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High levels of covid and RSV in the US are leading to health authorites saying wearing masks is needed to prevent it from spreading. Los Angles is likely to introduce a mask requirement for indoors by the end of December 2022. Carrying hand sanitizer and keeping wipes with you is a good idea because RSV spreads through touching infected surfaces. Vaccination for flu and covid is also a key prevention action. As most people are no longer wearing masks in the US the practice of wearing masks is becoming a good idea once again.

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US president's sweeping powers to use tariffs as a tool for policy when American people's jobs, communities, health, is threatened by fentanyl and concentration of manufacturing jobs in China, unfair trade by EU and Japan, is the issue presented to the US Supreme Court. The US president presented it in this way- tariffs as a foreign policy tool, not a way to impose economic policy in the form of a tax on American importers or buyers which is the power allocated to Congress by the US Constitution. Justices who mentioned these powers called them sweeping powers but would not say the word fentanyl or look back at the recalcitrant behaviour of Asian nations Japan and China when it comes to unfari trading practices, where the US could literally negotiate forever and get no result, or to the enormous concentration of manufacturing power and supply channels in China that not only ships out American jobs but leaves Americans at the mercy of foreign powers for cost of living. Nowhere was this more evident as during covid years and now in rare earths export restrictions from China. The Justices assumed it was just alright to ignore this or leave it unsaid.  The cost to American buyers is small because most of the tariffs are borne by foreign suppliers in China, Japan and Germany, who as in the case of automobiles unfairly benefitted for decades and are now bearing most of the cost of tariffs. The large business in the US have increased their margins so much in the 2020-2024 period that they are now bearing some of the cost of the tariffs, as reported in WSJ. So that inflation in the US is at 3.0 % in the US less than anticipated, when average tariffs are at about 10% overall, not what the headlines say of 15-20% because of the product exceptions made in the tariffs for each nation. Justice Roberts may be right when he says more care should be exercized in the placing of a tariff, but even Roberts and Justices Barrett, Gorsuch, Kavanaugh and others know that the US has used this as a last resort, as a policy tool to protect the American people. Sweeping powers need care and caution as Justice Roberts stated- “power to impose tariffs on any product from any country in any amount for any length of time. It does seem like that’s a major authority."   ...

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The failure of the 117th Congress to pass key parts of president Biden's agenda for hard hit families and workers in America is now taking place. The 50-50 standoff in the US Senate and failure of two Democrat senators Sinema of Arizona, Manchin of West Virgina to support Biden's Families and Workers Plan leaves key parts of the safety net being left out. This leaves out the education, and paid leave part of the agenda and provisions for utilities to accelerate shift away from coal out of the bill. It fails to implement a new national agenda for upward mobility, child care and paid leave to help stressed out mothers and families. The failure to include even a modest community college 2 years of support at a time when men's college enrollment is dropping to disastrous levels for America's economic competitiveness is a failure of the 117th Congress to grasp the needs of families and workers in America today. Only a new Congress in 2022 can take up the needed action for families and workers in education, health care, child care and help for families. The passage of the infrastructure bill and the current version of the social spending bill can only be seen as a first step in the right direction, after three decades of different administrations neglecting infrastructure, education, healthcare, childcare, elderly care, upward mobility, and climate change. On the plus side as the first step to restore dignity and health of families and workers in America it includes- $150 billion for rental assistance, home buying help, public housing repairs, and building 1 million affordable housing units. $150 billion for federal programs for home health care and community care for older Americans and people with disabilities $165 billion to reduce premiums for people under Affordable Health Care Act, cover additional 4 million through Medicaid, adding hearing coverage but not dental or vision to Medicare. $200 billion for child care tax credit to parents. $400 billion to reduce health care costs and give universal pre-kindergarden for 3-4 year old children. $40 billion for worker training $555 billion for fighting climate change including through tax incentives for sources of energy that are low emission and low carbon. It will be paid for by additional taxes on incomes of very high income earners in annual $1 million plus range, and by having a corporate minimum tax of 15% for large corporations, including on profits overseas, that previously did not pay this tax. A wealth tax on unrealized capital gains of billionaires or other wealth of the richest Americans is left for a future Congress to consider for financing the key parts of climate change provisions, education and health care that were left out. The education and healthcare provisions need to be expanded to restore America's historic mission of upward mobility for all. A provision for Medicare to comprehensively negotiate prices with pharmaceutical companies that would be taken for granted in any advanced country as in Europe, is also left for a future Congress that understands and responds to the dire needs of families and workers in America for affordable healthcare medicine neglected by administration after administration for the last three decades.   ...

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A sense of how the U.S. Supreme Court Justices viewed key aspects of the Obama Health Care Law after three days of hearings on March 28, 2012.

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The knowledge that the virus  caused human to human transmission and that it spreads to wide parts of the population very quickly were critical pieces of information that remained with Chinese epidemiologists, doctors and medical researchers, and were suppressed by local authorites in Wuhan.  Yet China's version of the U.S. CDC, China's Centre of Disease Control and Prevention, modeled on the U.S. control efforts worked effectively to identify the problem. Virologist Gao Fu, heads China's CDC. This report in Germany's Der Spiegel says Mr. Fu made it a habit to scan China's internet before bedtime for any signs of possible disease outbreaks. On the night of December 30 he came across rumors of an internal memo from the Wuhan Health Commission of an outbreak of a vaguely worded lung disease. When he called the Wuhan health authority he found their answers to be evasive which alarmed him. The next morning December 31 Mr. Fu sent the first of three teams to Wuhan which is how China was able to identify the problem, in the sense that Chinese authorites in Beijing were to rely on Dr Gao Fu to overcome the problem of Wuhan provincial authorites. He informed the World Health Organization Beijing office on that day. The Der Spiegel report says "shortly afterward," the Seattle Times in its report says this was about New Years Day 2020- Mr Fu made a call to Dr. Redfield, head of the U.S. Centre for Disease Control, who was on vacation. Redfield is deeply disturbed on hearing this from Fu and they have conversations over the next few days to the point that Dr. Gao Fu is in tears about what has happened. On January 1 Taiwanese public health authorites shared the information with WHO that the cornonavirus was a human to human transmission, would the Taiwanese authorites not have shared it with the U.S. the same week during calls from the U.S. CDC or other public health authorites alarmed about the situation. (The WHO was proving useless by Jan 14 when it contradicted Taiwan's more reliable assessment  on Jan 14 going by the letter from president Trump to WHO). On January 6 a few days later Dr Redfield and Dr. Azar head of Health and Human Services ask China for permission to send a team of CDC U.S. experts to China. This is cited in the U.S. letter to the World Health organization- the lack of human to human transmission information being given to the U.S. officially early by China. A risk that could have been a topic of conversation between the U.S. and China heads of CDC. That letter from president Trump also points out that the team of experts the U.S. planned to send was not accepted by China till Feb 16, one and half months after that series of conversations between Dr. Gao Fu of China CDC and Dr. Redfield of U.S. CDC in an alert message.  In effect removing one of the key defences for the U.S. and Europe in making their own defensive actions and plans, laying the basis of the worldwide coronavirus pandemic affecting millions of people. Dr Redfield is a AIDS researcher at the University of Maryland who spent most of his life trying to control spread of HIV and was appointed by president Trump to head CDC agency in 2018. He set a goal of eliminating AIDS by 2030 and is more comfortable with aids patients and research than the bureaucratic nature of agencies- CDC has about 11,000 employees. Once it was clear that a team of U.S. experts was not given permission to make its own assessment in Wuhan in the few days after January 6 offer to sent the team to China by Redfield of U.S. CDC and Dr. Azar, would it have alerted the U.S. that something was seriously heading the wrong way for a epidemic risk. That letter of president Trump cites how the head of WHO during the first SARS crisis in 2003, Dr. Harlem Brundtland acted when she faced China's lack of cooperation during that crisis by saying openly that this was a danger to world public health and millions. Could CDC in the U.S. and the other connected health authorites have taken the responsibility and filled Dr Brundtland's role in this crisis, that the WHO failed to perform?    ...

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Jeremy Hunt, head of the Health Select Committee and Health Secretary 2012-2018, says Britain needs to take up mass contact tracing as its next national mission. Britain he says has passed 20,000 tests a day for coronavirus. America has passed 150,000 tests a day. Both more than South Korea. What is missing when compared to South Korea and Taiwan is mass contact tracing.  The app TraceTogether is not enough, as it was used by only 20% of Singapore's population. Only South Korea and Taiwan are able to open up the economy, have workplaces and life function close to normal through extensive testing and mass contact tracing, with feet on the ground. This is the only path that has worked with South Korea successfully out of the lockdown. This means "feet on the street." Making these calls requires skills, getting information, getting cooperation, offering guidance, and ensuring people isolate themselves after contact with an infected person. Sometimes it is by phone and sometimes in person wearing full PPE. They need to be sensitive enough in talking to someone feeling ill and to see how home isolation can be achieved, who else the coronavirus infected person or someone in the chain of contacts has been in contact with. Mr. Hunt says no effort should be spared in doing this as the millions of jobs in Britain, of people without work, the economy, and the need for light at the end of the tunnel of lockdowns, requires a way out. A huge task but a lot of impossible tasks are being tackled in the health services. The resources of Britain, every spare civil servant, every administrator not working, every one who can do this, needs to be enlisted to do this. The same task needs to be tackled in America, and in other countries as a national mission. ...

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This interview with Indian Health Minister, Harsh Vardhan, by Amitabh Bachchan and Anant Goenka of the Indian Express covers a range of questions including India's low fatality rate for coronavirus of 1: 46, its vaccination programs for polio, malaria and other diseases long before the pandemic for a population of 1.3 billion people, respect for healthcare workers, and the distribution of the new vaccines under development in India. Vardhan says there are of the 100 vaccines being developed 30 are in India,and of the ones nearing approval 5 are in India.  India makes 60% of the world's vaccines and its distribution capacity for such a large population has been proven many times. During this coronavirus months of preparation are going into reaching the whole population including remote parts in the mountainous areas. Vardhan says the plan is to vaccinate about 30 crores or 300 million people by June-July 2021 out of a total population of 135 crores or 1.35 billion. The vaccination will start with health care workers, moving on to essential service personnel in the military, police and other occupations, and to vulnerable parts of the population based on age and health conditions. Vardhan who is also the chair of the executive board of the WHO as India's representative, says the prime minister is personally holding two 3 hour long meetings to monitor the preparations for the vaccine and its distribution. Vardhan lists the achievements of the Modi administration and the quality of leadership provided by the prime minister- 2100 testing labs, 97% of the country having a testing facility within 3 kms, testing 1-1.5 million people each day, 1 million testing kits produced daily, 2 million beds in India with oxygen support or in ICU, 13,000 quarantine centers. By personally visiting the vaccine development facilities in Ahmedabad, Pune and Hyderabad, the prime minister also directly supported and encouraged scientists and their efforts. ...

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The arguments of both sides in front of U.S. Supreme Court Justices on the Health Care Law's expansion of Medicaid. Justice Scalia said the law gives the states no choice. Justice Kennedy pointed to the situation of the states which have no way to opt out without stripping millions of Americans of medical care. Justice Roberts pointed to the states willingness to accept federal aid for years which brings us to the current situation. The attorney generals of 27 states have objected to the Health Care Law's provisions which they believe effectively requires the states suffering tight budget constraints to cover more of the poor than they they think they can, with the alternative being dropping out of Medicaid totally, not giving them much of a choice. As the three day hearing came to a close on March 28, 2012, the Supreme Court's conservative Justices expressed doubts whether the Obama Health Care Law could surivive if some key parts are struck down. With Justices Sotomayor, Ginsberg, Kagan, on one side, and Scalia, with other conservative Justices on the other side, the Court's final decision depends on Justices Kennedy and Roberts. ...

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The 2016 Republican platform is written to express the ideas in the Republican Party for family values, child rearing using the Bible and traditional values, calling pornography a "public health crisis."  The Family Research Council and tradition or family focussed groups played an important role in writing it, with Mr. Trump playing less of a role. Instead of "physical barrier" with Mexico, it says "a wall"  should be built in a taking up Trump's idea, but in general it is a clear expressing of traditional family values that Republicans have supported for years and expressed frustration with the movement of social lives in an opposite direction. The same sex marraige decision by the Supreme Court and transgender debate were not present in 2012 election, so in that sense the Republicans see the country as moving in a different direction. More of the pendulum having swung too far in another direction is how Republicans perceive it, and their response is to go back to how things used to be and the world they knew, based on what they see as positive outcomes for the whole of society. Hence language that encourages teaching of the Bible in public schools, condemning pornography as a menace particularly for children, and insisting on "man made laws being consistent with God given natural rights." A good understanding of the Bible is considered "indispensable for the development of an educated citizenry."   Amendments opposing gay and transgender are being added. ...

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The title may not reflect the content of this report on Admiral Giroir who heads the U.S. coronavirus testing effort. He is a pediatrician who worked for hospitals in Texas before heading a vaccine project at Texas A&M University.  Internal politics led to his resigning from the effort to build a vaccine development capability with pharmaceutical companies at Texas A&M. Most of the rest of this report shows a physician who is determined to pursue big projects such as the one he is tackling today. President Trump appointed him to lead FDA, and to be the Assistant Secretary of the Department of Health and Human Services. With the missteps of Secretary Azar testing suffered in the early months of the crisis as reported in the WSJ. Adm. Giroir has taken a leading role since  this period. He also heads the U.S. Public Health Service Commissioned Corps of 6200 staff playing a vital role. On March 13 he was asked to lead the effort in testing.  He comes to this role with experience in the field of vaccines realizing that "the challenges are not just biological but engineering." New technology would be needed to make massive amounts of vaccine. His idea is that transformational efforts are needed. His idea for a billion dose per month facility in Texas did not work, yet he worked on it for about 5 years from 2010 to 2015 at Texas A&M University, at one point being the vice chancellor. He was selected by Texas Governor Perry as chairman of the task force in Texas in 2014 to oversee the effort to fight the Ebola virus. He now is in a position to bring all his experience and aspirations to tackle the coronavirus, cutting through much of the red tape and bureaucracy, and pulling together the effort combining science of pharmaceutical companies with the technology of manufacturing billions of vaccine doses in a record time. Today he sees capacity for testing reaching 40-50 million tests a month by September 2020.   ...

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WSJ's Monica Langley provides an exceptional report with a close look at the first woman CEO at a large corporation in the cusp of great change. IBM CEO Ginni Rometty is remaking IBM by moving out of existing businesses and shifting to new growth areas such as analytics, cloud computing, new R&D advances. She sees her job as building the IBM of the future, and this includes divestments and phasing out of some businesses, acquisitions, and building some businesses such as the Watson Heath Care business from scratch. In some fast growing areas such as cloud computing this means competing with other established competitors, Amazon, Google, and Microsoft. Rometty's job is tough because of the size of IBM with 380,000 people in 170 countries, a culture that lacks the agilityof younger companies, and the older businesses which continue to slow IBM's progress, and where divestments reduce revenues. IBM sales are down for 12 consecutive quarters from the year earlier quarter. IBM's share price is down about 10% since Rometty became CEO in Jan. 2012, resulting in investor dissatisfaction with results. Rometty's goal is for 40% of IBM's revenues to come from corporate markets in analytics, cloud computing, cybersecurity, social networking, and mobile technologies, increasing it from 27% of about $93 billion in sales in 2014, and 15% of $105 billion in sales in 2013. Sold off and divested are low end servers, IBM's chip maker, and other hardware businesses. It is so extensive that whats left of the mainframe business is focussed on new technologies for mobile. Rometty setup a partnership with Apple for the corporate mobile market, and started Watson Health as a new venture in analytics for healthcare using its Watson Computer technology. Rometty grew up in Chicago, one of 3 daughters raised by a single mom, who says she was taught to be "fearless" by her mother. She graduated from Northwestern University with majors in electrical engineering and computer science, joining IBM as a systems engineer in 1981. She carries a backpack, school size notebooks, on her frequent trips to see customers in person and is constantly prodding employees at IBM to go faster. Rometty has a passion for scuba diving in her spare time and always carries the gear with her. Christine Lagarde at the IMF is one of the few women heading large organizations that have the same level of energy. Lagarde's passion is swimming having competed in sychronized swimming, and both Rometty and Lagarde describe the loss of a parent in different ways as a significant impact in their life. ...

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The former Surgeon General of the U.S., Vivek Murthy, has tackled issues such as the opioid crisis, obesity and poor health outcomes. In his new book "Together: The Healing Power of Human Connection in a Sometimes Lonely World," Murthy looks at the loneliness he says is pervasive in the new culture of iphones and social media that have perversely reduced not increased social connection and the feelings coming from good relationships and social concerns.  A 2020 Cigna survey shows 61% of American adults are lonely, up from 54% in the 2019 survey. It is not about having a lot of people around you, it is about feeling a genuine connection and the quality of relationships. Murthy finds this lack of genuine social concerns and social connection as fairly pervasive from his conversations with people all across the country. Normally it is felt in the fifties as life changes, and in the eighties with loss of mobility. Today the tech devices and what is called scoal media that appear to have increased communication have actually reduced the level of quality connections and interactions. Dr. Murthy suggests volunteering, and service in the community or larger communities worldwide as a way of breaking this. Capitalizing on informal day to day contacts, including with people one has not known before, is another way. This shifts the focus to the people around us and brings a new dimension and quality to our lives.  Saying hello often and smiling genuinely, says Murthy. Improving the  quality of time in day to relationships is another. This can also give us the confidence to connect with people on a regular basis.  ...

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Questions about the every 5 years 20th Party Congress of the CCP or Chinese Communist Party, and the 2300 representatives attending from all parts of China are answered in this report in The Guardian.  Xi Jinping is expected to get a third term. To outsiders in US and Europe it is all about power in China, to insiders in China it is about China making it through the 100 years since the 1901 revolution and the tumult, the chaos of the first 100 years, and now a period of modernization and growing incomes,  the need to create jobs, tackle climate change, ensure a good future for the Chinese people. 2300 party members representing millions of party members in China attend the gathering. New appointments and retirements take place at this Congress. Of this there are 200 elite members of the Central Committee with voting rights. This central committee is responsible for electing a 25 member Politburo, of which the seven most senior persons are appointed to the Politburo Standing Committee. Xi Jinping is the General Secretary, the most senior position in this hierarchy. Age related retirements are at 68 years and a new Politburo standing committee is announced at each Congress. After the Bo Xilai effort to take power and take China in a new and unknown direction, and the gradual loss of the party's respect from corruption and abuses of power by local officials, Xi Jinping sensed problems in the future and conducted a anti-corruption campaign. Most of the system of government set up during the Deng and Jiang Zemin years after 1980 remains in place with Jinping calling for a revival of China, the next stage of modernization, under the banner of the CCP. The result of the anti-corruption campaign and a third term assumed by Xi including lifting of a term limit for heading the CCP, gives Xi Jinping an opportunity to shape the future for China as Deng did after 1980. Jinping in the manner of Deng sees the CCP as the organization that can continue the modernization and growth of China. The model set by Deng and Zemin of local autonomy for economy and centralized overall direction continues under Jinping who is General Secretary since 2012. China has made rapid growth during the period 2000-2022, but faces challenges of reorienting its economy away from dependence on a tight economic export oriented relationship with the US and EU, as supply chains are being shifted after the pandemic. This means more unemployment and need for careful economic planning and investment to create jobs in other sectors, and to meet the challenges of unequal distribution of wealth in China after hypergrowth that hurt China in some ways, and in the climate change effects of use of coal other fossil fuels. As focus of interest is on Jinping externally, within China it is these three challenges that must be uppermost in the minds of the 20th Congress members. Much of this stems from the tumult of the century that began with the 1901 revolution through Japanese invasion and upheavals in the 60's and 70's, leading to the rare period of stability and growth in the last 20 years. Jinping like Deng and Zemin has personal memories of the anguish of this period and the tumult, the chaos of the 20th century for China, and the yearning for stability with modernization.   ...

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This Washington Post editorial says Obama and the politicians, both Democrats and Republicans, want something for nothing. The Ryan budget, Obama's health care plan, all require paying for it with higher taxes, but the mention of the word "tax" is the last word any of the politicians will say. These comments come as the U.S. Supreme Court considers the mandate that young Americans and others be forced to pay for health care along with the rest, as required by the health care mandate, with the idea of keeping costs down. The idea of getting something for nothing was also emphasized in an op-ed in the WSJ, March 29, 2012, by Mayor Bloomberg of New York City, where he called for letting the Bush tax cuts expire for all income groups, and an up or down vote in Congress on the Simpson-Bowles deficit reduction plan, as part of a two step plan.

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President Obama told a press conference after the Supreme Court hearings on the healthcare law: "For years, what we've heard is the biggest problem on the bench was judicial activism or the lack of judicial restraint, that an unelected group of people would somehow overturn a duly constituted and passed law." In doing so Obama was framing the argument he might use should the Court rule against the law, putting the Supreme Court in the role of villain placing its judgement ahead of elected representatives, as the U.S. moves into the presidential election in November 2012.

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The U.S. Supreme Court lets the Obama healthcare law stand in a 5-4 vote with Justice Roberts casting the deciding vote. The Court ruled that the government could impose the individual mandate that all people carry health care insurance not because of the commerce clause but because: The provision "need not be read to do more than impose a tax...This is sufficient to sustain it."

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Legal aspects and challenges to the Obama healthcare law that may have been overlooked by the Obama administration.

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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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Experts say Chief Justice Roberts somehow found a path through in bridging the ideological divide and avoiding a show of partisanship in an election year. He somehow navigated and found a path through in his vote on the U.S. healthcare law letting it stand. Early on Roberts advocated "judicial modesty and humility" in jurisprudence. He compared the judge's role to that of an umpire in baseball during the 2005 confirmation hearings. The umpire would not pitch or bat, his job would be to call balls and strikes. It was seen as a determmined show of independence at a time when Justice Kennedy was seen as the swing vote. He has also earned political capital to be able to vote independently on other issues before the court instead of becoming embroiled in controversy about the role of the Court in overturning the work of Congress during the early part of the Obama administration.

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Seib points to the intangible assets Ryan brings to to the Romney presidential campaign, which fill in for areas in which Romney is weak. The working man touch to connect with working class voters, avid sportsman to connect with younger voters, a practising Catholic to reach out to Catholic voters given Romney's Mormon background, the energizing effect for conservative voters having someone who has fought hard for the conservative cause. Also important will be Ryan's friendly manner, down to earth talk, and ability to talk to voters of all opinions, to reach out to independent voters.

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Race and religion as a quiet issue for both candidates in the 2012 U.S. presidental candidates, with Obama and Romney both reticent and unwilling to talk about the defining aspect of their lives fearing voter prejudice.

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A Yale scholar's view of the Obama presidency based on what he sees as a presidency struggling for compromise and consensus.