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NYT reports show the Republican health care bill AHCA 33 votes short of passing the House and likely to fail. Conservative Republicans were looking to whittle down the safety net in the Affordable Care Act, and moderate Republicans could not stomach the whittled down bill removing guarantees of essential benefits for instance. The basic problem- no real consensus among Americans about providing health care to all Americans, and no real solutions possible as long as there is acceptance of disproportionately high levels of medical care costs for treating each disease in the U.S. compared to Europe and other countries.

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Ezra Klein says about the contrasting choices offered by Romney-Ryan vs Obama-Biden, that everyone wanted to see a clear choice between different approaches to the issues, and now they have got one. Its almost a repeat of Reagan-Bush vs. Carter-Mondale during a period of high unemployment with Democrats risking underestimating the importance of the careful choice made by Romney today.

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Speaker Paul Ryan's effort to fix what he calls "a House that is broken," as he becomes the new Speaker of the U.S. House of Representatives in Oct. 2015.

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This report in the WSJ by Peterson and Hackman shows how the American Health Care Act proposed by Speaker Paul Ryan provides less financial support and allows premiums to go higher for seniors approaching retirement in the 50-64 year age group. Premiums are allowed to go up 5 times that of premiums of young people in the Ryan House  plan compared to 3 times in the Affordable Care Act. Subsidies in the form of tax incentives provide $2000 to younger people going up by age not income to $4000 in the Ryan House plan. By contrast someone 60 years old making $20,000 a year can get Affordable Care Act credit of $9874, and making $40,000 a credit of $6752, according to analysis by Kaiser Family Foundation. The Ryan plan makes health care costs lower for young people in an effort to bring more young people who use less services into the system to support its overall financial condition. Another feature of the Ryan Plan is that it allows only for CPI index +1% even if health care costs are rising faster. Deep cuts to Medicaid affect lower income seniors on Medicare. As a result the AARP organization representing seniors has come out in opposition to the Ryan bill. The GOP plan wants to reduce premium costs yet in the process it makes vulnerable seniors with lower incomes pay more, which is likely to hurt Republicans who won by winning a large part of the senior vote. ...

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Janna Ryan, wife of Rep. Paul Ryan of Wisconsin, Romney's running mate in the 2012 U.S. presidential election.

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Rep. Paul Ryan got his start in politics in 1983 when he was hired to work for a think tank Empower America. This think tank was formed by Weber, Kirkpatrick, Bennett and Kemp, to preserve Reagan era ideas of focussing on economic growth generated by private investment. This was followed by working as an aide to Senator Brownback of Kansas and Rep. Jack Kemp till his election to Congress in 1996. Kemp was the big idea guy and it was Paul Ryan who delved into the budget details at the time to support Kemp's ideas. Kemp was Republican vice presidential candidate, the same position that Ryan is in today. Ryan represented the area around Janesville, Wisconsin, in the U.S. Congress. He graduated from the University of Miami, Ohio.

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Rep. Paul Ryan tells Bill Keller that his ideas on Medicare and Social Security are not "the last word" but a way to start an "adult conversation." Keller describes what a Romney administration might look like with Ryan, Dan Senor, and Glenn Hubbard.

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Kimberly Strassel says the choice presented in the 2012 presidential election with Romney's pick of Rep. Paul Ryan of Wisconsin, is between stagnation and national renewal.

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The positive influence for the Romney campaign on conservatives, independents, seniors and working class voters of the selection of Paul Ryan. Ryan gives a well received speech at the Republican convention in Tampa, at one point referring to college graduates facing a tough job market "staring up at fading Obama posters."

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In this insightful essay Peggy Noonan, former spokesperson for president Reagan, says that Republicans like Speaker Ryan with the Republican Health Care bill are making the same error made by president Obama.. Noonan says she had suggested a different way for president Obama to show compassion for the uninsured- first wait till the 2008 financial crisis was tackled, tackled waste and fraud in Medicare first, then look at the option of expanding Medicare to help the uninsured, and not the approach taken of swiftly focussing on the Affordable Care Act early in the first term disregarding Republican objections. She says Republicans are making the same mistake now by ignoring the impact the bill would have on Trump's base of working class Americans who may be affected by the bill's provisions not taking into account incomes in offering incentives or subsidies. Noonan says Trump did get one thing right in calling it a "carnage" for the worsening opioid epidemic in America which has hit rural areas and parts of the midwest hard. Noonan says Eberstadt has correctly documented the collapse in working class Americans wages and standard of living, and Caldwell the opioid epidemic at another level to their health. She also supports journalist Carlson who questioned Speaker Paul Ryan's judgement about eliminating the tax on wealthy investors in new legislation in a Fox News interview, as she says responding to the sense of America at the moment means listening to the sense of being left out of ordinary Americans, who have done not as well as the wealthy who have benefitted from a surging stock market.  ...

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Stephen Moore says both Paul Ryan and his mentor had a singular grasp of the importance of faster economic growth on the deficit and fiscal problems. Though spending restraint is necessary the key to avoiding a fiscal crisis is economic growth generated by private investment. He says the increased focus by Ryan on spending restraint compared to Kemp reflects the difference between that era and this one, with the deficit much larger now. And not a reflection on Ryan's grasp of problems of the urban poor and struggling working class, something Kemp grasped. The problems are large on the spending side but says Moore this can only be solved by pushing hard for economic growth of 4% as targeted by Romney and Ryan. It is also important says Moore for the Romney-Ryan campaign to emphasize growth as the key message and not having this message lost in a back and forth with the Democrats about Obama's economic failures and voter fears about cuts that lead voters to tune out the conflicting messages....