that they would get reimbursed yes then their medicare medicaid payments then the next year are bolstered with these rebates in what's called disproportionate share hospital payments so the hospitals are are incentivized to create these gigantic bills because they get paid even when they don't get paid the insurance companies another counterintuitive thing they they actually want the patients to go to the highest priced hospitals because they make a whole bunch of their money on something called claims repricing ok what repricing so in the instance of the arizona woman she had an eighty three thousand dollar bill in her insurance company paid fifty seven thousand of it so the insurance company wrote in to the rescue and discounted the bill by twenty seven thousand dollars well what they don't want you to know is that they then back charge the employer's group plan a percentage of that twenty seven thousand dollars fall savings and many times it's thirty five percent of the savings and a lot of the money that the insurance companies make comes from claims repricing and if you

end of the decade we spend more on interest in the national debt than we do on defense or medicare or medicaid. 14% of the federal budget goes to all non-defense discretionary spending. social security and medicare and medicaid are mandatory spending programs. talking about the discretionary part of the budget. that gives you an idea of the order of magnitude. the items in the federal budget, on the one side you have revenue. on the other side the big ones are social security, defense, medicare. you want to frame this as a simple choice is among those things. what do you do with revenues? programs for the elderly or defense. those are big choices in your federal budget. >> you laid out the number from the planned obama of budget. what is your rough scenario for a plan that you previously said if you carried it out it goes up by 40%. how does that change those numbers? >> haven't projected the other categories because a lot of programs, social security and medicare and medicaid on autopilot because they are mandatory programs. congress doesn't have to appropriate for these programs each year. t

it's in better shape than medicaid and medicare. it's only $18 trillion in unfunded liability where medicaid and medicare are around $38.5 trillion. at least medicare is and medicaid is almost that bad. so, you know, and with regard to -- with regard to mitt romney, yes, he was inare articulate. there's no way in this world that mitt romney meant his comments to be taken the way that have been taken by the left in this country. all he's saying is look, there are too many people riding in the wagon, not enough people pulling the wagon and we're going to have to get jobs for those who should be outside the wagon pulling the wagon and help them to have the self-esteem that comes from working. that's that what the whole welfare bill of 1996 was all about. and having a work requirement. we're going to help you, we're going to subsidize you, give you job training, but at the end of a certain period of time if you don't have a job, you're off the dole. and that's just -- and literally two-thirds, almost two-thirds of the people have been on

medicaid. with medicare, what paul ryan and presumably ryan want to do is to turn medicaid into vouchers. they do not keep up with expenditures in health care costs. with regard to medicaid, they want to turn it over to the states, reduce federal funding so the states do not have any money. the states have rigid budget constraints, and they cannot run deficits, which means medicaid, the program for middle class, elderly people, and everybody that is goingrmpoor, to shrivel to a small portion of what is today. those programs are going to suffer, and the people who rely on them are going to suffer. under obama's plan the way you save medicaid and medicare is you reduce the amount of payments to providers, hospitals, drug companies, and other providers, and at the same time you help people avoid getting sick with regard to cancer and heart disease and major killers, and you include deficiencies because you do not rely as much on private insurers and who have administrative costs to go into simply the transactions that put money into people's pockets but have nothing to do with medical care.

i think that not only as a fact for medicare but also medicaid and what that means to our seniors and those who are reliance on medicare and impacted by the severe medicaid cuts because of their need for nursing homes. in my speech, i spoke directly about my mother. i know how people have paid for this already and how important this is an to the impact on some many families across this country. this is personal. this is not a matter of statistics. this is not a matter of spreadsheet or data. this is a real people. i can see my neighbors and friends and relatives going through similar situations. this is personal. now, let's look at the reuters report that came out more than three years ago now and subsequently enhanced -- it says, look. when you are at 16% of gross domestic product costs for health care, should we start drawing down from medical devices? or should we begin with beneficiaries? it is personal. democrats will make short -- make sure that we get away with all of those specific problems, including repayments, including everything with regard to inefficiencies that exist, a

medicaid. that's expendable. medicare, a little tougher because the seniors are not going to like that. rity, a little tougher. medicaid is seen as a program for the poor. seen as a program that has a very -- a constituency that doesn't have any power. and -- what people don't realize is about 60% of that is for home care for the elderly taking care of persons with disability. it is our final safety net in this country on healthcare but it is seen as expendable because the constituency is seen as not mattering that much. >> eliot: to seems to me that the republican willingness and paul ryan's almost intensity in his belief you have to repeal president obama's healthcare reform which would add 30 million people to the healthcare rolls then he wants to cut medicaid which would cut 25 million people off the rolls. what more direct contrast can you see? >> there is no logic. and anything in the ryan budget that's been adopted by the republican party as part of their platform and in particular, this area. as you squeeze out medicaid and get rid of it as we know it, you're also talking about c

social security, medicare, medicaid, interest on the debt. things that people are entitled to receive. so she feels that we have made called interest of sovereign debt. sometimes because of court decisions that say that even though we don't have the money, these people who are in the beneficiary class are allowed to get this money. if you take a look at social security and these other entitlements, notice that within about 15 years, they consume all federal revenues. what does that mean? that means transportation. that means scientific research. whether it is health or basic science. energy research. it means education. those things, in fact, we'll all have to be paid for out of new debt. let's go to the next one. >> may i ask one question on this one before you go to that next one. >> okay go back. >> okay, you are saying that that revenue line, the 100% revenue, is that assuming the revenue is going to stay at about historical average? >> yes, sir, about 18%. between 18 and 19%. >> to basically you are showing that social security, medicare

this is showing is that the cost of the three major entitlement programs, social security, medicare and medicaid, will expand over the next couple of decades from about 10% of the economy to around 16% of the economy. now, in and of itself -- and it shows that the health care programs medicare and medicaid are much more of a factor than social security which is just affected by the demographics alone. growing by 6% of gdp might not sound like too much, and maybe this is not in the way it's presented the most dramatic chart one would ever see. but it is, in fact, quite a dramatic growth. if you're talking about gradually adding 6% of gdp to federal spending, consider a couple points. today the entire pentagon budget, the defense budget is around 4.3% of gdp. so we're talking about adding an annual amount to federal spending that's more than the entire defense budget. if people were talking about gradually more than doubling the defense budget, that's what we'd be talking about. keep in mind, this is all happening on autopilot because these are entitlement programs as steve mentioned, so they don'

. >> tommy thompson is taking gamble saying he's going to get rid of medicare and medicaid. >> this is another one of those it secret may videos that are coming back to get the republicans in september. but there was another part of that video just after what you played, ed, in which tommy thompson says we'll b put it on vouchers down the road and by 2020 nobody is going to want to pick medicare rather than the vouchers because medicare is going to be broke. and there what you see is an even deeper cynicism in which tommy thompson is saying, we're going to run medicare in the ground in the meantime so that when it comes to this choice they want to make between taking a voucher for a certain amount of money in medicare, medicare actually won't be a viable option. that's the most damaging part of what he said because he explains the mechanics behind it. and baldwin, who is already ahead in that state, i think, is going to move farther ahead based on these comments. it betrays a real cynicism on behalf of tommy thompson, who is a guy who, at least back in the old days, had some support on

for the rich getting rid of you know capital gains tax you know getting rid of suits security medicare medicaid i mean it's bizarre for our this party has moved to the right and i think they're really hurting themselves because they're basically playing themselves out of the game there is no appeal here you know you talk about the big tent i swear to god that the republicans are playing small tent . no women no gays no blacks small or no labor smaller and smaller tent you can't win that way but i guess we've got to teach it well they're going to try it as long as within that small tent they've got all the billionaires and multimillionaires or at least a large chunk of them do you think there are there there is there in that town you're right yeah do you think the american middle class is going to wake up to the scam that romney and ryan are trying to pull off here before election day think they'll wake up before election day. well i think we're going to see a lot of slick ads come out here they have unlimited money they're going to outspend the progressive people in this country you know eight

of that, about 1.5 was social security, medicare and medicaid. three big government expenditure programs are about 45% of goth expenditures. those are growing. in 2010 medicare and medicaid combined crossed social security and combined spent more than social security. social security's a $700 billion program. it's growing. health care, medicare, medicaid, it's growing. if we don't do something to rein those programs back in and change the incentive structures to get more pro-market growth-oriented policies this be place, we are going to hit a fiscal cliff not at the end of year. we're not going to be able to afford our interest payments. we're lucky our interest rates are so low. we're not the ugliest person at the beauty pageant, if you will. where are you going to put your money? people are putting it here. our interest rates are so low, we can borrow low. that's not going to last forever. we go back up to a long-term average of 6, 8%, we add a trillion dollars in debt service and cost to our interest in over ten years. the interest alone will s

so it's not just medicare, medicaid cuts 34% would be very harmful. the ryan budget also cuts transportation by 25%. now transportation is a job creator. transportation puts americans to work. building roads, bridges, transit , helping people get from here and there, i can imagine high-speed rail cars. i'm from minnesota, i'd love to see us have a high-speed train from duluth to minneapolis to chicago. it would be a great thing. it would put lots of people back to work and it would improve productivity. it would allow people after it's built to get from here to there fast sore they can to

medicare. don't cut medicaid. ask the wealthiest people in this country to start paying their fair share of taxes. and by the way, take a look at military spending as well." that is what, by and large, the american people are saying. >> the polls show that? the polls show that? >> polls show that. so you would think that even if you were a hack politician who didn't believe any of this, you would stand up and fight for those principles. what i am going to do working with some of my progressive colleagues is say, "no, we are not going to balance this budget on the backs of the elderly, the children, the sick, and the poor. social security has not contributed one nickel to the deficit. we are not going to cut social security." i am waiting. and we're doing everything that we can to beg the president, "get up and say what you said four years ago." and that is you're not going to cut social security. that's what the american people want to hear. >> you know, everyone seems to agree that our deficits are unsustainable,

. >> here is the thing we have bigger fish to fry, medicare, medicaid and by the way, you know, whatappened to europe. >> and the republicans now, and they're-- >> and tt the restaurant with these guys and likes them. >> i just spoke with john boehner, i would just say, you have an economy that's, you know, the numbers don't look good right now. the unemployment looks pretty bad and i know the overall number went down, but because people are dropping out of the work force and now is the time to destimulate. >> but it's a political calculation. the republicans who are in favor of spending cuts are saying, well, we're waiting until november and then we are going to do something big when the republicans, if they take it, if they take the white house, but-- >> that's what they're hanging their hats on. we'll do this because the election and i do want to bring in-- what do you make of the fact that everyone, including mr. gasperino has sold his soul? >> well, it's encouraging that that the republicans-- and this is, let's for cu-- focus on news not old news, charlie knows i'm kidding. it'

about the defense budget, entitlements comes up all the times in terms of social security, medicare, medicaid. what do you think will move the needle in terms of cutting spending. >> the heart of the matter, social security and medicare. the first is $800 billion a year. the second is 600 billion a year. that's a trillion and a half. that's the heart of entitlements and romney doesn't cut social security ever. ryan gets around to addressing medicare in 2023, but for the next ten years does nothing. >> what about the president? >> the president does nothing. he's the great defender. so if you have both parties essentially giving 1.4 trillion of spending a pass how in the world can we begin to close the deficit without major tax increases? so when romney says no taxes for anybody, he's not telling the truth. when the president says 98% of the public will not have a tax increase, i'm for the 98%, let the 2% pay. he's not telling the truth either. >> let's get your take on where we are in this campaign. of course we have been watching the missteps that have happened around mitt romney and the 47%

medicaid is a middle class issue. it helps with autism and assisted living. this is their priority debate. they want to end medicareicaid, the bought line is they believe you grow the economy from the top down. we believe you grow it from the middle class out. >> eliot: as one the president said in one of his many great lines, they want to double down and trickle down and it's not the way to run an economy. medicaid in dirk which is paul ryan's budget, would throw another 30 million people off the rolls of healthcare which seems antithetical to what we believe. >> this is what i worry about. if mitt romney and paul ryan win this and the republicans win the house, it's over. they will not only double down, they will triple down. they'll have the plant and medicare in the white house, and the house of representatives. >> eliot: i think most polls are saying that president obama will be re-elected. the house is a tough battle. you're leading the effort to get the democrats back to make speaker pelosi the speaker once again. the margin is 25 net seats to pick up, how does that look? >> it's in play. we start on the 25-

she also went on to add, social security, medicare and medicaid are vital to the economic and health security of millions of senior americans. chad stone was also there and he talked about the jobs picture and he actually referenced a poster right here as well. and chad stone, he's a chief economist for the center for budget and policy priorities and he said that piling tax cuts on -- will only lead to draconian cuts in programs millions of americans rely on. so we can't go at this cuts-only approach. we got to have some jobs and we got to have some investment. and steve from the center of tax justice put it best. he said, quote, i think all of us here agree that the most important job for congress right now is to help the economy to create jobs, tax cuts are one of the least effective tools to accomplish this goal. and so we had a great lineup. i urged folks to go on our website, study what we're there to say. but i do want to go back for a moment to just talk a little bit about the ideas larry core shared. and what he said was that -- he mentioned sequestration. he said that seques

. >> social security, medicare. >> medicaid. everything that people think of as part of their plan knowledge for their future. things that they have counted on and hs been vy clear pro-ryan that if you are under 55 you cannot expect social security under his plan to be anything but privatized. and if you're over 55, your benefits will be cut. they keep saying that barack obama cut $716 billion out of medicare. what he did was he cut administrative expenses and reimbursements to insurance companies and put every penny of that back in to mammograms, annual check ups, et cetera. ball ryan cuts the same $716 billion but he takes it directly out of benefits and doesn't put it back in to the system he throws it back on the defense budget. >> we are out of time on this topic. let us know what you think. please follow me on twitter @bonnieerbe. with the economy and jobs key issues in the upcoming election i sat down with labor secretary hilda solis. as part of our labor day coverage i wanted to ask her how women are faring in the job ma

. >> jonathan dine >> like many of the government entitlement programs, medicare, medicaid are all coming to a cusp. they are coming towards a financial cliff where we will not going to be able to save them. i would propose block granting the states money based on population to deliver healthcare for seniors and people over 55. i feel that the states will be more closer to people of the state actually more listen to the legislator and provide you better service. any time you expect the government to manage your money efficiently, we can look at the record of spending mon wrecklessly with mismanagement. i feel hadwe really need to make tough choice or we will all be left with nothing. >> congressman an and senator mccaskill privatized medicare. would you like to respond to that? >> the idea is that the senior has a choice in medicine. that's the idea. instead of having one size fits all, which is the big government solution. we're tryingo allow choices. look, there's one thing in medicine that i don't like. that's when an insurance company gets between the doctor and patient. one thing tha

she said that 90% of the revenue -- revenue stream was from medicaid and medicare, and the goal is to pay the workers. the workers will get a notice to apply and get on cobra. the company official says as monies due from medicare and medicaid come in, but workers may need to file a claim with the bankruptcy court. wbal-tv 11 news. >> thank you. in other news tonight, vandalism appears to be targeting mosques in virginia. worshipers at the shenandoah valley and harrisburg found graffiti on the building. on wednesday, the windows of 30 cars were smashed at a mosque near falls church. authorities are looking into whether these incidents are related to anti-u.s. protests sparked by a film for trying to profit mohammad. in beirut, the leader of the militant hezbollah group urged the process to continue. earlier protests in afghanistan said fires near a u.s. military base and demonstrators clashed with police in pakistan and indonesia. >> this is about politics and world power. this is about what is taking place in these countries. a tremendously complex and painful transition. >> nato has

it went for medicare, medicaid and for social security and we borrowed to fight two wars, do homelandsecurity, culture, infrastructure, r&d. is anybody missing what happened? >> darren: the number one thing i get from people is they are convinced the budget problem is someone else's problem, they shouldn't have to pay more and their program shouldn't be cut. it's somewhere else, the problem is someone else's problem. how do you change that and is it changing? are people beginning to take personal responsibility and say we have to come together and help fix that. >> we talk about shared sacrifice. we use that in our 67 page report. we talk about skin in the game. we talk about that. we talk about going broke and we also say-- really quite effectively-- pull up a chair. you're talking to two guys who don't do b.s. or mush. >> it's simply with facts and what we have to do is make sure that americans know what the real effects of this debt is and just give you one example. ask anybody what do you love? do you love education? do you love the research that helps create the next new thing th

and on up through the '60s, but really since then we have, besides social security, we have medicare, medicaid, food stamps, earned income tax credit, on and on, help with housing. so what we have is keeping 40 million people out of poverty. instead of 46 million people who we do have in poverty, which is unacceptable, we would have 86. so the question is not whether we don't care about it or whether we haven't done anything about it, but why is it that despite all we've done we still have poverty rates that are this high. tavis: the reason for why they're still this high is? >> we had a change in our economy starting in the 1970s, where the good, high-paying jobs that built much of the middle class in this country, certainly built the african american middle class in this country, along with municipal employment, those jobs went away. they were replaced, and it's good that they were replaced, by low-wage jobs. there's a flood of low-wage jobs. half the jobs in this country pay under $34,000 a year. a quarter pay under the poverty line for a family of four, $22,000 a year, and that number has