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The BBC's Soutik Biswas takes a look at prime minister Modi as he seeks a second term in India's general election in May 2019.  Modi's first term is marked by exceptional development schemes, efforts to provide health insurance to 500 million people who cannot afford health insurance, bringing cooking gas cylinders to hundreds of millions of Indian women especially in rural areas, efforts to jumpstart building of infrastructure projects such as airports and metro subways. A new law for GST brings together the country with one tax instead of a hodge podge of state taxes for interstate commerce, something India needed for a long time but different governments failed to implement. A failed effort to fight corruption by removing from circulation large denomination currency notes reduced economic growth briefly during the first term, though it may have accelerated the shift to formal economy needed in the long run to improve tax revenues for development needs. One of the problems for the Modi government is how do you put a value on something like Swach Bharat Mission, the achievement of the goal of defecation free India in 2019 by 100% on the 150th anniversary of the birth of Mahatma Gandhi, getting rural toilets up from 38% to 100%. Development had to start from the bottom up. Similarly in a country where middle men took up a lot of the transfer to poor families of government assistance- the delivery to hundreds of millions their own bank accounts.- how do you put a value on something like this, but it is essential for development from the ground up. More than missiles or other talk this has got to be the spirit of any development oriented administration in India. Ground up, big goals and rapid delivery and an apology for the difficulties that the people suffered earlier for lack of this infrastructure. For both China and India it is the same - moving quickly to make up for 100 years of colonial rule and stagnation. The Modi government has responded to rural farmer distress with support for guaranteed crop prices. As more young voters vote for the first time an important factor is how the new voters see the years ahead under either a government led by the BJP or by a patchwork of parties as the previous ruling Congress party depends on alliances with other parties with conflicting agendas or lack of rapid development agendas. The Modi government sees itself as setting the stage for the next phase of development that would change the economy through new infrastructure development and create jobs in construction and engineering, and other areas. The criticism is that not enough jobs were created in the first term. Yet bold infrastructure development targets such as transformed the Chinese economy could be the answer for job creation. The question then is who is better qualified to launch that effort based on its track record. The Congress party's main criticism is that it has to make alliances with parties that could stall development with conflicting agendas. The other is that in the the 2 years leading to the election of Mr. Modi the Congress led government of Manmohan Singh was stalled due to corruption charges, leading to a lack of decisionmaking at the highest levels, and stalled efforts for the rapid development that could deliver the kind of jobs India needs.  Young Indians would like to see growth first and foremost, only something rivalling China's transformation over 2 decades can do this. It should be kept in mind that China poured more concrete in the 21st century so far than all the concrete the United States poured in the 20th century, according to The Guardian report. The question then is who is best qualified and in a position to deliver this needed economic miracle.    ...

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This New York Times editorial says a smaller Wall Street and growing jobs in other fields will be good for New York as well as good for the country. It says New York politicians should focus on finding new ways for New York to broaden its tax base and get new businesses and new opportunites in fields such as media, advertising, entertainment, health care and tourism. Especially welcome are initiatives such as the science and tech campus of Cornell University promoted by Mayor Bloomberg. Tighter financial rules and higher capital requirements are good for the country and for New York the editorial emphasizes, because they help control reckless banking practices that destroy capital and opportunities for growth elsewhere in the economy. It points to Kevin Rose's Nov. 21, 2011 account in the Times showing a healthy culture shift in New York and the country with the status jobs being seen not at Goldman Sachs but at Google, Apple and Facebook. Rose's account shows that in the last 3 years the number of Wall Street employees of ages 20-34 declined by 25%....

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More than 30 states in the USA are facing budget deficits totaling more than $127 billion over the next 2 fiscal years. A look at how Mississippi Governor Barbour has tackled this issue. Barbour has cut the state budget 5 times, including education, mental health and other areas being cut by 10%. Barbour has access to $2.6 billion in stimulus funds from the federal stimulus, which prevented deeper cuts, and he signed into law 2 tax increases. Now Barbour feels he has reached a limit to the effectiveness of budget cuts he can make across the board, and he will have to look at restructuring some things. 2012 is going to be another tough year, as state tax revenues continue to be hurt badly because of the economy.

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House Budget Committee chairman Paul Ryan said in remarks at a breakfast hosted by the Wall Street Journal- he would submit a budget plan that would balance the budget in 10 years by cutting government spending and without raising tax revenues. This comes before the House vote to suspend the debt ceiling till May 18, 2013, giving more time for deficit negotiations. Ryan said: "Hopefully, people can come together to agree on getting a down payment on the debt crisis."

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One of the favorable factors for Iraq in recent years was the surge in oil production, adding 1 million barrels a day to reach 3.3 million barrels a day. It surged to an average of 3.7 million barrels a day in December 2014 after a deal with the Kurdish region in northern Iraq for an additional 550,000 barrels a day in exchange for Kurds getting a 17% share of federal revenues. This helped Iraq overcome other problems. The drop in oil prices has led to a 40% drop in revenues and the invasion by Islamic State in a loss of some production.The federal budget of $101 billion planned revenues is based on an oil price of $56 and exports of 3.3 million barrels a day, resulting in a $20 billion deficit. It assumes $10 billion in new tax revenues which may be hard to achieve with a lack of strong central government. Experts on Iraq's oil industry say large investments are needed to offset declining oil production from older oil fields in southern Iraq. Oil exports were 2.5 million barrels a day in 2014, and experts say even this will be hard to achieve for 2015. Investments could come from western oil companies, but Iraq and the Kurdistan region are behind in payments to oil companies. Iraq is considering issuing bonds for $10-$15 billion....

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Krugman questions the Paul Ryan U.S. budget proposal on several grounds. He says the Ryan proposal depends on projections by the Heritage Foundation for its assumption that the tax cuts would generate higher revenues by creating a booming economy. The Heritage Foundation projection is for revenue increasing by $600 billon over the next 10 years as a result of tax cuts. Krugman cites a different view from the Congressional Budget Office estimate for the Ryan proposal, which shows assumed savings from spending cuts will go not to reduce the deficit but to pay for tax cuts, with bigger deficits in the next decade. He says the spending cuts excluding Social Security, Medicare and Medicaid- but including defense- go down from 12% of GDP in 2011 to 6% of GDP in 2022- meaning that cuts in public services will need to cut to the bone. The Medicare part of Ryan's proposal does not say how spending on medical care will be reduced. The voucher or premium support Ryan envisages is estimated by the Congressional Budget Office to cover only one third of the cost of insurance premiums for Medicare equivalent care by 2030. Krugman cites the Center on Budget and Policy Priorities, which says the Ryan proposal achieves two thirds of its $4 trillion in spending cuts over the next decade by cutting programs that primarily serve low-income Americans. ...

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The IMF's changing views on the value of fiscal austerity. In the current debate about the value of fiscal austerity, there is the IMF view, a German view based on its own experience, and the views of other countries in Europe. The IMF's view has shifted over time. The IMF World Economic Outlook 2010, describes its view of the effects of austerity measures in the form of spending cuts and tax increases- "Fiscal consolidation typically has a contractionary effect on output. A fiscal consolidation equal to 1% of GDP typically reduces GDP by about 0.5% within 2 years and raises the unemployment rate by about 0.3% percentage points." Over the longer term there are benefits as the private sector is not crowded out in the search for captal funding by the excessive government borrowing. The IMF's economic models suggest that it would take 5 years before reaching the breakeven point when the benefits of austerity measures exceed the effects of austerity. The German view held by German central bankers is that the actions stimulate growth in the short term. Manfred Neumann, professor emeritus at the Institute for Economic Policy at the University of Bonn, says this is called the "German hypothesis" as it reflects the experience of Germany from austerity actions taken by Germany. Laurence Ball, professor of Economics at John Hopkins University, is critical of the "German hypothesis" and its application across Europe in different situations. Germany is a large exporting nation and exports helped counterbalance the effects of austerity measures. Within the eurozone with fixed exchange rates the exports of less competitive countries cannot be boosted through devaluing the currency to gain price competitiveness. The other problem is that with interest rates close to zero in the euro zone the central banks cannot cut rates aggressively to counteract the effects of spending cuts. The problem gets compounded when a number of countries are taking austerity measures at the same time accentuating the downturn....

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Martin Feldstein supports cutting "tax expenditures," -the special purpose deductions such as the deductions for mortgage interest, charitable deductions, state and local government taxes and other such exemptions- as Bowles-Simpson Deficit proposals have recommended. Bowles-Simpson would use this money to reduce tax rates and only $80 billion of this to reduce the deficit. Here Feldstein suggests capping the individual's benefits from such deductions at 2% of adjusted gross income. Research by Feenberg and Feldstein on the use of such a cap shows that this would reduce the federal deficit in 2011 by $262 billion or 1.7% of gross domestic product. The list of deductions used by Feenberg and Feldstein for these figures are: deductions for mortgage interest, state and local income and property taxes, charitable contributions, credits for dependent care, children and certain education costs, and the exclusion of employer payments for health insurance. Sunc a cap would not affect the 46% of taxpayers who use the standard deduction and would induce others to shift to the standard deduction. By doing so this will simplify the tax system and reduce economic inefficiency. Feldstein advises that Congress should include and individual cap on total benefits from tax expenditures in any program to tackle the deficit....

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S. Gurumurthy of the Hindu points out the dangers of economic growth without job creation in a country like India. He points out that demonetization- removal of high denomination currency notes- came at a critical time when the economic growth was not creating enough jobs. He points to the five year period till 2010 as having created 2.7 million jobs with 8.5% growth. Even though with lower growth of 5.4% in the period 1999-2004 the job growth was for 60 million jobs created. Had demonetization not happened he says, the economy could have seen the problems the U.S. faced in 2008 with a bubble developing in the real estate market. The fundamental shift of the economy to digitization of payments, increase in tax receipts brings more of the informal economy- with a size of 50% of the economy generating 128 million jobs ten times the formal sector - into the formal economy. A step that is key for India to see rapid growth in the decade ahead. The slackening of the economy for a year is part of  a needed long term plan, says Prof. Gurumurthy, visiting IIT faculty in Bombay, just as liberalization was in the 1990's.  Some errors were made in implementation and flow of credit to the informal economy, including by the RBI, yet the fundamental shift through demonetization served a good purpose. Gurumurthy says, sadly this is missing in the current politicized debate.  ...

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Paul Ryan, chairman of the House Budget Committee, explains his U.S. budget proposal to bring down the deficit. Ryan's Republican budget proposal is a bold effort to make a break from a status quo which is leading to higher levels of U.S. debt as a percentage of GDP. It envisions changes to Medicare, Medicaid, and the tax code. It is built on the idea that sustainable finances will lead to a better economic future for America, compared to small changes to the staus quo envisioned in Democratic proposals and the 2012 budge proposal of the Obama administration. It is also bold in its effort to tackle Medicare with a "premium-support" system, and Medicaid by turning it into a block grant system. It also incorporates the Bowles -Simpson President's Deficit Commission's ideas for simplifying the tax code.

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It is too much to expect central bankers to solve the US economy's problems, especially with rates nearly zero, and no agreement between the political parties before mid-term elections. The Federal Reserve by itself cannot fix the economy's problems, with the US economy facing prospects of deflation in 2011; and local governments cutting back as they face revenue shortfalls. Deficit concerns have led to inaction on further stimulus or help to local governments, and the Bush tax cuts are expiring shortly. In 2011 austerity cuts will be the singular theme in the western world, and these cuts are of a magnitude not seen in 40 years. In this situation there is only so much the US Fed can do.

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Krauthammer says there is reason for optimism that the super committee of the August 2 Debt Ceiling and Deficit bill can achieve major results. The reason he says is that much of the work in key areas has already been worked out by the Simpson-Bowles Commission. This has also received extensive public scrutiny and discussion. Its now upto the committe to make some choices for tax reform. For the sake of efficiency and fairness this needs to be done. Efficiency is gained by closing the loopholes and the tax exemptions for mortgage interest deductions, health-care exclusion, and subsidies such as the one for ethanol. And in its place moving to lower tax rates, the 23% envisaged by Simpson-Bowles, or the 28% from the Reagan days, down from the 35% today. Fairness is gained by removing tax breaks for special interest groups that do much of the lobbying. The mortgage interest deduction can be phased out starting at $500,000 in the inital phase or using the plan for tax expenditures proposed by Martin Feldstein. Feldstein's proposal outlined in the New York Times on May 4, 2011, (see group for Feldstein) was to limit the reduction in taxes from deductions and exclusions to 2% of the person's AGI or adjusted gross income. The other part of the Committee's focus would be the structural changes to Social Security and Medicare- raising the Social Security and Medicare ages and changing the inflation formula, and means testing Social Security. Obama has already considered the raising of the age for Social Security and changing the cost of living formula....

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The WSJ looks at Elizabeth Warren's Medicare for All plan that marks a major shift for the U.S. economy.  Households would see their costs go down by $11 trillion, boosting their ability to spend on other goods and services. Because income and wealth was highly skewed in the past three decades in one direction, the spending capacity of lower and middle income households was pushed down. This and other similar plans would help restore a higher level of spending and with it an essential element of inflation of 2-3% to the U.S. economy which was missing in the last decade. This sets the tone for the kind of broad based recovery that happened after 1950 that strengthened America's middle class and made it the core of the economy, the core of the post World War II recovery in America and Europe. The plan would be paid for by higher taxes on corporations, tax rate of 21% for corporations going back up to 35%, and reverse depreciation schedules in the 2017 Republican tax law. The argument that this would reduce business investment does not hold that much says the WSJ because amid new trade tensions business investment has declined over the last 2 quarters, and has been sluggish overall. The other source for the estimated $13 to $20 trillion cost of Medicare for All plan of Elizabeth Warren is a 6% annual wealth tax on billionaires, in an attempt to have all pay their fair share and reduce wide disparities in wealth. Mark Zandl, chief economist of Moody's Analytics, says his sense is at the end of the day from a macroeconomic view- because $11 trillion in the hands of 80% of households who could boost spending after lagging behind in the last decade- the negative effect on business investment will be cancelled out by the higher consumer spending. The overall effect and today's context is infused in this analysis. Private insurance, premiums for insurance, and out of pocket cost that the public pays would disappear in this new system where all health payments pass through the government. Health insurance premiums paid by employers would convert into a new employer Medicare contribution to the government starting at an amount employers pay now and adjusting gradually toward national averages over time. Smallest businesses are exempted. Mr. Zandl says the most important aspect of this now is that Mrs Warren has shown that her plan's revenue sources match the cost so that the plan would not lead to deficits increasing and pushing interest rates higher, leading to negative effects on the economy. Republicans under Mr. Trump have paid little attention to expanded deficits caused by their tax law, and economists across the landscape have also shown less concern. Still attacks are made if the plans don't add up. For this reason a sound assessment in today's context of depressed consumers and an overall impact becomes essential. The WSJ quotes from a pre- assessment of Warren's plan by Simon Johnson, a Massachusetts Institute of Technology economist who co-wrote it with Mr. Zandl and Betsey Stevenson of the University of Michigan. What they point out is that putting cash in the pockets of the lower and middle class for spending makes a lot of sense today, and taking money out of the pockets at the way upper wealthy end,  does not contract the economy at all. Other effects they say are constructive by letting all workers get health coverage from the government instead of employers, this makes it easier to change jobs increasing labor mobility and productivity. A worker getting a better job and better utilization of skills could then shift without looking at the employer health care plan. Warren says there would be a five year transition so that workers in health care insurance industry can work in other insurance fields and in Medicare, no one would be left behind. The important thing being to build America's middle class again. ...

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Colonel Stevenson's efforts to limit features on a new bomber for the U.S. Air Force to replace aging B-52's and B-1's. Contractors added a kitchenette in one design which was turned down by Stevenson and senior officers at the Air Force. Senior officers were mindful of how it might be seen by the public and aware of the need to keep costs down during a period of austerity budgets. Barnes describes the efforts of Colonel Stevenson as he led efforts to limit the new plane to essential features, turning down contractor proposals for a plane that could be converted into a drone, reconaissance and cyberdefense features, and other embellishments that would drive up the price tag per plane. In 2011 budget negotiations defense officials agreed to limit the cost to $550 million per bomber, a third of the cost of the B-2 which cost $1.8 billion per plane. Because new planes take a decade or more to design and build with cost overruns, it is also important not to venture too far into technological unknowns. This adds more time to build and proves costly. The Long-Range Bomber project started in 2011 with Secretary Gates signing off on the requirements for it to give the president the option to move quickly in a matter of hours to penetrate distant airspace. The cost is $600 million spent till Oct 2013 for research, and $8.7 billion budgeted to 2018. The Air Force is sticking to existing engine design, and Stevenson says if the technology has not been tested the Air Force is not interested in experimenting with it. In the process Stevenson finds himself trying to change the culture at the Air Force, where putting cost as the top priority is a new concept....

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Martin Feldstein on the U.S. economy in 2014 and the risks of the U.S. Federal Reserve tackling the economy on its own with monetary policy, without Congress taking on the task of policies to promote economic growth. Feldstein points out the 3.6% GDP growth estimate for the third quarter 2013 does not look that good considering that half of this is from buildup of inventory. GDP growth is about 2% as net result. With paralysis of Congress and the Executive branch the Fed's policy of huge buildup of long term bonds to reduce short term interest rates to zero and stimulate stock and home prices, he describes as the only game in town. The problem is that the size of the effect of increase in consumer spending from this increase in household wealth is small and not enough to contribute to significant GDP growth. The risks of this approach are that it contributes to destabilizing the economy as investors buy risky securities and bid up prices. He suggests a five year $1 trillion infrastructure development program, including defense, as a stimulus Congress should consider. Not the kind of stimulus that happened after the 2008 crisis. If not enough investment ready projects are available as in 2008 that will contribute to future growth, Congress should take another one year to prepare for this before moving forward. Debt reduction is key, and debt as a percentage of GDP should be reduced and set on a path to go where it was before 2008 to about 40%, deficits to below 2% of GDP. This should be done by slowing growth of Social Security and Medicare, and increasing revenues by limiting subsidies in the tax code that Feldstein as pushed for since 2010....

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Moody's downgraded its outlook on Germany's triple-A credit rating to negative. It also shifted to negative the outlook on triple-A ratings of Netherlands. Spain's ten year bond yield went up to 7.51% on July 23, 2012 according to Tradeweb. Analysts estimate Spain needs to issue 28 billion euros of debt for the rest of 2012 to cover deficits and repay maturing debt, and 50 billion euros in short term Treasury bills. An additional 30 billion euros may be needed if tax revenues decline increasing the deficit, and to meet the needs of regional governments. In changing the outlook for Germany, Moody's emphasized the costs Germany would incur if Spain needed a full bailout and if the situation spread to Italy, including the large exposures of German banks to Italy and Spain.

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Felipe Caldron, Mexico's new President, addressed one of Mexico's biggest problems low tax revenue by getting passed through the legislature a tax bill that will increase tax revenues from 11% of gross domestic product to 13.5 % of GDP. This will be done by a corporate tax that taxes sales rather than profits starting at 16.5% in 2008 and rising to 17.5% in 2010. The original proposal Calderon requested would have taken this to 19%. The bill cuts taxes on Pemex which will give it an additional $3 billion a year as it is falling behind in new reserves added from exploration and drilling that would replace ones being depleted leading to a decline in output. And the tax bill imposes a tax of 2.5% on cash deposits above $2200 to attempt to collect some taxes from the underground economy which employs about a quarter of the workforce. In addition it imposes a gasoline tax of 5.5% that will go to the state governors for local spending needs. The deal was negotiated by giving the opposition reforms in the electoral process including replacing all commissioners of the Federal Election Institute, and bans radio and television advertising for candidates. Calderon wanted to increase the taxe revenue to 14% of GDP, this would increase it to 13.5%. Considering the previous administrations failure to get any legislation through Congress while Pemex production slipped, and tax revenues were some of the lowest in the world due to widespread evasion (see a similiar problem and tax reforms in the Philippines recently), this is a breakthrough. But Pemex has to turn the corner, and lags way behind Petrobras in Brazil in terms of progress in exploration and new reserves. Revenues from the oil company largely help fund state spending in Mexico. However reforms that free up the state energy sector as Brazil has done (see the recent article on Petrobras in wsj ) some years back are still for the future. How much will this help. Its a modest beginning from a low point under the Vicent Fox administration. The additional $10 billion it generates next year will go to fill the gap in declining tax revenues from state oil company Pemex, and rising health and pension committments of the state....

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Even with the growth strategies of the Abe administration in 2014, projections of the IMF show growth rate for Japan are at 1.0% for 2015, compared to 3% for the U.S., 2.5% for UK, and 1.6% for Germany. The Third Arrow in prime minister Abe's Three Arrows program now follows the implementation of the other two Arrows- monetary easing and public works spending. Abe is faced with the task of convincing foreign and domestic investors that he can implement a winning growth strategy for Japan. The plan announced in June 2014 is an effort to overcome barriers to growth with a strategy that will work. The core of the plan is to cut the corporate tax rate from 35.64% to below 30% in the next couple of years. The corporations are expected to do their part to improve corporate governance and return on equity, so that shareholders, domestic and foreign investors, have more incentives to invest in the Japanese stock market. Analysts and economists say this plan has attractive features. It asks Japanese companies to increase ROE and ROI to global levels through a Tokyo Stock Exchange corporate governance code. Companies listed on TSE and not following the code will have to come up with reasons why they are failing to do so. Some analysts say this would increase the value of companies. Companies are more likely to make investments with cash that is not being invested. The plan includes measures for bringing more women into the workforce, which is seen as a serious committment to women. In addition to increasing the number of child care centers, this plan includes tax revisions that benefit women joining the workforce. Increased representation for women at the executive level is also part of this plan. Hiroshige Seko, a top adviser to Abe, says importance was given to execution for results, so that a score of 80 with definite results was preferred to an uncertain attempt to get a 100. To do this some compromises were made. The plan for special economic zones is still in the drafting stage as discussion is just beginning. A shakeup of the Central Union of Agricultural Cooperatives and more flexible medical care will be taken up gradually. The efforts to increase ROI, ROE, and improve corporate governance were initiated from the time of the Koizumi administration, and the latest plan may bring results after over a decade of effort in this direction....

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Pemex (Petroleos Mexicanos) CEO Emilio Lozoya is fired and replaced by Gonzalez Anaya, a close friend of finance minister Videgaray, as the company experiences a liquidity crisis by Jan. 2016. Anaya is known for cost cutting as head of Mexico's government healthcare institute. This report in the WSJ cites a Pemex official who says at one point in Jan 2016 Pemex was down to $8 million in cash. Under Lozoya Pemex failed to introduce financial discipline ahead of collapsing oil prices. Anaya is expected to cut spending by 19% or $5.8 billion. Mexico's governemt made a capital injection into Pemex of $4.2 billion to pay debts to suppliers, and offered tax relief of $2.8 billion. Pemex output is down to 2.2 million barrels a day in March 2016, decline of 4.5%. Pemex cuts will come in putting off exploraion spending of $800 million in one field in the Gulf of Mexico and paying less to rent oil platforms.

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Russia does not face the risks it faced in 2008 when $80 billion was owed to western and other foreign lenders, according to the chief economist of financial firm Otkritie. This debt has been brought down by paying down much of it and extending the maturities. In the fourth quarter of 2011, about $35 billion will be coming due. Russia still faces a serious risk from another direction. Every $10 drop in the price of a barrel of oil reduces Russia's GDP by 1%, according to Kingsmill Bond, chief Russia strategist for Citigroup. Government spending has increased rapidly and the government estimates it would take an oil price of $120 a barrel to generate enough tax revenues from the oil export tariff and mineral extraction fees to balance Russia's budget in 2011. The government needs to borrow the extra money from domestic and foreign investors. A slowing global economy could mean significantly lower prices than the current price of $87 a barrel on August 17, 2011.

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The gradual end of pro-democracy protests as courts allow a taxi unions lawsuit for clearing streets and police clear barricades by Nov. 26, 2014. The government in Beijing makes no concessions to student protesters and adoped a waiting strategy till public opinion shifts away from protestors blocking streets.

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The Republican House health care bill AHCA  keeps some some of the more popular parts of the Affordable Care Act such as not taking pre-existing conditions to deny insurance, keeping children covered on parents insurance till age 26, and increase contributions to Health Savings accounts. It is different in that the expansion of Medicaid at 138% of poverty rate threshold is rolled back. Age is used for tax credits instead of income, hitting those approaching Medicare age harder. The maximum charged to older people is now set at  5 times compared to 3 times what young have to pay. In general the Republican bill is seen as targeting the elderly to keep premiums down. The elderly on low incomes are hit hardest. Fox News O'Reilly Show showed the host questioning House Republicans, citing the CBO estimates that elderly on low incomes may have to pay as much as $14,000 a year for insurance making it basically unaffordable, and 52 million Americans would be affected adversely. Large companies are no longer required to offer mandatory health insurance under the new bill. Conservatives from Freedom Caucus wanted to see the essential areas of benefits covered by the law limited to fewer than the ten areas in the Affordable Care Act. The ACHA Republican bill leaves to states to determine what are required essential benefits. At one point maternity benefits were to be dropped but this was changed to let states decide. As a result the bill is 33 votes short of the number needed for passing the house in March 2017.   Neither the Democrats Affordable Care Act or the Republican House bill of Speaker Ryan do much to tackle the real problem- the absolute amount and increases for health care dollars for treating each disease in the U.S. compared to European and other countries. As a result health care has become more of a partisan struggle between the two parties than a real effort by all to overcome the problems that have to be tackled. Republicans want to see premiums drop and keep the burden on the deficit down- but with the level of U.S. health care costs disproportionately high compared to Europe and the rest of the world the arithmetic is tough and ends up leaving out vulnerable groups such as the elderly on low incomes, thus making the whole proposition prone to fail. For the same reason the Democrats failed to keep premiums down with a wider safety net leading to calls for repeal of their version.   ...