article includes an analysis of the out of pocket to the pairs. i didn't include it. o we did see the out of pocket went down to our members to oure members. and in general, if you think t about somethinerg like -- in th case, the deductible plays a big role in terms of how the out of pocket hits you. knowthing with the colonoscopies, the cataracts, b the co insurance still plays a t roll othere, and so the lower costs are going to benefit you out of pocket. in terms of total costs, that t was also included, looking at out of pocket plus the net pay and the loud costs, that went down dramatically as well. think for the hips and knees, that mab have been due to the deductible reached in a number of cases., t

and then i think the last part was talking about the bubble. if you touch down on the balloon, it comes up over here e that's something we'll have to h look at and be aware of and concerned about. >> i think there is awareness on behalf of the pairs and the purchasers that this is somewhat of a short term fix. but it is one of the few short e term fixes that actually is th seeing positive results. and so in the absence of being e able to look at the total and so being able to bend the total cost down the strategies have to be a little more piecemeal, it's not that we're not conscious of the impact that it could have, it's just that sometimes things have to occur incrementally, an, as dr. bowman said, some of the incremental thins haven't worket so far, this is an incremental e

set that is starting to work and then we'll have to see what lessons can we learn from this to look at the total costs and not having the balloon impact.dp part of this is disruption.t-tem and innovative disruption that can help with short term costs which we're all struggling with and learn from that to see the r long term lessons and strategies we can put in place. >> is that is a fittingly big picture end to this discussion final comment anyway, if not the end. this has been quite edify iing. i'd ask you to, while you're filling out the evaluation forms

that you've not had a chance tou do yet, note that we are inning debted to our friends at well w point to think through this of session and put it together. and for your great questions, i which covered a number of i aspects of this, that weren't all that clear.[applaus and finally ask if you would join me in thanking our panel to help us understand this concept. [ applause ] today marks the 150th anniversary of president lincoln's gettysburg address. next week thanksgiving day at

4:00 and 10:00 p.m. eastern on c-span 3's american history tv. ben bernanke is expected here live shortly speaking to the federal economists clubs. a number of stories have been written about what he is expects to say. australian shares lower, bernanke's speech watched. treasury's fault ahead of bernanke. we'll have bernanke's remarks live when they happen here on c-span 3. until then, treasury secretary jack lieu said the debt ceiling should be extended and he earn couraged capitol hill to take acti action.

>> what are we going to do on the data issues. we got these more looming deadlines in january and february. you're saying we're not going to have another experience like we had in october? >> i think if you look at the things republican leaders have said since october. it's clear this was not a good experience either for the country or for them politically. i know the right answer, the right answer is, they should just extend the debt limit way in advance and not have any sense of crisis at all. the debt limit expires. we do have extraordinary measure s when they start moving forward, they do the debt limit in a businesslike way and give

some uncertainty to the u.s. economy. >> we're going to hear from paul ryan later this afternoon what would be the right way too go forward. >> trading off the sequester for some significant changes to entitlement reforms. what's your position what's the best outcome here? what can we expect in a couple months. >> my view of the best option i think the president's budget lays out a clear path and i think the president's budget is a blueprint, were we to follow it, were to give the economy the kind of certainty and tail wind that it needs to grow i don't want to get ahead of the budget, the president lucien of the debt limit in october they've been

meeting, senator murray and congressman ryan have been meeting. there is any number of possibilities that they could come out with. and any number of sizes, it could be small, medium or large. i think that anything they do that shows that they can work together to kind of chip away would be -- instill some confidence both in the process and the substance. i don't want to jump ahead of where they are. the challenge, i'm doing something really big, both sides have to do something really hard. we've made clear that in order to do the kinds of entitlement reforms that are in the president's budget, it would require moving tax reform and raising some additional revenue. if that's not a possibility for the republicans, then something large is not likely. but there's other ways to -- for these countries to work things

out. i would leave it to them. >> can you see all of treasury secretary's jack lew's remarks at c-span.org. we're live again waiting to hear from ben bernanke. speaking before the national economist's club in washington. the associated press has a bit of a preview of ben bernanke's speech. bernanke says the great recession made it essential for the economy to become transparent so it could explain why record low interest rates were needed to support the economy. in that story, he goes on to say the recession meant the fed's communications had to evolve in ways he didn't envision when he became chairman in 2006. so we'll hear from federal reserve chairman ben bernanke momentarily. the room has filled up.

more about the health care law. >> joining us now is tom daschle former senate democratic leader from 1995 to 2005 and represented the state of south dakota. welcome. >> thank you. >> talk about what you brought to the table as far as the affordable care act. >> i had an advisory role. talked to my former colleagues and members of the administration, given my views. i had written a book called critical, that laid out a lot of the principals that i thought ought to be included. some of them were, some of them weren't. it was an exciting, very transformational time and it still is. >> give us your sense as far as problems that have been laid out with the affordable care act. tell us what you're seeing, the main problems right now, and how they can be addressed. >> the main problem is the execution of the website itself. keep in mind the fundamentals of what it is we're trying to do

here are to contain costs we're going to do that over time. there's no question, we know that we can't continue with the current system as it exists. we're paying more at that point next ten countries combined. we have 50 million people uninsured. 20,000 people every year die because they have no insurance, and we have terrible quality overall. we can do a lot better, this is in part an opportunity to do just that, to address those problems in a meaningful way. are there going to be glitches? absolutely. we're getting there, and we have to continue to be patient and do the right thing. >> specifically, what about the signup problems with the website in. >> there are problems, we're going to keep -- i don't know of a site, massachusetts when they started their site, had 123 people that signed up in the first month. it's now been an enormous success, if you had to vote

today on massachusetts, i dare say 90% of the people would say, let's keep it, well, that over time had the same, not the same degree of glitches, but the same kind we're experiencing at the national site. >> different scale? >> exactly. there are going to be things that have to be addressed. some of it was avoidable and it's unfortunate we didn't catch this earlier and didn't address it earlier. that doesn't deny what our country recognizes as such an imperative. all of those who oppose, and criticize and all of those who really find fault are really not providing the kind of opportunities for alternatives. i mean, what is it we do if we don't do this what solutions are there that might provide a

better solution than what we're looking at today. none of the critics i've seen have really been forthcoming in that regard. that's something i think american people ought to be asking. >> the exchanges where the states are operating are pretty good, i think we're going to see volume continue the american people want to be able to shop, understand, and make their decisions in a slow and careful way i know when i was helping my mother with medicare part d almost ten years ago now, we have a lot of the same challenges, trying to figure out what was the best plan and how she might be affected by this, we had a lot of the glitches that we're experiencing now with part d as well. we worked through those glitches and my employer made a good decision with regard to her medicare coverage. and then ultimately i think

today, it's one of those popular features of health care, provided in large measure because of the legislative approach that we used with the aca. that is working extremely well. we're going to see that happen with the aca as well. >> you can see washington journal every morning live on c-span. we're going live to hear from ben bernanke, he's being introduced right now by robert graybois. >> he had a reputation and was quite beloved on both sides of the aisle. last year we had edmond phelps from columbia university and the good fortune of herb stein's son, the actor ben stein who came and gave an address, remembering his father. and the only thing i'll say

beyond that is, as ben stein mentioned last year, stein's law, which is something of a famous piece in economics is, if a thing cannot go on forever, it will stop. his father was just about as dry as he is. he noted it's often forgotten that the second sentence of his father's law was, if we only do the things we can do forever, we won't do very much. he thinks that's the more important of the two sentences. we'll have our second stein lecture tonight. i'll give only the briefest intros, since everyone knows the speaker. today is november 19th, 2013, which would be the 150th anniversary of lincoln's gettys berg address. i'm hoping that tonight's lecture will be on a similar par

as far as peopler ability. i'm hoping it's a little longer than lincoln's address was. but that's entirely up to the speaker. ba from harvard. princeton professor until 2002. chairman of the council of economic advisers. that's the stuff you'll see in the program, and, of course, we could go on all night about his accomplishments. it's important to those of us that are active in the nac that chairman bernanke has a long history with this organization as well, and something for which we're quite grateful. november 21, 20012, he gave the

most widely quoted speech in nec history, entitled deflation. making sure it doesn't happen here, he spoke also october 11th, 2005, and tonight november 19th, 2013 he will give the second stein lecture, with that, i will welcome chairman bernanke up and please, a big round of applause. >> thank you. gettys berg address? a little pressure. it's nice to be back again with the nec. nearly eight years ago, when i began my time as chairman. one of my priorities was to make the federal reserve more transparent in a particular, to make monetary policy as clear and transparent as reasonably

possible. i believe then as i do today that transparency and monetary policy enhances public understanding and confidence promotes informed discussion of policy options. increases the accountability of monetary policy makers. and ultimately makes policy more effect i effective between tightening the real economy. responding to the financial crisis soon became the main focus. following the stabilization of the financial system. supporting our economy's recovery from the deepest recession since the great depression has required a more prominent roll for communication and transparency in monetary policy than ever before. my remarks this evening, i'll discuss how the federal reserve's communications have evolved in recent years and how

enhanced transparency is increasing the effectiveness of monetary policy. despite the challenges inherent about a future that can only be imperfectly foreseen, i will explain why i believe that policy transparency remains an essential element of the federal reserve strategy for meeting its economic objectives. it's useful to start discussing the role of communication more generally. including the relationship between communication and the broader framework. making monetary policy is sometimes compared to driving a car. with policy makers pressing on the accelerators or brakes, depending on whether the economy needs to be sped up or slowed

down at the moment. that analogy is imperfect for two reasons the main effects of monetary policy are not felt immediately but play out over quarters or years monetary policy makers cannot simply respond to what lies in front of them. but must try to look ahead. second the effects of monetary policy on the economy today dmend not only on current policy actions, but also on the public's expectations on how policy will evolve. the automotive analogy breaks down here. the published expectations matter today because those expectations have important

effects on current financial conditions which in turn affect output employment and inflation over time for example, because investors can choose freely between holding a longer term security or rolling over a sequence of short term securities, longer term interest rates today are closely linked to market expectations of how short term rates will evolve. if monetary policy makers are expected to keep short term rates low. current longer term interest rates are likely to be less than expected. experience demonstrates that a useful approach to managing expectations, one that dove tails well with basic principles

of transparency involves policy makers stating clear objectives as well as their plans for obtaining those objectives. over the past two decades, many central banks have experienced inflation about supplemented by regular publication numerical inflation goals have helped increase policy in a number of countries. the fomc has clarified the federal reserve objectives and policy strategy. because of its dual mandate for the congress the federal reserve could not adopt a numerical inflation target as its exclusive goal. nor would it have been appropriate for the fomc to provide a fixed objective for

some measure of employment or unemployment in parallel with the inflation objective. in contrast to inflation, which is determined by monetary policy in the longer run, the maximum level of employment that could be sustained over the longer run is to determine primarily by none monetary factors, such as dem graph irks, labor market institutions and advances in technology. moreover, as these factors involve, the maximum employment level may change overtime. consequently, it's beyond the power of a central bank to set a longer run target for employment, that is independent of the underlying structure of the economy. the approach on which the fomc agreed is described in a statement of longer run goals issued january 12th, and reaffirmed january of this year. the statement begins by affirming the fomc's commitment

to meeting both of its statutory objectives. it then indicates in the context of the fomc's mandate, the committee sees stability as corresponding to the longer term inflation goal. on the employment side of the mandate, the committee makes its best assessment of the maximum level of employment at any given time, recognizing that such assessments are necessarily uncertain and subject to revision. in practice, the committee often expresses its employment objective in terms of the longer run normal rate of unemployment. currently fomc participants estimates of the longer run normal rate of unemployment as reported in the quarterly survey of projections range from 4.2 to 5.6%. many central banks supplement their announced objectives with

foish casts that impress italy lay out plans for achieving their goals. although the size and diversity of the federal reserve's policy making committee has made achieving a single consensus forecast difficult, quarterly summary of economic projections reports each fomc participant's view of the most likely future paths of inflation, unemployment and output growth. in recent years, the survey has also included participants projections of the path of future short term interest rates that they see as most likely to achieve the committee's goals. in general, the committee's two objectives of maximum employment and price stability are complimentary. when they are not, the fomc has stated it will include a balanced approach, working to ensure that both inflation and unemployment are close to their desired values in the longer term. in short, the federal reserve

like many central banks around the world has made significant progress in recent years, in collar phiing its goals and policy approach, and providing regular information about the future path of policy that it views as most likely 20 obtain its objectives. this increased transparency has reduced uncertainty and made policy more effective. the financial crisis and its aftermath have raised even greater challenges for and demands upon the federal reserve's communication. we've had to contend with the persistent effects of the financial system, the collapse of housing prices and construction. new financial shocks in europe and elsewhere, restrictive fiscal policies at all levels of government, and the enormous blows to output and employment associated with the worst u.s. recession since the great

depression. the rate is efeblively at zero, and cannot be lowered further. consequently, to provide needed support to the economic recovery and minimize deflation, reduce challenges. i'll discuss how to further inform the expectations about how the fomc will employ currency tools. it's plans regarding the short term interest rate and purchase of securities. as the economy weakened over 2008, the fomc repeatedly cut the short term policy rate the target ranged from 0 to 1/4%.

thus using the standard means of further easing the policy, cutting the target interest rate was no longer possible the zero lower bound on the f1 c's policy interest rate was not the only challenge the committee faced. the depth of the reception combined with on going concerns about the functioning of the financial system raised significant uncertainties about both the likely pace of recovery and the effectiveness of monetary policy in supporting growth. the recoveries from most post world war ii u.s. recessions have been relatively rapid, with production and unemployment. the key variables returning to values within 6 to 8 quarters. in such cases, the financial markets is just the next several quarters. in the aftermath of the recent crisis, the committee had to

consider the possibility that a highly accommodative policy may be required for a number of years. second a federal funds rate created an important asymmetry for policy planning. on the one hand, if the economy were to recover rapidly and inflation were to increase, monetary policy makers would be able to respond in a normal way by raising the federal funds rate. on the other hand, if the economy were to remain weak or recover only gradually, the case we faced. the fo omc would not be able to cut the funds rate further. in the latter case, the economy could face an increased risk of deflation or falling prices. as the case of japan illustrates. try to preempt such outcomes, a strong case existed for monetary policy to be more accommodative than suggestive by standard

policy rules calibrated to normal times. the committee faced a situation which more monetary policy accommodation was needed and possibly for quite a long time, yet its basic policy tool, the federal funds rate target had been pushed to its limit. to put the committee's problem another way, standard policy rules and a range of other analyses implied that to achieve the fomc's directives the federal funds rate should be set below zero which was not feasible. fortunately, as i discussed earlier, the accommodation provided by monetary policy, depends on not just the current value of the currency rate but future settings of that rate. the committee accordingly realized it could ease policy further and reduce uncertainty about future policy by assuring the public and markets that intended to keep the policy rate low for some time, and to you

for a longer period than the public initially expected at first, the committee employed qualitative information to deliver that message. they decided it would be appropriate for the federal funds rate to be near zero for some time. it changed the formulation in march 2009 to an extended period. such language did not convey the committee's intentions. the committee introduced a specific date into its guidance, stating that conditions would likely warrant keeping the federal funds rate near zero at least through 2013. this guidance was more precise than the kwaulg tative language that the committee had been using, and it appears to have been effective in communicating the fomc's commitment to the policy.