefits to gain public support as in Brazil when basic sanitation and health services were neglected in a shocking way. The health system was weakened to a great extent when it lacked the resources to tackle an outbreak of yellow fever in 2018 as it moved south from the Amazon region towards Sao Paulo and Rio de Janeiro. Protests against the lack of investment in public services such as transportation and bus systems resulted in the public protests in big cities that led to the rise of Jair Bolsonaro in an effort to bring new administration to tackle the problem of financing for infrastructure, public services, health and education.    ...

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Putin takes the first step for Russia to join in discussions for a lasting peace. More than a ceasefire is needed, as many ceasefires have come and gone and the war is now over 15 years old, pausing for a while and then starting again many times. Russia calls for addressing the underlying issues behind the war.  It started with Russian support for Yakunovich 2010-2014 which ended with the Maidan protests in Kviv and Lviv. Russian and Putin strategy at that time was that as long as  a pro-Russian or a person leaning towards Russia with good relations to the West -as existed in some of the former states in Eastern Europe during the 1980's during the Soviet Union such as Poland and GDR- this would be acceptable. The Maidan protest led upheaval thus had a contrary effect which Germany under Merkel and France under Sarkozy and Hollande failed to grasp. Obama judged Russia by its GDP, ignoring its history and relations among European states as one of the major powers in Europe, a technological state with nuclear power. As China shifted away making the integration of Hong Kong and now Taiwan a priority under president Xi, and asserting the virtue of its state run capitalist system over free market capitalism, the fissures began to develop in the system that prevailed after World War II and which survived the fall of the Berlin Wall. These are some of the origins of the war and are also in some of its aspects geopolitical and relate to world peace,, and peace inside nations in general outside the Ukraine war. And here relate to Venezuela Mexico and US inaction in tackling borders and cartels, the US border with Mexico, Syrian war and Syrian refugees entering Germany/Europe, the anti refugee movements in Germany and the EU, refugee crime in US and Europe, all connected in some way to the unsettled borders of the Russian state with US and Western European + Eastern European states in NATO and the EU nearby. And the limiting or removal of Russian influence in Ukraine seen by Russia as unacceptable in regions nearest to Russia that speak Russian. Britain has the virtues of its parliamentary democracy, yet it is far from Russia's borders and it just like the Russian Empire had an Empire in India and a near thing to an Empire in China, as recently as 1950, over history of western colonial empires of 500 years not too long ago. Which means it is good to be starry eyed but the reality in European history since 1400 is of dominant states and colliding or co-existing spheres of influence, mostly co-existing in some balance of different states in the interests of peace and welfare of the people.     ...

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The cultural shift as jobs in investment banking are not the status jobs anymore.

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Leonhardt points out that public workers receive lower salaries and higher benefits than private workers. They are being paid in the wrong ways. For example with health insurance coverage that require little or no co-payment, which lead to overuse of healthcare services that don't necessarily improve health. Politicians and unions appear to have accepted this practice over the years. Public sector unions have blocked efforts to improve efficiency and find better ways of doing things from the classroom to work in government offices. Reforms in states such as Indiana have produced some results. But even these improvements do not address the magnitude of the problems facing the U.S. which stem from the public's desire to have it all- from large defense spending, public services, low taxes and no changes to Social Security and Medicare. Polls show Americans want to reduce deficit spending, but the same polls show Americans unwilling to make some difficult choices.