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The health care system is designed to encourage procedure based specialist practices and discourages the patient understanding education and monitoring that occurs with a well designed preventive family physician practice. As a result a patient only spends 30 minutes ayear on average with family physician compared to one hour in other developed nations. In the USA there has been a steady decline in the level and quality and extent of family care and the close one on one rapport with well trained family physicians who enjoyed their work and understood their patients and kept up with their health conditions and provided good and regular advice on these conditions. There is no money in this care as a result first you provide an environment where a whole range of medical conditions can flourish and expand, and then you hit them with a whole series of tests to rule out specific medical conditions. It is a perfect way to expand the testing and let testing flourish, so it would appear that if someone had wanted to start with a goal of letting testing proliferate unhindered then this would be the perfect way to design it. ...

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Morsi's authoritarian personal style, decrees and failure to give adequate weight to liberal opinion alienates liberals supporting El Baradei. The Salafi Nour Party is alienated by Morsi's improvement of relations with Iran. This weakens his administration with street protests in June 2013.

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Friedman on the ouster of president Morsi after only one year in office following large scale protests. He sees this as the beginning of a fallback of political Islam, with the protests of secularists in Turkey, the shift to a moderate candidate Rouhani in Iran's presidential election, the shift of the Emhada Islamist party in Tunisia to work with center-left parties in writing the constitution, and the election of a western educated political scientist to lead a coalition government in Libya. In each country the secular and liberal leaders and the young people felt the revolution was being stolen from them by Islamist parties and are asserting themselves to gain a voice in government. The Islamist party in Egypt has older leaders, an authoritarian structure and hierarchy, which failed to incorporate liberal and other opinion in writing the constitution and in forming the government. A more tolerant and open Islamist party needs to be part of a broad based government with other parties, which can focus on the economy, unemployment, infrastructure and public services....

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Kessler in the WP corrects Obama's claim that he created 800,000 jobs. He says this is clever arithmetic as it takes a low point in Feb. 2010 following the financial crisis. Kessler points out that according to the Bureau of Labor Statistics, U.S. manufacturing jobs were 12.56 million in Jan. 2009 when Obama became president. In Nov. 2016, early estimates show there were 12.26 million manufacturing jobs, a loss of 300,000. This loss does not reflect the problems in the U.S. auto industry and older industries in the midwestern states as a result of trade and globalization that speeded up with the rapid industrialization of China. And led as Greg Ip pointed out in a recent WSJ report to a rapid acceleration of job losses in a decade that did not happen in the same scale during Japan's industrialization and urbanization in the sixties. This aggravated the situation in Michigan, Ohio, Wisconsin, Indiana, and Pennsylvania, and was met with a feeble response from Democrats. Even a economist like Krugman favoring the Obama administration's efforts came to the conclusion that TPP did not add much to gains from trade as most of the gains had already been realized. More of the gains went to tech and IT in California, at the expense of the auto industry based in the midwest. A report in WP show a president too close to IT in California and failing to grasp the situation in the midwest. Voters punish whoever is in power, regardless of being Conservative or Liberal, in Canada the hollowing out of manufacturing under Harper in Ontario and Quebec led to the win by Trudeau's Liberals.  ...

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The European Union Commission says Ireland must recover 13 billion euros in back taxes for giving tax preferences to Apple that are against EU rules. The EU Commission says Ireland allowed Apple to pay a corporate tax rate of 1% on its European profits in 2003, and .005% in 2014. The EU Commissioner says the use of Ireland as the place where Apple pays taxes on operations in Europe has no base in reality, as most profits are earned in other countries outside Ireland. Taxable profits of Apple "did not correspond to economic reality," according to Ms. Vestager, the EU Commissioner.  In the current environment where political upheaval is unsettling the democratic process in the U.S., Britain, Spain, France and Italy, as well as in Brazil and other countries in the developing world- because of deep recessions, and efforts to cut the deficits with deep cuts in state spending including in education and healthcare, basic services- the moves by companies to reduce taxes to these absurdly low levels such as .005% when other companies in the EU are paying 12.5%, is becoming increasingly unpopular. As pointed out in this BBC News article this sounds like the way Carnegie, Rockefeller and Vanderbilt operated during the late 19th century, and were seen as operating in a manner that was above the law. Janet Yellen pointed out at a Boston Fed Conference on inequality in Oct 2014 that the bottom half of the distribution or 62 million households in the U.S. in 2013, had a net worth of about $10,000, One quarter of these households had a net worth of zero dollars. The working class and blue collar workers in the U.S. provide much of the support at Trump rallies. Younger college educated people support Sanders, because of the situation of the working and middle class in the U.S., and a similar situation exists in Europe. It is for the sake of the democratic process and delivering services in education, healthcare, and other basic areas to all, that companies small and large need to pay their fair share of taxes, regardless of size, influence, or technological advantages. Today this is is seen by most leaders who draw public support as the right way forward for the U.S., Latin America, Europe and Asian countries, including proper allocation of resources to best serve the needs of working people. For example the 13 billion euros is equal to all of Ireland's healthcare budget, and 66% of its social welfare budget.    ...

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Peter Funt points to the time before the internet when daily papers were delivered and radio carried the news between music, and it was hard not have it rub off while hearing the radio or glancing at the sports pages. This rub-off effect meant that even by casual listening or accidentally people got the news. Before cable television the news came from nightly and evening general interest news broadcasts. People usually caught the major news at dinner time or before bedtime as most entertainment broadcasting paused for news broadcasts. By contrast in today's environment news is pulled on the internet home page only from the sources and topics one has selected, or watching one of the 24 cable channels that are essentially covering a liberal or conservative agenda, leaving people less informed about current events except in ways that reinforce one's opinions or biases. Others get their news from tweets, or social media. Funt call this a complete inversion of the traditional process of getting news- where the traditional process was to combine what people wanted to see and ought to see, the new process was to give what people wanted to see. Add to this competitive pressures and budget cuts, and news was shifting by design and intent to what people wanted or were likely to click on frequently, even on sites like BBC News with proliferation of trivia. The net result- there is too much which poses as "news" but is not news such as trivia, less coverage of news, and as the title of this article suggests, too much media and too little general news to shed light on events that affect our daily lives. Funt was writing in 2009, when Google News and Facebook News Feed were just getting started. By 2016, this inversion was causing serious alarm because of the way misinformation was becoming prevalent. This article reminds one that this was not always the case, this is something that has developed only in the last couple of years- that it is not a constructive development, and which we now realize can have a disruptive effect on democracy through spread of misinformation. Funt cites Scripps News slogan- "Give light and the people will find their own way," - that there is a role for traditional general news in our daily lives which informs and lets us form our own opinions afterwards,  that the social media news feeds on the internet run by algorithms or 24 hour cable news channels run for conservative or liberal agendas is not a subsitutute,  that most of us can use the help of good editors, and good broadcasters.       ...

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Egyptian leader ElBaradei describes his talk with U.S. Secretary of State Kerry and E.U. leader Ashton on the day of the coup on July 3, 2013 to convince them about the need for the military to intervene to oust president Morsi. He says two and ahalf years have been wasted but this time Egyptians have to get it right. Morsi was elected with the help of liberals, but failed in ElBaradei's view to form an inclusive government and respect all sides of opinion, including the young people who formed the core of protests against years of military rule.

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David Brooks of the NYT comments on the Hillary Clinton interview by Goldberg in the Atlantic magazine, where she criticized U.S. president Obama for a weak foreign policy and failure to act in Syria. Brooks says Obama's failure to act in the robust manner Clinton is advocating only leads Obama into situations where he is forced to act later as the situation deteriorates with more serious consequences for the U.S. By not acting in a timely manner the U.S. may be forced into greater involvement later, which makes Obama's "don't do stupid stuff" less of a sound idea than it appears. As Clinton points out not leading to better decisions in the same manner as the Bush-Cheney jingoistic policy making.

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John Bolton looks at the continual dithering behaviour of the U.S. president in the Middle East- Iran, Libya, Syria, Iraq in sequence- and provides some insights into the president's behaviour. He says it comes from Obama's distrust of the U.S. role in the world as a positive factor, and a deterministic view of the "arc of history" bending towards outcomes he finds ideologically acceptable. This coincides with a different public perception of America's role in the world, not so much of mistrust and skepticism, as of indifference and focus back on domestic issues following the event of the first war in Iraq and of the 2008-2009 financial crisis. The two are different in nature as the public including women may not share the ideological frame of mind of the president that the U.S. is not overall a serious positive factor in the world through the presidencies of TR, Wilson, FDR, Truman, Ike, to Kennedy, Reagan and Clinton, from the Russo-Japanese war, through the First and Second World War, the Berlin Airlift and the Korean War, to the Balkan conflict. Bolton writes at a time when the two perceptions are about to diverge as the U.S. returns to its normal role of positive and constructive engagement with the world....

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Tunisia's president Moncef Marzouki comments on the violent demonstrations in Arab countries after the anti-Islamic video in Sept. 2012. He says the violent demonstrations do not reflect the true feelings of the vast majority of Arab people. He says the Arab Spring is not pro or anti-western but focussed on social justice and democracy, and not even about religion when truly understood.

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Thomas Frank writing about the public outrage about executive compensation quotes Bill Black, a Professor of economics and law at the University of Missouri-Kansas City, who makes an important point. Beyond the size of this compensation there was something else happening that was perverse in its design and in its effects. Black says that at each point in the development of the disaster of mortgage securitization, it was the pay for performance systems that sent the wrong signals to loan officers, real estate appraisers, accountants, and bond rating agencies. The compensation or reward systems actually encouraged wrong, unethical and ultimately disastrous behaviours for the companies and the economy. Another way to look at it, the way it happened on Wall Street- especially at Merrill Lynch and some other financial institutions- the bonuses and other compensation was a way for executives to recklessly milk (loot is the other word) the companies for all they could yield regardless of the results afterwards. And as Black says, to do this through normal corporate mechanisms. A whole range of behaviours of this type took place in the final years of the boom. See other articles by Thomas Frank. ...

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Kirkpatrick and El Shaikh give an account of the days and events leading to the ouster of president Morsi of Egypt in July 2013. Morsi and the Muslim Brotherhood forge an alliance with the military under Gen. Sissi, a younger officer open to working with the Muslim Brotherhood in power. Morsi is elected with the support of liberals and the military under Gen. Sissi against a Mubarak era candidate. Morsi wins with 51% of the vote, which liberals say would not be possible without their help. Morsi fails to form an inclusive government. His authoritarian tendencies from decades of working under a strictly hierarchical leadership in the Brotherhood, a personal style that does not take into account opposing views, and a lack of experience in democratic forms of governance where the opposition, the media and the judiciary, are important to balancing powers of the executive, lead to alienating liberal opinion and younger protesters who initiated the struggle against Mubarak. Gen. Sissi tries repeatedly to achieve a compromise including appointment of a new prime minister and cabinet but Morsi rejects all efforts, leading to the takeover by the military and appointment of the chief justice as president and ElBaradei, as prime minister....

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Helene Cooper and Worth point to the vacillating response to the Arab Spring and movement for democracy and freedom in the Middle East of the Obama administration and President Obama. The dangerous overtones of this lack of U.S. leadership in the region as the U.S. completes a withdrawal from Iraq without an agreement for a residual presence, sees diplomacy reaching an impasse with Iran's development of nuclear weapons, and the Syrian civil war drawing in Turkey with its long border with Syria, and drawing in Saudi Arabia as a defendor of Sunnis in Syria. The stakes for Russia in Syria were minimal compared to that of people in the Middle East and the U.S., yet it had an outsized influence with its early military assistance to the Assad regime and the lack of U.S. leadership to resolve the situation in Syria in favor of the democracy movement.

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Infratest Dimap polling institute is commissioned by DW.com to find out what Germans think of the refugee policy of chancellor Merkel one year later. In summer 2015 Merkel said on Aug 31, "We can do it." Costs related to the refugees are about $17 billion, do Germans think services are overstretched for education, healthcare housing and other services. On the other side German society is aging and for every 100 unemployed people there are 200 open positions for skilled personnel. But the refugees who are accepted do not have the skills required and have to acquire the skills or given training and education. On this issue DW.com asked the question whether it will strengthen the German economy. About 51% agree and 45% disagree on this question, and about the same number agree and disagree on the question that Germany will be overstretched providing the services for housing, education, healthcare and other services. The higher educated and young are more favorable to accepting refugees, with those over 50 and basic schooling unfavorable. On the AfD side most people are unfavorable, and in the Greens party most are favorable. On terrorist incidents probability, over 58% think this is more likely, 38% disagree. On the question of whether this will make Germany more diverse 56% agree, 40% disagree. Overall the situation appears to be balanced, with a range of views expressed, and the positive and negative sentiment "evenly balanced", says DW.com.  ...

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Galston of the Brookings Institution says globalization has hurt workers in manufacturing with job losses and declining incomes. It has produced outcomes that have favored some industries such as tech, and not others such as automobiles which in the past helped create the broad middle class by offering good paying jobs to people with less than a college education. Immigration has created an issue that political leaders outside of the main parties have appealed to in France, the U.S. and Britain. The result is a polarization in the voters that has rarely been seen to this extent before. The middle class in the period from the 1950's to the 1980's is not the middle class that we see today in Europe and the U.S. The 2008 financial crisis added to the problems with the slow and uncertain recovery for some groups such as white men, the less educated, students, and people on minimum wage. 

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Islamist parties are having difficulty integrating into political life and bridging the differences with secularist or liberal political parties in Egypt, Libya, Tunisia, Pakistan and Turkey following the democratic transition in 2011-2013 in the Muslim world. Some progress has been made, but lack of experience, lack of respect for the opposition and other opinion, overreaching, personal styles of individual leaders such as Erdogan and Morsi, and poor economic conditions after decades of neglect under military rulers in Egypt and other countries, is creating problems for Islamist parties in government.

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A young socialist leader in the Sanders campaign effort asks what it is about aging socialist leaders Jeremy Corbyn, 68 years, in the UK, and Bernie Sanders, 75 years, that makes them popular with young people. She says both leaders stood up consistently for decades on issues important to ordinary working class people, when Labor under Blair and Democrats under Clinton abandoned their base to a point when one political expert could say Democrats  were the "second most enthusiastic capitalist party" in the U.S. She says under Blair Clause IV was rewritten. That clause committed the Labor party in Britain to "common ownership of the means of production, distribution and exchange." Under Corbyn, with support from young people, Labor received 40% of the vote. The party was reenergized on issues important to students such as making higher education accessible to all. A similar situation happened with Sanders in the U.S., who received more of the young people's vote in 2016 primaries than Trump and Clinton combined. ...

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This Journal editorial on Oct 5, 2012, says that by not offering leadership in the Syrian conflict beause it would lead to a wider conflict the U.S. and the European Union face a wider conflict. The current crossborder shelling between Syria and Turkey is the latest evidence of this. Turkey and the Saudis cannot handle this on their own. Without U.S. leadership the costs of this conflict will be even greater, and even poses risks for the Turkish economy if handled badly.

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During the early weeks of the Libyan people's struggle the Wall Street Journal was one of the rare voices that stood up for freedom in Libya, saying the U.S. had to have the will and was not so overstretched that it could make a difference working with its allies in NATO. It took some time for the Obama administration to make up its mind by which time the Gaddafi forces would have entered Benghazi. It was the leadership of Sarkozy of France and Cameron of Britain that made the decisive difference at the right time. And as the tide turned it was the young people of Libya who could be seen in the video footage who showed bravery against the organized heavily armed forces of the Gaddafi regime. The lesson from the U.S. support for the Libyan people's movement for democratic government is that the U.S. can make a moral difference and a strategic difference when it follows the right instincts that have guided the country since its founding.

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For the first time since the 2008 global financial crisis a initiative has been put to voters for tackling executive pay and bonus. A large majority of 68% of Swiss voters supported the 24 item Minder Initiative which restricts executive pay and bonuses. The Minder Initiative sends a signal to the rest of the world, says Christa Markwalder, a legislator for the pro-business Free Democratic Party. It provides other countries with a distinct approach to corporate governance and executive compensation. The EU decision to impose strict limits on executive pay and bonuses influenced Swiss voters. The EU decision bans bankers bonuses from exceeding fixed salary without shareholder approval, and limits flexible pay to twice the salary. The 24 item Minder measure gives shareholders the right to block proposed executive pay and bonuses. It also has penalties for violators of 6 times annual salary or imprisonment of upto 3 years. Businessmen and politician Thomas Minder has worked for three years promoting his Initiative and it was finally put to voters in 2013. For the first time since the 2008 global financial crisis, serious action is being taken to limit excessive executive compensation and bonuses in banking and other industries. It comes as austerity measures and high unemployment are influencing public opinion in Spain, UK, Italy and other European countries which have suffered banking crises....

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Critics of the Obama administration's so-called "light footprint strategy" for the Middle East say it is more about keeping distance from problems in that region. This is a reaction to the extensive involvement of the U.S. in two wars in that region and intuitively makes sense, as well as being in line with American public opinion to focus on problems at home. The shift or pivot to Asia of president Obama also comes in that context. The problem with this approach is that this ignores the fact that most of the momentum and effort for the freedom struggles throughout the Middle East from Tunisia first, then Libya, Egypt, and now Syria, comes from within. The lead role is now being taken by France and Britain, with German public opinion also lined up in support. The U.S. in forfeiting its role as a facilitator with strategies such as "no-fly-zones" is losing the opportunity to gain the goodwill in the Middle East with cost that is negligible in comparison to the cost of Iraq and Afghanistan, and comes after the huge U.S. effort to remove one dictator in Iraq. A minor followup effort is all that is required from an administration that pushed for the "surge" in Afghanistan. When history is written the investment of the Obama administration in Afghanistan may show little results, if what is considered by the media and experts as an unpopular and undemocratic government of Karzai falls in the aftermath of the U.S. withdrawal. There is little doubt in public opinion in the U.S. and worldwide that the movement for freedom and democracy in the Middle East and democratically elected governments will become a lasting facet of the new Middle East. It also provides huge opportunties for trade and investment as is shown by the gains made by Turkey in just 2 years. This is why the Obama adminstration policies in the Middle East show a lack of grasp of the facts showing the Middle East as opportunity more than threat for the next decade, especially in its overreaction to the Bush era policies. This happens as there is a demographic explosion of young people in the Middle East. An administration that was keen to sense the demographic changes in North America, has failed to grasp this fact and why the struggle in the Middle East flashes daily on television screens young people carrying on the struggle. A pivot to Asia means a pivot to the Far East more than Asia because India is part of the South Asian-Middle Eastern region, which presents another paradox because as China is slowing the entire South Asian-Middle Eastern region of Asia is where future growth is expected to accelerate in the next decade. ...