“I don’t think even Obama is that politicized,” said Bolton, who has been warning of Tehran’s nuclear threat for years. He hastened to add, however, that “Netanyanu is another story,” referring to the current Israeli prime minister, who is believed by some to be preparing a self-defensive pre-emptive attack on Iran.

He stated that Romney has certain advantages in Pennsylvania that other recent GOP presidential candidates haven’t had. First, since Romney comes from the moderate wing of the GOP, he may have appeal to the four counties that surround Philadelphia that include Delaware, Lancaster, Bucks, and Montgomery Counties. Many of the Philly suburbs lie in these counties, and it’s an area where very conservative Republicans have not fared well. A Republican who is perceived as more moderate might do well there.

He also mentioned the Western part of the state (West of Pittsburgh), where there are a lot of conservative Democrats. They are the ones Obama referred to as “bitter clingers.” And they are much like the conservative Democrats in West Virginia who gave Keith Judd about 40% of the vote in this year’s West Virginia Democratic primary over Obama. Romney, he said, has a real chance at getting their vote.

Finally, sometimes Pennsylvania is described as Philadelphia and Pittsburgh with Alabama in between. The official said that Romney will have to drive up turnout in that area.Of course, Romney trails Obama by 8 points in the RCP average for Pennsylvania. When we mentioned this, the official said to keep an eye on upcoming polls. Will they show that Romney is gaining? Stay tuned...

However, while these groups are willing to turn out the vote for Romney, it was clear that there was still varying degrees of comfort with Romney and Republicans in general among these Tea Party groups.

Sally Zalikovsky, coordinator of the San Francisco Tea Party, is going to the Republican National Convention as a delegate for Romney.

On the other end of the spectrum, Suzanne "Zan" Green of the Alabama Rainy Day Patriots insisted, "We are nonpartisan. We go in the direction that we need to go and right now that is the Republican Party. We are Tea Party. And by Tea Party I mean citizens who have that have taken up the responsibility of restoring this country."

For the time being, the dislike of Romney among Tea Partyers has been eased by his selection of Paul Ryan as his running mate. It is also likely being eased by the fact that there is still a very real chance that Obama could win this election.

But any GOP establishment types who think that this election will mean they can always count on Tea Party support in the future will likely be unpleasantly surprised at some point in the future.

Follow David Hogberg on Twitter: @DavidHogberg

Those are the questions that I examine in my new study released via the National Center for Public Policy Research titled, “The Next Exodus: Primary-Care Physicians and Medicare.”

In 2008 the National Ambulatory Medical Care Survey found that about 7% of physicians were no longer seeing new Medicare patients; by 2011 that had jumped to 17%. American Medical Association survey found the same, 17% of physicians restricting the number of Medicare patients they would see. It was worse among primary-care-physicians, with 31% limiting the number of Medicare patients they were willing to take.

The study relates the experiences of two primary-care physicians, Dr. Juliette Madrigal-Dersch, who had dropped out of Medicare entirely, and Dr. John Slatosky, who has stopped taking new Medicare patients.

The simple answer to why they and other primary-care physicians are increasingly limiting their exposure to Medicare is that it doesn’t pay them enough. The answer to why it doesn’t pay enough is considerably more complicated.

In the study you will learn about:

1. The Resource-Based Relative Value Update Committee (RUC) which has considerable influence over how much Medicare pays physicians and why RUC is biased against primary-care physicians.

2. The paperwork costs Medicare imposes on all physicians — billing and coding — and why this falls disproportionately on primary-care physicians.

3. The Sustainable Growth Rate, a formula that was intended to keep Medicare physician fees in check. It has failed, but is has had the effect of keeping physician fees rising at a rate lower than inflation. Since primary-care physicians tend to be paid less than other physicians, this hits them the hardest.

So, how do we get out of this mess? The study proposes a solution called “Medicare Primary Accounts.” To learn more about that and the other topics, go here.

Follow David Hogberg on Twitter: @DavidHogberg

Overall, Romney leads President Obama 47%-46% after trailing 45%-47% back in July.

The poll finds some mixed results, but, nevertheless, states that taken “as a whole, these data indicate a small bump in the immediate aftermath of the Ryan announcement ... it is also the first sign of positive momentum for the Romney campaign that we’ve seen in the Purple Poll in the last few months.”

The survey also does some extra sampling in Ohio, Virginia, Florida, and Colorado. The evidence for the Ryan bounce is that in three states and in the survey as a whole, Ryan has a net positive favorability rating. The only exception is Ohio, where it is 40% favorable, 41% unfavorable. But even in Ohio, Ryan’s rating is better than Obama’s 45% favorable 50% unfavorable, Romney’s 42%-52%, and hapless Joe Biden’s 41%-48%.

The Ryan bounce has given Romney a turnaround in Ohio, going from trailing Obama 45%-48% in July to now leading 46%-44%. It’s given Romney the biggest boost in Virginia, where he now leads 48%-45%, vs. trailing 44%-46% last month.

Doug Usher, a managing partner at Purple Strategies, says, “For the last few months we’ve seen lots of negatives about Romney in the press, from Bain Capital to tax returns. With Ryan, he’s now getting more positive coverage.”

However, the poll did show that Obama improved in Florida and Colorado. In July, Romney led in Florida 48%-45%; he now leads only 48%-47%. In Colorado Obama now leads 49%-46%. He had a smaller 46%-45% edge in July.

In explaining the jump in Colorado especially, Usher said, “I hate to use an old pollster’s excuse, but I’m guessing it is margin of error. The overall poll does show a small bounce from the Ryan pick.”

Going forward, Usher said that Obama would have to take some of the wind out Ryan’s sails, and predicted that we’ll see attack ads aimed directly at Ryan any day now.

For Romney to keep this momentum going, “he’ll have to come up with a more positive reason to vote for him. That he’s ‘not Obama’ isn’t enough,” said Usher.

Follow David Hogberg on Twitter: @DavidHogberg

Searching through YouTube, both Romney and Ryan have been heckled a lot over the last year. And, if it looks like Obama is going to lose, you can expect the heckling to not only increase but also become more provocative.

{qtube vid:= v4bNAUORtwo w:=425 h:=324}

Now, before I continue, let’s just be clear that I’m not saying Obama has been heckled less than Romney. There are plenty examples of that as well on YouTube, and there is no way to be certain since, as far as I know, no one collects statistics on the heckling of politicians. Nor am I suggesting that it is just a left-wing activity. Indeed, not long ago Romney’s campaign sent a few supporters to Boston to give David Axelrod a warm welcome.

That said, heckling is an activity that tends to be the purview of the left, especially the radical left. After all, the tactic conforms very well to Saul Alinsky’s “Rules for Radicals.”

Here is Rule No. 3: “Whenever possible, go outside the expertise of the enemy.” Look for ways to increase insecurity, anxiety and uncertainty. (This happens all the time. Watch how many organizations under attack are blind-sided by seemingly irrelevant arguments that they are then forced to address.)

Heckling works well because politicians usually expect to address receptive crowds. Hecklers can throw them off stride, make them look anxious and confused.

The problem is that politicians can get better at dealing with it. Apparently Romney has. Compare his reaction at last year's Iowa State Fair to his reaction to being heckled in Wisconsin last weekend. Furthermore, the politician’s supporters can get wise to it as well. Listen to Mitt’s supporters drown out the heckler with chants of “USA! USA!” or, in this instance, with “Mitt, Mitt, Mitt!”

As heckling becomes less effective, it will become more provocative. Alinsky’s Rule No. 10 states, “If you push a negative hard enough, it will push through and become a positive. Violence from the other side can win the public to your side because the public sympathizes with the underdog.”

Thus, expect to see hecklers provoking confrontations with Romney supporters or putting themselves in situations where they get hauled off by police — in front of the cameras, of course.

Here is a classic case. Paul Ryan is speaking at a luncheon, when 71-year-old Tom Nielsen stands and begins shouting questions at him. The police take him from the room, put him on the ground and arrest him.

According to the text under the video, “Nielsen repeatedly told police that he wasn’t fighting them and that he didn’t want to make any trouble. He also told them several times that he had a broken shoulder. Police officers ignored his comments as they wrestled him to the ground despite his howls of pain.”

From the video you can only hear what sounds like a “howl of pain” from Nielsen once. You never hear him say he has a broken shoulder, and he doesn’t seem to be howling in pain when the police lead him away in handcuffs. You also never hear him say that “he didn’t want to make trouble.” But even if he did say it, um, really? You interrupt the planned speech of a congressman by shouting questions at him, and you don’t want to make trouble? Hey, I want to eat nothing but pizza, cookies and ice cream, and I don’t want to get fat!

Anyway, we shouldn’t expect accuracy from the description since the propaganda value of such an incident far outweighs the value of the truth.

So as the heckling gets worse, what can Romney supporters do? The first is the exercise of enormous self-restraint. The radicals will call you all manner of expletives, get in your face, stick their fingers in your chest, etc., etc. You must back away. The second you throw a punch, the hecklers get their PR victory.

Also be sure to have the video recorders on your cell phones ready to record these events. The hecklers will be quick to load their versions up on YouTube. Be sure you have your versions ready to go.

Finally, when the police do get involved and remove the hecklers, record that as well. The hecklers will be quick to claim police brutality. Although the police don’t always exercise restraint, most times they do. A video showing that will also undermine the hecklers.

By exercising restraint and videotaping the heckling incidents, Romney supporters can be the ones that can push a negative into a positive.

Update:  Matthew Vadum notes that the people who heckled Ryan in Iowa are part of Iowa Citizens for Community Improvement, an ACORN-like group.  They are the same group that shouted at Romney last year.  More here.

Follow David Hogberg on Twitter: @DavidHogberg

They continued:

The Ryan budget will be at the center of the 2012 election no matter whom Romney picks. Democratic strategist Joe Trippi told The Weekly Standard that his party plans to spend much of October talking about the Ryan budget. Paul Begala, who is advising Priorities USA, the pro-Obama super PAC, told the Huffington Post the same thing. This should surprise no one. Democrats have for months been calling Romney’s plan the “Romney-Ryan” budget in their talking points. And Democratic candidates across the country have been demagoguing the Ryan budget for two years.

Since Democrats were sure to try to hang the Ryan budget around Romney’s neck, their reasoning went, why not have the best defender of the Ryan budget fill the VP slot?

Now, while at least one of us at Capital Hill still thinks Florida Sen. Marco Rubio was the best candidate, even he will admit that Ryan is still a very good choice and, aside from Rubio, better than all of the other possibilities.

That said, there is no way of getting around the fact that now everything Ryan has put in his Path To Prosperity is on the line. The stakes have gone way, way up, because not only is the election on the line, so is the future of the United States

If Romney had picked someone else for the VP slot, then should Romney lose it would not be clear that it was due to the Ryan budget. Romney as a candidate, the competence of his campaign and other factors would have muddied the waters. And those factors may still result in a Romney loss. But with Ryan on the ticket, his budget, tax reform and entitlement reforms will be front and center. Anyone can reasonably argue that these were put in front of the voters in the fall. And if Romney loses, anyone can also reasonably argue that he lost because the voters of America rejected Ryan’s ideas.

You can be sure that Democrats and other liberals will bring that up every time a Republican in Congress brings up reforming entitlements or the tax code. “That was part of the Ryan plan,” they’ll respond, “and the voters rejected that in 2012.”

It is a response that will be difficult to overcome. The reforms that American so desperately needs to avoid a fiscal meltdown a decade or two hence will become nearly impossible to achieve. Rather our tax system will continue to be a hindrance to robust economic growth and our entitlements will be patched over with tax increases, rationing and borrowing until the market finally decides that our bonds are not longer worth buying.

That is what is likely in store if Romney loses, because his loss means that Ryan’s ideas will be, fair or not, discredited.

Many conservatives have said that this is the most important election of our lifetime. By picking Ryan as his vice-presidential candidate, Romney has made it more so. Much more.

Follow David Hogberg on Twitter: @DavidHogberg

They look set to do the same in Wisconsin on Tuesday.

Wisconsin holds a GOP primary for Senate that pits ex-Gov. Tommy Thompson against ex-Rep. Mark Neumann, businessman Eric Hovde and Assemblyman Jeff Fitzgerald.

Thompson was the early favorite, having been a relatively popular governor. But Tea Partiers clearly think he’s part of the GOP establishment, and they’re not wrong. His sometimes-cozy relationship with ObamaCare has only reinforced that image.

Add to that a major advertising blitz in the neighborhood of $4 million by Hovde and this race has become a nail biter. The latest Public Policy Polling survey gives Hovde a narrow 27%-25% lead over Thompson, with Neumann at 24% and Fitzgerald at 15%.

Of course, primaries are notoriously hard to poll because a lot of people who say they’ll vote don’t show up on election day. But is there much doubt that if Thompson were still the frontrunner he’d be polling much better, even if it was among a lot of people who weren’t going to turn out?

There may be only one way left for Thompson to win.

“I think there’s an outside chance that Thompson could lose,” said Geoff Peterson, professor of political science at the University of Wisconsin, Eau-Claire. “What could save Thompson is that the conservative wing of the GOP will divide between Hovde, Neumann and to a lesser extent Fitzgerald such that Thompson could squeak by.”

Talking to Tea Party members in Wisconsin reveals some divisions.

“Most of the people I’ve talked to are either for Hovde or Neumann,” said Dick Koltz of the NEW Patriots group.

Indeed, some are torn between the two.

“I’m hedging between Nuemann and Hovde,” said Diane Malecki, a Tea Party member from Osh Kosh. “Hovde I like because he’s a new face and we’re looking for someone who is going to change what is going on in government, but part of me says Neumann because he has been quite conservative.”

Another member of the Tea Party who asked to be quoted on background said she was still considering Fitzgerald, who also has a conservative record. Fitzgerald’s problem, however, is that he doesn’t have much campaign money.

Patty Kohlman of the Manitowoc County TEA Movement has made up her mind.

“I think more Tea Partiers are leaning toward Hovde,” she said. “Hovde is not part of the ‘good old boys;’ Nuemann has already been out there, he’s never fixed a problem and we are not going to send him back.”

What may also hurt Nuemann is the tough race that he ran against Scott Walker in the GOP gubernatorial primary in 2010.

“For some people that does make a big difference ... but it doesn’t bother me,” said Malecki.

Whoever wins the GOP primary will face Democrat Tammy Baldwin in November. The latest polls from Marquette University and Quinnipiac showed Thompson faring the best against Baldwin. Yet Hovde polled only a few points behind Baldwin, and he will bring something to November that Thompson will not, namely Tea Party enthusiasm.

ObamaCare is requiring insurance companies to send rebates to their policyholders, so the liberal pundit thinks he has conservative, libertarians and others who believe in free markets in a bind. “(Y)ou must send back any of those rebate checks you receive from your insurance companies thanks to the new law,” Dionne writes.  “If you think free enterprise should be liberated from Washington’s interference, what right does Uncle Sam have to tell the insurers they owe you a better deal? Keeping those refunds will make you complicit with Leviathan.”

Dionne may think that he has ObamaCare opponents nailed as hypocrites, but it seems any ObamaCare opponent would be just fine with the rejoinder, “I’m keeping my ObamaCare rebate this year so I can use it to pay for the ObamaCare premium increase next year.”

ObamaCare puts a “Medical Loss Ratio” standard on health insurance companies, requiring them to pay 80% of premiums on health care costs and allowing only 20% for administrative costs. Any company that doesn’t reach the 80% mark has to rebate the difference to its policyholders.

A few weeks ago the Department of Health and Human Services breathlessly announced that insurance companies would be sending back $1.1 billion in rebates to about 12.8 million Americans. That amounts to about $86 per individual and $151 per family.

Now ObamaCare will cause insurance premiums to rise in the coming year because of all the new “free” preventive services it forces insurers to provide to women beginning this month — not to mention the other “free” benefits that it has already imposed, like letting young adults stay on their parents policies until age 26.

How much will they rise? The National Business Group on Health recently released a survey of large companies saying that, on average, they expected premiums to rise about 7% next year. Now, not all that increase will be due to ObamaCare, but it doesn’t have to be.

In 2011 the average annual premium for a family plan in a large company was $15,520 and was $5,477 for an individual (see page 22). The amount of the ObamaCare rebate for a family, $151, is about 1% of that family policy. The $86 rebate for an individual is about 1.6% of the individual policy. Thus, ObamaCare would have to be responsible for less than two percentage points of that 7% increase for it to wipe out any savings we get from the rebates.

Oh, and the suggestion that you hang on to the rebate to pay for next year’s premium increases is not really in jest. According to the National Business Group on Health survey, “six in 10 employers (60%) plan to increase the percentage of the premium paid by employees in 2013.”