International investors seem incapable of ending their love affair with the dollar. America’s economy has slowed sharply this year, yet its currency has risen to a 15 year high in trade weighted terms. (46) Against the euro the dollar touched $ 0.88 — 8% higher than in early January and close to the level at which the European Central Bank and the Federal Reserve jointly intervened to prop up the European currency last September. Why is the euro looking sickly There are plenty of theories. One is that the markets do not trust the ECB: (47) the euro area economies are not immune to America’s downturn, yet the central bank still seems more concerned with fighting inflation than with supporting growth; another more plausible explanation is that, in an uncertain global economic climate, the dollar has resumed its traditional role as a safe-haven currency. Most economists reckon that the euro is undervalued and expect a rebound over the next year. One of the most optimistic is Goldman Sachs, which is predicting a rate of $1.22 in 12 months. But an analysis by David Owen, an economist at Dresdner Kleinwort Wasserstein, gives pause for thought. (48) He has found that, over the past decade, movements in the real exchange rate of the euro against the dollar have closely reflected the difference between productivity growth in the euro area and in America. When productivity growth in America has been faster than in Europe—as it was in most of the late 1990s—the euro falls, and vice versa. This is exactly what economic theory would predict: countries with faster productivity growth in the traded goods sector should see rising real exchange rates. Mr. Owen uses monthly data for productivity growth in manufacturing, a good proxy for the traded goods sector. Using annual productivity data for the whole economy (which are available over a longer period), the broad relationship between the exchange rate and relative productivity growth in America and Europe seems to have persisted for most of the past 30 years. Mr. Owen reckons that, in the short term, America’s downturn will reduce the productivity gap between America and the euro area, and so boost the euro. (49) But in the long term, he expects productivity growth to remain faster in America—in which case, a sustained rise in the euro is unlikely over the next few years. Only if the downturn completely kills the belief in America’s new paradigm, and its productivity growth plummets, will the euro be able to rebound more permanently. The strength of the dollar this year does indeed seem to hinge on a belief among investors that America’s slowdown will be brief, and that in the longer run America remains the best place in which to invest. (50) But they may be underestimating the potential for productivity gains in Europe, as the single currency boosts competition and encourages firms to exploit economies of scale through mergers and acquisitions. The adoption of more flexible working practices in many countries should also help to improve productivity. Studies in America suggest that the bulk of its productivity gains from information technology come from the use of it rather than from its production. So the euro area, too, should start to enjoy productivity gains over the next decade, as it makes fuller use of it. If you believe that Europe really is starting to change, buy Euros. If not, stick with the darling dollar.
Years ago, Charlie, a highly respected orthopedist and a mentor of mine, found a lump in his stomach. He had a surgeon explore the area, and the diagnosis was pancreatic cancer. He went home the next day, closed his practice, and never set foot in a hospital again. He focused on spending time with family and feeling as good as possible. Several months later, he died at home. He got no chemotherapy, radiation, or surgical treatment. Medicare didn’t spend much on him.It’s not a frequent topic of discussion, but doctors die, too. And they don’t die like the rest of us. What’s unusual about them is not how much treatment they get compared to most Americans, but how little. Of course, doctors don’t want to die ; they want to live. But they know enough about modern medicine to know its limits. Almost all medical professionals have seen what we call "futile care" being performed on people. That’s when doctors bring the cutting edge of technology to bear on a grievously ill person near the end of life. The patient will get cut open, perforated with tubes, hooked up to machines, and assaulted with drugs. I cannot count the number of times fellow physicians have told me, in words that vary only slightly, "Promise me if you find me like this that you’ ll kill me. "How has it come to this—that doctors administer so much care that they wouldn’t want for themselves The simple, or not-so-simple, answer is this: patients, doctors, and the system.To see how patients play a role, imagine a scenario in which someone has lost consciousness and been admitted to an emergency room, and shocked and scared family members find themselves caught up in a maze of choices. When doctors ask if they want "everything" done, they answer yes. Then the nightmare begins. Feeding into the problem are unrealistic expectations of what doctors can accomplish. For example, many people think of CPR as a reliable lifesaver when, in fact, the results are usually poor.But of course it’s not just patients making these things happen. Doctors play an enabling role, too. The trouble is that even doctors who hate to administer futile care must find a way to address the wishes of patients and families. Imagine, once again, the emergency room with those grieving family members. They do not know the doctor. Establishing trust and confidence under such circumstances is a very delicate thing. People are prepared to think the doctor is acting out of base motives, trying to save time, or money, or effort, especially if the doctor is advising against further treatment.It’s easy to find fault with both doctors and patients in such stories, but in many ways all the parties are simply victims of a larger system that encourages excessive treatment. In some unfortunate cases, doctors use the fee-for-service model to do everything they can, no matter how pointless, to make money. More commonly, though, doctors are fearful of litgation and do whatever they’re asked to avoid getting in trouble. In the passages that follows the last paragraph in the excerpt, the author is most likely to ()
A. discuss the way to overcome the problem of overtreating in medicare system
B. suggest the patients to adjust their expectation on medical treatment
C. appeal to doctors to adhere strictly to their moral grounds
D. urge relevant department to issues policies to reform American medicare system