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Lobbying by the pharmaceutical and health care industry and U.S. president Obama's promises to the industry as part of his shaping the health care law.

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The distrust in negotiations between Republicans Boehner, Ryan, Cantor and Democrats Reid, Obama, and Pelosi, during the weeks in October 2013 preceding the reopening of U.S. government after the shutdown. Republicans call attention to the rising deficit from $4.9 trillion in 1993 compared to $16.7 trillion in 2013, triple the increase in the deficit in just one decade compared to the five decades prior to this period. Democrats say sharp spending cuts would hurt economic growth and the unemployed.

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A report by pharmacy benefits managing company Express Scripts shows a 13% increase in the price of branded drugs in the U.S. from Sept 2011 to Sept 2012. Generic drug prices declined by 22% in this period. The report also shows that growing spending on specialty drugs for cancer, MS and other diseases is a big reason for the increase in prices of branded drugs. This report is from a random sample of six millon Express Scripts members using prescription drug coverage. Prof. Schondelmeyer of the University of Minnesota, who manages the drug benefits program at the university and conducts a similiar price report for AARP, says the potential benefits for these specialty drugs are not that good to justify the high prices.

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Karl Rove says he was in his 20's working in the Reagan election campaign in Texas which was declared a close contest by the New York Times polls. Gallup in October showed Carter ahead Oct 13 by 4 points, and by Oct 27 by 8 points. He expresses skepticism about current polls because of 91 national polls in the last 30 days (including Gallup and Rasmussen) Obama was at or above what he calls the critical or magic number of 50% in only 20 polls.

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Pearlstein quotes Dickens in "Oliver Twist," about the law being an ass, and the constitutional law exercize in the Supreme Court of the U.S. giving a sense of a failure of the so-called best and brightest in reasoning out the issues. He points out that a serious problem is that American business which is burdened with high health care costs for employees is seriously missing in this debate after years of complaining about high costs. The National Federation of Independent Businesses is actually one of the plaintiffs questioning the constitutionality of the Obama health care law. Pearlstein says business wanted an end to the fee-for-service medicine that increases consumption of medical services and pushes up cost relentlessly, and that Obama's health care law does this. This is not the case as both Democrats and Republican administrations have failed to resolve this side of the cost issue, and this is the hidden reason for the loss of credibility for both sides in this debate, leaving health care problems to be resolved in future administrations. ...

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The FDA sets a pathway for developing "biosimilar" drugs in the U.S. Biosimilar drugs are cheaper versions of higher cost biotech drugs. Europe has moved further ahead in this area.

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The healthcare reform bill has lost the support of the SEIU (the Service Employees International Union) , and the AFL-CIO union. Its also lost the support od Howard Dean and of his Democracy for America. Voters aged 18-34 and Hispanics are much less enthusuastic for he party. And only 23% of blue collar workers in December 2009 express positive feelings about the Democratic party in a Wall Street Journal/NBC News poll, a 30 point drop from February 2009. And the same poll showed that there just isn't the same level of interest in voters who back Democrats or Obama.

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The role of Super PAC's and new nominating rules in the Republican presidential primaries of 2012.

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The EU's competition commissioner to crackdown on pharmaceutical companies that are delaying the entry of generics drugs with various tactics that are anticompetitive. EU has raided the offices of several marge drug companies and retrieved documents that show this activity was going on. About 5% of medical bills or 3 billion euros coud have been saved from 2000 to 2007, if companies had allowed generics to enter the market earlier and not resorted to these antitcompeitive strategies. Like paying off generics companies or having so many patents on the ingredients of the drug, in one case 1300 patents on one single drug, and then suing the generics companies to tie up the case in the courts.

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UnitedHealthcare says it will keep parts of the healthcare law relating to preventive healthcare services without co-payments, allowing parents to keep children on insurance till age of 26, even if the Supreme Court rules against the healthcare law. Most insurers see these parts of the law that are popular quite favorably.

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The Roberts Supreme Court's liberal leaning tendency with swing Justice Anthony Kennedy in 2014-2015. Bravin describes the tendency of the Robert's court to stay with the status quo. Restraint and stability appear to be strong preferences for Justices Kennedy and Roberts as seen in the ruling on the Affordable Care Act, and in the ruling on the Environmental Protection Agency. The four liberal Justices on the court, Kagan, Sotomayor, Breyer, and Ginsburg voted consistently together in 2015.

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Former Senator Jim DeMint lays out his reasoning for the Republican fight to defund ObamaCare, as the healthcare legislation is now called by Republicans. He points to problems with the legislation with issues about how much the added entitlements will cost in the future( more than the $250 billion by 2023 estimate of CBO insists DeMint based on the general lowballing of projections), and higher premiums for the young and elderly on exchanges. He says the 2012 elections were fought on economic issues not ObamaCare, and that the public he has met in visits to different states as president of the Heritage Foundation continues to be skeptical about ObamaCare. He sees the correct role of the Opposition party to point out the deficiencies in the law and call for corrections in the path for healthcare.

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Tightening budgets in Greece, Spain and Germany, mean that governments are now cutting the prices they pay to pharmaceutical manufacturers. The governments are the largest buyers of pharmaceutical and medical products in Europe.

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A Romney win would end the gridlock in Washington reducing the political uncertainty in Washington D.C., with both Republicans and Democrats supporting short term efforts to revive the economy. This would increase confidence for business investment and create a better business climate after the divisive politics of the last 4 years. An alternative scenario in which this happens is a large Obama win with Republicans offering cooperation with the new administration, which is less likely with the condition of the economy.

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Claire Cain Miller provides this exceptional account of the ways lack of family friendly and maternity leave policies is hurting not just women in America, but America's economic and technological progress. Strangely one hears little about how the lack of paid leave for women for maternity and other reasons, even as it hurts economic growth with the lower participation of women in the labor force. This is being vigorously discussed in Germany and Japan with calls for more family friendly workplace policies and more child care facilities to encourage women to join the workplace or continue working and pursuing careers. This happens when the overall labor force participation rate for women and men in the U.S. is declining, making this an important issue. Equally significant is that this reduces the contribution women can make to technological and scientific progress, and productivity improvements, because 59% of higher education degress are now going to women. The case of a Toshiba research engineer who was able to tackle a problem critical to development of the next generation of television technologies after Toshiba let her continue in her research role with friendly maternity leave policy, is an example of the kind of technical progress lost to the economy without such policy in Japan or in the U.S. See the link for Toshiba. Miller provides the example of Google, where attrition for women employees dropped by 50% with family friendly maternity leave policies. For Google, Toshiba, and other companies with women having advanced degrees the cost of hiring a new employee or making up for the loss of losing valuable women employees is significant. The U.S. is the only developed country without paid maternity leave. Only 59% of workers say their employers offer them paid maternity leave. California is the first state in the U.S. to offer paid parental leave. ...

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A large surge in funds raised for the campaign in July 2012 has helped presidential candidate Romney.