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Eyal Press brings ups the issues of moral injury when physicians work under a system of corporate takeover of medicine. She cites  the situation of Emergency Room's at hospitals where the service is outsourced to private groups working only with profits in mind. Sociologist Paul Starr in his book  The Social Transformation of American Medicine said that about 50 years ago this was not the prevailing practice in America, when physicians earned the public's trust by being "above the market and pure commercialism." The trend now is to form unions such as the one at Stanford University for medical professionals, as this provides a balance when dealing with corporate interests. A 30 year old resident at Stanford is cited, who says the prestige of the profession of medicine does not any more prevent the degradation that is being experienced by workers in other sectors of todays economy. With its excesses in one direction away from the values of the past. Physicians he sees as moving to the category  of "laborers," like other workers in such an economy, that is far removed from what existed in America 50 years ago. ...

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The German people offer a warm welcome to refugees from Syria and North Africa suffering enormous hardships to make their way across seas and overland through Eastern Europe to Germany's borders. Germany of its own accord waived the right to deport Syrians back to the first European nation entered, and supported Syrian refugees right to stay with an 87% acceptance rate for Syrians seeking asylum. In August 2015 alone 100,000 refugees were accepted. Chancellor Merkel and Germany lead the European Union by example, and what an example it has been. Faiola of the Washington Post tells the story of Abed Almoen Alalie, a civil servant from Syria who fled with his family, and after being roughly treated in Budapest, Hungary, cannot believe his eyes seeing the welcoming crowds as he gets off the train in Munich. Never has a nation in such a short time made its way into the hearts of so many as Germany has done in 2015. The crisis found Germany, or Germany found the crisis, either way Germany embraced it and the people who came with it in a way hard to imagine. With chancellor Merkel leading the way using strong words and courage of her Lutheran convictions- "The fundamental right to asylum does not have a limitation. As a strong, economically healthy country, we have the strength to do what is necessary." Many Germans have responded in a degree and manner that is hard to imagine . They say this was Germany's effort at redemption after the war. In a poll by ARD released September 3, 2015, 88% of Germans said they would donate money or clothes to refugees or have done so, and 67% say they will volunteer to help. ...

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Brett Arends cites several factors for his skepticism about the 4th quarter 2010 US stock market rally. Cyclically adjusted price to earnings ratios that are 75% above their average value. A market value for US equities excluding financial stocks, that is within 15% of the October 2007 peak. Fed data that shows nonfinancial corporations have debt of $7.4 trillion at the end of the third quarter 2010, an increase of $250 billion in one year, and up from $5.5 trillion in 2005. This Fed data shows the debt for nonfinancial US corporations is 58% of their net worth, up from 41% five years ago. US consumers are still have the kind of debt burdens they had in 2008, with US households having reduced their debt by only about 3.5%. Arends says the leveraging is through the roof when you add up the debt that government and corporations have run up. Total debt has risen to $36 trillion, up 15% from the fall of 2007. He cites other experts who were right for the last decade who are skeptical this time- Rosenberg at Gluskin Sheff, Albert Edwards at S.G. Securities, John Hussman at Hussman Funds. The latest analysis by Jeremy Grantham at GMO is that large cap US stocks are not likely to beat inflation by much over the next 7 years. Arends has not mentioned global risk indicators such as the asset price bubbles developing in emerging markets, and the sovereign debt restructuring needed in debt burdened countries of the European Union. Analysis by the Economist in year-end 2010 points to the diverging directions of austerity in Europe, spending in the US and asset price bubbles in emerging markets, as a disturbing sign for 2011-2012. Risks in the US that Arends has not mentioned include problems in housing. Nouriel Roubini sees problems in housing in 2011. ...

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Both sides harden positions before the June 30th deadline for 1.5 billion euro repayment of debt to the IMF. Greece's prime minister Tsipras accuses the IMF of "criminal responsibility" for the pain of austerity programs in Greece. Eurozone leaders says Greece's default on its debt and exit from the eurozone is a possibility. The Economist points out that a Greek default and Greece's exit from the eurozone would be a mistake. It points out that this means repudiating debts of 317 billion euros, or about 180% of GDP. Yet the repayment is at low interest rates spread out over decades. Until the early 2020's interest rates are about 3% of GDP a year. In theory a devaluation would help exports, but Greece with its small trading position, may not see much benefit. The drop in nominal wages by 16% has not led to a surge in exports. The cost in terms of broken banks, sharp decline in savings, and collapse of confidence could be disastrous. The very people Syriza is trying to protect the poor and elderly, would be hit hardest, as the collapse in the currency would lead to a shift to a barter economy as in Argentina during its default crisis. For the European Union, the problem would not go away, as it would have to deal with a bigger problem of a failed state on the Aegean on the EU's southern flank. Syriza's gamble that this can be used to extract concessions by holding off till the last minute is failing, because it is leading Greece back to contraction after the small growth in 2014 under prime minister Samaras- with capital flight from the banks and investors leaving in a general fall in confidence. The management of the economy and negotiations by Syriza is now seen as incompetent and has jeopardized any difficult progress made....

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The collapse of the will of people around Yanukovych, including a deputy interior minister, as fighting units moved with weapons taken from an armory in Lviv towards Kiev, may have been the decisive event that decided the fate of the Yakunovych government. The deputy interior minister then negotiated with a protest leader Levus realizing that other than the front line of police the rest of the police were ready to abandon the fight. Levus then negotiated a safe corridor for the police to withdraw. As the Polish diplomat Sikorski came out to the square he found to his complete astonishment the police simply disappearing from the Square in Kiev. Hours earlier he had warned protesters that a crackdown was coming and they would all be wiped out, according to a report in the WSJ by Benoit, Norman and Fidler, 2/22/2014, so that they should accept a deal which would set a date for new elections but not lead to the immediate resignation of Yakunovych. That deal it also appears came after a Putin call to Yakunovych and not simply from diplomatic pressures, and it is probable that Putin had realized earlier than the diplomats that most of the police were not going to fight. Bringing in the army would have had dangerous consequences for relations between Germany and Russia in particular- as German public and chancellor Merkel felt strongly about the situation in Ukraine- and relations with the European Union and the U.S. Putin, Yakunovych, and even the EU diplomats may have missed the depth of feeling in Ukraine and the organization of the protest movement. Germany and chancellor Merkel, with her determination to make things come out right in Europe after a flawed history, gave hope to the protest movement. ...

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Holman Jenkins makes some good points as the auto companies in Detroit look for government rescue. He suggests dumping CAFE altogether if Congress is serious about conservation, a gas tax would be the only intellectually honest thing to do. In the light of falling gas prices in November 2008 with $1.98 a gallon in Michigan and across the country, how will demand for hybrids and the Chevy Volt at $40,000 fare? Its hard to tell but some serious thinking about energy and automobiles is in order. Congressional mandates have a tendency to have poor consequences as Holman mentions, because of the loopholes in the mandates like the fuel mileage rules that allowed fleet averages, loopholes Detroit automakers used to lead the trucks and SUV boom to coverup hidden problems for so long. Some of these had to do with the UAW's insistence on rules and benefits and things like the Jobs Banks that were obsolete in a age of globalized manufacturing and unequal playing fields with the Japanese and Koreans in mostly unuionized factories in the southern United States. Some of them with lack of effort, vision and innovation by Detroit car companies to make the fuel efficient technologies to reduce costly fuel imports, and the failure to bridge the union management divide that has been there all the time in the postwar period skewing decisions and leading to obsolete behaviours. Holman sees nationalization of the auto companies as the only possibility given the car companies history and failures, with or without bankruptcy. Even then he does not see them becoming competitive without good leadership and right policies in running the companies and honest policy at the government level, and courage to get a firm grip on reality. ...

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The port of Long Beach which takes in 20% of the container shipping of the USA,, and is next only to Los Angeles port in container shipping, is becoming a story of two economies, the American and the Chinese. Thousands of cars from Toyota, Nissan and Mercedes are piling on port property turning it into one huge parking lot, as dealers across the country say they have no need for them, and piles of paper and metal baled together to be shipped back on these ships to China to be recycled into cardboard for export boxes are also piling up as China no longer needs them. The drivers who drive the trucks are also being laid offf and looking for new jobs, which are signs that a deeper economic downturn is underway and the the Detroit automakers GM and Ford CEO's who told the Banking committee that they are making their estimates for 2009 on the basis of a 13- 14 million vehicle sales year may be in for another rude shock. The figure for the last quarter may be running at 10 million, and if this continues into 2009 as its expected to do, even the producton of cars after accelerated plant closures may have nowhere to go in 2009. Which is why there are so many questions about what is going on in the auto industry and so much need for candour and frank discussion that was missing in the evasiveness apparent in the Senate hearings on November 18, 2008, as CEO and union president skirted around the issues and senators failed to ask many other questions like these on what is happening on demand as well as many others....

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The astounding fact in this French FR24 report on the Paris Climate Change Agreement and country carbon emissions show that China's emissions accelerated to rise 3 fold in 2015 to about 12 billion tons of carbon emissions from about 4 billion in 2000. US remains at about 6 billion. India is at about 3 billon tons of carbon emissions, about where China was in 2000 when it had about 4 billion tons of carbon emissions. This is shown in the graph on carbon emissions from FR24. The US, European Union graph curves on tons of carbon emissions since 2000 are all flat or declining, India rising slowly from a small base, China's curve is rising straight up from a large enough base at an unbelievable and dangerous rate. What has happened and is it getting worse? China's economy expanded too quickly as globalization was accelerated by banks, and business in the US and Europe, and by the Chinese governments at the local level and the state level. This had negative consequences for US, Europe and China. The too fast growth in China at rates of 10-15% based solely on False GDP indicators that did not take into account damage to the environment and workers was that it hurt manufacturing and working class in US and Europe and contaminated the environment. This was not like growth of Japan in 1960-1980, a smaller country in the way it affected the US and European working classes. Hyper Growth at 10-15% of a large country with 1 billion people compressed over a short period, is cited by Greg Ip in the WSJ as the cause of the negative impact on America.  It hurt China through pollution of rivers and land at an accelerated pace. It hurt China as trade with US and Europe became unsustainable with the loss of manufacturing in the US and Europe leading to a trade war. From these graphs of emissions it now appears that the 3 fold rise in carbon emissions from about 4 billion tons in 2000 to about 12 billion tons in 2015 is the result of unregulated business activity of all those who preferred to push hyper growth in China purely for reasons of profit such as investment banks and corporations in US, Europe, and state or local companies in China.  This has also aggravated inequality in US, Europe and China, and hurt rural populations. Xi Jinping is attempting to correct this in China, Biden is trying to correct this in the US, and Scholz will now attempt to correct this in Germany and the European Union. It is also to be noted that China in 2000-2015 did not have the benefit of the newer technologies that India now has access to, which is why India says it is able to reduce carbon emissions per each unit of GDP by 35% from 2005 levels by 2030. It is this efficiency in producing units of GDP with newer and newer technologies that China lacked in its period of hyper growth 2000-2015 that now looks to have hurt China- with overflow of highly polluting steel mills and other factories which it would prudently and wisely have cut back on. Looking back at this period one sees the wholesale transfer of highly polluting plants in Germany being sold and put up in China, a poor developing country in 2000. Was this a good decision for Germany or for China? In this way the banks and large corporations in the US and Europe who use economic indicators that are limited such as dollar profits, without overall indicators that include negative effect damage to the environment that requires huge investments to correct, problems of trade wars leading to political conflicts, are acting like a person walking blindly in one direction.  With some foresight China and all its trading partners would have done better with slower but more careful Chinese growth of 7-8% that would have better met societal goals in US, Europe and China, avoiding high carbon emissions segments of industries from Day 1. Jinping is doing this in China, and Biden is doing this in the US- cutting out highly polluting factories and segments of industries- but in a climate of mutual distrust, which could have benefitted the world when conducted in a climate of cooperation and trust. The pandemic made the situation even more difficult. Power shortages in factories and blackouts in Chinese cities have led to a reversal of policies on use of coal in China months before the COP26 Glasgow conference and G-20 summit leaving a huge gap. Without the presence of Xi Jinping at COP26 in Glasgow and with Chinese participation uncertain significant progress on climate change is elusive. Estimates by US Renewable Energy Agency is that it would cost $131 trillion to pay for limiting emissions to global warming of 1.5 degrees Celsius. Some major share of this cost can be attributed to the increase from about 4 billion tons in 2000 of carbon emissions in China to about 12 billion tons in 2015, increase by 3 times. One can clearly see from this sudden jump in carbon emissions in China that policies of hyper growth with unregulated polluting industries adding to GDP growth figures was bad policy for China, bad policy for US, and Europe, even if it offered temporary profits for individual companies. India has the advantage of learning from this experience and charting its own wiser course as a partner with US, Europe and Japan and by Modi's vigorous efforts in renewable energy. The lesson- look at all indicators of progress, including climate and society, not just economic indicators in profit or dollar terms, take the tough decisions early in regulating polluting companies and industry segments, and bring full and active public participation with transparent access to data on climate damaging activity in real time because climate and the environment we live in free of polluting substances belongs to all the people, belongs to all life on the planet from trees to animals and birds, not companies that can choose to ignore it. ...

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Already lead US negotiator and ambassador to Ukraine Lt. Gen. Keith Kellogg has created a miscomprehension on the US and European side as to who will participate in negotiations. Lack of experience in tough negotiations to end a conflict is showing as it must be evident that Ukraine and the European Council, the EU, would expect to be part of any negotiations that settle questions about the security of Europe and what kind of Europe emerges from the negotiations. The European problem comes from the European lack of resolve to set aside or settle internal divisive issues such as migration, privatization, globalization winners and losers, rural vs urban, that have created economic and political divisions in Europe to concentrate with unity on issues that have common interest. Bad policy as in the US from business and government to overconcentrate manufacturing in China, in Germany to overconcentrate energy supplies from one provider, are sources of the conflict and have taken years to fix alongside the pandemic. European leaders scramble to define their position after statements by US Defense minister Hegseth and US's Ukraine ambassador Kellogg that suggested direct talks US with Russia would leave out the EU and Ukraine. Hegseth stepped back from some comments. Marco Rubio, US Foreign Minister, says Ukraine will be at the negotiating table in talks the US holds with Russia. Macron meets with Scholz, EU's Tusk, and NATO's Rutte this week.  Ambassador Kellogg and lead negotiator had said to European leaders about their being at the negotiating table-  “I think that’s not going to happen.” The EU Council head Costa after meetings with European leaders says Europe's position is-“In a nutshell: There will be no credible and successful negotiations, no lasting peace, without Ukraine and without the European Union.” Further he said-  “It must guarantee that Russia will no longer be a threat to Ukraine, to Europe, to its neighbors,” he said. ...

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The European Union’s total defense spending increased by 30% from 2021 to 2024, to 326 billion euro or $341 billion. That is 1.9% of the EU’s GDP it's economic output, according to European Defense Agency. It is still short of 2%.  Britain will ramp up defense spending all the way up to 3% in 2027. Britain is short of defense equipment with transfers to Ukraine and with much of the defense budget going to maintain a nuclear deterrent. This leaves less for other defense needs. This report says most of the procurement for defense equipment goes to countries outside Europe.The Kiel Institute says 80% comes from outside EU. It is not mere shortage of funds it is the severe bottleneck from lack of defense manufacturing industry  that is putting Germany, France and UK in a situation where they are too dependent on the US. It takes years to build this capacity. Russia built it up during 3 years of war by going to a wartime economy and it now produces 4 times the ammunition Europe produces. The US did the same to match and exceed Russian capabilities and capacity, Europe lagged behind with unwillingness of Macron and of Scholz in particular to switch funds from needs in transport, infrastructure to defense. The debt brake Merkel to stop debt based infrastructure investment is what ails Germany. It has had two pernicious effects it created the AfD's surge by lowering economic growth and investment in public needs - housing, transport, public services. It worsened the SPD and CDU performance by not investing in security with no policies to return crime committing refugees to their home countries. A combination of aid and other assistance, diplomacy, secured the cooperation of countries to take them back. A strong display of action on removing refugees committing any offenses would have lessened the number of terrorism incidents. ...

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WSJ report shows that on the morning of the 90 Day Pause in Tariffs announcement discussions took place with the Swiss prime minister, with Treasury Secretary Scott Bessent, and watching Fox News interview of JP Morgan Chase's Jamie Dimon. Seeing the turmoil in financial markets and bond markets, US president DJT made the decision to give time to make the agreements with about 50 countries, and time for financial markets to understand the president's  policy and goals to reformulate the world trading system into one that offers a level playing field. The chart showing the Tariffs of 67% by China and US 34% imposed tariff in the Rose Garden on April 2, 2025, was say reports the result of the influence on the president of the advice of Peter Navarro.  Treasury Secretary Scott Bessent's expertise is in financial markets as a protege of Soros, Navarro's is world trade. Bessent stepped in when financial markets appeared to reflect the uncertainty and convinced the president that the 90 day pause would be the best way to implement the policy on trade. There is a vigorous debate in the administration about how to get a level playing field for trade, and get the job done without disruptions in financial markets or a recession induced by uncertainty. On April 10 as part of the effort to talk to the American people US president DJT opened up his Cabinet meeting to the media and had Bessent, Borghum, RFK Jr and Marco Rubio talk about their plans and policies. Proper implementation, gaining confidence of the people of America and financial markets, is now as important as the goals and policies in the next 90 days. Getting the trade deals with the European Union, Japan, South Korea, Taiwan, Britain and India would go a long way to reassure financial markets and set the right tone for the future.   ...

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Russia experts Robert Nurick of the Atlantic Council, and Graham Allison of the Belfer Center of International Affairs at Harvard, see a sea change in attitudes to Russia following the interventionist policies of president Putin. The Obama administration will now focus on limiting Russian influence for the remaining two years of Obama's second term. There is a loss of faith in Putin on the part of Obama and close advisors. Russia is seen as a regional power, and the Ukraine crisis is seen as having a serious impact on the Russian economy through decline in trade, foreign investment and capital outflows. Russia is a regional power because it is not the same as the old Soviet Union, it is much smaller, with a declining population, and dependent on oil revenues, and in this sense not the Russia U,S, president Truman and Kennan faced during the Cold War. Obama advisors see Putin's actions as counterproductive for Russia, as the economy is now seen as contracting in 2014, making its actions in Syria, and in Ukraine, unwise foreign policy moves that hurts Russia's economy and future prosperity. Democratically elected leaders in Turkey and Russia with control over the media and shutting down the opposition using control of the judicial process, have shortchanged democratic ideals, and in the process concentrated powers in one leader. This creates risks of arbitrary exercize of power without the checks and balances that are built into a truly functioning democracy, with foreign policy errors eventually leading to a resolution of the conflicts created as these policies are increasingly called into question. Putin and Erdogan were reelected because of economic growth- a contractionary economy or steep declines in growth put everything at risk. A footnote on Kennan, American diplomat and linguist, is appropriate. A quick reading of Wikipedia's excellent account of Kennan will show that Kennan was in favor of a nuanced approach to Russia based on changing conditions. He observed that policies that were seen as anti-Russian actually helped Russian leaders throughout history solidify autocratic type rule, which actually hurts Russia's normal evolution and development. Normal development and evolution similiar to ways Germany and other nations left behind Prussian history and traditions for a open, free society, and in the ways even the U.S. left behind older practices such as slavery in the south and limited representation democracy. In fairness to Kennan it should be said that containment of the Cold War was more a Truman-Acheson doctrine- continued under Eisenhower by Dulles-Nitze, and under Kennedy by Rusk-McNamara- which has roots in Soviet intentions of destabilizing war ravaged western Europe starting with Greece, following similiar efforts in Eastern Europe. Truman was right in aiding Greece, but the U.S. needed to be aware of changing conditions and not take a rigid stance, and get locked into supporting client states just because they were "our guys," a lesson Kennan emphasized throughout his life. Putin and Erdogan use appeals to Russian and Turkish nationalism to improve electoral support and stifle free expression of ideas necessary for growth in any society. This also provides a way to have a discussion with our German friends on engagement and economic relationships, without the rigid outlook of a Wilsonian or Acheson-Dulles kind. ...

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

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Jorg Asmussen, Germany's representative on the ECB'S Executive Board, will take the position of deputy secretary in the Labor Ministry in the new coalition government of Angela Merkel with the SDP. He moves to Berlin from Frankfurt to be close to his two small children and family, who continued to live in Berlin after Asmussen moved to Frankurt ECB headquarters. Germany is likely to nominate Sabine Lautenschlager, member of the executive board of the Bundesbank, to Asmussen's position on the executive board of the ECB. The ECB Governing Council, including the six member executive board and the heads of 17 central banks, will now have the first female member. Ms. Lautenschlager's expertise is in banking regulation, which is relevant today because of the ECB's new role as regulator of banks in the eurozone. Asmussen, who is from the SDP, assumes a position under Labor minister Andrea Nahles. He will be responsible for introduction of the national minimum wage, which was a key demand of the SDP for joining the coalition with Merkel....

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Francois Hollande becomes the first Socialist candidate to be elected president of France since Francois Mitterand 17 years ago.

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A sense that the policies of Hollande in France are better aligned with the Obama administration's position on economc issues.

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This is an adaptation in the Washington Post from the book by Neil Irwin- "The Alchemists: Three Central Bankers and a World on Fire," published by Penguin Press in April 2013.