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Alan Blinder, Princeton University professor and former vice chairman of the Federal Reserve, says the biggest reason for the growing deficit in the years out to 2040 is because of increases in health care spending. Its not that there is runaway spending in other areas. He cites CBO projections that show other costs stable relative to GDP from 2015 to 2035 and declining. This is why healthcare spending is at the heart of the problem. And why tackling the deficit has a lot to do with reducing healthcare cost increases.

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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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U.S. states want flexibility in applying the Medicaid program which covers 53 million Americans earning lower levels of income. This amount was $11,616 a year for working parents in 2009, according to the Kaiser Fondation. Some states have a higher income level, as high as $48,400. The problem for states are serious budget deficits, with Medicaid comparing with education as a major cost. The recession and job losses has added 8 million Americans to Medicaid rolls. The Federal government supports 57% of the Meddicaid budget on average. A provision in the 2010 health care law says states cannot limit Medicaid eligibility, or they would lose funding by the federal government. The Obama adminstration's position is that eligibility or provider cuts will not bring in large savings, and will allow larger cost-sharing by Medicaid users, with only minor cuts in eligibility. Its position is also that the law does not give the federal government waiver authority. Some of the issues raised relate to the structure of Medicaid cost and its rapid escalation. Health and Human Services says 1% of benificiaries, especially the long term care, use up 25% of the Medicaid expenditures. One astonishing fact is that two thirds of all U.S. nursing home residents are on Medicaid. The total cost is rising, from $187 billion for Medicaid in 2000, to $346 billion in 2009, according to the Centers for Medicare and Medicaid Services. In July 2011, $26 billion in additional federal Medicaid funding expires, which will be added to state expenses as they struggle with large deficits. In states like Maine, with generous benefits, about one fourth of all residents are in the Medicaid program. ...

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Education policy reform and serious action expected from the government. Obama has agood grasp of what is needed and what actions to take to improve the quality of education in our schools, and the support from parents.

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Romney emphasizes that he supports some of the popular parts of the Obama Healthcare Law such as coverage for people with pre-existing conditions. He tells voters he got everybody in his state insured. He also says there will not be a huge cut in taxes that would worsen the deficit. He would close loopholes and deductions to offset any deductions as shown by his advisor Harvard economist Martin Feldstein. The idea is to get a message across that will resonate with women, minorities, the middle class, workers, and business- the 100%, something he is able to do with some credibility having come from Massachusetts, a liberal state in the eastern United States.

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California's governor Jerry Brown has put forward his budget plan for fiscal 2013 showing a budget surplus of $851 million. Brown was able to get Proposition 30 passed in the November 2008 elections. Higher income earners pay more in taxes for several years and the sales tax is increased. An improved economy with unemployment down from 11.3% in 2011 to 9.8% in Nov. 2012 is helping with higher tax revenues. General fund revenues are expected to increase 3.3% to $98.5 billion in the 2013 fiscal year from $95.4 billion the prior year. Brown has accomplished a remarkable feat of balancing the budget for 2013 and still continuing to invest in education and healthcare. Spending will increase 5% to $97.7 billion in fiscal 2013 from $93 billion in fiscal 2012 with higher spending on education and health care and lower spending in other areas. Brown's path to achieving this was eased after Democrats won control of both houses in the the state legislature. Says Brown: "Right now, for the next 4 years, we'll be talking about a balanced budget, we're talking about living within our means... This is new." Even Republicans praise this effort from a veteran of California politics- his father was governor in the Kennedy years, and he was governor in the 1980's....

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The close contest between Republicans and Democrats in Wisconsin to recall Governor Walker five months before the presidential election. Grassroots activists pushed hard for the recall after large protests at the state Capitol. The national Republican party has invested resources in this and sees this as part of the national campaign. Walker has raised $25 million, according to the Wisconsin Democracy Campaign, and has far larger election campaign funds. Romney needs to win in the midwest in states like Wisconsin and Ohio, to win in November, and this recall election is being taken seriously by the Republicans.

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A shocking statistic. Of the 12 metropolitan areas in the US with over 15% unemployment, 10 are in California, and this is because the construction industry has taken a severe hit. It lost 74,000 jobs in the 12 months ending in June 2010. From June 2006 to June 2010, this industry in California lost 43% or about 402,000 jobs. And the construction industry is still shrinking there. One reason why the unemployment rate in California is 12.3%. The overbuilding during the boom makes it that much harder to rebuild. The construction industry has been hard hit in Los Angeles and Riverside metro areas and in Napa and Solano counties.

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A study by the National Employment Law Project shows most of the job creation in the economic recovery to 2014 in the U.S. is replacing the better paying jobs with lower paying jobs in fast food retail and similiar low paying industries.

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Senator Edward Kennedy turned a close election around with an ad in 1994 attacking Romney for job cuts. The result was a 58% to 41% defeat for Romney. In Iowa a Perry ad presses this issue saying "Mr Romney made millions buying companies and laying off workers."

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Governor Jerry Brown of California's call for fiscal restraint. In his annual State of the State address Brown said the emphasis must be on fiscal restraint and prudent spending so that the budget does not swing back to deficits. Brown was able to achieve a budget surplus of $28.9 million after spending cuts and temporary tax increases. In doing this Brown is seting a new tone for the U.S. of fiscal prudence after the budget surplus of the Clinton years was followed by swelling deficits. This also comes from the U.S.'s most seasoned governor, from the largest state in the Union, who has seen all sides of the picture. Brown said: "It's cruel to lead people on by expanding good programs only to cut them back when the funding disappears... We're not going back there." This may be the lasting legacy of Brown in his second effort as governor after two decades.

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The US House of Representatives voted 245-189 in favor of repealing the health care law. Only 3 Democrats joined the entire Republican caucus in voting for repeal, compared to 34 Democrats who voted in March 2010 against the health care law. This is a largely symbolic move as the Democrat controlled Senate will not consider the repeal, and even if it did the President would veto it. Republicans favor some aspects of the health care law which allow children to be on the parent's insurance till age 26, and a ban on insurers denying coverage due to pre-existing conditions. Opinion polls show 46% of respondents opposed repealing and eliminating the law, and 45% favored repealing it. The health care issue ranks third among the economic issues important to respondents, behind unemployment and reducing the federal budget deficit.

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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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Feldstein says that for the 85% of the people who have healthcare the Obama proposals are not a good deal. The Obama proposals mean higher taxes in the long run to pay for the $1 trillion cost of healthcare for the uninsured group over 10 years. This lower income group has no coverage despite the $300 billion Medicaid program. Feldstein says there surely must be better and less costly ways of getting this lowincome group healthcare. Raising the top income tax rate to 45% from 35%- as a result of letting the Bush tax cuts expire and adding aproposed health surcharge on higher income individuals- would actually lower revenues for the government, as it would change behavior of high income individuals in ways that lower their taxable inome. The result is higher deficits and higher taxes when even without this large deficits are projected for the future. How to slow the rapid growth in healthcare spending? The Obama plan is to cut spending on Medicare. Feldstein sees the govenment's effort aimed at reducing the amount of medical services, as reduced spending comes from fewer services, not reduced payments to providers. Will this result in enough of acost reduction to make the system work. And if the cost reductions are too heavily weighted towards reduced services and not reduced payments to providers would this result in large cuts to services to affect the quality of healthcare for the 85% who are accustomed to a different pattern of healthcare, even though it is structured to allow cost escalation. Feldstein offers no solutions to the problems of cost escalation except to suggest that the Obama plan does not really tackle the cost escalation issues directly with providers, and instead burdens the national finances to an extraordinary degree. And the need for apause and reflection....

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Krauthammer cites Congressional Budget Office numbers that show the Obama U.S. health care law continues the spiralling costs of health care with new government mandates at a time of severe budget cuts in education and other areas- for 2013-2022 the costs come to $1.76 trillion. The initial Obama administration figures of 10 year costs of $938 billion announced in 2010 reflected the fact that the new U.S. health care law would take 4 years to fully go into effect. Costs after 2021 are shown to be $250 billion each year in the CBO figures. The law is now before the Supreme Court in 2012, which has to decide on the basis of the limits of the Commerce Clause.

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Are there costs or are there savings from the Obama health care bill? Does it affect jobs and how? The Congressional Budget Office says the health care law will save $230 billion in ten years based on a whole set of calculations and assumptions. Commonsense and basic math leads others to question how spending $930 billion on insuring 32 million Americans could end up with significant savings. The different view argues that the Budget Office erred in making some calculations, by counting $70 billion in premiums from long term care because they would be used to pay benefits later, omitted $115 billion in spending to adminster the law, and omitted $208 billion needed to prevent scheduled reductions in Medicare payments to doctors. The money needed on the Stimulus, on two wars in Iraq and Afghanistan, and the uncertain prospects of the US economy in the longer term till debt and other issues are resolved, injects the critical element of difficult choices and priorities. If state and local budgets are severely strained in 2011-2012 would that require federal help and will there be other needs that will have to be met by the federal government that are critical such as another unexpected downturn, or a resolution of unresolved bad debt at the large US banks There is also a sense that the health care law does not do enough to reduce the cost of health care that will be needed over the next decade so that other priorities are not neglected. Both parties are not up to the task in this respect for running the country's finances withot using the numbers to tell different stories....

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The US economy grew at 2% in the third quarter 2010, compared to 1.7% in second quarter 2010. Unemployment remains at 9.6%, and the growth did not generate hiring. Much of the growth came from business building inventories, exports grew at 5%, imports rose 17%. Residential construction plunged, state and local government spending contracted as it did for 6 of the last 8 quarters. This increases concerns about the economy.

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Britain's National Institute for Health and Clinical Excellence (NICE) says Glaxo's drug Benlysta for lupus is not "good value for money." The drug is priced at 10,000 pounds a year in the U.K. ($15,600) and much higher at $35,000 a year in the U.S. Benlysta is covered by insurers in the U.S. and some European state run health systems according to Glaxo. NICE also rejected a new multiple sclerosis drug Gilenya, which costs 19,000 pounds a year in the U.K. ($29,700), and $48,000 a year in the U.S.