is it the 1%, or is it the middle class? we have a debate. a fascinating debate between two 1%ers. finally, thanks for the memories. a somewhat beautiful ballet by 50-ton ballerinas. ♪ but first, here's my take. many liberals now believe that the affordable care act, sometimes called obamacare, is unpopular only because most americans don't understand it. there's some truth to this. studies show that the core provisions of the bill are more popular than the bill itself. but there's also a reason rooted in reality why many americans worry about obamacare. its cost. remember, most americans have health care. what they worry about is the cost of insuring 20 million to 30 million more people. and unless the meteoric rise of health care costs is slowed, a big expansion of coverage might well remain unpopular no matter how it is explained. now, how is that going to happen? well, republican alternatives to obamacare such as they are do have a strategy to control costs. get consumers to pay more for their health care. the basic idea is iuitively appealing. markets produce efficiencies. they presumably would do the same thing in health care. but the situation on the ground suggests that markets work imperfectly in this realm. a new study conducted by the pharmaceutical company novartis and mckenzie and company shows a stunning difference among countries with regard to health care efficiency. for example, smoking rates are higher in france than in the united states, so the french population has hire rates of lung disease. yet, the french system is able to treat the disease far more effectively than happens in the united states. its levels of severity and fatality are three times lower than in this country. and yet, france spends eight times less on treatments per person than the u.s. system. eight times less. or consider britain which handles diabetes far more effectively than the u.s. while spending less than half of what we spend per person. the study concludes that the british system is five times more productive in managing diabetes than the united states is. to understand this issue better, i spoke with daniel vercello of novartis and a physician by training. he's also frankly pro-market and pro-american, both of which have occasionally made him a target for some criticism in europe. he emphasizes there's no single model that works best, but he explained that france and britain have been better at tackling diabetes and lung disease because they take a syst systemwide approach that gives all providers an incentive to focus on early detection and cost-effective treatments that make wellness the goal. so i asked him, is the lesson that only the government can produce systemwide improvements? his brief answer is yes, this is a case where you need government action. you see, economists have often written about the asymmetry of information. areas where consumers are not expert enough to be able to determine what product is best. evidence increasingly shows that this is true for health. after all, consumers freely make the choice to smoke, eat junk food and forgo preventive care, all of which are highly likely to make them sick, force up their health care costs, and lower their quality of life. having us spend more of the money ourselves is not likely to solve the cost crisis in health care. let's get started. let's get right to our global panel. in london, ann applebaum is a columnist for "the washington post." in paris, dominique is the founder of the french institute of international affairs. in singapore, mubani is the dean of the school of public policy at the national university over there. and also in london, mark brown was deputy secretary-general of the united nations and a member of gordon brown's cabinet. welcome to you all. so let's start with the crises. mark malick brown, you've dealt with these issues often, and your former boss, kofi annan, is now trying to broker some kind of settlement in syria. is he likely to be successful? >> well, i think you've got to go on giving diplomacy a chance while being very realistic that it may not get us across the finishing line. in the balkans, many of us remember diplomacy went on for too long, and we didn't, you know, turn to military solution soon enough. but i do think that kofi annan has made progress. the russian and american positions in private are closer than they often appear in public. and still, if there is a united international community, the regional neighbors plus russia and the united states and europe all rowing in the same direction on this, this is the best way to get the transition to a legitimate government that the country has. >> dominique, in france, there seems considerably less enthusiasm under francois hollande's government compared with nicolas sarkozy in libya. sarkozy, of course, led the charge in some way for the intervention in libya. >> yes, definitely. we have no money. there is no enthusiasm whatsoever for what would look like a much more difficult military adventure. and the shooting down of a turkish plane last week was a kind of warning by the syrian government. don't try to do with me what you did with libya. it wouldn't work. >> ann applebaum, you just got back from libya. what is the perspective over there about welstern interventions? >> well, the libyans would love to see western intervention because they feel, in a way, that this is part of their revolution, too. i don't know that they're so focused on it at the moment because they're worried about their own elections, which are strangely both very, very chaotic and very optimistic. it's a very strange moment in libya. it could still go either way. there's an enormous kind of gathering together of civil society. people wanting to make this work. and at the same time, this is a country which hasn't had elections or political parties for 50 years. so it makes a kind of interesting template which maybe, you know, we can see how other countries follow it or watch it. >> what does this look like to you on the other end of the world? do you think that -- how do the issues regard this talk in the west about getting involved in syria? >> well, i think, number one, let me emphasize that assad has to go because he's lost his legitimacy. and it's only a matter of time before he goes. but at the same time, i mean, there's not -- there isn't any kind of enthusiasm in asia for any kind of military intervention, again, in syria because if you look at what the west did in iraq, even in libya, at the end of the day, can you show that any such military intervention will lead to better results? and there's no one in the west to finish the job. and if you start, you'll have an incomplete problem again. >> mark, do you think that the russians are the key here, and can they be brought around? >> well, they're one of the keys. i think in a sense they've been a useful device for everybody. for the russians presenting themselves as the key has meant that diplomats have had to make their way to moscow and put moscow at the center of things again. and clearly, they do have influence over assad. what's not clear is if they told him to go, whether that would indeed be the decisive thing or whether the support of iran be continued, degree of support he has inside the country would let him still hang on. but i think it's convenient for everybody to present russia as either having a veto on change or at the very least, being the key to it. i think frankly, the russians will come into line on this. i don't think they like this public demand that assad's departure be spelled out so explicitly. but i think they, as longtime syria watchers, recognize he's finished. it's just a matter of when and how he goes. >> and when you look at the situation with iran, dominique, are the europeans, you think, comfortable with what are now pretty crippling sanctions on the iranians? is this a strategy that the europeans will stick to? because it certainly seems as though iran is going to suffer some very, very serious economic consequences, not just the regime, but the whole country. >> yes. there seems to be scenes from europe that the tougher the sanctions are, the less likely a military intervention will be. so i think there is that logic which is shared, i believe, by the french and the americans. and i think there is now, with hollande in power, a line in paris which is probably more in tune with the line in washington. as if yesterday, sarkozy was even tougher than the americans were. >> do you think that line is shared in china? beijing got a waiver on the issue of importing iranian oil, making the case that they had cut down their imports, but they still need iranian oil. do you think they're comfortable with where things are heading? >> let me say something quite provocative here. because it's impossible to get out of the western perception of this problem. in the west they can go around changing government is ending. western power has peaked. and from now on, it will go down. the only question is how are you going to change iranian behavior? and i truly believe, frankly, that the only way to change iranian behavior is to engage the iranian regime. now, of course, this is unthinkable still in the west, but you asked about china. frankly, from china's point of view, the more the west isolates iran, the more iran becomes a gift to china. and now that america has said, okay, you can go ahead and buy oil, china is off the hook. and that's happening because it is impossible for america to impose the same sanctions on chinese banks. they can impose on any other banks in the world. and that's why china can get away with it. so you're presenting china with a geopolitical gift, and china will accept it. >> we're going to take a short break. when we come back, the point about the decline of the west. we will talk about greece, the euro, but also we'll ask, as we always do on international shows in america, enough about the world. what does the world think of us? when we come back. [ male announcer ] citi turns 200 this year. in that time there've been some good days. and some difficult ones. but, through it all, we've persevered, supporting some of the biggest ideas in modern history. so why should our anniversary matter to you? because for 200 years, we've been helping ideas move from ambition to achievement. and the next great idea could be yours. ♪ and we are back with ann applebaum in london, dominique in paris, kishu in singapore and mark mallich-brown. ann, you've written there really is no solution. no matter how you structure the deal, no matter the rescue operation, greece is simply bankrupt. is that right? >> yeah. well, i pointed out that greece's problem is to do its math. and the greek government is bankrupt, and the money has to come from somewhere. and so -- and right now it looks like the money needs to come from germany. so therefore greece needs to reach an agreement with germany. and that's created -- we've already seen it's created all kinds of odd politics, the emergence of a far right, a far left, all kinds of dissatisfaction. and i don't think -- there was a kind of sigh of relief recently when the greeks elected a kind of mainstream government in their recent round of elections. but i don't think the trouble with greek politics is over yet. >> mark, will this be solved? will the germans essentially agree to bail the greeks out, understanding that this is a very large bill that will never be repaid? >> well, look. i think the whole of this crisis is, you know, it's always one minute to midnight. and the germans come in and do something that buys a about the more time. unless there's a much more decisive intervention that goes much wider than europe, the money must be on anne's, i think, belief that ultimately greece is going to fall out of the euro. it finds itself trapped from its point of view an overvalued currency. it's trapped in an austerity economic program. the combination is it can't grow, it can't export. it faces an economy which is at best taking over. it's an unsustainable long-term situation. >> dominique, what is going to happen in europe? francois hollande wants to try to change that austerity regime, but will he be able to? at the end of the day, the european countries, as anne said, they do need to borrow money. and what the bond market seems to say is you've got to get your fiscal house in order. which means it's very tough to say, we don't care about that. we're just going to spend our way out of this problem. >> well, i would say something as provocative as khosur. i think it would be hurtful to bury europe right now. i think a lot of big investors are hedging their bets between emerging countries and the west. they are, in a way, saying the virus is in europe, but the antibodies are probably stronger in the western world than they are in the emerging countries. so just wait. europe and the west may be slowly starting to be back, especially if they don't -- are falling under the guillotine in the next coming weeks or coming months. >> when you look at this issue -- and i'm going to broaden it to the united states -- do you think, you know, this is july 4th weekend, do you think that the rest of the world looks at the obama administration as having restored some of the credibility of the united states? do you think that they look upon, you know, what america is doing now as showing a certain degree of leadership, whether it's in economic policy, whether it's in geopolitics? >> i find it quite frightening that so few americans are aware that in ppp terms, as they said in "the financial times," the united states' economy is going to become number two in the world in 3 1/2 years from now. now, the rest of the world is preparing for a new world order slowly, carefully. and america is not aware that this is happening. and here, unfortunately, the thing that's keeping the rest of the world reverted is the fact that washington is so divided, to polarized at a time when they should be coming together. so everyone's waiting for the elections to be over. then we hope something will come out of washington. >> mark, you've spent time on both sides of the atlantic. how does the united states look to you this july 4th weekend? >> not too bad. not too bad. i think it gets written off very prematurely. i think the extraordinary change in the energy scenario which will make it energy self-sufficient through the discovery of shale, tremendous changes in manufacturing in terms of the contribution of labor costs, against intellectual property and transport costs mean that a certain amount of manufacturing is going home to america. and a fiscal deficit which is so dramatic that the politicians will have to sober up after the election. and one way or another address it. so i think those longtime american virtues that reflect ability and resilience, don't discount them yet. i think america has another chapter left in it. >> dominique, as a frenchman, from a country legendary for its anti-americanism, you have a last word. >> well, i'm like mark. i think by the end of the day, america, to me, looks better than china because its fundamentals are probably righter. >> thank you all. fantastic global panel. up next, "what in the world?" i'll give you one reason why america has a big advantage over china. right back. tdd#: 1-800-345-2550 tdd#: 1-800-345-2550 let's talk about that 401(k) you picked up back in the '80s. tdd#: 1-800-345-2550 like a lot of things, the market has changed, tdd#: 1-800-345-2550 and your plans probably have too. tdd#: 1-800-345-2550 so those old investments might not sound so hot today. tdd#: 1-800-345-2550 at charles schwab, we'll give you personalized recommendations tdd#: 1-800-345-2550 on how to reinvest that old 401(k) tdd#: 1-800-345-2550 and help you handle all of the rollover details. tdd#: 1-800-345-2550 so talk to chuck tdd#: 1-800-345-2550 and bring your old 401(k) into the 21st century. tdd#: 1-800-345-2550 ♪ pop goes the world ♪ it goes something like this ♪ everybody here is a friend of mine ♪ ♪ everybody, tell me, have you heard? 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[ female announcer ] allstate customers affected by the recent wildfires call 1-800-547-8676. visit a mobile claims office, your agent or allstate.com now for our "what in the world" segment. i was told to read the tragic story. she was seven months pregnant, but she already in one child. so local officials forced her to abort. the story could have ended there. another loss, another sad story. but friends and relatives posted graphic images of her fetus on the internet. the pictures went viral. forcing government officials to apologize. the story led to a government-affiliated think tank calling for change. writing in the china economic times, it suggested beijing should switch to a two-child policy. even a few years ago, it would have taken a very brave chinese thinker to pose that question in public. now there is public discussion about china's one-child policy. could it actually change? when the one-child rule was first introduced in 1979, china's leaders were reacting to an unprecedented population boom. from 540 million to 960 million people in just under 30 years. and this was happening while china was one of the poorest countries in the world with little prospect of economic growth. with certain exceptions, the policy was meant to restrict married urban couples to having only one child. officials sometimes resorted to extreme measures to implement the rules. but do they make sense anymore? leaving aside the immoral practice of forced abortions, china is facing a demographic disaster. china is going to get old before it gets rich. right now only 8.9% of chinese are over the age of 65. compare that to the american ratio of about 13%. but come 2050, china's percentage of elderly people will overtake that of americans rising to 26% which is more than japan's right now. look at the median age over time in china. it's gone from 22 in 1980, rising steadily upward to 35 now, roughly the figure for a rich country like america, not a developing society like china. but continue the projection until 2050, and the numbers get even more troubling for beijing. while the u.s. will have a median age of 40, china's will be closer to 50. so half of all chinese will be over the age of 50. the implications are immense. china's work force will shrink. it will no longer be the world's factory. all those older people will need to be supported by their families or by the state. and china will likely need to import workers instead of exporting them. and china is not exactly an immigrant-friendly society. societies with fewer young people become less dynamic, less risk taking and less adventurou