today we are joined by glen hack hackbar are th the chairman of med pack. he has served for ten years and is appearing before the sub comment this time. we are pleased to have you with us again. you will have five minutes to present your written testimony. if you could hit your mike. >> okay. thank you. >> thank you chairman and ranking members of the sub comment. i appreciate this opportunity to talk about our june 2012 report. the report contains six chapters and covers quite a bit of ground including reforming the design. in particular for duly eligible beneficiaries risk adjustment and management plans and medicare coverage for home in fusion services. i am going to focus my opening comments on two of those chapters. our chapter on benefit design includes the recommendation that the congress should redesign medicare's benefit package with the following elements. first, no change in agregate cost sharing at the point of service. add to the program out of pocket limit as it is sometimes called. third, where ever possible used fixed specific dollar amount