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Checking the facts, Obama's claim of Romney's $5 trillion in tax cuts and Romney's claim of Obama taking $716 billion out of Medicare.

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The Congressional Budget Office analysis of the Republican healthcare plan advocated by Mr. McConnell, Senate Majority leader, is that it would add 22 million uninsured if implemented. That plan ran into opposition from Republican Senators Collins, Capito, Murkowski, Paul, and Moran, and lacked enough support in the Senate. All Democrats opposed it and with the thin majority Republicans were divided. By taking away some benefits given under the existing Affordable Care Act the plan hurt the elderly and low income people, making some Republicans listen to their constituents in home districts and not the Republican leadership. The NYT profiled two in particular who astonishingly in a sign of today's strange politics were the only ones publicly holding townhall type meetings to hear the views of people in their voting districts- Susan Collins of Maine and Jerry Moran of Kansas. Both senators were listening to rural communities and Moran stated his opposition with the words- "I am a product of rural Kansas." With it the nation takes a breather and the message goes out that it is best to listen first and then to seek middle ground, not do what both parties Democrats and Republicans did in 2009 and 2017- rush serious legislation through without support across party lines and without serious discussion.   ...

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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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Amy Goldstein spends time in Janesville, Wisconsin, in U.S. vice presidential candidate Paul Ryan's congressional district, and talks to local people to give a glimpse of life in Janesville after the closing of the GM plant and the 2008 financial crisis. She looks at the effects of long-term unemployment and cuts in services in communities such as Janesville as a public policy scholar at the Woodrow Wilson International Center for Scholars, while on leave from the national staff of the Washington Post. Ryan was first elected to the U.S. Congress in 1998, about a decade before the closing of the GM plant, and has been reelected to Congress each time for 7 consecutive terms. Goldstein says Janesville is typical of the communities across America that have suffered job losses- the loss of more jobs in manufacturing than any other sector, a greater impact of job loss for men than women, and a large impact on people who had less education but well paid jobs. As shown by the recent settlement for a Caterpillar plant in Joliet, Illinois, and across the U.S. manufacturing landscape, older workers who enjoyed higher wages are retiring with newer workers coming in at a lower wage, which is improving U.S. manufacturing competitiveness but also increasing the importance of education for higher paying jobs....

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A short biography of Wisconsin Congressman and Romney's vice presidential pick, Paul Ryan.

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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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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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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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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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Paul Ryan asks President Obama to put forward his plan for deficit reduction the day after the passage of the August 2, 2011 Debt Ceiling and Deficit Reduction bill in Congress. Ryan points out that health care cost increases are on an unsustainable path with costs going up by 8% in 2011 and projected to go up by 8.5% in 2012. The Obama Health Care legislation tries in Ryan's view the same failed bureaucratic efforts of the past to cut health care costs. Without a genuine and sure plan to cut costs the only way to pay for Medicare with new mandates is to increase taxes again and again. He cites the CBO's Long Term Outlook in June that total tax revenues would have to double by 2050 to finance the current rate of spending on Medicare and other programs. For Ryan the failure of the Obama administration to come up with its own plan for deficit reduction after passing the Health Care legislation- with expanded mandates and no certain cost control in the reform - is the most difficult to swallow. ...

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This New York Times editorial describes the impact on lower income Americans of spending cuts that are part of the Romney-Ryan plan.

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Epic Systems of Verona, Wisconsin, is one of the companies engaged in digitizing health records. It has helped develop records for 40 million patients in hospital systems such as Cedars-Sinai Medical Center in Los Angeles, Kaiser Permanente, the Cleveland Clinic, and John Hopkins Medicine in Baltimore and the Weill Cornell Physicians Organization of New York. Epic provides the software, the IT systems, the training and support. Epic is one of the pioneers in this, having been in the business for 30 years. About 40% of primary care doctors in the U.S. and 25% of hospitals use electronic patient records. The Federal government has provided $2.7 billion in funding from $27 billion of Stimulus funds assigned for the purpose of conversion to electronic medical records. This is likely to speed up the conversion. Other providers are Cerner, Allscripts, Meditech, Siemens Healthcare, G.E. Healthcare, and IBM. Epic Systems is considered the defacto standard in the industry for medical schools and some of the major hospital systems in the country. New contracts are leading to a major expansion of Epic Systems which employs 5100 people. Epic plans to hire an additional 1000 people. Revenue for the privately owned company are estimated at $1.2 billion, a 45% increase over the prior year. Epic is expected to have 127 million patients under medical records by mid 2013. To get the feedback essential for such a large conversion, CEO Faulkner relies on feedback from 250,000 doctors who use the Epic systems software, and on nurses and doctors from Epic who visit customer's sites to see first hand how it works and what needs improvement. Judith Faulkner started Epic more than 30 years ago. A project for the Psychiatry department led to other projects after she graduated in computer science from the University of Wisconsin. Epic continues to attract programmers to Wisconsin by making the Epic campus a fun environment and a great place to work. ...

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The rarely mentioned origins of the U.S. Medicare reform proposal of Rep. Paul Ryan and Rep. Ron Wyden, which includes work done at the Hoover Institution and liberal think tanks, in a debate subject to distortions on all sides.