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Covering healthcare insurance costs for two-thirds of the American population is a competitive disadvantage for US companies in a global marketplace. Their rivals don’t have to shoulder that burden.

So, writes Rana Foroohar in her latest column, the news that Amazon, JPMorgan Chase and Berkshire Hathaway are joining forces to form a not-for-profit that aims to cut healthcare bills is exciting news. But, Rana asks, which bit of the “Gordian knot of US healthcare” will they be able to unravel? Jeff Bezos, Jamie Dimon and Warren Buffett may be able to reduce costs for their own employees, but it’s not clear that they’ll be able help others without some fundamental structural changes in the American healthcare system taking place.

What’s more, the shifts that need to occur are not just technological — although more innovative methods of delivering care will make a difference. The biggest change required, Rana argues, is “existential”. Americans still hold fast to the view that it is “choice” that makes their healthcare system fair. And as long as the US continues to prioritise the individual over the collective, then healthcare costs will remain a “hungry tapeworm” eating away at the economy.

The prospects of the US doing what other advanced nations have done and moving to a system of socialised medicine any time soon are slight, Rana concludes. In the meantime, at least “some of the smartest business people in the country are agitating for change”.

The Yellen legacy:
Janet Yellen has completed her term as chair of the US Federal Reserve with the American economy in better shape than when she started, writes Lawrence Summers. Ms Yellen recognised that some deep structural changes had occurred and was nimble enough to abandon old models that no longer applied. The challenge facing her successor, Jay Powell, is to figure out how to achieve growth that is “both adequate and financially sustainable”

Coalition chronicles:
There is something in the preliminary agreement struck between Germany’s centre-right Christian Democrats and the centre-left SPD that leads Wolfgang Münchau to wonder whether yet another “grand coalition” might not be such a bad idea after all. Both parties have accepted the principle of a European fiscal union and transforming the European Stability Mechanism into an institution of the EU. German politics might just be tilting in the direction of federalism, Wolfgang writes. But opposition among conservatives in the CDU is growing.

The old alliance:
Turkey’s cross-border military operations in northern Syria have raised the prospect of a direct confrontation with its Nato ally, the United States, writes Sinan Ulgen. A clash between Turkish and American troops would have disastrous consequences for transatlantic security. It is essential, Sinan argues, that Washington identifies areas of mutual interest with Ankara — and fast.

Best of the rest

Trump’s infrastructure plan has intended winners and losers — Tom Toles in The Washington Post

Why Macron is struggling to impose his ideas — Eric Le Boucher in Les Echos (in French)

This Brexit mess cannot go on. Theresa May must stand down now — Matthew d’Ancona in The Guardian

The City desperately needs some Brexit certainty — Catherine McGuinness in Prospect

Janet Yellen’s Fed tenure may be the calm before the storm — Tom Stevenson in The Telegraph

What you’ve been saying

All must be vigilant against those spreading fear — letter from Alan Capps in response to Trump unites Republicans in his war on the ’deep state’

Edward Luce adroitly pinpoints two actions undertaken by the Trump administration before the delivery of the State of the Union address: one “ominous for US democracy”, the second “worrying for global stability”. The alarm is sounding around the globe. And yet, the most troublesome sentence in Mr Luce’s column is: “Half of the country does not seem to care.” To those Americans who, for whatever reason, reside in the half that does not seem to care, the words of James Madison, founding father and fourth president, should prove enlightening: “I believe there are more instances of the abridgment of freedom of the people by gradual and silent encroachments by those in power than by violent and sudden usurpations.” Thanks to the courage, tenacity and skill of a journalistic cohort who refuse to be intimidated into silence or pander to egos, the encroachment is not silent, but it is, nonetheless, ongoing.

Comment by Harry Parkes on Beijing plays its advantage to press Theresa May on trade:

[British] officials have made clear since before even the Brexit referendum that they would be very willing to grant China market economy status, no questions asked. So don’t expect to see any standing up on that front once we’re out of the EU, even if it does mean the closure of what’s left of the UK steel industry. And for visas at least, the relationship is far too reciprocal — China makes a point of charging UK visitors the same as Chinese visitors have to pay for a UK visa, with similar constraints and red tape surrounding them.

Make Big Data open and available in real time — letter from Gavin Hayman on Mapping the economy in real time

Governments spend about $9.5tn, about 15 per cent of global gross domestic product, on millions of contracts each year for everything from pencils to airports. Imagine the benefit of having that data open, accessible, online and available in real time. Such registers could have helped those tasked with due diligence to understand risks and predict (or at least clean up) the recent UK mess with Carillion rather than being left digging through a mountain of paperwork scattered across hundreds of government offices.

Today’s opinion

German politics is tilting towards federalism Conservatives see measures proposed in the coalition talks as a slippery slope

Instant Insight: Jacob Rees-Mogg recognises a Tory party ripe for capture A lack of competition means there is a chance for almost anyone to break through

Anatomy of the escalating bond bear market With term premia now back to ‘normal’ bonds look better underpinned

Jay Powell’s challenge at the Fed He must work out how to achieve growth that is adequate and financially sustainable

Co-operation is in Turkey and America’s best interests Ankara’s activity in Syria raises the alarming prospect of military confrontation

The American way of healthcare Reforming the US system is both a technical and an existential challenge

Wanted: an opposition that will stand up to May on Brexit Don’t expect the Labour party to hold this government to account

FT View

FT View: Modi will struggle to meet promises to poor The prime minister shows signs of weakness ahead of next year’s polls

FT View: Trump’s attacks on US law enforcement The president, playing to his base, undermines crucial institutions

The Big Read

The Big Read: Nuclear’s hazards: struggling industry aims for power surge The UK’s Hinkley Point C has become a critical test of developers’ ability to compete with cheap gas and renewables

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