maybe it was claritin and allegra. i think he used one of the other. let's say cer comes out and says one is better than the other. what's going to be the require me ment? what's going to be the requirement for somebody who is practicing medicine and allegra doesn't work for their patient but claritin does? >> the doctor -- excuse me pooim sorry. the doctor decides what the concurrence of the patient. >> so does he have to document that he didn't follow cer guidelines? >> i'm not sure what the rules and regs would be. that would be part of what the secretary puts together. >> that's my whole problem with this is what's the secretary put together? the fact -- i have an amendment, coburn number 9, that i'd like -- >> coburn number 9. >> let's go to coburn number 9. >> we ask the clerk to distribute that. >> tom, you got copies of that? >> thanks very much. mr. chairman, some of the conversations that we've had, especially during the roundtable was the fact that the cer section was to provide research but to not necessarily mandate standards or deny care.

on the other hand, i you allegra to control allergies. $500 for a four-month spread supply in the u.s.. it is under $200 for a four month supply in canada. host: do you go to canada to get your supplies? caller: i do. i cannot afford to pay $500 every four months for allergy medicine. host: another view from michigan. good morning. caller: thank you for this opportunity. the main points i would like to make is that in america, we spend one-third more per capita for health insurance. one-third more for prescription costs. in spite of that, we, at one time in the '60s, we were equal to or above other countries. since we have got this extreme for-profit system with insurance companies and pharmaceutical companies. everything is maximize profits, we have fallen behind. our life expectancies are lower than other countries. many countries have life expectancies at 82 years of age. i would like to see the elimination of all insurance companies for care. for everybody to have single payer. we know from studying these countries that the actual quality of health care of comes is better in all t

what is going to be the requirement for somebody was practicing medicine and some allegra does not work for their patience but clear 10 -- by clariten does? >> the doctor decides for the patient. >> does get a document that he did not follow cer guidelines? >> i do not know what the rules would be. that would be part of what the secretary puts together. >> that is my whole problem with this. what is the secretary putting together? i have an amendment that i would like to -- >> let's go to coburn #9. >> do you have copies of that? [inaudible] >> thank you. >> mr. chairman, some of the conversations that we have had during the round table was the fact that the cer section was to provide research but not necessarily mandate the standards or deny care. if you go to section n13 of the modernization act, which ask artists -- congress for bipartisan support, and you look at that, this should not be any reason to oppose this amendment. what this is designed to do is to not allow somebody besides you and your position to decide what your care is going to be. as senator mikulski has correctly not