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Lipton, Austin and LaFraniere of the NYT tell the story of how the serious differences between the prime contractor for the federal healthcare website, CGI Federal, and the Obama administration officials handling the website, evolved into conflicts that could not be resolved. This led to the flawed website being rolled out on schedule ignoring serious problems with the website. The detailed report comes after interviews with Obama administration officials and specialists who worked on the project and looking into government and contractor documents. A month ago in October 2013 the healthcare website for the Obama healthcare law was up only 42% of the time with 10 hour failures happening frequently. Basic steps for the functioning of website backup systems in case there is a failure, testing to ensure negligible or no outages, were not secured. The government officials responsible for the rollout did not have the capabilities to handle such a project. Henry Chao, who worked in the Medicare agency for 19 years was left to oversee day to day questions for the website HealthCare.gov, but lacked a formal background in software engineering and no authority to make the decisions needed. The $630 million project was setup inside the Medicare Agency, instead of a separate agency specially setup for this project and staffed with the appropriate skills as originally proposed. Five different lower level government officials made decisions without the authority needed and no one person with the necessary skills was given overall responsibility and decisionmaking. A series of missteps were allowed to take place- settting many added requirements that made it difficult for contractors to focus on basic steps and get them right, use of the MarkLogic database system instead of systems from IBM or Oracle against the advice of contractors, multiple contractors without a way to control the overall project, shifting requirements from the government and bureaucratic delays for resolving basic issues such as use of social security numbers, all worked to create delays. With the delays came a deterioration of relations between Obama administration officials and the contractors. The government officials response was to stick to the deadline of Oct. 1 rollout, with Michelle Snyder, chief operating officer of Medicare agency telling people she would fire the contractor if possible. In the end no one took responsibility for a safe reliable rollout, even though the system failed a test of 500 users in late September and was down half the time in mid-October. President Obama or his advisors were either not kept fully informed, or did not grasp the significance of the collapse in relations between contractors and the government and a project out of control. His aloof distanced approach was not an asset in such matters- saying about the rollout and use of the website: "this is real simple" like using the Kayak website for travel bookings- and he saw no need to take action leading to the major failure for the administration that followed....

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In this essay in Der Spiegel, Charles Hawley says that the Trump movement has become a movement of patriotic downtrodden whites, with a whole range of interests-of extreme right talk show hosts, Tea Party politicians, white power supremacists, those left out by globalization in the working class especially in the midwestern states. The danger he says is that this movement of which Trump has become a part, rejects the narrative on which America is based of the Constitution and the Founding Fathers establishing a country based on principles of "the inalienable rights of man," that have evolved through the years to include black people, women, and minorities.  To put this in perspective, president Obama writing for The Economist magazine in October 2016, puts this movement in a different context- that of the Alien and Sedition Acts of 1798, Know Nothing Movement of the 1800's, the anti-Asian sentiment in the late nineteenth and early twentieth century, periods when anti-immigrant or anti-foreign sentiment gained prominence. Obama's view is that it is not fundamentally economic. In this he is right in that some of the forces on the far right do not stem from globalization. Yet he would be missing a great deal if he did not address the economic problems for the middle and working class that have given such views the support of a broad segment of the population, especially in some midwestern and older industrial states compared to say the economy of California or New York. Obama is aware of the problems in his essay as he points to the problems of workers trying to get a decent wage, of job losses through globalization, and the aggravation of these problems by the financial crisis of 2008 when some of the potential physicists and engineers as he calls them went into the financial sector to create faulty mortgages. Yet he goes back to the free trade and global networks of supply chains as having reduced global poverty, without showing a keen awareness of how it has through a combination of events and decades of policy indifference to manufacturing communities in the U.S.- as documented by experts and shown in Lyrarc, with David Autor and Gordon Hansen in the WSJ, 2016- 08-16. A Gallup Study, WSJ, 2016-05-16, supports Obama's assertion by showing that many of Trump supporters are actually self-employed and not in economic distress. Yet the movement would not have taken its proportions without the merging of different groups particularly largely disadvantaged working class voters, and fortunately Hillary Clinton, Bernie Sanders, have a better sense of this than the president. It is by their efforts that income and wealth disparities can be tackled in a way that restores the social fusion of all parts of society- in Hillary Clinton's emphatic words in the final debate by "growing the middle," growing the middle class. This is the task of the next decade, or possibly two decades. (For Gallup study see WSJ, How Economic Anxieties Explain Trump's Appeal- And Where They Fall Short, Nick Timiraos, 08-16-2016. And for Autor, Hanson, see Tallying the Toll of U.S.-China Trade, Justin Lahart, 08-27-2011)   ...

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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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Public opinion in the district of Steve King, a Republican in the House of Representatives favoring defunding of Obamacare healthcare law.

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With the rushed approach adopted by the Trump administration not enough consideration was given to winning support in the House from 25 conservatives in the Freedom Caucus. Without their support the bill cannot be passed in the House of Representatives. The fight also includes one over what are essential health benefits including whether  maternity care would be included. As a result some moderate Republicans are also expressing opposition on the grounds that less people will be covered and fewer benefits will be provided under the Republican House plan called AHCA. President Trump has not involved himself in the details, and the bill comes very early in the first 100 days, leading to the perception that health care has become a partisan conflict without really grappling with the problems of high cost of health care and creating a solution that all can support. Democrats are seen as having made the same error early in Obama administration's first term. President Trump sees this as a much needed win with a drop in his approval ratings, making this even less of an effort to come out with a good plan.  ...

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The coverage of the Republican healthcare bill and how it affects the elderly, and people on Medicaid, people in rural areas, is likely to have changed public opinion in the U.S. about the necessity of ensuring all Americans have health coverage. The Pew survey cited here in this NYT report by Zernike and Goodnough was done in Jan 2017, and shows a shift. The shift would be much higher today after people look hard at the consequences of what were simply hypothetical positions or ideological positions taken without looking at consequences in daily living. On Medicaid that opinion by July 2017 compared to Jan 2017 has shifted 10 percentage points for Republicans to 53% who think Medicaid is important to them and their families, according to Kaiser research. There is stronger sentiment about people having benefits taken away.  [article-55059] The opinion has shifted to where people see that coverage is important and people should not have coverage denied or benefits taken away from them. Opinion remains strong in favor of changes to reduce the high premiums, but not to replace the existing health benefits and law with no law at all to replace it. That leaves 20 million more uninsured according to the Congressional Budget Office. Changes have to be constructive is the popular view today,  and this requires dialogue between Republicans and Democrats- which has not taken place. ...

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The divisions in the Republican Party as Trump wins in Arkansas, Alabama, Tennessee, and Cruz wins in Texas, Oklahoma, and Alaska, in the March 1, 2016 Republican primaries.

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Senators Mike Lee of Utah and Jerry Moran of Kansas declare their opposition to the Republican Health Care bill proposed by Senator McConnell. This decision by the two senators makes it impossible to begin debate on the bill. Earlier two other senators, Susan Collins of Maine and Rand Paul of Kentucky announced their opposition. This means the Republican health care bill has no chance in the Senate even after changes to the bill passed by the House of Representatives. Republicans have a thin majority in the Senate make it difficult to pass legislation. Collins met with residents in Maine and Moran with people in his home state of Kansas, and both senators heard a lot about the negative effects of the Republican bill on people in their state. The bill is seen as hurting people in rural areas, elderly, and not likely to do enough to bring down premiums. Its plan to slash Medicaid spending has drawn strong opposition from all Democrats.

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The last minute efforts by Boehner and Reid to come up with their own backup plans for U.S. deficit reduction one week before the August 2, 2011, U.S. debt ceiling deadline.

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Chief Justice Roberts let the Obama healthcare law stand arguing that the individual mandate for everyone to carry health insurance acted as a tax, and was on these grounds constitutional. Justice Roberts found middle ground by first rejecting the Obama's administration's argument that asking every American to buy health insurance was legal under the commerce clause, and following this with the a non partisan approach that found the mandate legal under the tax clause. Roberts was guided by the writings of an eminent legal authority, Justice Oliver Wendell Holmes. Roberts referred to this in his opinion saying: "It is well established that if a statute has two possible meanings, one of which violates the constitution, courts should adopt the meaning that does not do so." Legal scholars speculate whether Roberts changed his vote later on or whether the Justice had used the questions in the hearings on the law to explore the idea that the law could be constitutional on different grounds. During the arguments in the hearings Roberts said: "The idea that the mandate is something separate from whether you want to call ita penalty or tax just doesn't seem to make much sense."...

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U.S. Senator Ben Sasse suggests an alternative approach of simply repealing the Affordable Care Act called Obamacare and replacing it at a later date. This is endorsed by president Trump. This is the new Republican strategy in July 2017. Forty nine senators voted in favor of this repeal in 2015, when president Obama vetoed this legislation. Two more senators are expected to support repeal according to Ben Sasse.

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Republican voter sentiment in Springfield, Ohio. Warren Davidson is running for former House Speaker Boehner's seat in this Congressional district in Ohio with the support of Tea Party activists. The median income in the city is $31,635, $15,000 less than the Ohio median. The population has declined from 80,000 in the sixties to less than 60,000, according to Census Bureau. Only about 15% of the Springfield population has a college degree compared to 30% in the U.S. Speaker Boehner had a small group of loyalists and tight control of the Republican party in his district, leading to charges that he was too close to the establishment and business. Trump has support from Republican voters who feel the party has drifted away from them.

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Samuelson points out that the golden age of bipartisan harmony never existed. Yet it is true to say that with the constant chatter on cable television and stridently expressed views, the activism of the more extreme wings of both American parties, and the role of money in politics, the partisan nature of politics in America has increased. And this is happening even when the Gallup polls from 1992 and 2010 show similiar numbers for the people who describe themselves as Conservative, Liberal or Moderate, showing that the people themselves haven't changed (42-43% Conservative, 35-36% Moderate, 17-20% Liberal), but activism at the edges of both parties has. In this condition, only 7% of americans have a "very positive view" of the Republican party, only 11% of Americans have a "very positive view" of the Democratic party and only 12% of Americans have a "very positive view" of the Tea party (even though the Tea party is at the height of its mometum). The net impact says Samuelson is that the nation's important problems get neglected. There is little discussion about the expenditure of blood and treasure in Afghanistan, says Tom Brokaw, see his article. There is little discussion of the need to rebuild America's deteriorating infrastructure. Or a serious discussion on deficits or energy. All this is lost in the dysfunctional politics of the moment. This is a significant observation....

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This is an exceptionally humorous operating room story of Dr. Trump and Dr. McConnell by Kristof of the NYT. Sometimes humor tells the story- and Kristof does this using a story of a surgeon president Trump in the operating Room trying to address the concerns of the patient Janet, as he keeps telling her she needs a new heart with great benefits, great benefits, before she implodes or goes down failing. Flat out take the old heart out even if a replacement hasn't been found, believe me great benefits the surgeon tells her, just that the patient just isn't getting convinced as its happening to her. The analogy is with replacing a health care plan, not just the Obama plan, any plan without something to take its place. For a few days before this article by Kristof, the Republican effort to repeal the Affordable Care Act without having a replacement was presented as a good idea. Janet is like the three Republican women- Collins of Maine, Capito of West Virginia, and Murkowski of Alaska who wanted to keep the heart they had till a replacement was found, against the surgeon Trump's advice. In a way it is about politicians in the last decade who never had any discussions as they rushed through with their own agendas, as the Republican and Democratic health care plans were rushed through Congress with relatively little participation and debate to hear all viewpoints. ...

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Eric Cantor is the senior Republican leader in the House of Representatives. He is a key figure in the negotiations with the Obama White House over the budget, deficit reduction, and raising the debt ceiling. Cantor and House Speaker Boehner are leading the negotiations on the Republican side. Cantor rejects any compromise on tax increases. He told reporters: "I think behind this notion of 'We want shared sacrifice' that they continue to say means 'We want to raise taxes,' and we don't accept that we raise taxes in an economy like this." Cantor is a lawyer and a former state legislator from a district that covers the Richmond, Virginia, suburbs. He was elected in 2000. Through his "Young Guns" program Cantor recruited many of the 87 new Republicans who were elected in 2010. It is this support from rank and file Congressman that has propelled Cantor into a leadership position for the deficit talks. Responding to critics that say a compromise is needed from both sides in the talks, Cantor says- "I don't think the White House understands how difficult it is for fiscal conservatives to say they are going to vote for a debt-ceiling increase." On June 23, Cantor pulled out of talks with the White House. In the current round of negotiations Boehner pulled back from "a grand bargain" which included tax increases, after consulting with Cantor....