tv Capital News Today CSPAN August 26, 2009 11:00pm-2:00am EDT
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have a very little effect on it. there are a good many issues that we have some attitudes toward. we support a premium conversion, which is a benefit for federal employees, which allows them to pay for the health insurance premiums with pretax dollars. retirees do not have that benefit. i tried to get the measure attached to the health care reform bills. congressman connolly supports a stand-alone bill which was introduced in maryland. . .
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we favor expanding medicaid eligibility but the problem is how he is going to get paid for. we favor a portability credit for retirees which are included in house bill, and increasing the age cutoff for coverage of dependent children to 26 and in our last convention, we have a recommendation to get the age
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cutoff raise to 25. we were happy to see it at 26 in the senate help build. -- help bill. this is currently not part of any of the three bills, but is has certainly been talked about and in the senate finance committee. it is a cloud on the horizon that we are watching. we are concerned about opening the federal employees' health insurance benefits program to nonfederal civilians. this is another measure that has not been included in any measure yet. it has been talked about for the last few years. narfe's position is that we would not oppose that its separate risk pools were maintained. we are -- we're concerned about the effect of the reform on
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employers and insurance carriers. required benefit packages could affect their ability to ensure competition and offer choices such as we now have under the federal employees health benefits program. as far as enhancing long-term care insurance, we do not see that a house and senate help committee bills do much at all for the current proposals. the prospects of slowing the growth of medicare and medicaid payments for providers worries us a bit, because i believe it was the congresswoman who mentioned the fact that if you cut back on provider payments, providers will back out of medicare and medicaid programs. that is a short summary of our
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non-position on health care reform. i will wrap it up and weaken open questions. -- and we can open questions. [applause] >> thank you, charles. i am going hand this meeting over to the guy you really want to talk to, congressman connolly. i will come back at the end when we have to cut it off and leave this room. we're doing something slightly different in order to get as many questions as possible. steve is going to be on this side with microphone. raise your hand, steve. sharon is on this side with a microphone. rather than moving around a room, we are coming to you. we think that will expedite things and make it happen quicker. without further ado, congressman, the floor's yours. >> can you hear me?
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this is a residence forum. we're going to take questions first from the residence of greensprings. there are another hundred residents on the waiting list. we want to be fair for them. we have outside guests and we will get some questions from them if we can. let's start right every year. steve? and just give us your name. >> irene orange, a resident here at greenspring. i have some concerns about h.r. 3200. h.r. 3200, page 284-288, section 1151. i'm opposed to it and i do not want to read it all. dollar >> tallis your concerns on the pages.
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-- >> tell us your concerns. >> it deals with three admission procedures and there will be no judicial review. the secretary of hhs is above the boards. if your doctor recommends that you go back into a hospital after a stay, the secretary of hhs will be making that decision and not your doctor. i oppose that. section 1121, page 239, the government will limit and reduce fiscal services for medicaid and seniors, low-income and for being affected in a very negative way. i oppose that. h.r. 3200 -- i have seven questions here. [laughter] >> we've got lots of people with lots of concerns.
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if you want to give me all the details of what concerns you, i will take those into consideration. as i work for the bill. on the problem of readmission, one of the things i think the bill is trying to get at is that a very high percentage of people that are discharged from hospital end up being readmitted within 30 days, of very high percentage. one of the reasons is because of infections that they got in the hospital or that the treatment was not adequate. i expressed that in my own -- i have experience that in my own family where someone should not have been released initially, was released, and had to go back in another week for the emergency room. i think the language is designed to better manage debt so that people are not released before they should be, and that hospital takes responsibility for making sure that when someone is released, they are well cared for and the condition
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has been addressed. let me talk to you here. let me introduce daddy troutman, a senior member of congressional staff and has been part of the process of overseeing this draft. she is a nurse herself. the one a comment on that? -- do you want to comment on that? >> i am a nurse and happy to talk to you about health care reform and to see so many of you here to comment specifically about readmission. we are trying to improve the quality of health care. we heard a story that is not unfamiliar to many of you in the room. there was an 82 year old gentleman the came to the hospital, his wife had recently died, so for six months he had been on his own. he was discharged from hospital on eight different medications
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and was required to follow up with five different doctors. he could not do it. he did not have the support -- his wife with his -- was his primary support. he ended that coming back into a hospital. we do what -- we do not want to prevent that man from getting care. we want to make sure that that does not happen. the hospital has the responsibility to make sure that he can get a prescription medicines that he wants, and that he is able to get assistance for the follow-up services. the language in the bill is intended to prevent that type of situation from happening. it is really all about trying to better coordinate care and having hospitals be more responsible. >> irene, we will take the other six you have got. i'm going to take michelle and then we will go over here. >> my name is michel, and i'm a
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former food and drug employee. my concern is about the insurance company. paypal lot of money -- they pay a lot of money to buy the votes in congress. the mccain fine goleingold has t limits. >> what about those insurance companies and are they making a lot money and also spreading a lot of lobbying money to members of congress? clearly the insurance industry does not want competition. clearly the insurance industry is benefiting from the system the way it is right now. the way that they are doing that, maximizing their profits, often is frankly that and i all of care. we talked about rationing. that is one indeed myths that
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the bill rations health care. but insurers, if you are exposed to private insurance, you know that ensures very frequently than i care and very frequently for whimsical and suspicious reasons, and they jeopardize lives in some cases. i repeat this statistic -- the profit of the insurance industry, a top 10 ensures that dominate 90% of the market, one of 428% in the last few years. the way that they did that is by jumping up premiums, jumping up deductibles, then nine more care to more claims, and increasing co-payments. -- denying more care to more claims, and increasing co- payments. before the draft legislation was developed, the pharmaceutical industry went to the white house and voluntarily promised to get $85 billion in savings. voluntarily.
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the american hospital association said ok, we will put $130 billion on the table in savings. we will voluntarily provide that to help get savings in health care system. the insurers put $0 on the table. they need to be heard from. we need to make sure that they are doing their part. we need to make sure that as we left him -- listen to various voices, we understand who represents whom. and i want to welcome vivian watts who is with us here today. thank you. my former opponent from last year is here. thank you. former senator, my friend is also here. jay, where are you? he left already. he is going to read the bill, i think. [laughter]
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sir, if you could tell us if you are. >> i have a problem that i cannot understand. most of the industrialized nations had universal health care and have had for many years and they are not going broke. so how come we have some much trouble with this thing that we talk about many, many institutions and people saying that we cannot afford it? why is that? why can we afford it? >> what is your name? >> william stevens. >> what a great question. there is a great book if you have not read it. it just came out last year. "over treatment" bayh shannon brown. we spend virtually twice what any industrialized nation does. for that money, we still have 33% of our adult population
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uncovered. if you look at outcome, and there's a health profile, we are in the middle low. we do not have the best outcome. so we're not getting what we are paying for. we pay twice of what anyone else pays, and you think that we give us gold-plated health care, but it does not. the reward system is a fee-for- service system that rewards the wrong thing. there are lots of models in the united states that show us how he could be done, still using the employer-based private insurance system. we are not going to change that. but we could make our system of lot more efficient. the draft bill here does attempt to affect your weight savings in the existing system. -- effectuate savings in the existing system.
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administrative costs, i just saw my doctor the other day, my primary care physician. he says his overhead is enormous, at least 30% of what he does, just filling out the right paperwork for everybody. instead of providing health care. and he wants to provide health care into a lot less paperwork. lots of over treatment and unnecessary procedures, medications, imaging, all that stuff that we have to get our arms around in the united states to make a more efficient system to provide a better outcome. you look at the mayo clinic and the cleveland clinic, they have got some models that really work well, have a much more affordable health care system and have better outcomes. we can do it in the united states based on our system, but make it more effective and efficient than it is right now.
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>> my name is cap -- catherine the otherstone and i am a resident. -- i'm catherine fan eatherstone. what i don't know about this age are 3200 bill, i don't think it passes the smell test, but for our personal health and it is bad for the economic health of america. my husband had alzheimer's disease for 10 years, and sadly he died last year. but i had the freedom to talk to his doctor and participate in his treatment. i would lose that freedom under this bill. some panel of bureaucrats would decide what his treatment would be, and whether or not it would be cost-effective. i agree that our american health care needs reform, but we can do lots of things to improve our present health care.
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i don't think we need to throw out our present health care and have a whole new government system. i am totally against the government taking it over. [applause] i wanted president obama to succeed, but i am not terrified at the way -- at the direction at this country under president obama, harry reid, and nancy pelosi. they have spent billions of dollars in the last few months, and we're trillions of dollars in debt. congressman connolly, you are our representative. you represent we the people. i implore you to vote no on this bill, preserve our freedom, and prevent our country from sliding into economic ruin. >> thank you, michele. i am sorry for your loss. micron mother -- my grandmother had alzheimer's. she was help the other wives, and so she lived along wake --
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all long time with this debilitating illness that is so devastating, to see someone gradually fade away from the person that you knew. i have deep empathy for what you went through. while there may be the impression out there, especially if you watch too much of fox news -- [unintelligible] i cannot help it. i'm a democrat. but there are not panels that will tell you and your doctor what i loved one is going to get, suffering from alzheimer's. there are going to be studies looking at comparative effectiveness so that we know what treatments make sense. let me give you an example. we now know that in the treatment of breast cancer, many women even in this audience may suffer from breast cancer. for many years the prescribed treatment was a radical mastectomy. it wasn't devastating surgery for women.
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-- it was a devastating surgery for women and their loved ones. it was the entire removal of the entire breast, of the lymph glands, the muscles, the recovery was long and painful, and emotional trauma associated with it. comparative effectiveness study showed that a lumpectomy combined with chemo radiation is just that -- is more affected than the radical mastectomy. we now know more about treatment. we know more about prostate cancer treatment and heart treatment, and so what this bill does is try to make sure that the treatment we are putting out is in fact efficacious, effective, what we need to cure the disease or manage the disease for our loved one buried there is nothing in this bill that creates a panel that is going to supersede this. there is something else that kathy said that i want to say honestly to the audience.
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when asked how many were on medicare, every hand went up. when i asked how many were federal retirees, a lot of hands went up. medicare is a federal program. no, medicare provides something and some of you are old enough to remember when senior citizens have a lot of trouble getting health care coverage in america. medicare in 1965 was a program put in place by that president and a different congress over a lot of opposition. i was a young man in 1964. i was a high-school debater. and a topic that year was, does medicare equal socialized medicine? that was the national debate topic and i had to debate both sides of it. do we regret that we instituted medicare? i do not. it has saved a lot of senior citizens from going into penury
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and has provided quality health care for millions of americans, and we need to make sure that it will be there for the next generation as well. that is how i am going to look at it. as i said, i am not committed to any particular bill but i am sure committed to making sure that we build on the system that we have. we're not trying to change it, and we're not going to federalized healthcare in america. but the federal government already has a strong presence in medicine. and it makes sense in military benefits as well. somebody else. [applause] of here, sharing. i see an old friend. >> my name is charles fletcher. i'm a born and bred northern
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virginia and i am resident of greensprings. i want to bring a different tact to this if i may, to this approach to medicine. reform -- much is being said today talking about government control, something that concerns many of us. this government control with the new president we have has tendencies leading us along a line of socialism, which is not in the best interests of this country. >> greensprings rules, civility and respect. >> thank you.
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the type of government control in 11 countries has not all -- has not been all that successful. we're looking for a report and medical care that is going to be successful for the type of medicine and the great medical care that we have had in this country. we do not want to destroy but to improve it. we need to be very careful in the moves that we make, mr. congressman, and we ask you to be very careful as you move in that direction. >> charles, thank you. charles and i go way back. we were both civic leaders in our respective communities. i am glad to see you again, charles. i think that those are very useful warnings. i do not want to see wholesale change in our health-care
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system in america. i want to see government protect our citizens and try to encourage the extension of coverage through a series of rational incentives that do not entail a government takeover of medical care. now the way we would do that, really, is a single payer system. junking everything and moving to a single payer system would be a government takeover of health care in america. although there are people who absolutely, passionately, believe in a single payer system, and there may be some of them in the room, there is no proposal passing house and senate that will involve a single payer system. we are only debating how much federal regulation there will be to bring down costs, and will there be a public option as one of a number of options available to citizens who are in that 47 million pool who do not have
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health care coverage? that is a big debate. the senate does not want a public option, apparently, and a majority in the house do. that will have to be debated out. i believe that if a public option can bring down the cost of health insurance premiums and deductibles by providing rational competition, and people want to opt into it, no one being mandated, we ought to take all look at it. a house version does have this. how about you, steve? you know what, sharon? i am going to go back and forth. >> i am resident of greensprings. we had been considered to be the greatest generation. i think that this generation is afraid of what is coming next. i have several points to make.
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this has been a very good pep rally for reform of health care. i don't think there is anyone here that would doubt that it needs to be reformed. but whether any is to be borne by the government taking it over eventually or not makes the difference. the point being, in most of the countries where you find it, canada, britain, italy, where u.s. found government takeover of health care, any place from 50% to 75% required that they actually opt for getting private insurance. also because the government health care does not cover everything that they need, they have to wait. it is rationed. they have long waiting lists. in germany and the netherlands, there is a sub rosa form of end
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of life consultation. in the netherlands, it is not even voluntary. >> it thank you very much. >> can add that few things? i understand that whatever is passed, this program will go into effect in 2013. and then it will be revamped every five years. anything that might be passed now could be revised by government control in five years after it goes into effect. and we need legal reform. we need portability, there is no doubt. we need catastrophic disease, pre-existing conditions -- but many of those things can be done without government control. >> ok, well, thank you, millie. millie has covered a lot of reforms. i certainly support them. we might disagree about can we
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expect to wait all of those reforms without legislation -- effectuate all those forms without legislation? yet insurance companies wanted a pledge by now that they would not deny pre-existing conditions, there is nothing stopping them. but they are doing just that. and frankly we've got have some protection for the public. some time the government plays a positive role in protecting the public interest. we have to bring down the irrational cost to our system. he is right. how come the other systems are more effective and less expensive than ours? whatever we do in terms of health care reform, it has to build on the existing system of private employer-provided insurance. we have some big federal programs, and most of you participate in one of them. but we have a vigorous private
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insurance program in america. that will remain a model. that is not going to change. we're not going have a federal government takeover of health care in america. but we have always had a strong presence since social security got started in 1935. and it has improved the health posture in the united states. can we do it better? that is what i wanted to. i wanna make sure that medicare is available for all of you in an improved form, no benefits changing other than an improvement, and i wanna make sure it is there for the next generation, the second greatest generation. >> i am a five-year president. i have a question and not a speech. [applause] my question is, i am perfectly satisfied with medicare, blue cross blue shield. will i, according to your understanding, be able to retain
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that under the legislation? >> absolutely. if you are happy with what you have now come the only thing that possibly happen is if it better. i promised to sharon, and then we will come over here. >> i am tom harrison and speak to you as a constituent. >> it could be closer to the microphone. >> my subject is the constitution of the united states. when i entered the military, my oath of office was to defend the constitution of the united states against all enemies, foreign and domestic. i don't think the health care bill is about health. i think it is about power. [applause] let's see if what has happened to our country since the 20th of january. the financial sector has largely been taken over. we have legislation -- the
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president does not have the constitutional authority to require the ceo of a large company, and they have taken over 75% of our motor vehicle. cap-and-trade will -- >> do you have a question in there? >> my question is, your sincerity. if you believe in this, i would ask you to cover congress and all federal employees with the same insurance that you are enforcing on us. >> tom, thank you very much. like you high-tech and the oath, and i had taken it six times representing this community to uphold the constitution of the united states of america. i take that of the very seriously. -- i take that oath very seriously. your comment about january 20 it is wrong. the takeover -- yet that is what
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it was -- the intrusion of the federal government in an unprecedented way in the financial-services industry of america occurred under the previous administration. tarp, a troubled asset reset program, was a program of the bush administration, not the obama administration. and it tipped over a number of financial institutions and bail them out unprecedented ways, and in return the federal got a major stockholder in a number of financial institutions. that was done by hank paulson, the republican secretary of the treasury, and ben bernanke, a republican appointed chairman to the federal reserve who has just been renowned -- it announced he was reappointed by a democratic president. echoes back to september fete -- 17th, when a financial meltdown happen, and we were looking at the worst one since the great depression.
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i don't know if there is anyone here that remembers the great depression. [laughter] here is a trick question. the largest bank failure in american history occurred in 1929, right? no, it occurred in 2008. the largest corporate loss in american history occurred in 1929, right? no, it occurred in the last quarter of 2008. is called a i g, which was bailed out by the previous administration to an unprecedented degree, and then the executives were allowed to get out bonuses. -- to get out bonuses. i wanna make sure that we get our facts right in terms of who did what to whom and win in. -- and when. i will be eligible and a few
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years for medicare. i get the same health care -- we hear about members of congress get special privileges. i was looking for the special privileges when i got a congress. where is the line to sign up for them? and i at the same health care benefits package to sign up for that in a wreath -- any federal employee gets. there was not a single thing offered to me other than for an extra payment, i could use the services when i am in congress for the capitol hill decision for a fee. -- the capitol hill phys ician for a fee. this is not to make sure that everyone has the minimum health
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care but to improve everyone's health care. thank you for your question. steve? >> my name is erma jackson. i worked for 40 years. i work for 40 years is a registered nurse. i have very strong feelings that healthcare is a right, not a privilege. i think there is going to be something in the government's action, millions of people the aura of the medicaid level but can in no way in court -- afford health insurance. i think the people of the most important to cover. those of us here, i feel that we are fat cats, we are able to live in all luxury level. a lot of people cannot live at it. >> thank you so much. nurses have a special place in my heart. my mother was a nurse for 40
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years in boston, mass., a night nurse. i saw her go so many years going without sleep, raising a family during the day and working as a nurse at night. he gave me a profound respect for that profession. the sacrifices that nurses may. i held none of you had to be in a hospital lightly, but you know that nurses make the institution. they humanize what is sometimes and in personal -- and in person -- an impersonal health care system. health care ought to be our right, and not a privilege. even if you get outside the humanitarian aspect of that, economically it is a huge problem that a lot of americans do not have health care coverage. some of them are young people who ought not have that -- who
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opt not to have it. we want them in there some are small businesses that cannot afford a give their employees health care. 60% of business is provided. today it is less than 40%, and intend years it will be less than 30% in the health-care cost trajectory continues. there are some stunning statistics about the consequences to you as an individual if you do not have health care coverage. if you are a child in america and your appendix bursts, you are five times likelier to die from peritonitis than if you are in insured child. the parents not having health care insurance, they hope for the past and i hope it is just a bad timing. by that time it is clear is much
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more serious than that, there is a high risk interdependence has burst. if you have primary care through the insurance, if you get that kid to the pediatrician and get the care that that child needs. there are real consequences. if you had cancer without insurance, you're twice as likely to succumb to the disease than someone who is insured and can afford the treatment. we can go on and on. there is no question that they are economic consequences and social consequences to a system that allows 47 million people to be uninsured. it all becomes uncompensated costs in the emergency room. schering, your next. and then we're going to come to you. steve, we will come to this gentleman appear. where sharon? >> we who live in this country, which is founded on the basis
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of -- >> if you could speak closer to the microphone? >> it is on. we have to live in this country, a land of the free and home of the brave, ought to be feeling that this is really all moral issue and the congress ought to feel that very strong way, because of the 47 million people who do not have insurance. we are our brothers' and sisters' keepers. we need to keep that mine when we feel comfortable as we do here in greensprings. i do have good health insurance -- health care. i did not have to worry about that. who is responsible for a huge 70 million -- $70 billion deficit that we are in? [unintelligible]
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>> i don't know what i want to get in to blame here. all of us are now responsible for it. we have to clean it up. that is what this debate is about -- health care is almost one-fifth of the economy. we wanna keep it there. we do not want to grow more. -- we want to keep it there. we do not want it to grow more. we want to make that descent -- the system more efficient and make sure that we actually improve health. one of the things that the draft bill does do and gets no credit for is that it significantly promotes preventive health care. let me give you an example. there are four things we know that if we did as a country could significantly, positively have a positive impact on health care in america. don't drink so much. drink a moderate amount.
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don't smoke, and don't ever start. watch your weight and do not get obese. exercise a little bit. those four things could have a profound impact on health profile in america. i spoke to a major employer in our district about a month ago. they tell me that their ceo at a congenital heart condition that required heart bypass. after he had a bypass, he got religion about exercising, watching what he ate, because heart disease runs in his family. he is in great shape, by the way. so he started as the ceo, inviting people to walk with him after lunch break. you do not have to, but i will give you a pedometer and you can join me. we would do it company-wide for those who want to do it. just that simple, voluntary change in that company, encourage people to walk several times a week, but is the company's health-care costs by
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5%. we know that prevented if health care and pay off, especially if we can start people young and make it a lifetime habit. they are going to incur a lot less health care costs than an older generation did. unfortunately, the congressional budget office cannot get its arms around how much that saves. how do we quantify that in dollars and cents? unfortunately, preventive health care does not get any credit in the bill, even though we know more than intuitively that it would effectuate savings. we have all got to work together. we have got to get it right and that is why i am dialoguing with you today and lots of others. we have got to make sure we get right before we vote. you have been waiting patiently. >> i am a resident. i'm a graduate and i have a
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master's degree in government administration and finance. my name is edward, and i am also a combat veteran, a fighter pilot, serve my country with all these decorations, and i really am worried about the situation now, in particular my grandchildren and so forth. i think we will all agree that everyone is well meaning. we want to help and do something positive. i think we also agree that if i spend money i do not have, i am in deep trouble. while we are doing all of this, i hope we don't bankrupt the country. if you look at everything, this is what people are really worried about. i speak seriously now from my own experience. look at what is the problem. the soaring, high costs of being
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ill, from the prescription drugs, but doctors, and when you go in the hospital. i cannot believe they can suck up $100,000 of your money be there for a weaker two. my brother is just coming out of the hospital for a second heart attack. i look at his bills and i cannot believe it. what can we do? we all agreed that there seems to be excessive profits -- three different things that we have. the filmmakers, but doctors, and hospitals. -- the pill makers, that doctors, and hospitals. is there something to be done to prevent excess profits? dollars air would -- >> edward,
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thank you for your question and for your service. i don't know that we're going to cut the price control, but the more we create large, competitive pools, we bring down the cost of services and drugs. for example, but medicare and the federal employee health benefit program at much lower administrative costs than do some private programs. [inaudible] edward is saying -- medicare sort of this, but the federal coverage is competing with the private sector. most americans have private insurance. they are happy with it. but they are anxious about the rising cost of that and will it still be there in a few years? with respect to prescription medicine, which you raised
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specifically, again, i think competition would be a good thing. remember that when the medicare part d program was adopted by a previous congress and administration, i want to point out two things. they did not pay for that benefit. this bill, for good or ill, according to the congressional budget office, is fully paid for. it does not add to the deficit. i think that ought to be one of the criteria. is it paid for? we do not want to put that burger on -- burden on future generations. i agree with you totally on that. but explicitly in that legislation, creating the drug benefit, not now -- not only doughnut hole did it doughnut -- not only did it pcreate a doughnut hole, explicitly cat
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people for negotiating a tree that was the influence of the drug companies in the congress. it was unconscionable. your drug prices are higher than they need to become even year copayment, and your doughnut hole is reached faster. and in other countries, the same drugs are at much less cost. think about a few years ago, paul issue of real importation of drugs from canada -- of importation of drugs from canada? these drugs are produced in the united states. they were marketed for sale in canada and read imported from canada back to the united states, and still were cheaper than just buying it here. how could such a thing happen? i think competition is a good thing any can bring down the cost of health care, whether
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drugs, whether services, whether a doctor visits, and whether it be insurance. foreside, sharing. who are you -- your side, sharon. >> my name is joan. i am a resident. i am concerned about what they are planning on doing for the military veterans, the retirees, regarding try care for life? >> tricare is alive and well and is not affected. we are also looking at trying to make the provision of medical care even more efficient. there are a lot of other discrete things that we're doing, depending on whether you are in the army are not. as you know, right here in our
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district, the army hospital is building an enormous complex with many more patients services for veterans, for army veterans, with a center of excellence for medical care. we're trying to make the system a lot more efficient in the provision of medicare's. in many ways it has set some standards that are very useful to learn from. they have made some real strides. we need to make sure that tricare is there for our veterans, and home care is there, especially for the men and women who served our country, where the deal was they answer the call. the other part of the deal is, when a home, we take care of them. -- when they come home, we take care of them. [applause] we've got lots of people wanting to be recognized, so bear with me. i know that everyone cannot stay forever but we're trying to get
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as many people as we can. >> my name is a llibby and i want thank everybody for giving their opinions on was this -- what seems to be insurance reform as well as health reform. i have a question for you, congressman. i know you are new to the congress but not new to public service. do you believe that americans have rights and freedoms that cannot be abridged or controlled by the government, no matter what kind of social program seems to be good at any given time? >> as i said to tom over here, i have taken and oath of all the constitution of the american -- and the united
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states of america. i like free debates like we're having right now, respectful but freed. and believe me, i wrestled with the issues i face in terms of what is good for the constituents, the country, and the right thing to do it. and i'm certainly wrestling with the health-care debate right now. i do not believe that we ought to be taking away any rights that currently exist. i am always looking for ways to augment and expand the rights that we have in our constitutional system. and i think america does that over time. we're not a perfect system but we are protecting ourselves in ways that ought to be the envy of other countries in the world. i have to switch to decide and i will come back here. jamie. >>-monty and i'm resident of greensprings. i don't question the need to overhaul our medical care
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system. but many of us feel that the overhaul of the tort system should be an essential part of that over all. i don't see that in any bill or in any project thus going. can you tell us if there is any anticipation? >> i agree with you, monty. is it part of the cost of madison in america, a defensive medicine, physicians and surgeons looking over their soldier -- over their shoulder if they do not do that test, and my answer is that that is probably true. there have been lots of studies about this question. what is a little surprising is that it is not a huge contributor to the cost of medicine. it is a contributor but it is not huge.
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in a state that rigorously controls malpractice awards, texas, they adopted some of the most stringent limits on what all board can be for someone suing a hospital or a doctor or a surgeon in the united states. the "dallas morning news" actually did a study of every hospital after they adopted that. number one, the alleged savings that were supposed to accrue from such rigid standards were not passed on to consumers. secondly, in many cases, health care costs in taxes rose at a faster rate than states that did not have such limits. i am not saying that defensive medicine is not real, but i am saying that we would be wrong to assume that somehow, it just like tort reform, we can bring down the cost of health care
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dramatically. not really. it will affect positively the growth in the cost of medicine, but that is not the biggest contributor to the health care costs spiral. but it is a factor. and i did not answer your question. there are two provisions added to this draft in the energy and commerce committee in july. they address this issue. do i think i'd -- do i think they address adequately enough? no, but they addresses specifically and we will see more of it as we see an evolution of the legislation. your side. >> thank you, congressman and the panel, for this great discussion. my name is onlleah lockhart, and i'm lucky enough to be able to afford greensprings.
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my question is, those who are so afraid of health care takeover, are you concerned about the 428% rise in profits for the top 10 insurance companies, yet i heard you correctly, congressman? they have 90% of the business. i think that we should be concerned about a private, greedy takeover of health care as well as other concerns. thank you. >> thank you, leah. somebody recently -- in some cases the federal government is monopolistic. i said, if you could make that argument on medicare. but there are whole states and regions of this country where one health care provider dominates the industry to the tune of 95%.
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that is virtually a monopoly. i want competition in the system so that people have choices. that is one of the principles that we ought to try. i have been dominating the answers here and i do not mean to. we have a wonderful panel so i want to give them an opportunity. >> congressman, we had been quiet because you're doing such a good job. i listen and look out as you listen to the answers. the conundrum that is congressman has is that you really reflect what is happening in the country. some of you want the reform. some of you do not want the reform. he is going have to balance that. i see an audience that looks like me, older, medicare, i've got blue cross, we are going to be ok no matter what happens.
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we're going to be ok. i have struggled in studied this question and i had members of all walks of life and all political parties, and i am convinced that doing nothing is not the answer. it has nothing to do what most of the people in this audience. what it has to do with is my four children and my 10 grandchildren. that is what we have to think about. it will be top of a congressman, but to do nothing is not the answer. -- it will be tough for the congressman, but to do nothing is not the answer. >> i had been waiting for something for the congressman to say that i could jump in and say, wait a minute. and i have not found it. aarp is committed to being the protector of medicare as we go through this. when you hear that a particular piece of legislation will cut medicare benefits, certain medicare beneficiaries, check it out. we want to be that source of
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information that sets the -- that separates the mtyhs from the facts. a r -- aarp has pledged that we will not endorse legislation like that. and barbara's comment as well, this is democracy. no one gets exactly what they want. we go through these debates and find a common-sense solution and reach across two different thoughts and ideas. if we are committed to the same goal, we will come up with something that is uniquely american. the real problem is just putting our heads in the sand and trying to move on. this problem is not going to go away. we have been debating this problem for 60 years, folks. this is not new with the last election. i hope we stay engaged and come up with the right american solution. doherty one of talk about a website? >> actually, you can go to aarp.org to find more
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information. another web site will give you current discussion about facts and myths as they are being debated. there's a chance to sign up to get e-mail from aarp that will keep you apprised at what is happening as we go through this debate. >> i was struck early on -- about a woman who talked about the phone book. that is not what he is going to be asked to bogdan. in all comes down to the nitty gritty. the bomb but will have to go to conference. the senate bills -- the phone book will have to cut it congress. who knows what provisions will have to come out? we are all in an amorphous situation. talking about web sites, there is the kaiser family foundation
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website which narfe has identified, doing side-by-side comparisons to the various bills in the congress. i can get back to you if you are interested in looking at that. it is www.kff.org/healthreform/sidebys ide >> let me say one last thing, i do a number of these town hall meetings around the country. i really have to say to you that your congressman has conducted himself -- you might not agree with everything he said, but he is very knowledgeable and you're lucky and have a man like that representing you. you know he is going to listen to you. you might not always agree with him but he understands what is
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of legal and every person that thinks of this insurance is an entitlement, something has to give. >> where did they come from? >> poland. >> my grandmother came from ireland in 1920. i do not know what bush-bashing are referring to. since january 20, there has been a takeover of the financial- services industry. i corrected him. i said it all occurred prior to january 20. i did not know actually -- the clinton administration was not involved in the takeover. we can argue whether that was a good or bad thing, but i simply was trying to direct it back. p. the issue of deficit. i am on the budget committee.
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most states have constitutional provisions that do not allow them to spend spending. they are required to balance the budget i am stunned when i get to the federal level. when you look at what was not funded under the previous administration and you look at the economy we inherited on january 20, about $5 trillion was inherited from that time. i will point out to you -- it is a matter of fact that in the year 2000, we experience for the
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first time since introduction to consecutive surpluses. the federal government was in surplus and we were projected surpluses until -- as far as the eye could see. we are paying down the national debt to the point where alan greenspan the then chairman of publicly worried what it would do to u.s. treasury. that is predicated on having the debt. in eight years, we took a two convicted year surplus -- consecutive surplus and we doubled the national debt. in eight years. we left half a trillion dollar deficit in the last fiscal year and a projected deficit of 1.3 trillion.
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there is not only 9/11, there was an unfunded war in iraq and afghanistan. they were very costly. under the previous congress --i just voted for the reinstitution of that to go -- petigo. hopefully, we will exercise a lot more discipline as you move forward. i think there is plenty of blame to go around. thank you. welcome. >> i am bob. i have a question for barbara. i have read letters from ncp signed by barbara kennelly since day one. the question is, at this stage today, do you barbara field that
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nctssm is making any headway? >> yes, i do, because the share is holding steady. we hear from our members. we have a grass-roots department. i talked to our members. i have my member listing in washington. i get a 10-12 cause an evening. -- calls and evening. medicare and social security are necessary for any industrialized nation. that is worth a call. we have to have social insurance for our retirees, otherwise it will not work. our members feel the way or the when the doors. to join us is $12 a year. we do not sell anything. we do not endorse anything. we just go up on the hill and say, our country needs to subsidize and have social
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security and medicare not only for ourselves but for our children and grandchildren. >> my name is diane. i am a resident here. is that better? i have been hearing a lot this afternoon about rights. everyone finds it very easy to get uptight very quickly if they think any of their rights are being threatened i do not hear anything about the responsibilities. with rights, responsibilities. we hear that there are 47 million people without health care. we hear that healthcare is a bright not a privilege. i think almost their body here
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would agree with that. maybe not. the doctors, the drug companies, and the insurance companies have had no trouble at all exercising their rights. they seem to have a great deal of trouble exercising their responsibilities. my question is, how can we, people generally with no great political connections -- >> what do you mean? i am right here. >> what can we do, what can i do, to try to enlightened these folks about their responsibilities? do not come to write my congressmen. i have already done that. -- do not tell me to write my congressmen. i have already done that. >> we get lots of mail. we are happy to get it.
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i think responsibility -- i think you raise a profound question. it is an enormous a question in terms of what our responsibility is. for our own health care, for that of our loved ones, for part of our strangers better part of our community. a little boy eight years ago in the district of columbia died -- he was 12 years old. he was uninjured. he had a to the infection. -- on the insured. he had a tooth infection. his mother connect 81 to treat the young man. the to the infection led to a brain infection. he died. -- the tooth infection led to a brain infection. he died. the cost was $250,000. a simple dental appointment would have saved them a lot of money and would have saved his life. it is not just a nice thing to
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do. it is a matter of life and death. what is our responsibility to that? as a society? i do not want to take away anyone's medical care. i want to enhance the. i want to make sure the families who have young children like that little boy do not ever have to experience that terrible, terrible choice in medicare. this gentleman has been very patient. we would like to hear from him. you will have the last word. i will stick around if anybody wants to talk to me. if you have any questions, you can write them on the card. >> last week, president obama -- can you hear me? what i can hear you. >> president obama last week
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that take you out to the picture for the health program? i want to know how you feel about op about otion. -- about -- aboutoption. -- the public option. >> thank you, a roy. he pointed out that president obama cited the post office in the competition with ups and federal express. i think that is one analogy. i do not know if it is perfect. i think personally that a public option is probably a good thing. a gives people an option. the congressional budget office looked at the number of injured people that has everybody get
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insurance. this and maybe 1/3 of the uninsured would opt for the public auction. two/they would offer private -- 2/3 would offer private insurance. i have a menu available to me and i can pick what plan is best for my family for me. this is to create an option. i think the cbo said with cbo saidoption steve 100 -- with the public who -- i think the cbo said that with the public option, we save $170 billion. we are pulling out all the stops to try to kill the public auction. the competition said it will drive it. there is nothing that suggests that that is the case.
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we are dealing with this pull a 47 million. they do not want any competition. there are huge people in the 90 states were only one insurance provider dominated the market. that is not competition. that is why costs -- why we cannot get our arms around the costs unless there is some legitimate conversation. if the public auction the only way to do it? not necessarily. they are looking at the series of nonprofit cooperatives, sort of like we had for electricity and some farm and credit co- ops. is that a model that will work? we have to look at it. the senate is enamored with that model. the house as more enamored with the public option.
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right now my inclination is to support it for those reasons. it is not theology for me. it is a matter of something practical. ma'am, you will have the last question. >> i am a resident. i am very happy with my medicare and my insurance has done well by me. i can say lot of problems that need working on. someone mentioned germany and their medical care. my youngest son lives there. he had a heart attack and got a wonderful care an. their taxes are much higher. we are comparing -- we are
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really comparing apples and oranges. they are both fruits, but they are not the same. . >> what -- >> i'm not through, sorry. there is always going back and forth. that is -- i have real concerns about these small business people in the unemployed about people who lose their jobs and they go on cobra. how are they going to pay for the cobra? it is very expensive if they do not have a job. all of a sudden, the cobra runs out in a year or so and there they are with no medical insurance, with a family that needs medical care. what is being done for these people? thank you very much. >> thank you. i'm sorry. i did not mean to interrupt you. but research with khobar. cobra is a federal law that
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requires employers upon the termination of an employee to make available to them for up to 18 months a continued private insurance coverage at their own expense. that "at your own expense" is a problem. the new no longer have the employer sharing in the cost of the premium -- then you no longer have the employer sharing in the cost of the premium. it is beyond their reach. they cannot afford it. it is not one that many can afford to exercise. it is a false a benefit in a way. that is a specialty have family coverage. the cost is almost ridiculous for many families. one of the things about health care reform we are trying to get at is, if we should seek them bring down the cost of the average premium by expanding the
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risk pool, that is why -- you asked me whether i was willing to give up my federal insurance or some other plan -- one of the reasons the federal insurance is affordable and has so many options is because there are so many of us in the risk pool. i want to create other risk pools, especially among those 47 million people without coverage. the public option has the petition -- potential to create competition to bring down the cost of premiums. that is the idea. hopefully, it is going to work. that sort of my answer on khobar. you mentioned in germany. sometimes in this debate, we had some big rhetorical questions
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that do not always involve facts. i said i was irish. sometimes people tease me. when we tell stories where neither constrained by the trigger limited to the fact. i i think our health care has had some of that coloration. apparently in britain and canada, people are dropping like flies from lack of health care -- they are all bitterly unhappy and in light to come to the united states. -- and in line to come to the united states. if you tried to change the national healthcare system of great britain, you would be hard to do that. are there problems of their health care? yes, but it is a system -- i am
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getting rid the notion that it is dreadful. they have some attributes of a health care system we want. it is a lot less expensive than the system in terms of what they spend on health care. it is a lot more efficient there is less administrative overhead. the outcomes are better. can you get top-quality health care in the united states that is unrivaled in the world? yes, absolutely. as a keep on saying, tens of millions of our country women do not access that health care because it cannot afford. we want to try to change that to the moving forward your children and grandchildren to not have to worry about whether they are unemployed and lose
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their health insurance. thank you for being with us today. thank you for your hospitality. [applause] god bless you and invite me back. [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2009] >> coming up on c-span, a look at the inner workings of the largest part of the medicare program. then at president obama, vice president biden, and senate majority leader harry reid talk about the death of senator ted kennedy after that, we will show you senator kennedy's speeches.
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>> as the debate over health care continue, c-span's healthcare hub is a key resource. bill online and follow the lead this -- latest bad and events. share your thoughts on the issue with their own citizen videos. there is more at c-span.org/ healthcare. >> tomorrow morning, there will be meeting on the wireless communications industry. they will live specifically on issues of competition and rapid access. we will bring it to you live starting 10:00 a.m. eastern. leader from the heritage foundation, a look at the recent
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presidential election in afghanistan and what it means to the fight against the taliban and efforts to create security there. live coverage begins and noon eastern on c-span. >> this week, "washington journal" is taking a look at the inner workings of medicare. on wednesday, thomas kelley discussed the largest part of the program, medicare parts "a ." this is an hour. host: what is medicare parts a? guest: it is the biggest part of medicare. medicare is of $480 billion per year program. it covers 45 million seniors and disabled americans, people over 65, and those under 65 who are disabled. part a concerns hospitals, and patient services, and the like.
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you get into complications of a lot of co-payments and deductibles, but the biggest part is in nursing homes, home health agencies, hospitals, and a variety of other things. it is paid for largely by hospital insurance tax that you and i see from our project if you are working. it is a 1.45% tax on the individual, along with your social security tax, and the same on your employer. everyone pays 2.9% to finance that. the taxes collected on the hospital side many times go back out to pay for medicare part a. host: a lot of information in that answer. let's pretty dumb. who is eligible for medicare part a? guest: the largest segment our
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seniors over 65. you have to have paid to be eligible und65thon -- on your 6h birthday. but, basically, then you are in. additionally, there is a large population of people who are disabled, about 7 million. they are declared by the social security administration to be disabled. after a two-year waiting period, then you are in. that is about 16% of the population. host: why do you have to wait two years? guest: there is a resumption that if people are long term disabled and fundamentally dissemble, -- there is a
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presumptive the note is to show that you could go back to work, or if you have lou gehrig's disease, or certain other types like renal disease, their qualifications to get in more quickly. host: those two? guest: als only happened a couple of years ago. it hits quickly and disabled people quickly. waiting two years is often not approve. when you have a kidney failure and have to be on kidney dialysis three times per week to survive, there are other qualifications. so, there is the acknowledgement that those two diseases lead to much quicker terminal illness. host: everybody pays 1.45% of their income to medicare?
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guest: if you look on your social security taxes on your paycheck, it's sayshi tax -- that is hospital tax -- it says hi tax. the best book of working americans pay this tax, as does your employer, alter your working life. that goes to the hospital insurance trust fund. that collected about $205 billion last year through various mechanisms. it then pays out the hospital insurance benefits or to a home health agency, or such. host: who administers into? guest: by the centers for medicare and medicaid services which i ran for two years in the early 2000's.
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it is in transition. medicare sets the policy. it is in baltimore. the program is administered by contractors, blue cross plans. in 2003 and was involved in in 2003 and was involved in putting a policy where we had there used to be 26 of them across the country if you went to the hospital on simitar claim, it would go to medicare. -- and some did your claim, it would go to medicare. -- and submitted your claim, it would go to medicare. part b and a choice together in a regional -- joins together in regional contractors.
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madam predict it'll all come through 15 plans. >> of those arhost: those are 1e plans? guest: it when the problem started in 1965, and it was a blue cross plan. -- every state was a blue cross plan. for many years of mutual of omaha was a big contractor. [unintelligible] host: if you are 65 years old and you are eligible for medicare, you cannot pay for it anymore, correct? guest: for part of "a." that varies greatly. buy private
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insurance, for the average senior it is about a $11,000 per person. -- for part a. it varies greatly. so, basically once you hit 65 you are covered. generally, you'll pay about $1,100 per year for premiums for a $11,000 benefits. 90% is covered by the treasury. it includes the taxes you paid your whole life. so, the premium is about 10% of the cost. the rest of it is covered by taxes you paid during your working life. host: for the next three days we want to explore medicare. how it developed and how it is paid for and how it fits into the healthcare debate currently going on on capitol hill. we will put up the phone lines. we have divided them
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differently. if you are 64 or under, dial in on the first line. if you are 65 or older, dial into -0002. then, we would like to hear from healthcare professionals on the third time. what services does medicare part a cover? guest: all inpatient hospital services. the deductible is a lifetime cap. medicare stops covering at some point. but party a has a $68 deductible which has been adjusted for inflation over the years. the first 60 days you are in the hospital, you pay the first
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$1,060. medicare pays the rest. if you are in for another 30 days after that, there is a copayment of $267 per day. beyond that $9, it gets more expensive. the best book of seniors have some type of supplemental insurance. -- the best part have supplemental insurance. -- the vast part. it tends to be about $3 or $4 per month for the supplemental insurance. -- $300 or $400 per month. the next for you about is
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medicare advantage. it is a private medicare plan to provide different benefits that usually do not have these gaps. host: why is there a deductible , $1,000.68? jake -- $1,0068. guest: it is not intended to cover every dollar. is more like if you hit a certain threshold it will cover these expenses. lower income people have medicaid instead. their 7 million seniors who have dual coverage. medicaid also provides supplemental coverage. so, the issue is that for people
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who are notpo poor, this should cover some of the cost. the idea was to make sure that the beneficiary has some sense of sharing the costs. and also to keep the cost down. host: what is the theory behind afr 60 days of big co-pay kicks in? guest: a lot of it was cost. in 1965 the program was originally projected to be $3 billion per year. this year is $470 billion. so, the issue is largely because. hospitalization is pretty high. very few seniors see the deductibles. the issue was cost.
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there's times the legislation was passed to cut some co-pays and deductibles for seniors. host: is the hospital fund self-funding? guest: yes, it is. it has a surplus that theoretically goes until you bring in more revenues until about 2019. that is before you have spinning going higher than the revenue. -- before you have spending going higher than the revenue. host: alex from cq politics is also joining us. is this part of the healthcare debate taking place on capitol hill? guest: yes, they have to pay for the bill somehow. one big way they want to
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generate revenue is by making some spending cuts to medicare. i hesitate to call them cuts, because they're more like decreasing the rate of growth. they add up to a substantial amount of money over 10 years. it is $200 billion in the house bill just from spending changes within part a. host: how did they make those changes? guest: by tying future adjustments and payments to medicare providers to productivity growth. this gets a little technical, but basically medicare at the moment does not take into account productivity improvements in the economy when they are updating payments for medicare providers. they will start doing that. that measure alone raises within part a about $100 billion.
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host: what does productivity mean? guest: slowing the rate of inflation. hospitals every year get 3% inflation adjustment for cause. you can assume that for productivity reasons they do not need three%, but less -- so it is lowering that to slow the rate of inflation adjustments they get. over a few years if you give them 2% rather than 3%, over 10 years you imagine to save quite a bit of money. host: how does medicare and set rate for open heart surgery in tennessee or new york city? guest: it is fundamental. my old agency, 500,000 people
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make judgments about the right amount to pay for heart bypasses. they do it based on hospital costs data from the private sector. it might be 15% more in new york city than in the rural area of new york or wyoming, but fundamentally every doctor and hospital is paid the same with regional adjustments. host: do hospitals lose money on medicare patients? guest: hospitals generally, you can debate that. generally, there is a cost shift across the board. medicare per service -- the argument is that there is much more volume -- but generally, hospitals probably break even or marginally lose money on medicare patients. they shift the cost to the private sector.
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there would probably charge of private insurance company 10% more than medicare pays. most health providers lose money on medicaid, a break-even on medicare, and make money by shifting the cost to the private sector. it is one of the reasons why people in the private sector want reform. host: so, it is not really a fee-for-service? medicare pays you a certain rate, regardless? guest: yes, i was in the first bush administration -- it seemed like a great idea at the time what i was doing. the average physician had an average rate of $34. today is about $35 after 20 years. the adjustment system ratchets down the stretch. what are you going to do? the physicians will provide more
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services, invest in and outside services and equipment. the systemhat sets prices in new it does not matter where your tenure is as a doctor. in theory by unit you are restricting in controlling prices. but there is a lot of volume and very few ways to control. host: is there much fallout on the proposed changes on capitol hill? guest: some polling suggests that seniors are the most opposed in the country to the president's plan over all. they are clearly concerned about what congress is doing with medicare as part of this effort. i think congress faces a difficult task. they are trying to toe the line between medicare spending in medicare benefits in cutting. if that sounds like a distinction without a difference, some republicans say that it is.
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host: let's go to calls. we have divided on lines a little differently today. -- divided the phone lines a little differently. our guests are tom scully, former head of medicare and medicaid during the first bush administration. andalex wayne of cq politics.com. irma, in arlington, texas, under 65, good morning. caller: good morning, this is my first time to calledlive. my comment is that in regard to the medicarea, or b, for senior citizens, or even for the disabled -- personally, we have suffered a loss in my family.
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my father turned 62 and he wanted to retire at 65, but got very ill with terminal cancer. according to the positions they told us he had may be less than six months. we turned around and applied for social security and disability benefits. they told us we had to wait six months until medicare would kick in for his disability. needless to say, what happened, my father's life depleted and he passed less than seven weeks later. of course, my mother was left with hospital bills that she could not get help with. according to the social security administration and the rules, my father did not last long enough to wait the six months to qualify for disability. it would be nice if there were a way they could find especially
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for the terminally ill, no matter the age, that you would not have to wait six months to qualify for any kind of benefits. host: thank you. guest: that is the whole debate about health care, try to find a way for those people, often right before medicare, and between50-65, so for such a sad example -- there would be away. host: is this the hospital portion, is it efficiently run? guest: yes, probably. if you good to george washington hospital down the street, 60% of their payments come from either medicare or medicaid and the price is the same. in the long run, what are the incentives to be the best
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hospital in town if it will pay the same@@s@' i think they probably have administrative cost of about 1%. host: bill from maryland is a health-care professional. will come professional are you? caller: i am actually a bureaucrat. i wanted to thank him for his service to the medicare agency. my question is, if he could explain the role of states in paying for the low-income beneficiaries and ask whether -- he did mention that medicaid was essentially underpaying hospitals and to what extent the medicare cost sharing by state
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was adequate on behalf of the low income beneficiaries? also, i do not know if he had any comments about senator kennedy's death, or anecdotes about interactions with him? host: bill, you call yourself a bureaucrat. what agency? caller: department of health and human services. guest: i won't say anything about senator kennedy because i will get choked up. he is a good guy. i spent a lot of time with him over the years. anyway, what do we think about the medicaid program? it was one program, but 50 programs. there are 50 different states -- excuse me, i'm sorry. but 50 states do different things. some have extensive coverage like california, new york.
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others like taxes do not have quite as much. at what income level are you covered depends vastly on where you live. all 50 states have different measures. some states do at a very good job of covering low-income single, and some do not do as. much it is all subject to state politics. it is roughly 60% by the federal government, and the rest run by this. it is 50 vastly different programs. you might be a low-income beneficiary in one state and the completely covered, whereas in a different state you would not be. host: is the healthcare debate on capitol hill taking on geographical flavor? guest: yes, absolutely. there is a group of conservative democrats known as the blue dogs who have pressured
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democratic leaders in the house to increase medicare reimbursements for rural providers. they feel medicare payments are not generous enough there. doctors are leaving small towns, going to larger city. that is definitely an issue. host: we're talking today about medicare parta which is the hospital insurance portion. our next call comes from maryland on the 65 and older line. caller: i have two questions. the personal question is, i have been told that i am prohibited from signing up for social security only. either i have to some of for medicare too. i have an excellent policy that my former employer has guaranteed me for life. i do not need medicare. i'm not interested in it as
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being my primary payer. why can't i sign up for just so- so security alone? the next question is in regard to the healthcare debate. why couldn't medicaid be tweaked to accommodate those people who can demonstrate they either do not have the means to get insurance and certify they do not have and available at work to fill in the gap? hostguest: the second question s simply a matter of expense. you have so many millions who are uninsured. their programs similar to medicaid. and the cost is now over $400 billion per year. you certainly could do that, and many states have along with the federal government. but the issue is cost.
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cross will wrap itself around medicare. you will not know medicare will pay -- is paying the bills. -- you not notice of medicare is paying the bills. you may not want it, but you would get it. medicare is pain before they do. -- paying a before they do. there he people turn it down. art a 65 years old you are on it, period. guest: you are on it if you pay in. host: florida. caller: this is dr. mckayla, thanks for c-span for doing this important segment. my question is why medicare denies the american liberties to patients and how they're going to make it worse. the medicare is running out of
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money. if you're a patient you want to pay an extra $50 to your doctor to get seen quicker, medicare denies that right to patients. also, if you want to leave the medicare program, as jat just said, you are de-- as the gentleman just said, you are trapped in that program and there's no competition. finally, medicare wants to institute called pay for performance that wants to pay doctors for meeting certain government cree with the medicare with the medicaid supplemental because medicare pays 53% of my costs so i lose money every time i take those patients. basically, why is medicare denying patients the benefits they expect and why won't they --
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host: what is your practice? caller: i do trauma call. the system needs to change. and we cannot have more government control. it's breaking the economy. and in the end the rights will be denied fishtse and there are rationing boards being set up. host: tom scully. guest: the more you have rational debates. i'd like to see health reform pass this year. less screaming, less politics, less people throwing bombs and talking more about health policies is a good thing. i disagree with one. we talked about health care policy for years. and another former c.m.s. administer is a good friend of mine. the doctor made a good point. a lot of crazy things in the system. we need to fix them. it's been going on for 40
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years. people thinks it's a war about anything. the fact it's a very complicated system. it's the single biggest thing our government does other than the defense department. we need to make medicare better, medicaid better. and the commercial sector. the history of the balance billing cap comes back. i was involved with this in 1989. there were some patients, some low income, and this the arp was saying you cover $50 a payment and some doctors, very few, would be charging $150 and the patients would say i'm getting this balanced bill for way more than medicare pays. so the reform that was passed in 189 and i was george bush number one's staffer back then, would have put a cap on it saying you can't pay as a doctor, if medicare pays $50 you can't charge more than 15% above that. that was part of the bill that was dealt with at the time
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because there was perceptions there was abuses of some providers, not just doctors, 20 years ago charging significantly more than medicare would pay and seniors were upset about it. they can't charge more than a certain amount. in private health plans, part c, if you are in a private medicare plan the rules don't apply. if you sign up f a blue cross plan or united or cigna or aetna, 90% of seniors do, the senior population, then those rules do not apply. host: the doctor called pay for performance, what is that? guest: it's saying, paying a hospital $20,000 for a stint insertion, we're going to measure your outcome and we are going to play some plus or minus 2%. we are paying doctors plus or minus a couple percentage points. i think that's absolutely the right thing to do. i had the first pay for
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hospital performans. it's measuring hospitals' outcomes and doctors' outcome . it says we'll pay you plus or minus 2% or 3%. i think it's better than doing nothing in my personal view. it's like having the defense department go out and pay trucks and pay 2% more for mercedes than we would for a ugo. on the margins i happen to believe that more private sector-driven -- my view -- works better. that's the system we have. but within the medicare system, there's a big movement which i totally support saying we ought to measure outcomes for all of the providers and the better ones get paid a little bit more and not a little bit less. host: alex wayne, any comment to what the doctor had to say? guest: i think it was more of a statement than a question.
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a couple callers ago mentioned medicaid and whether that could be tweaked to cover more people without insurance. the fact is that both the house and senate are looking to doing exactly that. they are looking at expansions of medicaid that would cost on the order of $450 billion over the next 10 years. they would cover practically everybody right around the poverty level using medicaid. and that would be a big change from now because right now medicaid eligibility varies from state to state as tom discussed a little bit, i think, and it averages about only 68% of poverty nationwide. so democrats see a medicaid expansion a major piece of their health overhaul efforts. host: tom scully, we've been referring to this as hospital insurance. what does part a cover again? guest: it covers nursing homes. you have to be in the hospital first and then go to a nursing home, medicare covers the first 180 days. if you have a hip replacement
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or knee replacement and go to a nursing home it covers that. and rehab hospitals if you have a hip replacement and goes to a rehabilitation hospital it covers that. key term hospitals for long-term illnesses. host: so skilled care? guest: it doesn't cover long-term care. if you need to go to a nursing home, lower acute hospital, it covers that. but after 100 days it doesn't cover it. it covers hospice care and after you come out of the hospital and the nursing care and also homebound. you have to be homebound. inability to leave the house. it covers home care for another 100 days with certain other provisions. nursing homes, hospice, home care and the acute care hospitals. host: that's all part of part a? guest: all part of part a. host: debbie who is under 65 from mobile, alabama. debbie, please go ahead. caller: yes. mr. scully, i'd like to ask you
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a question. i'm fortunate to be a young woman, 54, that i've had to get on disability. and i'm having to wait 24 and i'm having to wait 24 months before i can get on i cannot figure that out. i discussed it with them pretty often and explained the issue. i am hoping in march i will get mine. -- my medicare. the senate takes quarters -- you said it takes -- what you have to get to be your medicare? guest: to be automatically eligible, you have to pay the taxes a certain way. if you paid your 1.45% for 10
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quarters during her lifetime, at 65 you are eligible for medicare. either you are emigrated or were not here for that time, you can buy into the program. host: 10 quarters if you work full-time for 2.5 years? princeton, new jersey, 65 and older. what i am a 71 year-old retired mathematician. there are a lot of myths associated with health care. i want to talk about the myth of cost share. i knew you people get attached to it. i hope you'll keep an open mind. i will try to get slowly. please come interrupt and ask a question. your claim is that medicare does not pay enough and hospitals have to charge private insurers more money to make up for the
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loss. . . nts . now, if this were true it would have to be on a hospital by hospital basis. it doesn't do hospital b with all the medicare patients any good if hospital a charges private insurers more money. and this is true that private insurers do pay hospitals with differently sums of money for the same treatment. the same treatment. so if there were cost sharing hospitals with a large volume of medicare and medicaid patients would have to be paid and have to charge more to the private insurers. but medpac has looked into this and there is absolutely no correlation between the volume of medicare and medicaid patients and the amount the hospitals charge private insurers. some hospitals have a lot of medicare patients and they get paid less than private -- by private insurers than other hospitals with almost no medicare patients get paid by private insurers. cost sharing like others -- like malpractice is a myth and
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it's a myth that spread by the private insurance companies because they don't want us to consider the real problems in health care which is mostly caused by private for-profit insurance. i hope you understand this argument. did you understand it? guest: sure. i'm saying that medpac and -- it's the medicare payment assessment commission which is the advisory commission to congress. it's an advisory group of medicare experts, health care experts around the country, doctors, hospitals, administrators who make policies about enhancing that and making it a much stronger role. host: who appoints it? guest: the government accountability office. technically what happens the chairman of the ways and means committee, which runs medicare in the house, and the chairman of the finance committee, makes recommendations and largely congress suggests strongly to the government accountability
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office, the government accountability office who to pick. they do a good job. a lot of discussions. senator rockefeller, good friend of mine, has suggested enhancing it. you can debate that for three days as well. but they make most of the -- if you are a staffer on the hill and looking to write a medicare hill the first part is the medpac recommendations. that's the starting point for where these bills starts on the hill and it's a good start. host: how many people serve on it? guest: 20. i think there's roughly 18 or 20. host: all right. go on with your answer. guest: the point is there are many studies. you can certainly make the argument that different hospitals, but there's very little doubt, there are many studies out there that show on average medicare pays, depending which study you want to pick, 6%, 8%, 10% less.
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there's a huge program in the medicare practice. i think it's now doctor 25 billion a year. -- $25 billion a year. if you're a hospital that takes care of a disproportionately number of medicare patients and medicaid patients, you get supplement payments . the point is you take care of a large chunk, if insure boston and you get more seniors than the hospitals down the street you get a more supplemental payment for medicare to take care of that. and medicaid in every state has a disproportionate share of hospital payments . that's something up to $40 billion in medicare payments . if you take care of more medicare and medicaid patients than the guy down the street you get paid more. i would argue that substantively there's not much question that there's some cost shift to the private sector.
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host: alex wayne, is cost sharing the debate on capitol hill? guest: kind of. cost shifting is an interesting issue. i don't think anybody has a good handle of the extent to which the problem and how it balances out. what my understanding of it is that cost shifting often depends on who has more weight in a given market. if you have a big hospital group and a lot of insurers, the hospital has generally more influence to dictate prices to the insurers. conversely, if you have a big insurance plan in a state that controls a big piece in the market and a lot of maybe smaller hospitals take a rural state, like alabama or mississippi, in that case the insurer can dictate price to the hospital. medicare kind of gets caught in the middle of this kind of battle between insurers and hospitals over how -- who's going to pay for what and how
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much they're going to pay, i think. host: how big is the lobbying activity on behalf of hospitals and nursing homes during this health care debate? guest: well, there are two very large hospital associations in town. they are both heavily involved in this debate. they've already kind of struck a deal with members of the senate finance committee and the white house to contribute some savings to the costs of the overhaul. and so right now -- excuse me -- hospitals are supporting the overhaul or at least they aren't making much noise about opposing it so far. host: well, tom scully, you're former head of the federation of american hospitals. guest: i was the president of one of them for six years in the 1990's. host: what's the strategy for the hospital associations to support, as alex wayne said, the current health care debate? guest: money moving around for hospitals. than anybody else.
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and they probably have more political support than anybody else because every town has a hospital in it and people are fond of their hospital. the real issue is you have 47 million uninsured people. so the average hospital has anywhere 8% to 12% that walk in the door have no insurance coverage. and as you mentioned, medicaid frequently underpays their costs. i won't debate about that. medicaid almost never costs in any state. they have to cost shift. you have 8% to 12% of your patients that are uninsured, you're cost shifting the other patients. you're getting a lot of losses. if there is a coverage that covers everybody, that's a great win for them. everybody comes in with an insurance card. that's the right thing to do. you can average hospitals are excited about their bad debt being from 10% to 12% to 2% because nobody is talking about covering illegal aliens. there will always be some portion of people that aren't
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covered. if you are he a hospital that's a big wind fall for you. there is about $50 billion a year that is out there to pay for hospitals to help them -- help the costs. they get significant payments for medicare and medicaid to pay for this uninsured population, sort of a back door subsidy. if you have people that walks in for a blue cross card or an aetna card, should you give back some of those subsidies? and the hospital is saying, let's gets everybody covered. and as the existing subsidies go away, that's their concern. you can imagine hospitals are like universal coverage. they don't get to cover this enormous group of people that doesn't have insurance coverage. and they don't want to give up the existing subsidies before people shows up with insurance cards. it's a cost shift issue for the
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hospital. host: do hospitals have to treat anyone? guest: they have to treat anyone by law. in the emergency room, at least. there are certain places where you can transfer places out. by law it's the emergency room -- i won't get into the details -- you have to take the patient and treat them and stabilize them at least. it's a significant cost to hospitals, normally in urban areas. most people don't understand that. hospitals have a good argument. on the other hand, hospitals would love, just to give you the other side, they would love to have 47 million people all covered and not giving up their existing subsidies. how quickly do you get back the existing subsidies while if you get the universal coverage which i think certainly financially it would take a decade for a phase in this. host: lerla is a health care professional. what do you do?
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caller: i practice primary care. host: you're a doctor? caller: yes. host: go ahead. caller: i am calling because i am a supporter for medicare for all. however, there is some inherent and unfairness in medicare, as you've just spoken about, the cost shifting. especially as far as physicians are concerned. we've had a very small increase in our reimbursement over the 29 years that i've been practicing. and we get no supplement if we are in urban areas where we're more likely to see more medicare patients and more medicaid patients. i think that our health care system needs a complete overhaul. the insurance companies have also discounted their services in line with medicare. and so the cost shifting has become their bottom line profit because of that adjustment and their payments to physicians.
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so i'd like for mr. scully to talk about the unfairness that medicare has caused because it does not pay the provider adequately as a private -- as the private insurers follow suit. and there is no clear redress for physicians because of this. host: now, is she talking about part b more than part a? guest: all physician payments, even if you are in the hospital, they get paid by part b. when we talk about part a and you get a hip replacement, the hospital gets paid. the physician that comes in that gets the surgery, they're paid by part b. whole different schedule. the physician is paid separately on a whole different fee schedule out of part b. host: and, doctor, i promise you we will talk about cost shifting, that issue tomorrow
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on this program at about the same time we are going to be talking about part b which is kind of a medical insurance, i guess. is that a fairway of describing part b? guest: yeah. part b is basically physician payments other professional services, other cairo practers, at the die terrorists. if you go and have surgery at an outpatient hospital, that's part b. guest: if there is a heart surgery being done anywhere in the country, is it the same amount of money that's paid by medicare to that hospital for the services? guest: adjusted for geography. if you happen to be a hospital in new york with a high level of uninsured, you may get a supplemental payments . the payment is adjusted for geographic differences, and then there are some supplemental payments . essentially the price is the same. host: carolyn in kileen, texas,
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go ahead. caller: i'm retired and about 63, i'll be 65 in maybe a little over a year and right now i pay blue cross blue shield with $155 premium and then i pay $3,400 above and beyond that for whatever i need for the year. when i turn 65, what supplemental insurance will i need besides part b so i don't have to pay so much out of pocket? guest: well, that's a complex question. if you go to the traditional medicare program which 80% of americans are, you are going to pay $98 a month and you'll get part a and part b. in addition to that, you can choose part d, which is the medicare drug benefit. and the premium there can go anywhere from $15 to $60 for supplemental drug benefits. you're still going to have
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significant gaps in coverage and you're probably going to want to buy private medicare gap insurance. you can go to the website. aarp has probably the largest. it's so you don't have large co-payments, probably from $150 to $300. you are going to have a significant savings over what you're paying now because the reality is you are going to have essentially $9,000 to $10,000 subsidized medicare benefit. so your costs will go down significantly. another option is look for medicare advantage point which is a private insurance plan. none of these medicare rules apply. the government says here is $11,000, blue cross of texas or humana, call us next year and frequently what you'll find, and we'll get on this on friday, probably your costs will be lowest in that program for a variety of reasons.
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we can explain on friday. you need to look at that if you're relatively lower and worried about your cost. you will have to go into a network of providers. very likely you'll get more benefits at a lower cost but your choice of physicians and hospitals and other providers will be limited. you're basically in an h.m.o. host: alex wayne, once again, medicare part a, the hospital insurance part, what's its role in the health care debate on capitol hill right now? guest: right now democrats are look of revenue, essentially, for paying for the health overhaul effort. they'd like to reduce the growth rate, the rate in spending, i'd say about $120 billion over the next 10 years. they're trying to avoid those cuts resulting in cuts in benefits. and right now they seem to be toeing that line pretty successfully.
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aarp so far has not voiced any opposition to the medicare changes proposed, at least in the house version of legislation. host: with all the town meetings going on in august on health care, what are members of congress hearing? guest: well -- host: regarding part a and the medicare issue? guest: sure, i went to one last night and ploo of the opponents were -- looked to me were seniors. so seniors are worried about what congress is doing because opponents of overhaul are portraying the medicare changes as cuts in benefits. and so democrats kind of face the challenge and fighting back against that messaging and trying to reassure seniors that the changes they're making to medicare, it's a huge program with lots of money that the democratic argument is that they can make this program more efficient without really affecting services and benefits.
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host: how much waste, fraud and abuse is there in medicare that could be cut? guest: there's a lot. when you have a -- and there's a lot more waste, fraud and abuse in south florida than there is in north dakota. it depends on where you are. look, it's a big program. there are a lot of providers out there. there's always a couple billion dollars a year in a $484 billion program that you could save from waste, fraud and abuse. you should always limit waste, fraud and abuse and hammer providers that are scamming the taxpayers and the trust funds but you can't fix the health care system by going to waste, fraud and abuse. in health care debate, which i am a big fan of, you know, a moderated form of, is all about fixing the commercial insurance system for people under 65. medicare is to slow the growth of medicare and finance it. you can get into the debate of hospitals, honestly have proportionately and
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historically, relatively small cuts they are talking about. hospitals have great political support in congress. congressman rangel in the house is the major players. very close to the hospitals. senator bacus, very close to the hospitals in montana. cuts in nursing homes and health agencies. on a proportionately basis. i don't want you to get into debate here, for the point of seniors, benefits are not changing. paying nursing home less for their posthospital stay, ising that go to affect your care? they're trying to slow the growth rate saying, if we are going to cover 47 million people the money has got to come from some place. ising that going to affect benefits -- is that going to affect benefits? it could. host: what's a d.r.g.
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guest: diagnosis related group. host: what is it and how is it part of medicare part a? comboip there was reform in the early 1980's. if you were a hospital you sent in your costs for everything, the nurses, the laundry list, medicare paid your cost. it led to rampant inflation. congress said we're going to figure out what the cost of a heart bypass operation is, everything, and we are going to tell the hospital in philadelphia that your total costs are $50,000 on average. call us later. so the average hospital stay is 10 days, you make it work. it's one payment per diagnosis. when you go in the hospital, you get the code, that's all the hospital gets. if you stay in the hospital and have problems, they get supplementals. if you go for the heart bypass and the length of stay is seven days and average cost is
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$50,000, you get out in four days, they get $50,000 which is one of the reason why they want people out quicker. if you are longer you'll get more. the hospital gets on average -- and it encourages better behavior. hospitals get paid one bulk amount and it draws better behavior. it's clearly worked much better and the hospitals were finally opposed to it at first and now likes it. host: 65 and older, go ahead. we are going to put you on hold, kathryn. you know the rules, you have to turn down your volume on your tv. joe, 65 and older, please go ahead. joe. caller: yes. hello. i just got out of the hospital last night with a major, almost died in the hospital, and i asked the administration office here what three or four months ago and was deemed totally disabled.
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now they say i owe 20% of a $240,000 bill. how can that possibly be? host: this is on medicare, right? caller: yes. i was deemed totally disabled. i had medicaid and said i could not have both. host: 20%? guest: your hospital deductible, assuming you were in the hospital more than the maximum number of days, 60 days, your deductible for the hospital is by definition $1,068. if you had serious surgery or major complications, medicare part d, which is physician services, does have a 20% co-payment. as i mentioned, 89% of seniors don't generally see it because they have a supplemental service. they have a 20% co-payment. if you had a significant illness with many doctors visiting you, could you have a
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20% co-payment in theory? yes. if you are on medical, which is medicaid in california, and you're qualified for that, sounds like another complicated issue in that case, that should cover the bulk of it. but your hospital, the hospital cannot charge you more than $1,068. physicians and other related part b services, have a 20% co-payment. and many of the costs coming out of the hospital are physician-related. host: our last call for tom scully and alex wayne comes from under 65. caller: i have a question about death bed care. i've had two parents here in m.d. anderson hospital in houston and they had cancer and when they were terminally ill in a hopeless death bed situation their care was very aggressive. and the costs were just
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enormous. and i don't -- i didn't understand how the government would allow hospitals to extend the death experience and rack up big charges and pay those charges and it was very inhumane. i've talked to the many people whose parents at the time of their demise have been aggressively treated. and i think there's some advantage taking here of the government payments . guest: well, this is a raging debate in the health reform debate that gets out of blown out of proportion which is the end of life -- you know, a lot of costs are -- many people have family members who are sick. obviously senator kennedy family's -- kennedy's family succumbed to cancer. on the other hand, i think a lot of people believe about the
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hospice benefits. if a doctor diagnosis you within six months of care, can you go to another care which you can essentially acknowledge that you are terminally ill and have much more aggressive and comprehensive home health services and other support services to take care of you. many people choose that. there will be more education about that. some people when you are terminally ill and think hospice care is the way to go. there is a lot of bombs throwing back and forth within the last month, people want to ration care and take away your end of life choice. i think the less screaming and yelling and the rational discussion of these issues, when should somebody get the last $50,000 treatment in the last week of life, that's a choice you have to make. these are all -- these are some of the biggest costs to the medicare program. certainly i think a rational policy debate about it rather than a political debate is
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meaty. guest: i think they would default to providing as aggressive a treatment as possible unless the patient has what's known as an advanced directive in place dictating what kind of care they want in their last days. and lawmakers are paying attention to this issue. there is -- right now there's a provision in the house version of the legislation that would pay doctors and medicare for counseling their patients on making -- writing advanced directives or living also. that provision -- living wills. that's come under a lot of criticism. i think it's been -- inaccurately described by some of the opponents. this is where the term death panels comes from and that sort of talk. the provision wouldn't require anyone to write an advanced directive and it doesn't -- it is not based on whether somebody decides they want less
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aggressive treatment at the end of their life or not. it's simply -- it's simply designed to encourage people to have these conversations with their doctor so they don't wind up in the situation that the caller just described. host: alex wayne of cqpolitics.com, tom scully, former head of the centers of the medicare and medicaid and former president of the american hospitals. what do you do today? >> i spend half my time in new york wan investment -- with an investmeñ8 host: 84 helping us understand medicare part a. >> the series continues tomorrow as we talk to the former head of the health care financing -- financing administration about medicare part b. on friday, the series concludes
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with a look at medicare part c, the supplemental insurance program. "washington journal" is like each morning at 7:00 a.m. eastern time. >> of snacks, president obama, vice-president biden, and senate majority leader harry reid comment on the death of senator ted kennedy. after that, we will show you senator kennedy paused speeches at the 1980 and 2008 democratic national convention. and later, gerry connolly holds a town hall meeting endin virgi. on c-span tomorrow morning, the federal communications commission will hold a meeting on the wireless communications industry. that will look specifically at in -- issues of competition and
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increasing broadband access. we will bring it to you live, starting at 10:00 a.m. eastern. and later, from the heritage foundation, a look at the recent presidential election in afghanistan and what it means about the fight against the taliban and u.s. efforts to increase security there. live coverage begins at noon hear on c-span. >> go inside the supreme court to see the public places and was rarely seen spaces. hear directly from the justices as they provide their insight about the court and the building. "the supreme court -- home to america as high as corke." the first sunday in october on c-span. >> senator ted kennedy died on tuesday morning after succumbing to bring cancer. it was first elected to the senate in 1962 to succeed his brother, john f. kennedy. he won election to a total of nine times, serving 47 years in the senate.
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senator kennedy served on several major committees, including health, education, labor, and pensions, and the judiciary committee. senator kennedy unsuccessfully this challenge president carter for the democratic presidential nomination. under massachusetts law, a special election will be held within 150 days to fill his seat. president obama spoke about ted kennedy this morning from what this opinion -- from martha's vineyard where he is vacationing this week. i wanted to say a few words this morning about the passing of an extraordinary leader, senator kennedy. i have had the honor to call teddy a colleague, a counselor, and a friend. even though we have known this day was coming for some time
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now, we awaited it with no map -- with a sense of dread. we have seen the courage with which he has battled his illness. while these months have no doubt been difficult for him, they have let him hear from people in every corner of our nation in this world how much they meant to a look -- how much he meant to all of us. the blessing of time to say thank you and goodbye. the outpouring of love, gratitude, and on members to which we have all borne witness is a way that this singular figure in american history touch so many lies. his ideals are stamped on scores of laws and reflected in millions of lives. the seniors who note true dignity, the families that no new opportunity, and children who no education and -- to
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who know education's promise. the kennedy name is synonymous with the democratic party. at times ted was the target of partisan campaign attacks, but in the united states senate i can think of no one knew engendered greater respect or affection from members of both sides of the aisle. the seriousness of purpose was perpetually matched by humility, warmth, and good cheer. he could pass an ugly battle others and do so perilously on the senate floor for the causes that he held dear, and still maintain warm friendships across party lines. that is why i became not only one of the greatest senators of our time is but one of the most accomplished americans ever to serve our democracy. his extraordinary life on this earth has come to an end. the extraordinary good that he
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did lives on. for his family he was the party in for america he was a defender of a dream. i spoke earlier to his beloved wife, vicki, who was to the in such a wonderful source of encouragement and strength. our thoughts and prayers are with her, his children, and his stepchildren, the entire kennedy family, decades' worth of his staff, the people of massachusetts, and all americans who like us loved ted kennedy. >> vice-president joe biden also talked about senator kennedy today. he was at an energy department event on the president's stimulus plan. this is about 10 minutes.
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>> thank you for the privilege of being with you today which was to be a joyous occasion, announcing another step in the direction of energy independence. he said the president made a wise choice. the wisest choice the president made was asking you to be the secretary of the department of energy. you have assembled a first-rate staff and you have taken on a roll that is going to be -- in large part, it will determine the success of the next 3.5 years, whether or not we make a genuine intent in moving toward an energy policy that can help america lead the world in the 21st century as it did in the 20th-century. some suggest that we are trying
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to do too much, but my response is if there is any possibility of the american -- of americans leading the world without a energy policy? it is not possible. you're a nobel laureate who is as articulate as he has obviously bright, and a man who was assembled staff that can corral the bureaucracy. and we are all part of it, in a way that i have not seen in a while. and i had planned on speaking to the clean city's program as one of the several initiatives that we have to reshape our energy policy. but as if teddy were here, a point of personal privilege, i
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quite frankly think it is -- it would be inappropriate for me to dwell too much on the initiative that we are announcing today. and not speak to my friend. my wife jill and my son's beau and hunter and ashley, they all knew teddy. he did something personal and special for each one of them in their lives, truly, they are distressed by his passing. our hearts go out to teddy, jr., and patrick and kara and vicki with whom i spoke this morning, and the whole kennedy family. you know, teddy spent a lifetime working for a fair and
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more just america. for 36 years, i had the privilege of going to work every day and literally not figuratively sitting next to him and being a witness to history every single day the senate was in session. i sat with him on the senate floor and the same route, i sat with him in the judiciary committee, and i sat with him in the caucuses. it was in that process -- every day that i was with him, this is going to sound strange, but he restored my sense of idealism and my faith in the possibilities of what this country could do. he and i were talking after his diagnosis, and i said, you know, you are the only other person i have met who, like me, he is more optimistic and
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enthusiastic and idealistic, sees greater possibilities, after 36 years when reelected. you think that would be the peak of idealism. but i genuinely feel more optimistic about the prospect for my country today than i had at any time in my life. and it is infectious when you were with him. you could see it, those of you who knew him and those who do not, you could just see it in the nature of his debate and the nature of his embrace, and the nature of how he every single day attack these problems. and he was never defeatist, he never was petty. he was never small. and in the process of his doing
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, he made everyone he worked with bigger, but his adversaries as well as his allies. don't you find it remarkable that one of the most partisan, liberal man in the last century, serving in the senate, and so monday it -- and so many of his fellows embrace them -- foes embrace him because they made him -- he made them bigger, he made them more graceful and the way that he conducted himself. he changed the circumstances of tens of millions of americans in a literal sense, literally. literally. change the circumstances. he changed also another aspect
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of what i observed about him. he changed not only the physical circumstances, he changed how they looked at themselves. and how they looked at one another. that's remarkable, a remarkable contribution for any man or woman to make, and for the hundreds if not thousands of us who got to know him personally, he actually -- how can i say? he altered our lives as well. through the grace of god and an accident of history, i was privileged to be one of those people. and every important event in my adult life, as i looked back on my life, every single one he was there.
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he was there to encourage, to counsel, to be in but that it -- to be empathetic, to lift up -- he showed up in an armory and i won by 3100 votes and got 85% of the vote in the industry. i literally would not be standing here were it not for teddy kennedy. not figuratively. this is not hyperbole, literally. he stood there and stood with me when my wife and daughter were killed in an accident. he was on the fun with me literally every day, in the hospital where my two children were -- and thankfully, god,
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thankfully, they survived serious injuries. i was lit -- he was literally sitting in a room with me. you know, it is not just made that he affected like that -- it is not just me that he affected like that. it is hundreds and hundreds of people. i was speaking to begin this morning and she said he was ready to go, joe. but we were not ready to let him go. he has left a great void in our public life and a hole in the hearts of millions of americans and hundreds of us who are affected by his personal touch throughout our lives.
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people like me who came to rely on him. he was kind of like an anchor. and unlike many important people in my 30 years ththat i had the privilege of knowing, the unique thing about teddy was that it was never about him. it was always about you. it was never about him. they're people that i admire, and great men and women, but at the end of the day it is down to being about them. for teddy, it was never about him. well, today, we lost a truly remarkable man appeared to paraphrase shakespeare, i don't think we shall never see his like again. but i think the legacy left is not just in a landmark
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legislation that he passed, but in how he helped people look at themselves and look at one another. i apologize for us not being able to come -- going to more detail about the energy bill but for me if least it was inappropriate today. much more will be said about my friend and your friend, but he changed the political landscape for almost half a century. we will remember what he did. i just hope we remember how he treated other people and how he made at the people look at themselves. that will be the truly
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fundamentally unifying legacy of teddy kennedy's life. if that happens, and it will for allies to -- and it will for a while. mr. secretary, un your staff are doing an incredible job. i look forward to coming back at happier moment when your announcing even more consequential progress toward putting us back in a position where we once a went -- once again control our own economic destiny. thank you all very, very much. [applause] [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2009] >> senate majority were leader harry reid also commented on the
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death of senator ted kennedy. this took place at the university of nevada and las vegas on wednesday. this video as a courtesy of ktuv in las vegas. >> i spoke to the kennedy this morning -- vicki kennedy this morning. as we all know, ted kennedy died this morning. the kennedy family has lost the patriarch. my thoughts and prayers go to the entire in ads -- as well as those of the entire united states and it goes to his family. it is one of my highlights of the live to of work with ted kennedy. he was such a friend. a model public service and and -- and an american icon.
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at so many difficult times in kennedy family history, they turn to their uncle ted for comfort. so many times that america has turned to ted kennedy for the same comfort. i think we all remember watching the first lady at arlington national cemetery. i will never forget how his deep love for his brother, bobby, health and somehow summoned the strength to deliver that eulogy. how has -- how was patriarch -- how as patriarch, he agreed with us -- he aggreived with us of a loss of john-john. we must now remembered the man
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who helped us remember some money and help so many live better lives. i have been a devotee of the kennedys for a long time. as a student at utah state university, i formed the first young democrats club. i got a letter from president- elect kennedy, between the time that he had been elected and before he was inaugurated. he sent me this letter. i have saved it all these years, and when you come into my capitol office, up to the right is that letter. it was very often that ted would come and look at that letter. he was proud of his brother and proud that i have that letter there. i immensely appreciate to working with such a strong
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champion of what america stands for, caring for others, quality -- equality, and progress. senator kennedy's legacy stands with the greatest, most of voted, the most patriotic to ever serve in congress. because of ted kennedy, more young children can afford to be healthy. more young adults could afford to become students. more of our older citizens and poor citizens could get the care that they need to live longer, fuller lives. more minorities, women, and immigrants could realize the rights our founding fathers promised us. as a man of wealth, he fought for those less privileged. because of ted kennedy, more americans are proud of our country. ted kennedy's america is one in which we can all pursue justice, and enjoy equality, and no freedom.
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ted kennedy's life was driven by his love of a family that loved him and his belief in a country that believed in him. ted kennedy's dream was one in which the founding fathers fought and for which his three brothers died. the liberal lion's my hero are, we shall remember, but his dreams will never die. [inaudible] >> a lot people -- of black people think that he might have been a bully. just the opposite. he was a man that believes in compromise. legislation is the art of compromise. ted kennedy is the pinnacle of
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what a legislator should do. he was a really strong liberal and progressive, but all this legislation as the mark of the liberal lawn and but he was willing to make deals for the good of the american people. [inaudible] ted love to come in nevada. there are a lot of stories about his brother coming here during its heyday. his brother ted -- one of my route accomplishments -- proud accomplishment is helping to save the lake. john kennedy was fighting for that with his brother its many decades before i got involved in an. and before i got involved in an. he was a popular man. in my early years, running for office, people said, he is a kennedy liberal.
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that was a wet etch i put it down. teddy would be the last italian that i was -- would be the last to tell you that i voted with him on everything. but he always drew big crowds and everyone came to his fund- raising. i thought of this this morning. no one stepped out of their shoes to help me more than ted kennedy on nuclear waste. yucca mountain is dead, but one of the reasons is that people follow ted kennedy's lead. their nuclear power plants all the way through massachusetts. he believed it was good for the country and he helped me a lot. he never batted l.i. -- and never batted an eye. any other questions? thank you very much.
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>> i mother could -- and motorcade will transport him from hyannis port on thursday to boston. then on saturday, his funeral mass will be held at our lady o perpetual help basilica in boston before his burial in arlington national cemetery, where he will be laid to rest next to his brothers, john and robert kennedy. now, some highlights from the political career of ted kennedy. two of his speeches and democratic national conventions. first, his 1980 convention speech. that year, senator kennedy unsuccessfully challenged president carter for the
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country. i thank you for your eloquent introduction. well, things worked out a little different from the way that i thought, but let me tell you, i still love new york. [applause] my fellow democrats, and my fellow americans, i have come here tonight not to argue as a candidate, but to affirm a cause. i am asking you -- i am asking you to renew the commitment of the democratic party to economic justice. [applause]
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i am asking you to renew our commitment to to a fair and lasting prosperity back and put america back to work -- that can put america back to work. this is the cause that brought me into the campaign, and has sustained me for nine months across a 180,000 miles in 40 different states, we had our losses, but the pain of our defeat is far, far less than the pain and the people that i have met. we have learned that it is important to take issues seriously, but never to take ourselves too seriously.
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this serious issue before us tonight is the cause for which the democratic party has stood in its finest hours, the cause the kids our party on and may sit in the second century of its age the largest political party in this republic and the longest lasting political party on this planet. our cause has been since the days of thomas jefferson the cause of the common man and the common woman. our commitment has been since the days of andrew jackson to
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all those humble members of society, on its foundation we have defined our values, refine our policies, and refreshed our faith. now i take this step of taking my campaign to our national convention and i speak out of the debt -- get the sense of urgency about the anguish and anxiety i've seen across america. i speak out of a deep belief in the ideals of the democratic party and in the potential of that party and that the president to make a difference. and i speak out of that the trust to proceed with boldness and a common vision that will heal the suffering of our times
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and the divisions of our party. the economic planks of this platform may only concern punt -- material things, but it is also a moral issue that i raised tonight. it has taken many forms over many years in this campaign in this country that we seek to lead. the challenge in 1980 is to get our boys and our road -- our voice and our vote for these fundamental democratic principles. let us pledge that will never miss use unemployment -- that we will never misused on employment and human miseries as weapons against inflation.
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