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About 53% of the uninsured Americans disapprove of the Obama health care law, in comparison to 51% of the insured with health care coverage who disapprove of the new law. About 35% of the uninsured say they are likely to pay the penalty for not carrying insurance, and six of ten uninsured say it will make their health better. Overall the approval of the law is at 39% and disapproval at 50% in the Dec. 2013 poll. A striking part of the poll result is that 57% of the uninsured say it will increase their health care costs, compared to 52% of the insured. Only 20% say it will decrease their health care costs. This reflects the lack of serious controls on the surge in healthcare spending in the law. A separate research shows that more of the costs are passed on to users who will pay higher out-of-pocket costs after the law.

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This report in the Economist magazine says views in the Trump base of support in rural areas and among white working class voters are likely to persist for some time. One reason given is that many of these people live in isolation and little contact with the more educated urban voters in America. Another factor cited here is that only a fifth of voters follow politics closely, and of these voters only a small fraction have a good grasp of the positions of the two major parties. Most people follow the instincts and thinking of the groups they are with. As a result many of the issues covered in the media such as climate change and U.S. withdrawal from the Paris agreement, the Comey firing and the Mueller investigation into Russian meddling in the election, president Trump's Twitter comments, are not having much impact on the president's ratings among his support base at this early stage of the Trump presidency. Yet it is too early to tell only 6 months into the Trump term in office. After 8 years of president Obama's two terms in office voters who feel left out are not likely to change their views in so short a time. Republican voters as distinct from the core Trump base voter are also unlikely to change their views after 8 years of Democratic party administration. By staying close to traditional Republican party positions president Trump is likely to continue to have the support of the lifelong Republican party voters unless things change. Can a centrist position emerge after voter fatigue with excessive partisan opinion, as voters seek to make America a more quieter place and a consensus on working together to lift all boats emerges. This could be expected as time passes.   ...

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This Journal editorial says Romney is cautious and conservative in his politics, and finds his ideas for a value added tax problematic. It sees the need for Ron Paul's supporters in a successful Republican campaign in 2012 and critical for governing in 2013, because of Paul's genuine desire for change to the status quo. Of Santorum the Journal says there is need to broaden the economic message beyond reducing taxes for manufacturing companies, and going beyond the moral fervor to show how he would revive the U.S. economy and jobs growth.

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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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Dana Milbank of the WP says the views of some Democrats on Trump as a good Republican nominee based on the notion that he has high negative perception with voters is fraught with dangers for U.S. democracy. Milbank points out that this ignores what is good for the country. Having Trump as the nominee of one of the two main parties would create a divisive atmosphere and is not good for the country, says Milbank. In comparing Trump with Cruz, he says Trump is likely to follow his instincts to operate outside the U.S. constitutional system. Cruz as a person believes in the U.S. constitution and would never endorse violence or action against minorities. Cruz has not done enough to come across as a likable person with his persistent focus on conservative or Reagan values to the exclusion of everything else. This is changing in mid-April 2016 following a CNN interview with the Cruz family, a MSNBC town hall answering questions from undecided voters, and NYT coverage of Cruz at a Brooklyn bakery, that shows a different human face that people have never seen about Cruz. Cruz's self-deprecating humor in a NYT article where he talks about voters not liking "a hectoring scold," is part of this needed change that could have happened earlier in the campaign. About Trump Milbank cites Conservative party prime minister Cameron who says Trump would unite all Britons against him if he ever came to Britain....

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Romney and Santorum in a tie, with Romney winning by just 8 votes in Iowa's Republican caucuses. Romney got 23.6%, Santorum 23.5%, Ron Paul 21%, Gingrich 13% and Perry 10%. Romney received almost the same number of votes he won in 2008.

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Lobbying by the pharmaceutical and health care industry and U.S. president Obama's promises to the industry as part of his shaping the health care law.

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Stuart Stevens, the chief strategist of the Romney campaign points to the Romney campaign's success in getting a majority of votes of people making over $50,000, a majority of white voters under 30 by a 7 point margin, winning the votes of a majority of America's middle class, and falling short of a win of the Electoral College by 320,000 votes. He says Obama turned Democratic party weaknesses of being too liberal and too dependent on minorities into advantages. The Pew Research Center and other expert opinion cited as the principal reaon for the defeat, Romneys failure to empathize with voters. He appeared callous in his image with Hispanic voters with his self-deportation stand, and similiarly his position on the auto bailout was shown as callous in a barrage of political ads by the Obama campaign in the midwestern states, the remark about the 47% dependent on government help simply reinforced this notion of being insensitive to concerns of the less affluent. The candidate never succeeded in shaking off impressions in the minds of voters of being a private equity executive who could not empathize with weaker sections of the community, which were reinforced by heavy negative advertising in the 2012 election. Stevens says nothing about the short sightedness of a callous immigration policy of self-deportation adopted by a former governor of Massachusetts, in the face of Census statistics showing more children of minorities, especially Hispanics, born each year than children of any other demographic group in the U.S. The changing demographics may have made a crucial difference in many states....

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Bernie Sanders points out in this NYT op-ed the idea that Donald Trump could benefit from the same discontent among working class voters that helped the Leave campaign is a wake up call for the Democratic Party. He calls for global trade and a global economy that works for working class, middle class Americans.  Sanders is pushing for a Democratic Party that embraces the concerns of working class Americans, that understands the impact of factory closings and loss of jobs, of economic uncertainty, of declining incomes and shrinking opportunities.

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Romney promises to focus on everyday concerns of jobs, family, and budget deficits with his 5 step plan to revive the economy. He says he will not raise taxes on the middle class. The 5 step plan is to make America energy independent by making full use of domestic oil and gas resources, create jobs and provide skills for new jobs, make trade work for America, support small businesses with fewer regulations and smaller tax burden and smaller burden of healthcare, and reduce the deficit. His plan he says will create 12 million new jobs.

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David Brooks on the change in Romney as he breaks away from tea party orthdoxy to be the man Brooks believes he truly is.

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A report by pharmacy benefits managing company Express Scripts shows a 13% increase in the price of branded drugs in the U.S. from Sept 2011 to Sept 2012. Generic drug prices declined by 22% in this period. The report also shows that growing spending on specialty drugs for cancer, MS and other diseases is a big reason for the increase in prices of branded drugs. This report is from a random sample of six millon Express Scripts members using prescription drug coverage. Prof. Schondelmeyer of the University of Minnesota, who manages the drug benefits program at the university and conducts a similiar price report for AARP, says the potential benefits for these specialty drugs are not that good to justify the high prices.

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A study by AARP of 514 brand name and generic drugs between 2005 and 2009, shows that generic drug prices went down an average of 31% during this period, and brand name drug prices went up by 41%. One of the authors of the report says that it is important to look at individual drug prices and not studies showing total spending on drugs, because this is a significant cost for people paying out-of-pocket, It drives up insurance premiums, and pushes retirees into coverage gaps in Medicare Part D drug program. Analysts indicate pharmaceutical companies are increasing prices on drugs before patent expiration to get as much profit before the patents expire.

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Peter Orszag's role in the healthcare debate and the formulation of health care policy proposals. One proposal of Orszag, who heads the Congressional Budget Office, is to set up a new agency with powers to cut spending and implement changes in Medicare. Says Orszag, "one of the reasons we have such disjointed and skewed incentives is that we have an excessively political process." At a recent meeting with House Democrats, one Congresswoman said her top priority is winning higher payments for oxygen suppliers, and Orszag was taken aback. For years officials have been trying to cut payments to oxygen and medical equipment suppliers, which are said to be inflated. When a new competitive bidding process was set to take effect last year, industry supporters in Congress were able to delay the plan, and these supporters are still fighting to block changes says the WSJ. Here is a 40 year old Orszag, with degrees from Princeton and London School of Economics, who got his early experience in the Clinton adminstration at age 24. He then followed this with a number of policy oriented jobs, ending with appointment to head CBO in 2007. And he faces the whole system of Congressmen from both parties beholden to interests in the healthcare industry, who provide the donations for them to finance their election campaigns. Dan Eggen describes this in the Washington Post, 7/21/2009. Max Baucus of Montana, and to some extent Grassley of Iowa, are senators from both parties who Eggen points out are beholden to the healthcare industry because of large donations they receive from the interests in the healthcare industry. These interests want to see their payments system protected. The further escalation in health care costs, which would make the whole healthcare system unaffordable even as it delivers poor results, can only be prevented by making cost control an exercize that is not influenced by healthcare industry donations. Jackie Calmes describes the huge hurdles in achieving a deficit neutral move to universal health care in the U.S. in the NYT 6/26/2009. See the link. The exchange between Grassley and Orszag on the issue of the $177 billion in savings needed from the payments to health insurers under the Medicare managed care plans- which allow seniors to obtain Medicare coverage outside the government run program -went as follows. These are dubbed overpayments by outside experts and efforts have been made to cut them in Congress. When Mr Grassley raised concerns about the impact of such cuts in a hearing, -and Grassley has opposed the cut for this overpayment to insurers- Orszag responded saying: "I very firmly believe that capitalism is not founded on excessively high subsidies to private firms. This is what this system delivers right now." ...

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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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U.S. presidential candidate Mitt Romney is questioned about the depth of his beliefs by John Harwood, at the November 9, 2011, Oakland University, Michigan, televised presidential debate. Harwood asked Romney if his positions on issues "are rooted in something deeper than the fact that you are running for office." Romeny's response was that he had been married for 42 years, and "been in the same church all my life," and worked at the same firm Bain & Co. and Bain Capital, for 25 years, that he was a man of steadiness and constancy." On key economic issues such as revival of the auto industry and foreclosures, both major issues in Michigan, Romney continued to maintain that the loans made by the government to Chrysler and GM were a mistake. Oakland University is only half a mile from Chrysler headquarters. This view was challenged by Rick Snyder, Republican governor of the state of Michigan, who said- "it wasn't just one or two companies that were at risk, but the entire national suply chain." On foreclosures Romney maintained his position that the government should let the market work, even if this means millions of foreclosures. Romney said: "Markets work. When you have government play its heavy hand, markets blow up and people get hurt," putting the blame for the housing crisis on Fannie Me and Freddie Mac, agencies with a government guarantee that encouraged indiscriminate housing loans. ...

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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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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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The Romney story says this editorial is one of a turnaround- of a kind patiently nurtured from his days turning around businesses as a management consultant. This one was different and probably required a lot of soul searching and courage to take up new positions. As a technocrat, says the Journal, Romney would have been more comfortable with a room full of IQ's going over spreadsheets of numbers. He tried to do this by not taking up specific positions till the need to convince voters, first in the GOP base and then centrists and independents after the convention, forced Romney to make the reassessment and turnaround he needed to make. In November 2011 he accepted the Ryan position that Medicare needed changes, and in Feb 2012 he took up the case for lower tax rates and cutting deductions. In October 2012 came the first debate, with it Romney abandoned his reluctance to put forward a plan for the economic recovery and put forward his five point plan. That was the turning point in the campaign but all the other steps including the selection of Ryan, a Congressman from a working class district in Wisconsin, agianst the advice of advisors, were leading up to this turnaround. This was likely the most difficult of turnarounds, even searing in its soul searching as Romney scribbled "Dad" on paper at the lectern before the first debate- turning back to beginnings he had doubted for so long....

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The president of the Pew Research Center, Andrew Kohut, says Romney was an especially weak candidate for Republicans and this has to be taken into account in understanding the results of the 2012 U.S. presidential election. Romney failed when it came to establishing empathy with voters compared with Obama and this was a significant factor- 53% to 43% for Romney in exit polls. Even on the economy which should have been a Republican strong point Romney failed to get an advantage over the president with both tied at 48% to 49% for Romney. Republicans were favored in their approach to government- only 43% favored activist government in 2012 compared to 52% in 2008, and 49% disapproved of the Obama health care law and only 44% approving in 2012. On social issues exit polls showed 59% believe abortion should be made legal, and on immigration 65% support a pathway to citizenship for illegal immigrants. Early in the primaries some commentators said the Republicans were not fielding strong candidates for president who could relate to voters and this has turned out to be true. This also explains the Republicans retaining a majority in the House of Representatives and continuing the hold on governorships. ...

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A decade after the 2004 speech at the Democratic National Convention, Obama's message of change and hope as seen by American voters in 2014.