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CEO Ryan at CVS/Caremark. An unassuming man with a sharp focus on things, joined CVS right out of pharmacy school at University of Rhode Island. At 29, CVS owner Stan Goldstein gave him the chance to run pharmacy operations for CVS, then a regional drugstore chain in the eastern USA. Over the years CVS has made a number of successful acquisitions, the latest being the acquisition of Longs Drug store chain on the west coast, and it is now one of the largest chains in the USA. It has nearly 7000 stores and more than 50 million users of its CVS loyalty card in the US. As the pharmaceutical business evolved pharmacy benefit management (PBM's) companies like Caremark, Medco, and Express Scripts, came into being to manage burgeoning prescription costs. PBM's work with companies to save money, by filling recurring prescriptionsin 90 day quantities through the mail at reduced per pill cost. Now drug store chains instead of competing with PBM's are either creating or acquiring these larger PBM's. THe result is that a company like CVS which acquired PBM Caremark in 2007 for $27 billion, now has extensive computerized databases with patients information and drug usage histories. Ryan's clear focus is on these IT records as a distinct advantage, if he can use it to help the Obama administration's efforts to control health costs of chronic diseases like diabetes and arthritis, and back or neck pain, high blood pressure, and others, that end up clogging the hospital system and raising health care costs. By using these IT records to flag when a patient is not compliant or taking his medications and call the patient, Ryan can increase drug sales, get more visits into drugstores if the drugs can also be picked up at CVS stores, and increase sales through ancillary purchases during visits. This is now his strategy. It also includes setting up more clinics at stores and at corporate locations that divert the patient flow for small care like sore throats, flu and the like. As this is the way health care costs can be controlled, Ryan sees himself as helping achieve national goals while keeping CVS in the sales and profit picture for the US, even as health care as we know it goes through a complete transformation that removes the waste and unnecessary cost, and improves effectiveness and health. He sees CVS/Caremark right where it wants to be with its large patient drug database from about 1 billion prescriptions it fills each year, and as the largest single buyer and dispenser of prescription drugs in the country. ...

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Galston says the Hillary Clinton campaign strategy may be flawed. Following a president from the same party who has served two terms is difficult for a presidential candidate because of an anti-incumbency mood that sets in after 8 years. Galston cites an expert from Emory University about this costing the incumbent party about 4 percentage points in votes. This would eliminate President Obama's 3.9 percentage point win in 2012, says Galston. Hillary Clinton's cautious campaign sticking to the themes set by the Obama campaign and appealing to the core base of young people, women, minorities, and upscale professionals, runs the risk of not appealing to other voters needed such as the working class white voters. Stanley Greenberg, a pollster with much experience is cited by Galston as showing that the women's vote also is not the same for Democrats. Among unmarried white women for instance it has dropped from a 20 point margin in 2008 for Mr. Obama to a 4 point margin in 2012. By 2014 this was down to 2 points, and in 2015 this is now down to zero margin, with both Republicans and Democrats even among unmarried white women. Unmarried and working class white women are described by Greenberg as looking for a candidate who can help the middle class, with Democrats perceived as the party of government and special interests, making the 2016 election different from the ones before it....

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Nick Clegg, deputy prime minister, and the leader of the British Liberal Democrats party, the junior member in the coalition government in Britain, said he was "bitterly disappointed" by prime minister Cameron's decision to reject a pact for 27 EU nations to revise E.U. treaties. He told the BBC in a long interview :"This is bad for Britain." Britain is close to becoming a country "hovering in the mid-Atlantic and not being taken seriously in Europe." But he said "it would be a disaster" for the Liberal Democrats to withdraw from the coalition. Cameron's conditions for protecting Britain's financial industry were rejected by Merkel and Sarkozy.

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Hong Kong's new chief executive, Leung Chun-ying, is intervewed by the WSJ's Te-Ping Chen, Jeffrey Ng, and Robert Thomson. He was elected by 1200 business and political leaders in 2012. The term ends in 2017, by which time China says it will hold direct elections with universal suffrage in Hong Kong. Leung plans pro-growth policies and says Hong Kong's growth rate of about 4% for the last two decades lags too far behind Singapore's over 6% growth rate. No action is planned to reduce property prices by providing new land supply. He sees more room for growth in maritime insurance and ship financing services to complement Hong Kong's development as a global shipping center, citing London as an example. To improve the problem of cramped housing space and small apartments he is looking at ways to build new towns in the New Territories, which are on the border with mainland China. Leung will not change Hong Kong's flat tax structure, and is not going to follow Singapore's example in granting tax holidays. Growth in China will be about 7% in 2012, and future growth will depend on how fast China shifts from export led growth to domestic consumption....

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The story of a Russian startup company MeshNetics, that had a research project called Golden Box with a team of software programmers. It succumbed to the global financial crisis as it hit Russia and with it dreams of a new wireless technology that would help utilities keep track of energy conservation and other uses. No new investors could be found and the Russian investors cut the funding. Even western investors could not make the investments. Programmers like Bagrak, 27, from Berkeley, California, who worked at Google on an internship and came back to Russia to build its high tech sector. Luzhetsky, 26, from Obninsk, a city built by the Soviets for nuclear and military scientists, which fell into decay and poverty in the post soviet period, this was his first programming job after being educated in the Soviet Union. Mr Grinkug, 57, from a generation of the Soviet period that considered science a religion, he headed the 12 programmer team working on the Golden Box project. The project three ers in the making was expected to release in early 2010. Suvorov who headed MesNetics, who saw his work as part of the move by President Medvedev who came into power in the spring of 2008 to take Russia away from dependence on oil, with investment of $5 billion in a state corporation for nanotechnology. Anatoly Karachinsky, President of the Russian internet technology company IBS Group, who spun off MeshNetics using the brightest talent from his software development team and financed it with his venture fund Oradell Capital. First the optimism in the face of difficulty in the fall of 2008, as the global crisis began to hit Russia, then in October the message to Suvorov that he had to look for a new investor. Then the cuts, first 10% of jobs gone, nine days late a dozen more fired, then the shutdown phase. One person fired after coffee with Suvurov, as things moved quickly. Alexei Rybakov, director of the division that makes the ZigBit, calls 50 investors aday, makiung every kind of pitch, practical, global, patriotic. Grinkug packs up his things, 40 years of codes fit into a few CD's , a few programmers are retained if things change, but for Grinkug the Golden Project he says, will probably die in his head. Its mind boggling how mistakes and unethical behaviour in the banking systems in the west can wash ashore in emerging countries like Russia, and wash away what little stability to build anew life has been achieved in a few years after the 1998 collapse of the ruble and the Russian economy. Its also a contrast between the dreams, hopes and aspirations and the innocence of ordinary young Russian tech engineers and the swings of reality that surround them, of poverty and collapse in early post soviet Russia, then optimism , and now a new kind of reality trying to salvage what has been achieved, and the difficulties in forging a new future that goes beyond 120 million people collecting around a oil wellhead....

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McInerney takes personal responsibility and puts top priority on the Dreamliner. He says we will be defined by the 787, though not at this moment. This means he is personally walking through Boeing's and Boeing supplier's plants to see things first hand, and have the daily progress reports coming directly to him. This means closer supervision and taking steps to get things right. One step was to get some managers from its Defense unit into the 787 program management to correct things, buying Dallas based Vought Aircraft out of a joint venture with Italy's Alenia Aeronautica in South Carolina where sections ofthe 787 are being joined. He also stepped in taking control of key parts of the 787 program, and insisted on Boeing mangers closely monitoring and getting involved with first hand knowledge on supplier's sites and getting action where needed, and stationing Boeing people at each supplier's plant. His earlier style was a bit hands off in comparison. The 15 month delay in the 787 launch and the rather ill timed gala in Seattle for a plane that was hollow inside, and with managers having no idea that supplier's were already behind in their part of the program or not doing anything about it, may have suggested to investors that Boeing's McInerney and his key people were really not at grips with what was going on in their own company. From its July high of $107 Boeing stock has dropped 27% to $78 and recovered only slightly to $83 still 23% below the highs. Experts feel that McInerney will either lose big or win big. He wasn't there when the 787 program was started. Now he has to show he can get things right. His initial moves look like the right ones, taking personal responsibility, making decisions to fix things, and not hesitant to take corrective action in the midst of difficulties such as getting into suppliers factories first hand to see things on the inside. And gettiing his best people from other parts of the company into a team and putting them on the 787, and so on. See the link to the Airbus experience with their jumbo jet A380 which ran into similiar problems in the WSJ. There the French teams who were the better able to solve the problems were brought into the German plants to help get things right, even though there were cultural issues to be overcome. McInerney has process based experience at GE where quality and manufacturing were important, and he has delivered good results with an 84% increase in income to $4.07 billion, on an 8% increase in revenue to $66.4 billion in 2007. This comes just 2 to 3 years since joining Boeing in July 2005. Boeing may have to pay $4 billion in concessions and penalty payments for late deliveries, and Boeing is going to set aside this cost by booking the first 25 delieveries at zero-profit margin....

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The growth in U.S. GDP was 1.7 % in 2011, yet unemployment dropped by 0.7% in the last 12 months to 8.3% by Feb. 2012. A pickup in hiring is seen in job figures. Christina Romer gives as an explanation to the rise in unemployment in 2009 to 10%, more than expected, and the drop since then, to the overreaction of companies to the financial crisis by laying off workers and freezing hiring- with hiring picking up as conditions return to normal levels. The unemployment rate as defined is also not an accurate measure of the jobs situation, as it reflects only workers who are looking for work, and many workers drop out of the jobs market when they are discouraged especially the long term unemployed. Taking into account people who have dropped out of the labor markets the unemployment rate was 11% in Nov. 2009, according to Luce in the Financial Times- in Ezra Klein, Washington Post 12/12/2011, Wonkbook: Real unemployment rate 11%. Lawrence Katz, Harvard Labor economist also cites this as one of three jobs crises in unemployment today that need to be addressed, the other two being: foreclosures and debt, and the low number of jobs added because of automated manufacturing- in Friedman, NYT, 12/10/11, The Next First 100 Days. Explanations for the low GDP growth as unemployment declines is a likely productivity slowdown. Prof. Robert Gordon of Northwestern University, sees a slowdown in productivity. Worker output for every hour worked, how productivity is measured, increased only 0.4% in 2011 and 0.9% in the last 7 quarters, and is trending downward in the longer term. A more likely explanation is that unemployment is still at higher levels but is understated in unemployment figures....

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The coronavirus pandemic and the disaster in nursing homes, the chaotic conditions in the first wave, the lack of staff and poor attention to residents during the pandemic, has exposed the major weakness of nursing home care in western countries. Much of this sector is in the hands of private operators seeking a profit.  The staff is paid low wages and lacks the experience and empathy needed for care of older people. During a virus all these factors turn deadly. With some staff sick the other staff is overburdened. If the sick turn up for work they are likely to risk the safety of other staff and the residents. With the incubation period lack of testing there is no way to know. When deaths occur and the nursing homes are sealed from the outside world the deaths happen with no goodbyes as happened in U.S., Britain and Sweden. This has exposed the scandalous and shocking way in which the elderly are treated in today's environment where ridiculous amounts of money are being spent on other things and the the most basic "one's parents" are neglected and allowed to die in horrific manner in a pandemic. The new trend for home care for the elderly is a welcome trend and long overdue as one of the worst aspects of the system in the west is the treatment of elderly parents in nursing homes run for profit. The new technology tools available for monitoring a elderly person at home, and the help of stores such as Best Buy which are serving elderly at home, is making this more and more a choice for the elderly. Even older patients and ones needing significant care can recover and spend time at home in a better environment, a less costly one, as hospital managers and families have learned in 2020. Some hospitals in the U.S. say they never want to go back. That the drive to get every patient home who can be home is the right one for patients and families and for the government paying for the care so that dollars are well spent in quality of care. Home health care companies are working on providing new services for sicker patients recovering at home. Technology helps do better monitoring. Medicare now pays for digital doctor visits and intense hospital type care at home after coronavirus showed this as vitally needed.  Both the Biden and Trump administrations are firmly focused on this issue. Seema Verma as head of Medicare is clear about the need for a national conversation on how we take care of the elderly, of our parents. And Mr. Biden wants to spend $450 billon to make certain that people who need long term care can get the support they need in the home and the community. This report looks at the home health care companies and how they are improving their services. This and telemedicine are two of the major constructive changes coming out of the pandemic, clearing out some of the worst aspects of the old system of living the older years in the western world.  Nothing speaks more about humanity and a human world than the story here of Savanna Hollar, 90 years old and almost blind. She broke her shoulder in August, Her sons decided not to send her to a the rehab facility she went to after a broken hip 3 years earlier. The sons brought her home to recover in the farmhouse near Yadkinville, N.C., where she has lived since 1951. One of her sons himself 63 years says that at a nursing home she would be lonely, scared and afraid to move. The sons hired two people to help her during the day and a rotating system was used for having people help her. At home Mrs. Hollar could enjoy her gray cat, Buddy, her favorite recliner and tomato sandwiches made with produce from her garden. Really, if we can't do this much what good is the U.S.A.? or Britain? or Sweden? or India? ...

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The New York Times reports from the comments of current and former members of the Chase Chief Investment Office (CIO), that risk officers at Chase were ignored when they raised issues about the complex trades made by trader Iksil. Iksil's trades had the support of his manager Mr. Macris, and Ms. Drew who was in charge of CIO. The comments also indicate that at one point Mr. Macris brought in a Risk Officer with whom he had worked closely for many years. Risk Officers are supposed to be independent and their concerns seriously heard, with the authority to halt trades that pose excessive risks. Which made this kind of cozy behaviour in the CIO trading offices in London cause for alarm. These reports also say Mr. Braunstein, the new CFO at JP Morgan Chase, did not strengthen controls after he assumed office in 2010. Bank officials disputed this. The New York offices did not fully grasp the complex trades being made in the CIO London offices, and upper management let the CIO operate pretty much on its own, especially with CEO Jamie Dimon's confidence in Ms. Drew's management of the CIO. This led to another gap in the process of risk management. Dimon had other priorities and distractions, from problem mortgages coming with the acquisition of Washington Mutual, pushing back aginst financial regulation after the 2008 crisis, stress tests and others. At the same time the U.S. Federal Reserve, regulators, and Treasury's coordinated effort to merge failing banks with other larger banks- because of the lack of the process of unwinding failed banks provided later under Dodd-Frank legislation- created mega financial banks. Unlike what the U.S. under Treasury Secretary Rubin pushed for in the case of S. Korea during a banking crisis in 1997, Treasury under Geithner and Fed officials did not push for unwinding of failed financial institutions such as Countrywide and Washington Mutual in 2008-2009 Chase's own portfolio of assets under the CIO, increased by an astounding amount from $76 billion in 2007 to $356 billion in 2011. Even if Ms Drew had managed CIO well before, managing a portfolio of this size is most likely to have presented a whole set of new challenges and problems for which the CIO office was not prepared. Similiar concerns were raised by other Fed officials such as Fed governors, Hoenig and Fisher, who raised the issue that such mega-banks posed unacceptable risks and were too big to manage. Pressures to increase investing profits, growing complacency, relaxing risk management controls, led to the situation where a single trader Mr. Iksil, who had only joined the bank in 2007 according to other reports, could create large losses. This follows a situation at UBSin 2011, where a novice trader made bets that resulted in large losses....

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Timothy Geithner as New York Fed Chairman was a key person in the rescue of Bear Stearns. In an interview with the WSJ he recounts events and defends his actions on March 14 in a conference call at 5am in the morning with Ben Bernanke, Kohn, and other regulators and staffers and Treasury Secretary Paulson. By 7 am a decision was made choosing from 2 options not to do it, let Bear Stearns fail, and Fed would make an infusion of liquidity into the banking system to reduce the impact, or make a loan to to give time for Bear Stearns to make a merger. Mr Bernanke did the head count and all top officials agreed to the loan option. At 7.30 the morning of March 14 about $80 billion in short term loans would come due. If Bear Stearns went into bankruptcy protection lenders would get back collateral instead of cash and might sell the collateral en masse and pull back trillions of dollars of similiar loans to other investment banks. Also Bear Stearns had trading positions with 5000 other firms so the ripples would extend throughout the banking system. At issue in a Bear Stearns collapse with no Fed loan- a full blown run on Bear Stearns had begun on March 13 with customers and lenders pulling out billions of dollars. The man- Geithner does not have a PhD in economics and has never been a banker or trader, the background of previous chairmen of the New York Fed. He joined Treasury Department in 1988 and was an assistant to first Treasury Secretary Rubin and then his successor Sommers. Geithner was active in the rescue of Mexico, Indonesia and Korea in the Asian and Latin American banking crises. He was appointed to his position at the New York Fed in 2003, so he has 15 years of experience dealing with international banking crises. The criticism- has come from a colleague at the Fed Vincent Reinhart on the oped pages of the Washington Post, and from former Fed chairman Paul Volcker in a speech to the New York Economic Club. Geithner has asked to speak at the same club to give his account and his defense of his action. Note that Bernanke and Paulson and Kohn were in on this decision and voted in favor of it and there appears to be a consensus that all in the conference call supported it. Geithner kind of put it all together and so he is defending it. Geithner's contribution- Geithner pulled in the other players in the financial markets into close communication with the Fed. He assembled an informal advisory group including Rubin, Summers, Greenspan, Volcker, former New York Fed Chairman Corrigan and investment banker Pete Peterson. He would also phone them individually asking : what should we think about an issue? What are the best 3 arguments for or against? What do smart people think? He also initiated a series of dinners at the NY Fed's executive dining room in which 5 or 6 senior executives from a major investment firm would meet his own top people. He also calls CEO's of important banks and investment firms every week in a crisis situation to ask- Whats changed? Whats better? Whats worse? What worries you? And after the credit crisis in August ,Geithner joined Bernanke in a small group that included Fed vice chairman Donald Kohn and Kevin Warsh, a Fed governor, investment banker and White House aide. ...

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Tyler Cowan writes about the problems of crony capitalism and lack of opportunities in American capitalism as it is practiced today.

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Dionne cites comments by Bowles and Simpson saying the Paul Ryan U.S. budget proposal falls short of a serious bipartisan effort for deficit reduction for a number of reasons. The reasons cited by Bowles and Simpson are: The proposal exempts defense spending from reductions, does not apply savings from tax expenditures to deficit reduction, relies on much larger reductions in domestic discretionary spending than the Bowles-Simpson deficit reduction plan, and at the same time making reductions in safety-net programs that could in their words "place a disproportionately adverse effect on certain disadvantaged populations." This should give moderates in this debate time for pause and reflection says Dionne.

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Ann Lee a former investment banker and now adjunct Professor at New York University, gives us facts that show the smaller banks that lend to small and medium sized businesses in the country are being closed by the FDIC. According to ADP small business that employs between 1 to 49 people, accounts for 48 million jobs, those between 50 and 499 employees account for 42 million jobs, and large business for only 17 million jobs. Without access to capital these small and medium sized businesses will continue to layoff employees, creating a vicious cycle of falling credit and demand. According to Automatic Data Processing's August employment report large business shed 60,000 jobs, medium sized business 116,000 jobs and small businesses shed 122,000 jobs. These smaller banks says Lee have done most of the lending to small and medium sized businesses. And overall lending has dropped from pre-crisis levels. Treasury's Capital Purchase Monthly Lending Report shows that banks that received government money actually reduced loan balance by $54 billion. According to reports issued by major credit rating agencies $700 billion of asset backed securities were underwitten in 2007. In 2009 only $10 billion was issued. This has a significant impact in every area. Banks have no incentive to lend with all the bad nonperforming loans on their books. They only hope that over time renegotiated loan terms would enable to recover these loans. But this might take a decade says Lee, if this is similiar to other crises like the one in Japan. She says what the banks do to make money is to borrow virtually unlimited amounts from the Fed at near zero rates and earn money from the spread when they lend to the Treasury. Does our current banking system make sense she asks. Banks are not investing in economic activity, in real products and services,but engaged in agovernment backed shell game that enriches bankers at the expense of everyone else. She says that the banking lobby may prevail in preventing the nationalization of the banking system, but this will not prevent questions about the status quo and its assumptions from arising if the recovery and regulatory reforms fail. ...