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The influence of the AMA convened Relative Value Scale Update Committee (RUC) on how the Medicare payments to doctors is shared, and on the growth of the Medicare budget. Concern that the interested party is driving the decision making process. Medicare costs went up by 9% in 2009. Fears that doctors have too much control over the dollars in the $500 billion Medicare program. The tendency to focus on more expensive procedures and short change preventive and less costly care. Medicare spends $60 billion on doctors fees. The older codes remain in place even when costs are reduced, leading to higher costs for the Medicare budget each year. And there is little incentive for doctors in RUC to revise overvalued codes.

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Echoing ECB president Draghi's comments in 2013, Haruhiko Kuroda of the Bank of Japan says "we will do whatever it takes to achieve our price target." The central bank has set a target of 2% inflation to be achieved in 2 years. With deflationary tendencies and low growth estimates of 0.5% for fiscal 2014, Kuroda was taking the strong action to see that the gains made so far are not eroded. The Bank of Japan will target asset purchases of 80 trillion a year or $734 billion, increasing this from the 60 trillion to 70 trillion yen range set earlier. The Government Pension Investment Fund backed this move by saying it would increase the stock component in its portfolio from 24% to about 50%.

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Year over year inflation in Dec. 2013 was 9.9% in India. RBI Governor Raghuram Rajan plans to focus on headline inflation which focusses on food and fuel which are about 60% of the consumer basket in India. Earlier RBI efforts used a number of indicators- inflation, growth, financial stability and exchange rates which created confusion in the minds of investors about the serious control of rising prices. Inflation for the last 5 years has been over 8%, and is persistent even as growth slows. The policy rate is now about 2 percentage points below inflation. Inflation targeting under Rajan could take the shape of 8% target in the first year, dropping to 6% and then a range between 2-6%.

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German retailer Arcandor filed for bankruptcy after the government rejectd arequest for a loan guarantee for $650 million euros. Arcandor's Karstadt departmetn stores are in most downtown shopping areas in Germany. Faced with aloan repayment of 710 million euros, Arcandor was in talks to merge with its competitor Metro which has theKaufhof department stores. Karstadt has 89 stores in Germany and 43,000 employees. The rejection by Chancellor Merkel has some political risk and Merkel is counting on the public opinion against bailouts to withstand the fallout from the increase in the unemployed. The government setup a115 billion euros rescue fund in March, but this is meant to help only those companies that ran into difficulties from the financial crisis not from management misdeeds or mistakes.

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Old Lane hedge fund firm with old Morgan Stanley executives, was bought for 800 million by Citigroup partly for the executive talent of old Morgan Stanley executives. Mr Pandit reaped $165 million from the deal and Mr Guru Ramakrishnan, the CEO, tens of millions of dollars. How successful a firm was Old Lane and where is it now? Old Lane was started in 2006. It has returned all the money to original investors last summer, broke even on its original investments, and it has not lost money in the brutal market conditions. The hedge fund unit is now pretty much closed and the executives like Ramakrishnan are leaving. With Citi's worsening condition the hefty price tag for Old Lane has angered investors.

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After some ill timed acquisitions Tata Sons is strapped for cash. The value of Tata Sons holdings in the group's 27 listed companies has halved in less than a year to under $25 billion. This leaves Tata Sons, the parent company of the Tata group, strapped for cash, as one way it raises cash is by offering its equity stakes as collateral to lenders. A cash crunch is evident at Tata Motors with $2 billion of debt from the acquisition of Jaguar Land Rover due by June. Tata has to get its banks to roll over this debt. And this week Tata Steel whose shares are down 76% in a year stated that Tata Sons has pledged 13.2% of the company as collateral against borrowings.

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Excesses in condo building in Miami, a city of 400,000 people,where most of the condos were built for buyers buying for speculation hoping to flip these condos to the next buyer. Icon Brickell is one of these developments in Miami, with 1646 condos. Since 2003 83 towers with nearly 23,000 condo units were added to the downtown skyline. As of the end of 2008 45% of these condos were unsold. Only 30 of the 500 Icon Brickell condo units that were ready for closing in December actually closed, and many buyers including 144 represented by one lawyer are trying to get out of the contracts, according to Mr. Perez who is the developer for these towers. These condo units were listed for $400,000 to 800,000.

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The expected glut in office space in London. About 8 million square feet of new office space is being built in the financial district known as the City and a large part of it is coming in in 2008. The level of construction is 60% higher than the City's 10 year average. About 80% of this office space is speculative , that no tenants exist yet for the space, normally only 50% is speculative. And this is happening when new lease signings in the City fell by 49% in the 4th quarter compared to the third quarter. Big banks like Citigroup are cutting down on office space and Macquarie Group and Australian bank is postponing plans to lease office space for a London headquarters.

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Changing the way health care operates in the country, federal and state government agencies and the commercial insurers are looking at paying primary care physicians and family practice physicians more than the average $60 a visit that is paid out so that these physicians spend more time understanding their patients. At the present time the smaller payment per patient results in doctors only spending a few minutes with each patien. In the long run by diagnosing and treating diseases early through a better understanding of patients this upfront increase in payments should result in lower costs resulting from late diagnosis and treatment, and the problems that occur when the patient is not treated early on. It should also result in better and fewer errors in diagnosis.

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The Trump administration is set to impose 15% tariffs on $156 billion of Chinese goods including laptops, mobile phones, and apparel, on December 15, 2019. This is in addition to the tariffs already in place on $361 billion of Chinese goods. The new list of goods for the tariffs on December 15 are goods that are made mostly in China. About 87% of the goods on this list are made only in China. If talks fail with China by this week the tariffs will go into effect. WIth this tariff all goods imported from China will have tariffs on the goods imported into the U.S. adding to the difficulties facing the Chinese economy. A recent article in the WSJ shows China is shifting to higher skilled manufacturing and the service sector to maintain jobs growth.

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A local government vehicle in China, Sixth Division of XPCC fails to make a bond payment in August 2018. This is the first such instance of failure to make a bond payment for a local government vehicle in 2018. Economists estimate China's total debt at 242% of GDP in 2017, and government efforts to tighten liquidity and reduce support for overextended local government investment vehicles.

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According to analysts about 3.1 million workers across the USA work in auto manufacturers or related businesses. And every direct job at an automaker in the USA creates 5 other jobs according to the Center for Automotive Research, 2 of the 5 are related to suppliers or dealers and three are related to jobs a businesses where industry workers spend their paychecks. About 355,000 workers are directly employed by automakers, and the USA has 783,000 who make parts for automakers or the aftermarket including repair parts, says Debbie Menk project manager for CAR. Each of those supplier jobs has its own substantial trickle down effect. Another 1.97 million workers produce the steel, rubber and other materials to make the parts, or provide engineering, distribution and other support services, bringing the total to 2.78 million employees with jobs tied to suppliers. The spinoff effects spills into stores and restaurants relying on the incomes of those workers. Menk says that there are 1.7 million people who owe their jobs to the fact that the 2.7 million have jobs, getting the figure up to 4.4 million just on the supplier side. Factoring in some overlap in the retail spinoff from each supplier and automaker job, she estimates total employment in the auto industry at a minimum of 5 million jobs. She describes CAR's figures which are based on a study from earlier this year that used 2006 data, the most recent available, as conservative. Other experts like Anderson Economic Group using 2006 data come up with a higher figure of 8.7 million jobs. The auto industry spends spends more on R&D than any other industry except the government, $18.5 billlion a year says McAlinden, chief economist for CAR, with 85% of this done in Michigan. They also spend $15 billion in advertising. So why is this not registering in the minds of leaders around the country and in the minds of the public? Its possible that most people see only the 355,000 jobs at the automakers and not realize that the 355,000 direct jobs are assembly jobs which is what the automakers do and design and R&D, but there thousands of parts that go into this assembly, and the steel, rubber and aluminium that goes into the metal. And then there are the jobs to feed, clothe, and provide services to these workers. And its possible the arrogance and mismanagement at Detroit automakers, and failure to come up with innovative fuel efficient technologies at a time when the country was sending hundreds of billlions of dollars to the volatile middle east, and failure to come up with really appealing passenger cars, have soured the public mind and image of the Detroit automakers. Resulting in a public perception that the Japanese, Korean and other automakers could pickup where Detroit failed. In the process what is being missed is that the Detroit portion of the USA auto industry is a very significant part of the jobs and economy of certain states, and a big part of the economy of the midwestern states. And as CAR mentions most people do not realize that in the financial services industry one Wall Street job creates only 2.5 jobs elsewhere including spinoff jobs. Only high-tech comes close with 4 jobs including spinoffs for every direct job in Silicon Valley. ...

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The People's Bank of China lowers the benchmark lending and deposit rates by 0.25 of a percentage point, and cuts the reserve requirement ratio by 0.5 of a percentage point. The PBOC said the move was designed to offset "the persisting downward pressures on the country's economic growth." It was also designed to offset the large volatility in China's stock markets. The PBOC also removed the upper limit on interest rates for fixed term deposits of more than one year, as part of interest rate liberalization. The move also counters the large capital outflows affecting China, as is happening for all emerging markets, of $70 billion in July. These outflows may have accelerated in August 2015 with declining investor confidence. Experts say the reserve ratio cut should inject about $100 billion into the banking system.

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Thomas Friedman of the NYT sees a climate change as an area in which Trump has ignored the information of eminent scientists. He sees a weakness of the Trump administration in Trump's putting no importance to briefings by experts from climate change to national security briefings. Friedman sees Russia and hacking as a major issue facing the new Trump administration, including the new hearings in Congress from leading Republicans on the cyberattacks.

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Father Hesburgh became president of Notre Dame in 1952, at the age of 35, when Notre Dame was a small university known for football and theological studies. He greatly increased the size of the university, hiring new faculty, increasing the endowment fund from $9 million to $350 million, and changed polcies so that women were admitted in 1972. The endowment fund is now $9 billion. Father Hesburgh played a prominent role in the U.S. and was close to presidents Eisenhower, Kennedy, Reagan, Carter and Clinton. By the time he retired in 1986 after 35 years as president of Notre Dame, he was considered the most effective university president in the country, and the most influential priest in the U.S. He fought for civil rights, for peaceful protest on campus, and brought lay control through a secular board to run Notre Dame. In all these issues he stood up for his progressive views when faced by opposition from the Vatican and the U.S. government. Following the Second Vatican Council of the mid 1960's, Father Hesburgh initiated greater involvement of lay Catholics in the Mass and practices of the Church. At a meeting in Land O'Lakes, Wisconsin, 1967, a group of Catholic educators led by Hesburgh put forward the position that the pursuit of truth should be the ultimate aim of Catholic higher education in the U.S., not religious indoctrination. In this way Father Hesburgh created a new level of credibility and respect for Catholic based education in the U.S. Ironically Father Hesburgh was not a big football fan and refused to pose for a picture of him with a football, insisting that collegiate sports not influence higher education. His passion from his early years was to be a chaplain in the U.S. Navy. In fact he had to be dissuaded from going to the Navy as a chaplain in 1943, to stay on campus at Notre Dame to train naval officers during the war. Hesburgh was born in Syracuse in 1917 to an executive at Pittsburgh Plate Glass Company, and studied at the seminary on Notre Dame campus and in Rome for advanced degrees in philosophy and theology. He died in 2015 at the age of 97, having placed a large imprint on the shape of American higher education in the twentieth century. ...

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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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These are key provisions in the biggest climate change bill in history- Tax credits that last for over a decade for zero carbon plants- these tax credits go to companies that build new sources of emissions free electricity, for wind turbines, solar panels, battery storage, geo thermal plants. Tax credits also for new technologies that capture and bury carbon dioxide from natural gas plants and industrial facilities before it escapes into the atmosphere and heats the planet. This technology is rarely used because of high costs. Incentives for electric vehicles- It extends a tax credit of $7500 for new electric vehicles. It adds a $4000 tax credit for used electric vehicles. Tax credit goes only to people earning $150,000 a year (300,000 for joint filers) for new EV's and $75,000 (150,000 for joint filers) for used EV's. Help for people to lower energy costs - $9 billion in rebates for Americans installing energy efficient electrical appliances. And a decade of tax credits for Americans installing rooftop solar, heat pumps, water heaters and electric HVAC, or electric heating, air conditioning and ventilation technologies. Investments in Domestic Manufacturing- $60 billion for investments in clean energy manufacturing in the US. This includes $30 billion for production tax credits for solar panels, wind turbines, batteries and critical minerals processing. $10 billion in investment tax credits to build manufacturing facilities for electric cars and renewable energy technologies. This action is to halt the shifting of clean energy manufacturing overseas to China. $27 billion towards a green bank that would finance clean energy projects in disadvantaged communities. Cracking down on Methane- the bill places a fine on methane gas emissions from oil and gas wells and pipelines and other infrastructure. Fees of $900 per metric ton in 2024 and $1500 a metric ton in 2026 when it exceeds federally set limits.    ...

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Increasing college enrollment for women in the US shows no sign of changing. Women now make up 60% of college students for the 2020-21 college year, men 40%., according to National Student Clearinghouse. Another alarming piece of information is that there are 1.5 million fewer students at colleges and universities in the US, and men make up 71% of the decline. 3.8 million women filled college applications compared to 2.8 million men for 2021-2022 college year in the US, according to Common Application. The enrollment rates of poor and working class whites show alarming decline with rates of enrollment less than people from Black, Latino or Asian income backgrounds. Decline in male enrollment is highest for community colleges with family finances the main cause. The pandemic has accelerated this negative trend that is bad for America. 700,000 fewer students were enrolled in college in 2021 spring than 2019 spring, according to a WSJ analysis.  During the pandemic millions of women left jobs to stay at home with children. Many turned to sons for help, with some young men quitting school to work. Some examples shown in this report show parents having gone to college and sons deciding the skyrocketing costs of education make it too risky to take out loans that cannot be repaid. Many just feel lost, doing work landscaping for $500 a week or packing boxes at Amazon warehouses at $15.50 an hour. With so much going wrong in the way America is investing in its future generation, issues like wars in distant lands fade into insignificance, and president Biden's decision is surely "a wise decision." As is his effort to make community college at no cost given to young Americans. The $3.5 trillion investment in workers and families that Biden plans could not have been developed at a time of greater need than today. ...

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Clarence Cammers, 64, one of Paul Ryan's constituents back home in Wisconsin, has a question for Ryan at one of his townhall meetings. Clarence is worried about what would happen to his son Tim, 32, if Medicare cuts went through and his son had to use vouchers for getting health insurance. Ryan's district includes Racine withe high unemployment, and Janesville which was devastated by the closing of the General Motors plant in 2010. Most of the people there are conservative, believe in fiscal responsibility and a balanced budget, but they are also older, working class people. Some of them like Clarence are dependent on their Social Security check to get by from month to month and are not sure they can cope with the kinds of cuts Ryan is proposing. In this story Clarence and Tim discuss the meeting and come to the conclusion that Tim will lose either way- with taxes going up or Tim not getting the retirement that he should be getting. Clarence a life long saver decides he will cut back on his expenses and save $588 from his $1912 monthly social security check for Tim. Tim has severe attention deficit disorder and works for $10 an hour in food prep at a resort....

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IBM's Watson Computer business has set a target of $1 billion in sales by 2018 and $10 billion by 2024. Current sales are in the $100 million range. Manoj Saxena is the head of the Watson business unit. The Watson ranks medical treatments by "confidence scores" and incorporates learning from errors. The way Watson works is for IBM engineers to study the technical details of a customers business and store this information for the computer to use. Uses so far are insurer WellPoint using it for determining if doctor's treatments meet company guidelines and a patient's insurance policy. M.D. Anderson Cancer Center is developing a version that recommends leukemia treatments for patients by data mining medical literature. Watson was moved to commercial phase in 2011 after beating 2 Jeopardy champions. IBM has a $15 million deal, its largest so far, with M.D. Anderson. It has taken frequent interaction between developers and IBM engineers to develop a version that recommends cancer treatments. The versions are only as good as how well knowledge in the field is translated into usable software, a long and difficult process. Applications in health care are seen as the best prospects for revenue generation. Google with its data mining capabilities is seen as the closest competitor....

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Ford and GM employ 120,000 workers in Europe and sell roughly 4 million cars there. GM sold nearly a fourth of the 9.37 million cars it made worldwide in Europe in 2007. And 60% of these cars are small cars like theFocus and Fiesta in Europe for Ford and the Corsa and Astra in Europe for GM. The presence of a gas tax may be what makes Europeans choose smaller cars as gasoline is expensive in Europe. What makes them profitable in Europe is they are generally sold with all the features of bigger quality cars and command higher prices so that small does not mean cheap. But is there any reason that given the experience of Americans with gas prices, and a culture of energy conservation among younger and newer customers. apossible gas tax that funds public transportation projects, and the poor state of household finances, that the better appointed smaller cars that are popular in Europe cannot make their way into American homes. With all the experience with small cars in Europe are GM and Ford simply lacking both the vision and the courage to try something new with these cars when their bets with larger cars have failed....

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There are serious serious flaws with the FDA regulations for weight loss pills and dietary supplements. THe law enacted in 1994 gives the FDA jurisdiction only after the pills go on the market whereas for drugs they get reviewed first. THe re is only aspot checking of manufacturers and distributors once the pills are on the dshelves or on the internet. THe FDA believes there may be hundreds of contaminated weight loss diet supplements. Says Michael Levy director of the FDA's deivision of New Drugs and Labeling Compliance, alarge percentage of these products contain dangerous undeclared ingredients. Even after the products are on the market the FDA does not have thability to remove pills from stores, initially the law allows that its upto the companies to issue arecall. It is only eventually that the FDA can act and it does not have the resources to deal with this problem. This even though these ingredients can cause heart atttacks, seizures, and all kinds of health problems. About $27 billion are spent on dietary supplement, $1.7 billion on weight loss pills, and 15% of the population say they have used weight loss supplements, and most have not told their doctors about it. ...

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European countries are focussing on the environmental damage and emissions of biofuels generation, and will not subsidize biofuels that cannot show sustainability or prove that they are produced without causing some environmental damage. Germany has canceled tax exemptions for biodiesel at the pump and is mandating that only biodiels produced meeting sustainability criteria will count towards the national quota.The annual target of biofuels making 5.75% of transportation fuel in Germany. The European Union will require restrictions on imports of biofuels that are produced in an environmentally harmful manner. Europe rushed into the push to produce biofuels without thinking of these issues. In 2007 Europe paid farmers 45 euros per hectare or $27 per acre for any biofuel produced. Note that corn ethanol made in the USA does not meet this standard as its carbon dioxide reduction is 10-20% from the level of gasoli, neaccording to one German NGO. Quebec has discontinued the building of cornbased ethanol plants. The feeling is growing that corn is a less efficient source of biofuels because it requires a lot of processing and the environmental net benefits are small. It is also seen that the rush to corn ethanol in US may be overdone and pushed by politicians trying to help farmers more than the environment....

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With better control over the coronavirus than U.S. and Europe, South Korea is not rushing to buy the vaccines developed by Pfizer or Moderna. It is waiting to see how the vaccine rollouts work in other countries before buying the vaccine. South Korea is also looking at getting better price from manufacturers after the rollouts in the U.S. and Europe. South Korea is moving cautiously and has said it wants to get 10 million doses through the Covax initiative the main global effort to provide broad access to vaccines. Another 20 million doses would be secured from private companies. This is in contrast to the approach in Japan where the government has signed deals for purchase of 290 million doses for 145 million people for its population of 126 million. The money allocated is $6.5 billion and the goal is to vaccinate everyone by first half of 2021.  If it works this would prepare Japan for the Tokyo Summer Olympics to open in July, after 1 year delay. South Korea has the freedom to do this and wait to see what vaccine works best with least long term effects because their are relatively fewer cases there. A total of 313 new daily cases on November 18, lower than daily cases in a single county in the state of Michigan in the U.S. Moderna and Pfizer vaccines use anew kind of gene based technology that has never been approved to prevent infectious diseases. Other competition is the vaccine from Oxford and Astra Zeneca which uses an existing technology that is used in existing vaccines modified for use in coronavirus. The Oxford vaccine and a vaccine from Johnson and Johnson are expected to have a lower price. Because life is functioning very close to normal South Korea is in the unusual position of saying that its people have no reason to be anxious for vaccine procurement, as indicated by its deputy director of Korea Disease Control and Prevention Agency. Only three fifths of the population is the target for vaccination by fall of 2021. ...