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The influence of the AMA convened Relative Value Scale Update Committee (RUC) on how the Medicare payments to doctors is shared, and on the growth of the Medicare budget. Concern that the interested party is driving the decision making process. Medicare costs went up by 9% in 2009. Fears that doctors have too much control over the dollars in the $500 billion Medicare program. The tendency to focus on more expensive procedures and short change preventive and less costly care. Medicare spends $60 billion on doctors fees. The older codes remain in place even when costs are reduced, leading to higher costs for the Medicare budget each year. And there is little incentive for doctors in RUC to revise overvalued codes.

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A 2011 survey by Universum shows technology firms such as Google, Apple and Facebook as the most preferred choice of university graduates during campus recruiting. Financial firms lag far behind, with J.P. Morgan Chase ranking 41st in that list. At Harvard Business School only 17% of the class went into investment banking and finance. Students from the University of Texas at Austin to Yale, say they want to build something tangible or follow their dream project.

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China's prime minister, Wen Jiabao says he supports policies supporting stimulus and growth along with prudent monetary policy and efforts to dampen real estate prices to increase affordability. Efforts to strike the right balance and keep growth of at least 7.5%.

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Samulelson points to the problems of pushing college-for-all. He compares it to the misguided housing policy that sought to promote housing access to all Americans including those who could not afford it by lowering requirements on credit and downpayments. Problems include student debt without job prospects, inadequate vocational training, and lowering educational standards at all levels including high school and college. Compared to Germany and other European countries the U.S. does poorly in providing vocational training and relating education in college to jobs through apprenticeship and other training in companies. Combining classroom and on-the-job training is more advanced in Europe. As sociologist Rehman of Northwestern University points out its important to set different pathways to rewarding careers. In 2008 the U.S. had only 480,000 workers or 0.3% of the labor force who were apprentices, according to Robert Lerman of American University. Useful to note is also that only 69% of U.S. jobs in 2010, required a post-high school degree, according to the Labor Department. Putting everybody on the college track, belittles those who do not finish college, ignores the need for vocational skills and technical skills in jobs, and puts the diploma above skills and knowledge gained.. Taking the approach to an extreme hurts young people in the job market and reduces America's competitiveness. This is similiar to what happened in housing policies that sounded good but actually devastated the financial condition of minorities that it was supposedly intended to help, as seen in high foreclosure rates....

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David Wessel points to some problems with the Paul Ryan budget proposal. Ryan's plan does not balance the budget till after 2030, and Congress would have to raise the debt ceiling each year till then. The changes to Medicare Ryan proposes would limit how much the government spends, but the savings from this do not come for a decade, as people expected to retire in the next 10 years will still have Medicare. Ryan's proposal shows how deep the cuts will have to be if deficit reduction is done without raising taxes. Pete Domenici and Alice Rivlin who developed a deficit reduction plan, said they were disappointed that the Ryan plan "fails to address the need for new revenue," which they consider crucial for truly tackling deficit reduction. The Obama budget failed to offer a comprehensive deficit reduction plan, leading to openness for new ideas. The health care delivery system in the U.S. needs to be efficient and costs need to come down. Ryan's proposal gives no idea where the efficiencies will come from. Would they come from competition between private insurers? How will escalating healthcare costs be controlled. Another consideration is that even with its problems Medicare is less costly to administer than private insurance. Everything depends on seniors shopping vigorously for the best premiums because risks and costs are borne by seniors, with the idea that this will somehow control escalating medical costs....

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Walk in clinics at drug stores like CVS and stores like Walmart now have the cooperation of hospitals. Hospitals are now affiliated with 25 Walmart clinics. THe Cleveland Clinic has lent its name and backup services to a number of CVS clinics in northeastern Ohio. And the Mayo Clinic is operaing ne Express care clinic at asupermarke in Rochester, Minnesota, and asecond one at ashopping mall. This helps clear emergency rooms of people seeking bsic medical care as for astrep throat or flu. About one thousand clincs are operating in the US at drugstores, supermarkets and big stores since the idea took root 4 years ago. Wal-Mart has partnered with hopitals like the Christus Medical Group in Texas, Aurora Health System in Wisconsin and COxHealth in Missouri to setup clinics. Mayo did so after employees and patients said they wanted more convenient treatment for minor medical problems, so there may be a need here that as not been met. The lower costs at these centers compared to primary care doctors offices or emergency rooms make it possible for them to price lower and meet the needs of the 45 million or so uninsured people in the US, numbers growing as jobless rate increases. They are typically staffed by nurse practitioers or physicians asistants. Dr Herman at Mayo Clinic, who supervises its retail store clinics, says rather than fight this trend primary care doctors should learn from it, and work with hospitals around the country to offer more convenient locations and consumer friendly office hours, including periods of walk-in care with no appointment....

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With 5.7 million jobs lost since December 2007 fewer people are paying payroll taxes to support Medicare and Social Security says Labor Secretary Solis. As aresult Medicare will run out of funds by 2017, 2 years earlier than predicted last year. Medicare and Social Security issued their annual report yesterday, suggesting the nation cannot afford the cost of Medicare at the rate of current expenditure growth. Social Security will run out of money by 2037 four years earlier than predicited before. The only way to keep Medicare solvent says Mr Geithner is to reduce the rate of growth of health care costs.

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Tyler Cowen, Professor of Economics at George Mason University, points out some basic truths about health care as it is practiced today in the USA, and healthcare spending as it stands today. He questions whether starting out with extra spending plans to provide coverage to all will help solve the basic problems facing American health care. Too many tests and diagnostic procedures used by doctors is not aproblem that will be solved by spending more money to cover everyone. And government taking on more spending to cover all will not address all the other major shortcomings of the American way of practicing medicine, like prescribing a battery of tests, that tend to drive up costs, to just mention one of the problems. And it will not address any of the shortcomings in the way Americans take care of their health, diet, exercize and healthy lifestyles. THese are critical to get good health outcomes for the people, and which combined with careful spending of dollars where it will provide the greatest benefit, is the only way the health care solutions can be found....

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The Congressional Budget Office's Elmendorf says without spending cuts in payments to doctors and hospitals and other providers, providing coverage to the unisured will put the nation deeper into debt. Popular measures such as increasing preventative care, expanding medical records and rewarding doctors for choosing treatments that improve cost and quality have potential but its not proven how much the savings from this would be. The administration and the White House Budget Director, Peter Orszag, say they are in agreement with the CBO that something needs to be done to seriously reduce costs, reducing payments for Medicare and Medicaid to doctors and hospitals, and making other changes.

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As a group Hispanics are reported to be hit hardest by this recession, harder than African Americans. In a Feb 9, Washington Post poll, both African Americans and Hispanics were optimistic about the future for the next generation, even with the dismal economic prospects, because things have improved greatly for this generation of black people and Hispanics compared to their parent's generation. And this progress is projected into the future. As a group the most pessimism was shown by white people. Whites say the Obama administration is doing very little for their families, and not doing enough for the middle class and working class Americans and small businesses. They were much more critical about the the administration's cozy relationship and doing "too much" for Wall Street financial institutions. By a 2 to 1 margin whites saw the Obama administration's economic program as harming the national economy.

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The US economy is growing at a much faster pace than Europe or China in the last quarter of 2021- at 7% annualized growth in the fourth quarter up from 2% in the third quarter, according to Federal Reserve Bank of Atlanta. This compares to 2% in eurozone and 4% in China. Major US ports such as Los Angeles are processing 20% more container volume in 2021 than in 2019, while Rotterdam and Hamburg are almost flat compared to 2019 level. Consumption of durable goods has jumped 45% above 2018 levels in the US, only 2% in eurozone, according to ECB data. The factory gate prices in China are far outpacing the consumer prices in China, suggesting weak domestic demand and strong foreign demand. Lars Jensen, head of network at container ship company A.P. Moller-Maersk says the global supply bottlenecks were started by this surge in US demand with more ships headed for the US taking ships away from other places. The US economy will grow at 6% in 2021 and 4% in 2022, with wages growing 4% a year above the pre-pandemic trend rate, compared with 1% in eurozone, according to Bank for International Settlements. This is pushing inflation up in other countries by pushing up the value of the dollar. In Mexico hitting 7.4% and the central bank raising interest rates 0.5% point to 5.5%. In Russia inflation up to 8.4% and central bank raising interest rates by 1percentage point to 8.5%. The equipment investment in the US is up by 13% this year according to JP Morgan Chase, only 3.6% in eurozone, 0.1% in Japan. All this is creating a large gap between the US and Europe, US and China in economic growth and demand growth, and in income growth. ...

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On one hand Chinese environmental officials are aware of the pollution problems in Beijing and Shanghai and other cities. Levels of nitrogen dioxide in Beijing exceed the WHO clean air guidelines by 78%. On the other hand the newly emerging middle class is seeking car ownership, and the local government officials need growth in the car industry to show good GNP and GDP growth numbers on which their performance is judged. Beijing and Shanghai and Anhui province local governments are part owners of some auto companies. About 416,000 people are employed in the Shanghai area auto industry alone and the auto industry in Shanghai pays about 900 millon dollars in taxes, according to government figures. At seven cars per 1000 population car sales are just beginning to take off. And with China's population its clearly not going to be possible to have the same level of ownership as in the US. The same is true for India. This would increase by many times the current demand for crude oil and increase emissions to the point of creating a disaster. And even today because of lax enforcement, and older models on the road, about 40% of vehicles in Beijing have no pollution controls and the other 60% have varying degrees of pollution controls. Experts say changes to the subsidized oil price policy, refineries that produce cleaner gasoline, policies to build more mass transit which has lagged behind in China as car sales took off (and probably more GNP impact from car plants than mass transit which act as inducement for local officials), and stricter fuel efficiency and auto emissions standards are needed....

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A study done by the Hudson Institute shows an increase in sales of 5.5% on average in same store sales of restaurants which increased lower calorie items on the menu. The reverse is taking place for restaurants that have neglected to do this, with these restaurants experiencing a decline in sales. This was based on research firm NPD and restaurant data at 21 fast-food and sit-down restaurant chains between 2006 and 2011. Chains that include lower calorie counts on menus include Panera, McDonalds, Denny's and Au Bon Pain chain. Federal regulations will require restaurants with 20 or more outlets to post the calorie counts in early 2014. The process of moving Americans away from eating habits that lead to obesity is moving at a slow pace. Margo Wootan, director of nutrition policy at the Center of Science in the Public Interest, says large serving sizes at restaurants lead to overeating and obesity. Frequency of eating at restaurants is another problem, with studies showing women who eat out more than 5 times a week take in about 290 calories each day compared to women who do not eat out that often. The healthy options at restaurants are still restricted to a small portion of menus and healthy choices are limited....

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France, Germany, Italy, Spain and Britain agreed to have automatic exchange of information for offshore accounts to fight tax evasion. Luxembourg agreed to join this group. The EU nation move follows the U.S. Foreign Account Tax Compliance Act of 2010 which requires foreign banks and entities to disclose accounts of U.S. citizens, in an effort to fight tax evasion.

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Prof. Scott Kennedy of the Research center for Chinese Politics and Business, voices concerns of experts who think that the $585 billion stimulus and the doubling of lending this year, increase in exports by a third last month, all point to an economy that is expanding too quickly. Kennedy says that no one defies economic laws, that eventually endless growth can get get you in trouble. The concern is whether the overexpansion of credit and the size of the stimulus may have led to overreaction in stimulus spending. People's Daily newspaper of China said that China's leaders are moving much faster than leaders of developed nations. But the flip side of this is that in the rush to increase spending there may be a lot of wasteful spending resulting in many bad loans a few years from now.