to create a different level of relationship with the provider community. for example, why negotiate when you can share intellectual property around managing risk? and doing capitation, or the big global payment, how we work together with data, intellectual property around risk- management, and worse case management, and health information exchanges and technology to be of a provide the data to re-defining the notion of what to have where you get to keep your hospital and your physician instead of keeping your health insurance plan -- it would

redefine the health insurance model where we would no longer be negotiating with providers by partnering with that, much like intel inside and we would not be selling members. we would be converting patients to their local health system and their physicians. this is where the affordable care act does not go far enough, the problem is that we have increased access to help the jurors but we have not increased access to health care. managing chronic care is a very important aspect and were most of the costs are. we are short 160,000 primary- care physicians over the next decade with very little hope of catching up. how we design our system to patients to provide the care necessary to individuals who will need access to health care once we turn on the spigot and put 30 million more people

into the health-care system. if we do not address the issue of capacity, there will be people who will pay handsomely to get to the front of the line to get access to the best health care. they will get it. we need to do a lot of the way in capacity. the second piece are around the affordable care act is to have payment reform. this is so we can put the proper incentives in place where we can have indeed a win-win situation and we are experimenting with this across the nation. my last point -- 80% of the people use the health care system today use a commodity- like service. you saw the prices noted. another example -- in the city of san francisco, a routine colonoscopy cost anywhere from 1000 to under $50-$7,350.

i am not sure what to get for a $7,300 colonoscopy [laughter] may be a movie. it should not be that way. what we need is complete transparency in the system. bank of open table for restaurants, think of open table for physicians for lab tests, x- rays, vaccines, shots. allowing people to read the fine quality as convenience for the routine services that they get. that will do more to read the fine between aco's and a consumer marketplace and redefine the shape of our system and the cost structure and pricing in our system than anything the affordable care act contemplates today. i will turn it over to our next speaker. [applause]

>> let me remind the audience that you a rare opportunity to ask questions of the panelists. you can go to world health.com and submit your questions. >> good morning. the previous speaker poked -- spoke to the importance of prevention and transparency and the need for the transparency yielding improvements in health care as well as a system where the incentives are aligned to produce that effect. i want to think the world health congress for bringing us together on quality and the cost curve. i want to speak directly to the issue of the relationship between quality and costs. this is the case of the billion dollar babies. if ever we used the best

evidence that exists today, how $1 billion could be saved and not to be callous about that savings, it would save the unnecessary grief and stress the potential harm to babies and their families. quality is the best business case. let me talk about what can occur in creating a learning health system and how that learning can drive down the cost that was alluded to in both the previous discussions. if you look at the top graph, that is a normal distribution of term. where the evidence for term come from? it comes from an authoritative source. it may not be complete scientific. it was defined for western societies in the bible. that is terrific but in the days

of ultrasound, the marker of nine months for a nine motorcycles may not be the best definition. -- nine lunar cycles may not be the best definition. normal distribution is moving to the left from an average of 39- 40 weeks back to 38 weeks and back to 37 weeks. a normal distribution, anything but normal. if you look at the risk for bed outcomes, one sees that natal mortality decreases as one goes to term. would elected preterm delivery it postponed -- it postponed result in better outcomes for

babies and their families? the march of dimes and the american ecology of obstetric and gynecology came to us and said we deliver to enter 20,000 babies. over three months, we looked at a number of hospitals representing a population and looked at nearly 80,000 deliveries. we found elected early preterm delivery was in fact not the safest. it was not the most efficient. the babies have elected early preterm, either induction or induction rebel -- resulting in c-section. at 37 weeks, there was a 40% greater risk to going to the intensive care unit.

this suggests that we need to revise the definition of term. looking at the data, one found that the risk for hospitalization and the special care unit correlated with the early delivery because of the majority of llungs. are there potential long-term consequences? a nicu is more expensive than a regular postpartum sort of service delivery. if one created the evidence, we looked at three ways of changing clinical behavior.

you see the softer intervention where education was provided. in the blue section, you can see that there is a semi-hard stop which provides the obstetrician with information about the findings that early preterm delivery delivers at a high rest. risk. they were allowed to make the decision to go too early elected delivery. the hard stop was simply a policy. over the last year, all of them converged against national backdrop of somewhere between 80-85% compliance, we have moved up to 96% compliance with early preterm delivery. when one thinks about these

questions, what is intuitive may not always the correct. how can we go so long without this information? no doctor in his or her experience has enough caseload to detect what will take a fairly large sample to find the differences. in my experience, it is simply not adequate. there is a joke that if a doctor says that is something is in his experience, they have seen two of something. that is not evidence. evidence is looking at a powered sample to see what the differences are in the outcome. we need to use that learning to drive improvement. both the previous speakers i

agree with completely. the current environment provides the transparency. the incentives don't line up. if we as a provider do the absolute evidence-based right thing clinically and morally, it is actually financially penalized. we push that as far as it can go. we have to be able to call these questions through transparency and bring data together which is challenging and systematically redefined on the basis of evidence the standard of excellence. we require fetal monitoring.

we have had the data to re- define postpartum. instead of the incentives that support the linkage of the evidence with the best practice, the alternative is damage in terms of the quality of care that could be provided or ways that would not be the best. good quality should always be good business. it is easier to move when the incentives of line and an environment of transparency. if all providers were on board with this, u.s. healthcare can billionse.1

thank you very much. [applause] >> the title of our panel today is sending the cost curve. i like to have each of you address as the seventh question and we will get to some members. are we talking about ending the trend are going to a new cost curve? how much below the current curve does that need to be if it is a new one? if we're talking about the trend, what is that trend likely to be? you hear that we have to get the cpi and others say we have to get to where other countries are. we have not settled on what we are talking about here. >> i would start with a real

example of what has been going on in the industry for the past five years. when the bush administration put forward a change to medicare advantage, one question we were asked was how can we get you to take sick patients? they put in a risk adjustor based on the underlying prognosis of the medicare enrollee. we start with the program after the first year realized that getting 75-year olds with two chronic cases, we could dramatically reduce the cost of care. the industry started competing for 75-year olds with two chronic case by offering them more benefits. today, they can get a plan for 50-$80 that they bought all the would be $200

per month we paid physicians 125% of fee-for-service. we put embedded case management nurses it to their office and reduced acute admissions by 31% and sub-acute cases by 34%. that had a dramatic impact underlying health care costs. i think we can do more than bend the trend. we need to work together across the whole system. that is the biggest issue we have. how do we scheldt to a level where we could have the kind of impact -- how we scale to beckon a level where we can have that kind of impact? >> there is an important to

prevention. we really need to have coverage. it is not enough to have insurance today. one need continuity so one can support prevention over the longer haul. while we talk about one in six americans being uninsured, the sorts of preventive services and disease management that would need to occur would need to be given across the continuing. wynn: cancer was detected in 1996 veterans, -- when colon cancer was detected in 1996 veterans,

it was less an expensive and more efficient to treat veterans with polyps that had not advanced further. >> i think it is possible to get the cost of the rate of increase of care down to be cpi over a number of years if we do a good job identifying the patients who really need team care and deliver that care to those people and then don't allow the marketplace to price of care for the remaining population. if we have half as many heart transplants because we have delivered better care to heart patients but that charge twice as much for each transplant, we lose ground. we have to have half as many heart transplants because we have great care of fraud. then we need to pay the same

amount of transplants and the combination of bthat could get this down to the cpi. we could have a pair environment that challenges patients to best care and need a provider environment that is providing this care. it the business model of care is rewarded for doing best care in a team-based way it will happen. the only people who can create the business model are the buyers. it is the payers and buyers because that is where the money comes from. providers restructure the business model, care delivery will follow in a microsecond. care delivery is very nimble in responding to changes in revenue streams and cash flows. there is a lot of creativity there. it will not be channeled until the business model changes in a couple of basic ways. once that happens, there will be

a big change. there is all kind of opportunity. we can bring down the rate. i think we can get down to a cpi-sort of number. we have to stop the cost shifting. if we let fee inflation eat up all gains, they will be gone. we have one less hospital care and respect twice as much and hospitalization than anyone in the world because we have offset inefficiencies by doubling and tripling prices. >> we have a question from the audience. all of you have talked about, even in the face of reform,

using market-making mechanisms to help with this issue. with a question from the audience. some of the earlier speakers said that aco's don't exist. >> we are an aco. the first generation of aco articles were done about us. we are prepaid at which a total population. we function as an aco. the aco model but the rest of the world is trying to get to is various versions of us. the people who wrote all lot sitting in oslo rooms writing the aco law said they were trying to get the country so it would function like the kaiser health plan. the goal was to create a cash flow that is about prepayment to

the patient. the rest of the world is trying to figure out how to take advantage of that. that will do some creative and positive things to help create the business model of what to an aco is and that will be a positive thing. right now, the other version of aco is just being formed. >> are there good relationships you're looking at? it a strategic kind of relationship? >> the world would be a wonderful place of ever but it was organized like kaiser permanente. the structure works well, is just it has been difficult to get that model to scale anywhere else. our approach has been how do we

find the skeletal model? how do we think about retrofiting the current system to impact what we have in the united states and get toward the model that georgia as a northern california. that is a big task. in countries like china and india, with a much jet -- better chance of building the model because you start fresh. in the united states, we need to retrofit infrastructure and capacity and a host of other things. we have a number of pilots going on. we are literally involved in moving to the infrastructure of create a sustainable systems of data and intellectual property iran managing risk. which one of those will work? we're trying to pick our partners well early on so we get

people who can be successful that get it so when we're working with them, we can show it reducible model a -- producible model. >> from the hda perspective, in particular, the physicians, how are you working with your positions? this is a huge shift for practice patterns. how are you dealing with that? >> the promise of better clinical outcomes and utilization is key. much of the world is not organized. the great equalizer is information systems that allows one to create the system.

we want to make sure imaging is used appropriately. information becomes the great equalizer to managed care. i think it changes the possibility frontier from being restrictive to what has already been established as hard wired integrated network to a possibility for more traditional forms in the world more broadly. as to the accountable care organizations, i am not sure i have seen one singular model. in the commercial space, there has been a bunch of projects that have worked on the relationship, the ability to get better outcomes. >> there has been a question

from the audience -- among the various players, physicians, hospitals, regulators -- who really controls for bending the cost curve? >> i think the business model needs to change to reward bending the cost curve and the business model change can only happen from the pair. the pair controls the revenue and cash. the pay your knees to identify ways the cash will flow --the payer needs it to identify the ways cash will flow and they need to control it. we need to change the business model to make it work. the first step is the payer- provider. the second combination is hospitals and doctors. we have to start with the money. >> can we do with cms coming

along? >> i thinkcms is essential to make it happen. you have seen it happen many times. they change their reimbursement for nuclear medicine and cardiology practices. we cannot do it without them. the reimbursement changes around admissions create an opportunity to payer industry to move ahead. if we plan more carefully together on how to do it, we would have much greater impact. i don't think we act in concert. we are a fast follower when changes are made. >> care in this country is going to get safer because of what cms is doing in safety.

when you get hospital infections and you get paid twice as much, you get more infections. when cms stopped paying for those, the business model will change. >> how many folks in the audience are from provider organizations? that is a pretty good number. if all of you were advising a local community hospital, 300- bed, well-run hospital what to do about all this, what would you say? george, talk to me. [laughter] >> in 2002, 25% of physician

practices were run by hospitals. the number is now 55%. that will approach 80% over the next five years. the institution is going to become the nexus of where all this happens except for the large multi-groups. that will have a fairly dramatic impact on how you think about it. if you are a small community hospital in a small community, it depends on what your surrounding competitive environment is whether you should be part of a larger system or can create a strong enough model. i go back to my days in michigan that when i went out to leland,

mich., i told the positions you don't need me. you can go to the rotary and have a conversation because it is one community. you should talk to one another about what makes employment and business sustainable in this community and come up with an appropriate reimbursement model. i think that would be a great way to think about smaller communities. if you are close to major metropolitan area, you have to be part of a bigger system. >> the hospital and the community is probably a substantial player but backcountry is responding to the increasing cost of health care. the ability to begin working with other health providers toward wellness, keeping those

individuals and managing the out risks, with the individuals for chronic disease, the need to actively manage them will take the sort of collaboration working with employers payers to create incentives for health and the management and for well as. ness. there is a history in the hospital where the current environment, the update for a medicare is negative. there will be revenue pressure. while many have looked around health care to optimize the supply chain and revenue cycle, what better way to get the real value and driving the quality of care? the product of health delivery

as health care. -- is health care. incentives for safety and quality lower utilization, better outcomes for patients, better health for the population, a better value. >> if i were advising, i would say find partners that you like who do the things that you don't do to be in the aco world. find health plans that give you the infrastructure and to the parts that you do really well which is take care of the patients with chronic conditions in need the care. do it as a partner model. if these small hospitals when it to the insurance world, they

would have to create new departments. they won't do them well and they will do the matter high-cost. they focused on delivering team care to the right patients, partner so that you help the percentage of people who need care. >> i think we have time for one last question. do you see what will have to happen with bending the cost curve as antithetical to a continuing innovation and in clinically that the united states has been for the past four years? >> i think it is the opposite. if we start focusing on rewarding better outcomes, we

will see an explosion of creativity. i don't think it will back off on innovation. i think it will become better. >> i agree with that. this is a great opportunity to invest in one of the best areas of the united states. the pressures will lead to innovation and mechanisms to meeting the challenges of the environment in terms of organization but also in terms of technology. this is so that a patient gets the right diagnosis the first time. there will be molecular fingerprinting. this is so cancer is matched to the care. in the case of blood pressure, it does not work 60% of the time. take the waste out of the system and better out, for patient and better use of resources. >> there will be losers in this.

this system cannot continue to produce some of the things it produces today. for some, it will be painful. for others who have ideas, i think we will have a huge opportunity to invest in the system and we will be focused on the right things. there will be consolidation among the provider community in a number of ways . we have to think differently about the business model. the drug manufacturers, you have seen that happen in the pipeline of oral method -- medications and the focus on biotechnology. the medical device manufacturers are starting to think about how they fit into the system. i think the taller order is where do we have the right dialogue to find out where this works? who are the players to come

together and demonstrate how this can happen and create the momentum? >> thank you for an exciting dialogue, we appreciate it. [applause] [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2011] >> in a few moments, attorney general eric holder briefs reporters on plans to try 9/11 conspirators in military tribunals. "washington journal" is live at 7:00 a.m. eastern. we will talk about the ongoing budget negotiations. several live events to tell you about today on our companion network c-span 3 -- house republicans led by the budget committee chairman paul ryan releases their proposed budget for fiscal year 2012 at 10:30 a.m. eastern. at 12:15 p.m. eastern, immoral service for washington post

reporter david broder died last month at the age of 81. speakers include vice president joe biden and glen eiffel of pbs. >> this weekend, the co op there's of"why obamacare is wrong for america appeaa." also this weekend, live coverage from the annapolis book festival with panels on war, says some scientists, race and more. look for the complete schedule booktv.org or you can sign up for our e-mail alerts. >> attorney general american

holder -- attorney general eric holder says 9/11 conspirators' will be tried by military tribunals. >> in november of 2009, i announced khalid sheikh mohammed and four other individuals would stand trial for their roles in the terrorist attacks on our country on september 11, 2001. as i said then, the decision between federal courts and military commissions was not an easy one to make. i began my review of this case

with an open mind and with just one goal -- to look at the facts, to look at the law, and to choose a venue where we could achieve the swift and sure justice most effectively for the victims of those horrendous attacks and their family members. after consulting with prosecutors from the department justice and defense and after thoroughly studying the case, it became clear to me that the best venue for prosecution was in federal court. let me be clear -- i stand by that decision today. as the indictment unsealed today reveals, we were prepared to bring a fat powerful case against khalid sheikh mohammed and his four conspirators. one of the most well-documented cases i have ever seen in my decades of experience as a prosecutors. we had carefully evaluated the evidence and concluded that we could prove the defendant's guilt while adhering to the

bedrock traditions and values of our loss. we have consulted extensively with the intelligence community and developed detailed plans for handling classified evidence. as the case proceeded in manhattan or in an alternative venue, i seriously was confident that our justice system could have performed with the same distinction that has been its hallmark for over 200 years. unfortunately, since i made that decision, members of congress have intervened. they have imposed restrictions blocking the administration from bringing any guantanamo detainees to trial in the united states regardless of the venue. the president has said that those on was an unwarranted restrictions undermine our counter-terrorism efforts and could harm our national security.

decisions about who, where, and how to prosecute have always been and must remain p responsibility of the executive branch. members of congress simply do that have access to the evidence and other information necessary to make prosecution judgments. yet, they have taken one of the most tested counter-terrorism tools on the table and tied our hands in a way that could have serious ramifications. we will continue to seek to repeal those restrictions. we also must face this simple truth -- those restrictions are unlikely to be repealed in the immediate future. we simply cannot allow the trial to d -- to be delayed any longer for the victims of the 9/11 attack or for their family members who have waited for nearly a decade for justice. i have talked to the family members on many occasions over

the last two years. they differ on where the 9/11 conspirators should be prosecuted but there is one thing they all agree on, we must bring the conspirators to justice. today, i am referring to cases of khalid sheikh mohammed and the others. to the department of defense in military commissions. i have directed prosecutors to move to dismiss the indictment that was handed down in the southern district of york in december, 2009 and a judge has granted that motion. prosecutors from the department of defense and justice have been working together since the beginning of this matter and i have full faith and confidence in the military commission system to appropriately handled this case as it proceeds.

the department justice will continue to offer all the support necessary as this critically important matter moves forward. the administration worked with congress to substantial reform the military commissions in 2009 and i believe they can deliver a fair trial and just verdict. s. for the victims, the justice is long over due and must not be delayed any longer. since i made the decision to prosecute the alleged 9/11 conspirators, the effectiveness of our federal courts and thousands of prosecutors, judges, law enforcement officers, defense attorneys who work in them have been subjected to a number of unfair and often unfounded criticisms. too many people should know better. many of them do no better and have expressed doubts about our time-honored and time test its system of justice. that is not only misguided, it

is simply wrong. federal courts have proven to be an unparalleled instrument for bringing terrorists to justice. our courts have convicted on its of terrorist since 9/11 and our prisons today safely and securely hold hundreds of them, many of them serving long sentences. there is no other tool that has demonstrated the ability to incapacitate terrorists and collect intelligence from them. has ever traditional justice system. let me be very clear -- our national security demands that we continue to prosecute terrorism and we will do so. our heritage, our values, and our legacy to future generations demand that we have full faith and confidence in a court system that has distinguished this nation throughout its history.

i want to thank the prosecutors from the southern district of new york and the eastern district of virginia who has spent countless hours working to bring this case to trial. they are some of the most dedicated and patriotic americans i have ever encountered. our nation is safer because of the work they do every day. they have honored their country through their efforts on the case and i thank them for it. i am proud of each and every one of them. sadly, this case has been marked by needless controversy since the beginning. despite all the arguments, the prosecution of khalid sheikh mohammed and his co-conspirators should never have been about saddling ideological arguments or scoring political points. at the end of our indictment appear the names of 2976 people who were killed in the attacks on the deadly september day

almost 10 years ago. american citizens and foreign nationals alike. it is my sincere hope that we can finally deliver the justice that the victims deserve. >> there was a whole year when the indictment was handed up to the grand jury. why not move faster? in february, you ran into 9/11 families on capitol hill and you told them that going to military

commission was rolling the dice. today you say that you have complete faith in them. >> i made clear in november and today that in terms of this case, the justice department is the best place to bring these cases. we reforms the military commissions. congress started to deal with these restrictions that they put in place. we tried to fight them. we made this decision as quickly as we could taking into account all the factors. we consider bringing this case to another area besides southern new york. >> did this allow for seeking

the death penalty? >> the death penalty t can certainly be sought. whether someone can plead guilty and still receive the death penalty is an open question. >> it military commissions are held in guantanamo, does that mean that they will have to stay open? think it will have an impact on closing guantanamo bay. it is still our intention to close guantanamo bay. >> how long will these trials take? >> i would refer you to the department of defense. they should have a statement later this afternoon. >> you have been pretty clear on how you feel about the congressional actions.

presumably, most of the lawmakers represent constituents who have their own views. that you're thinking know best and there is just no room for the public view on where a trial should be held? >> i don't want to hold myself out as our mission. -- as all missions. -- as omniscient. i do no better than them. i respect their ability to disagree. i think they should respect the fact that this is an executive branch function, a unique executive branch function. i have to deal with the situation as i find it and i have reluctantly made the determination that these cases should be brought in a military commission. >> the groups in new york city

that came to oppose the trial there, should they have a voice at all in the decision? >> we took into account a whole variety of things to make a determination. this was one of the reasons why i consider the possibility of bringing it to the southern district in new york, in upstate new york. it would have lowered the costs to the city dramatically. it was taken off the table by congress. i grew up in new york city. i grew up in queens and went to school in manhattan. it is still a place i consider home. i have full confidence in the ability of the people of new york. to try this case safely and securely in new york. it is still my view that the case could have been tried in manhattan. >> you said the death penalty is an open question.

does that mean there's a real chance they deserve life in prison and as opposed to getting the death penalty? >> i will defer that to the folks at the department of defense to will be responsible for the case. it is an open question but as one that can be result. >> that sounds like 10 more years of litigation back up to the supreme court. this could still be litigated. >> i have confidence in the ability -- of the folks in the military side to bring these cases before the appropriate authorities within a relatively short period of time and resolve them i hope i have hastened to the date by which the families of victims will have some sort of justice. >> this year's studentscam

competition asked students to consider washington, d.c. through their lens. today's third prize winner better help them understand the role of the government. >♪ >> europe finally in congress. -- you are finally in congress. you have your own place to stay. you can do whatever you want. aboutn't have to worry anyone paying for your health insurance. the denizens of opportunity does not include only good things. -- the nuisance of opportunity does not include only good things. if you don't have health

insurance, and a thing can turn into a call for the doctor's office. one out of every five college students is uninsured. our government created the health care reform bill. >> if you don't have insurance or if you're not sure what your next job is going to be or there is a gap between getting a job with insurance, all new plants and some current laws will allow you to stay on your parents' insurance policy until you are 26 years old them up with all the newfound independence, maybe college students should not be depended on their parents. parents can provide help through their health insurance. students in our committee passed a 21 were dropped off their parents' health plan.

they extended the limits to age 26. >> dependence can now be covered on insurance up to age 26. for many students, they can be covered under the parents' insurance. >> the fact that college students can stay on their parents' insurance up to the age of 26, even if they graduate, is a big change. it used to be that as soon as you graduate, you know longer were allowed to be on your parents' health insurance. it takes a little bit of time to get settled in a job after they graduate if they can find one. we no longer have that gap. >> this edition is probably the

most significant for college students. >> i can be on my parents' plan until age 26. i don't have to pay for insurance right now. i'm working -- i am working a job while i am going to graduate school to pay for it. >> not only does it help them when they are students, but after graduation and looking for their first job. >> tens of thousands of uninsured americans and parents whose children who have a pre- existing condition, can purchase the coverage they need. >> starting on september 23, insurance companies can no longer deny coverage to a child because they have a pre-existing medical condition. >> along with the parent's plan amendment comes another support of addition and health care reform bill. this is the restriction of health-care companies turning away or not covered someone with

a pre-existing condition. this amendment is in effect for kids and should be put into place for adults in 2014. the health care reform also impacts college students for individual mandates. >> by 2014, there is a requirement that everybody in the united states has to have health insurance. >> that will be a major change that everyone will be required to have health care insurance. that will have a significant impact on college students. >> the individual mandate makes it required for you to have health insurance. if you do not meet this requirement, you have to pay a penalty either $750 or a 10% of your income, the greater of the two. many have referred to this as unconstitutional and have challenged the legality of it. >> it was an act that most americans themselves did not favor. certain congressional and other

leaders decided they would pass of understanding the opposition. >> many americans have voiced their opinion including a federal judge. >> the role of the individual medley was unconstitutional. >> the individual mandate is something that may benefit college students in the long run. >> young adults in their 20s for affordability reasons, generally young folks are not sick. they don't see the need for health insurance. a lot of college students and older go without coverage. it is quite a gamble. many times that now use health care but when they do, it is because of a serious or catastrophic accident. >> one of the many purposes of the health care reform was to lower costs for those especially in need of financial aid.

this could affect numerous college students. >> in a couple of years, after we set the whole thing up, millions of families and business owners will have more choice and more competition. it will finally be able to purchase affordable care and get a better deal health-care reform comes with some downfalls. >> sometimes you have to pay for other people's health insurance. >> that's what they're trying to deal with in congress right now. we would pay an average of 8% at the desk 10% additional federal income tax to pay for folks that did that have insurance. it would drive the economy down further. >> with over 2300 pages of legislation, most americans are confused about the bell. >> nobody knows what's in the bill.

they even admit that in congress. that is what is giving us a hard time. what will the price tag be? nobody knows family health care reform bill as positive and negative. by early 2011, health care reform will do americans good and bad. it has a few flaws but it is a good idea. >> this will affect us directly in 2015. >> go to studentcam.org to view all the videos. >> several live events to tell you about today and her companion network c-span 3 -- house republicans led by budget

committee chairman paul ryan will release their proposed budget for fiscal year 2012. that is at 10:30 a.m. eastern. at 12:15 p.m. eastern, a memorial service for washington post reporter and columnist david broder who died last month at the age of 81. speakers include vice president joe biden and don graham of "the washington post." in a few moments, a look at this point is headlines and your calls live on "washington journal." the house is in session at 10:00 a.m. eastern for general speeches with legislative business at noon. the agenda includes a bill that would overturn the fcc rules for neutrality. in about 45 minutes, we will in about 45 minutes, we will focus