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Leonhardt points out a couple of problems with Paul Ryan's budget proposal for Medicare. He says Medicare recipients, with the exception of the very affluent, currently haven't paid enough for the benefits they receive. He cites a study that shows Medicare pays out several hundreds of thousands of dollars for the average retiree more than they ever paid in. Medicare funds go for hospital expenses, the rest for doctors bills come from general government revenues. Government borrowing increasing the national debt to unsustainable levels so that current retirees do not have to pay higher taxes, is simply shifting the burden to the next generation. He says the Ryan plan shields those who will retire in the next 10 years because they are a powerful voting bloc, making this more of a political calculation than a bold reform step, as this means younger people will have to bear a disproportionate share of the burden. The other part of Ryan's calculus is that it has proven extremely difficult to reduce the volume of medical care that is consumed in terms of tests, lack of preventive care leading to graver problems, and surgeries. Simply by shifting a larger share of the cost to future retirees this will have an effect on the volume of medical care consumed and put a lid on costs. This is something that needs to happen says Leonhardt, but at the same time all Americans need to share in the higher taxes that are necessary to fund Medicare, exempting 75 million Americans only creates an imbalance in contributions. The other problem with this is that the costs of this exempted group will postpone serious deficit reduction for ten years....

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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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Senator Mitch McConnell, the Republican Majority leader in the U.S. Senate has come up with a new health care bill that is aimed at winning over reluctant Republican Senators. Two taxes on high income people on 3.8% investment income and a payroll tax of 0.9% on incomes over $200,000 for individuals and $250,000 for couples are retained in this version of the bill, which adds $231 billion over a decade. Some of this is used to offset rising premiums in the new bill, and provide additional funds. The deep cuts to Medicaid are retained and Senator Collins of Maine says she is opposed to the new bill because this will hurt people in rural areas of Maine, and does nothing to change this. Senator Rand Paul of Kentucky is also opposed to the bill. Opposition comes from moderate Senators opposed to deep cuts to Medicaid in Republican health care alternatives to president Obama's Affordable Care Act, and from conservative Senators opposed for other reasons.  Senator Graham of South Carolina and Bill Cassidy of Louisiana introduced their own version just minutes before Mitch McConnell brought up his revised bill. All Democratic Senators are opposed to the Republican bill and call the deep cuts to Medicaid disastrous for lower income people.  ...

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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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A study by Dr. McCormick of the Harvard Medical School and professors at the City University of New York School of Public Health at Hunter College, shows that the anticipated savings from conversion to medical records may not materialize to the extent expected. This study of data from 1100 doctors of 28,000 patient visits shows that with access to digital records doctors actually increased the number of tests ordered- from 12.9% of visits without digital records to 18% of visits with digital records. For more advanced tests such as MRI and CT scan the rate was 70% higher. Dr. McCormick says this may be because the new digital technology may have made it easier to order tests.

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Athenahealth, a provider of software for physicians, is intervewed by Jon Kamp about the efforts to promote digitization in physician's offices.

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Romney says in the first presidential debate he will not increase taxes on the middle class: "I will not reduce taxes paid by high income Americans. And I will not, under any circumstances, raise taxes on middle-income families. I will lower taxes on middle income families." How he would do this is through limiting or eliminating deductions and loopholes among several measures, with work done on this by his advisor Martin Feldstein, Reagan's economic advisor and a professor at Harvard University- Romney's Tax Plan can raise revenue, WSJ, 8/28/2012. Where the Democrats and Republicans differ is that economic growth generated by creating incentives for business to invest and hire also plays a part in generating the additional revenues as it did under Reagan's economic plan. Behavioural factors play a large part of this as much as the incentives and other steps, to create a climate of business confidence- search in Janvoo for the Group "Reagan memo of 1980 by Shultz, Friedman," for more on this....

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A WSJ/NBC poll of Sept 20, 2012 showing Obama with a eight percentage point lead in Iowa, and a five point lead in Colorado and Wisconsin.

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People who worked with Romney in the Mormon church describe the experience of Romney who started as an "iron rodder" walking the straight path, and gradually learning of other people's experiences that led to learning and growth and showing a new openness. In contrast to his "47%" remark about people dependent on the government, here he is seen telling another church member Barlow, that what bothers him most and what he has thought a lot about is how to genuinely help the poor in his church. Over the years he learned to compromise with Mormon feminists who sought larger roles in the church and was able to make the progress from being less flexible to being open to other ideas and perceptions. In other situations he allowed unorthodox progressives in the Mormon church to play a part in the organization and teach. The outreach efforts Romney participated in actively included efforts in the inner city and working with immigrants from Haiti, some of whom were illegal immigrants. This is a detailed well researched account from talking to many people active in the church organization and in the church community by Jason Horowitz of the Washington Post. It is one of the rare glimpses of the life of Mitt Romney inside the church. Because of the public perception of Mormonism there is a distance kept with accounts of life in the church, and Romney has shown the same reticence to talk about the church. Seen as a church it is is like other churches, Catholic or Protestant, with the same challenges that face all churches- keeping up the size of the congregation, the poor, immigrants, church organization, raising contributions, getting people to donate hours of work to the church activity. It is one of the ironies of the 2012 presidential campaign that Romney as a member of a Mormon church in a predominantly Catholic and Protestant world has remained reticent about his experiences and how it shaped him. And also remained reticent -till the last months of the campaign with the demands for authenticity growing strident- about how the experiences as governor of the liberal state of Massachusetts had shaped him, this time as the number of Republican politicians in sharply liberal states were a distinct minority in the Republican party. To voters this meant not knowing who he was beyond Bain Capital, the perceptions of which doggedly pursued Romney till the reticence became unbearable in the final weeks of the campaign....

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This WSJ editorial in September 2014 says many of president Obama's statements and decisions on Obama healthcare legislation and implementation, Syria, NSA and privacy, the Middle East, Russia, showed poor judgement. It refers to a piece by Peter Baker in NYT where it is said that Obama mocked how people see him as too professorial, diffident, in a sarcastic statement. The problem says WSJ is that president Obama has poor judgement. Being academically credentialed and quick grasp of subject matter is not the same as having the ability to discern things, instinct and grasp of the essence of the matter. George Bush senior had a long resume and was academically credentialed. By comparison Truman had a short resume and was not academically credentialed or quick with data and analysis. He had something more essential and important- a discerning mind and grasp of the larger picture, as well as listening abilities for exceptional advisors such as General Marshall and Acheson he gathered around him....

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Most Americans pay less in taxes, including state, local and federal taxes, today than in 1980 in inflation adjusted dollars. The taxes have gone down by 2-3% for incomes in the range of $50,000 to $150,000, and gone down by 3-4% for incomes between $150,000 and $350,000. Taxes have gone down over 7% for incomes above $350,000. The main reason is the decline in federal income taxes.Tax rates increased in the period to 1990 and declined from 1990 to 2010. The Democratic party and president Obama are pushing for increase in taxes for incomes above $250,000. Republicans are resisting the changes citing disincentives to investment and growth for small business which generates a large proportion of new jobs created in the U.S. economy. The New York Times study shows the percent of the U.S. population that makes between $200,000 and $350,000 almost doubling in the period 1980-2010 and at the same time its share of the U.S. income remaining the same - many small business owners who hire employees would fall into this income category. Republican's response is for tax reforms that reduce loopholes, deductions and other tax expeditures that disproportionately help the wealthy. Democrats say this cannot create enough revenues to address the deficit, when mortgage deductions, charitable deductions are excluded. The back and forth is leading to stalemate but also opening up discussion for the first time on whether the mortgage and charitable deductions make sense in today's environment. A significant portion of revenues lost in the mortgage deduction goes to affluent households, subsidizing larger borrowings to build larger homes than otherwise, according to the Brookings Institution. Politicians have resisted changes that would go against powerful lobyying groups in the past, yet the impasse has opened up new thinking outside the box because of the pressing need to come up with a solution....

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A new study by the Washington Post and the Kaiser Family Foundation shows partisan politics will affect the new president in the U.S. in 2013, to the point of making it difficult to govern.

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The skills to navigate different personalities and work patiently on the issues surrounding changes to the U.S. tax system of Rep. Dave Camp (MI), chairman of the U.S House of Representatives Ways and Means Committee, will be immensely useful in the effort to make changes to the U.S. tax system. Camp works well with fellow House Republican leaders Boehner, Ryan, Cantor, and his Democratic counterpart in the U.S. Senate Max Baucus. Camp is a good listener, refuses to engage in partisan criticism, and has the patience to work through difficult issues of achieving savings and keeping fairness in the the tax changes. Earlier efforts to achieve consensus in late 2011 failed, making it even more important to have leadership which can create productive debate and bridge the differences. The tax changes are part of the overall effort for U.S. economic recovery by reducing the deficit.

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Krugman points out that the federal tax rate for the top 1% is 34% in 2013, according to the Congressional Budget Office, because president Obama let the high end Bush tax cuts to expire. It is the number to remember says Krugman- 34. In 2008 the figure was 28.2. Under Hillary Clinton the average tax rate for the top 1% would go up by 3.4 percentage points, according to the Tax Policy Center. Some of this would help pay for the tution plan to provide access to the middle class to public universities. Under populist Trump, Krugman points to the elimination of the inheritance tax and tax rates going down substantially, and no such programs to promote the upward mobility that everyone is talking about, and no way to pay for a big infrastructure building effort for growth and jobs- upward mobility that is the focus of every candidate's election campaign including Sanders, Trump in appealing to older white working class families, Clinton, Ryan, Bush, and others in both parties.   ...

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Rep. Dave Camp, House Ways and Means Committee chairman, representing northern Michigan, says every deduction in the tax code is there because of a reason, and powerful lobbies will oppose any changes. The best he can do is work himself out of this job as he will have to tackle the Democrats on entitlements, the business lobbies on tax loopholes, and other lobbies protecting their preferences in the tax code. He plans to achieve a simpler tax code with lowered rates of 25% for business and earners above six figures, and 10% for everyone else. The approach he is taking is to be revenue neutral when tackling tax reform, in the belief that the economic growth generated from a simpler tax code and lower rates would generate revenues of 18 to 19% of GDP, up from about 16% today. He says the economc cost of not getting this done to get the economy rolling again is so high that he is upbeat that both sides can come together after the election no matter who wins. He is also looking at a repatriation tax of 5% on profits kept by American companies overseas, which would boost revenues for business which could be reinvested in stead of sitting idle. Today the much steeper tax rate on repatriation makes businesses reluctant to bring it back....

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The U.S. Census Bureau shows incomes of American households, the median household income, surged in 2015 by 5.2%. This increased by $2800 to $56,500. This is the largest increase since 1967. It shows that steadily improving employment and hiring is leading to improvement in incomes for the middle and working class. Ris in minimum wage has also helped . The largest increase was for the lowest 20% of the income tiers. Full time working women did better than men, with increase annually of 2.7% for women, and 1.5% for men. Nocitizen incomes increased 10.5% to $45,100, native born households went up 4.4% to $57,200. The number of people without health insurance also declined from 33 million or 10.4% of the population to  29 million people or 9.1%. Another way the changes are helping lower income households is the decline of the official poverty rate to 13.5% in 2015 by 1.2 percentage points from 14.8% in 2014. Through a series of small incremental steps the path is being set for a recovery of household incomes for the middle class and working class. A bright spot is that the improvement has affected all age groups, household types, regions and ethnic groups, though among full time workers women did better than men. In this recession older white men have had more difficulties getting back into the workforce. This is reflected in the political scene in 2015-2016 for the election season. ...