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A health care practitioner says the real problem is the high cost of medical care in the U.S. when compared to other countries. She points out that the Obama bill in 2008 did not take effective steps to bring down the cost of health care before enacting legislation to cover the uninsured, leading to higher premiums for the middle class. The link between healthcare and profits is seen as the main problem. 

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The high risk of failure as the U.S. withdraws from Afghanistan in 2012-2013. The U.S. is handing over to an Afghan Army that faces a high desertion rate, high turnover, and uncertain loyalties. The turnover is so high that the Afghan Army has to replace a third of the 195,000 army every year. The problems from the corruption in the Karzai government, the flawed elections, and other issues have not been resolved, leaving a fragile government and a fragile army and police force as the U.S. withdraws. A decade of sacrifices in resources, lives and wounded, is at risk. A negotiated settlement in talks with the Taliban has not moved forward to create a post U.S. withdrawal Afghan government that brings in all parties. The untimely death of American diplomat Holbrooke who set up the accord that made peace in the Balkans, and the failure to get results at the talks only leaves the whole U.S. project at risk.

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Mark Gilbert, a visiting associate professsor of European History at the John Hopkins School for Advanced International Studies in Bologna, describes the crisis of the political culture in Italy that goes deeper than the economic crisis and has lasted for most of the post war period. Gilbert says the political parties have avoided implementing financial discipline and opening up the economy for most of the last two decades, except for brief periods, and did not take the opportunity of joining the eurozone to make serious changes. Italy has many parties with the Democratic Party having 25-30% support in the polls and Berluconi's People of Liberty (PdL) having the support of 20-25% of voters. There is also the Northern League, the Third Pole of centrist Catholic parties, the Italy of Values party, and the Ecology Freedom party. Italy lacks a national consensus on making the changes. The risk is that Monti will not have enough time to make the changes, as new elections may be held by April 2013. His government was formed as a government of technocrats led by former EU commissioner Mario Monti, after President Napolitano forced the PdL, the PD, and the Third Pole to work together to support the new government. Changes are needed in the legal system, local government, the health sector, and in the university system. One factor favoring Monti is that 90% of Italians voters are dissatisfied with the political parties, according to Italian think tank ISPI. For Italy the EU crisis has in this sense a positive aspect as it has forced Italy to come to grips with economic and cultural changes under a leadership from outside the political system....

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A U.S. drone strike kills Tehreek-e Taliban Pakistan leader Hakimullah Mehsud in the North Waziristan tribal area near the Afghan border on Nov. 2, 2013. It also takes out several of his closest aides. This follows the arrest in Afghanistan of his deputy chief, Latif Mehsud leaving a power vacuum in the TTP. The government of Nawaz Sharif in Pakistan opposes drone strikes publicly because of the unpopularity of the strikes in Pakistan. Yet this week Pakistan interior minister speaking in parliament disclosed that only about 67 civilians had died in drone strikes that killed 2160 militants. Because Mehsud was an extremely violent leader in the TTP and remained a threat to the government and army in Pakistan, this may be seen inside the government and army with relief so that a new chapter can be turned for Pakistan that focuses on development efforts, something that Pakistan prime minister Nawas Sharif was elected to accomplish in his term in office. This may also be a positive step for a peaceful transition in the region following U.S. withdrawal, and for peace talks mediated by Britain's prime minister Cameron between Pakistan and Afghanistan....

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The WSJ's Spencer Jakab points out the role of politics- with Saudi Arabia in a standoff with Iran and Russia in Middle Eastern conflicts- and Saudi policy of full output with no cuts unlikely to change, ensuring lower prices for 2016-2017.

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Jackson Diehl, deputy editorial page editor of the Washington Post, says its hard not to conclude that Obama is really not engaged with the struggle for democracy and democratic process in the countries of the Middle East and the Arab World. His voice is only heard sporadically, and is missing altogether at crucial times, as the people of Egypt, Libya, and other countries express their democratic aspirations. This has been the case from the beginning of this struggle and continues today. He cites an Arab opinion poll, from Shibley Telhami of the University of Maryland with Zogby International, which shows a positive view of Obama at 34%, compared with 39% in 2009. When asked which countries have played a positive role, France and Turkey are given first place and the U.S. is close to China. This is because France's Sarkozy and Turkey have been actively engaged, and Obama has been silent for most of the time. Diehl says most Egyptians he talked to in Cairo in a recent visit, think that Obama's focus is on going along with the military and Israel. ...

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One of the severe problems noted in the recall disaster of 2010 was that practically all important quality and safety decisions are made in Japan. Without key American decisionmakers in the process this leaves Toyota exposed to all sorts of errors like the errors that ocurred in stalling the National Highway and Traffic Safety investigations into acceleration and braking accidents in Toyota vehicles. To compound theses errors managment at Toyota focussed on the $100 million in savings that avoiding or minimizing the recalls would generate, as revealed in internal documents. Early warning signs of similiar problems in Europe were not linked to problems in the U.S.. All this was ocurring against the backdrop of a change in management at Toyota- with the Toyota family once again regaining control of the company- and the failure of the management under Watanabe and previous CEO's to put quality before rapid expansion. The new changes are to have 2 new senior executive positions in the U.S. to focus on quality and safety. A chief safety executive will focus on safety and recalls, and a chief quality officer coming from the top ranks of the American operation will now sit on a special committee for Global Quality led by CEO Akio Toyoda. The commitee for Global Quality will address the global quality issues around one table with the highest ranking executives at Toyota right at the table to talk things out. ...

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Louis Gallois, CEO of EADS gives his views about reviving European industrial competitiveness.

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Proposed ideas being considered at the EU headquarters in Brussels include the European bailout fund, the European Financial Stability Facility (EFSF), being made a bank with funding from the European Central Bank. The EFSF would be able to buy the bonds of Spain and Italy in primary and secondary markets alongside private buyers. As an alternative the ECB would be able to buy Spanish and Italian bonds directly. Here the problem is keeping private investors in the market given the large financial needs of Spain and Italy. In the restructuring of Greece's government bonds the ECB took the position that it would subordinate the claims of private investors in Greece's government bonds and not take loss. Concerns of private investors could be addressed by the eurozone governments giving an explicit indemnity to the ECB to cover any losses suffered in the purchase of Spanish and Italian bonds. Both steps, the direct purchase of Spain's and Italy's bonds by the ECB or through the EFSF would mean doing something that is not in the ECB's charter- the financing of government debt- and would be done cautiously and only in a crisis situation. The caution would also be motivated by the need to ensure there is action to improve the competitiveness of Spain, Italy and other eurozone countries through specific measures, and no backtracking bygovernments....

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About $229 billion, three fourth of Greece's debt, is now held by the European Central Bank, the IMF and the European Commission. This is taxpayer money and the governments are making sure that they get back bailout loans in the form of interest payments. About two thirds of the $177 billion given to Greece as bailout loans since May 2010 actually came back to the ECB, IMF, and the EC, in the form of interest. The ECB is keen on recovering taxpayer money. The money route has been setup with an escrow account in Greece for bailout loans so that interest payments get paid, and this money cannot be used for any other purpose. Banking experts say this is a practice in risk management, and with Greece's poor record in finances the controls have been put in place to recover money the ECB invested in Greek bonds in an effort to calm nervous financial markets and now gets about 10% in annual interest payment. Under earlier debt restructuring for private creditors to Greece a haircut of over 50% on Greek bonds was taken, with the ECB insisting on receiving full payment. If Greece were to repudiate the loans under a new elected government losses would have to be taken by the ECB, IMF, and EC, and by private creditors. The ECB has Greek bonds in the range of $44 billion to $69 billion, and the European Financial Stability Facility $88 billion, by some estimates. Greece's exit from the euro would result in losses on these bonds .for the ECB and the EFSF, ultimately European taxpayers. It would also make the new bonds to private creditors under the restructuring of little value which is why European banks would not favor that outcome. Greece's tax receipts at some point, possibly 2013, would exceed basic operating expenses of the government, at which point a future Greek government might decide to exit the euro and stop interest payments on debt in its best interest....

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The Ifo Institute's Hans-Werner Sinn presents the German view on bailouts for Greece, Ireland, Portugal, Spain and Italy. He says that socializing of debt was proved to be a bad idea even in the U.S. experience when eight states and territories were allowed to go bankrupt in the 1830's and 1840's, and even though California is close to being bankrupt no one suggests socializing the debt. The European Economic Advisory Group has favored short term assistance and liquidity assistance but not aid for insolvency. Bundesbank assistance for international shift of refinancing credit, also called Target credit, is estimated at $874 billion, since 2007. Greece and Portugal current account deficits were financed using this. ECB purchase of government bonds $250 billion, and $500 billion in rescue programs from the IMF, and additional help from the European rescue funds such as EFSF. Sinn says Germany would lose $1.35 trillion if the euro fails. If Greece, Ireland, Italy, Portugal and Spain go bankrupt and repay nothing, and the euro survived, Germany would have lost $899 billion by his estimates. He responds to critics by saying that the Marshall Plan gave Germany 0.5% of GDP for 4 years, or 2% in total, or about $5 billion today if taken as 2% of Greek GDP....

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Spain's National Court is looking into the problems at Bankia and the leadership of Rodrigo Rato, a former head of the IMF and Economy minister in the government of Mara Aznar of the Partido Popular. The current prime minister Rajoy was deputy prime minister in the Aznar government which lost the election in 2004.

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Bernanke in reflections on his policies for quantitative easing in response to the 2008 financial crisis, says the policies were intended to protect Main Street and the average American, even though this is not readily apparent. He says the policies did not lead to inflation as critics have stated, and one has only to look at today's inflation statistics to know this- referring critics to the government CPI report in Jan 2014 that consumer prices went up by 1.5% in 2013 and less than 2% for 2012. Bernanke says he hopes he took the right actions, and still retains the conviction that the American economy will recover losses from the 2008 financial crisis- even though the answers to this questions won't be seen for some time.

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This piece by Cambanis in the NYT shows how even Syrian Free Army soldiers have switched sides to join the ISIS extremist Sunni militia. Sheikh Hassan a Syrian Free Army brigade leader describes the case of Mustafa who switches sides for a higher salary wih ISIS. ISIS gave Mustafa triple his salary at the Free Syrian Army - increasing it to $400. In a region with many unemployed youth the ISIS pays salaries for joining, and taps Sunni frustrations in Iraq, with money raising and financing capabilities a critical part of the organization's capabilities. A piece by Nordland shows how the ISIS's crude but effective money raising uses taxes and other illicit ways to increase revenues. This provides a unique insight into what is happening in Iraq and Syria after the failure of the U.S. to effecively support the Free Syrian Army and moderate groups in Syria, the premature withdrawal from Iraq, and the frustrations of Sunnis built up under the government of prime minister Maliki openly favoring Shiites. This has provided an opening for extremist groups in the region, and created more tangles for the Obama administration as its policies to distance itself from the region have not let it extricate itself from the U.S.'s important role in the region. The vacuum created by these policies has been filled by extremist organizations and created about 2 million refugees- a large humanitarian crisis and undone years of effort by U.S. soldiers in Iraq. ...