more care over good care, more expensive care over less expensive care, and less investment in the kindof things that tell your patient customers that you care about them. service and handling of information and all the other little things we see. and it's great in politics to find a villain in this, the evil drug companies or insurers, or the unions or whoever your villain is. but the problem is, you can spend anytime health care what you find are people who are often so motivated, there are people are devoting their whole life to the care of others, even in many of the evil institutions you will find lots of people who got into it and are still in it because they think they're helping others. so you have this interesting mix, a system that i regard as catastrophic in a number of ways, and people who seem to be motivated by greed reason for being there. and unique the bridge between understand those two, the incentives in the system, the economic incentives for bad outcomes are so powerful that it overwhelms the effort of good intentioned people. and not exactly very politically catchy

when we talk about health care we talked about health care.e don't say there's too many spinal fusion, two hip replacements, too many people on bills, there's too many -- we talk about health care as if it's a cheeseburger. but even cheeseburgers go up. my fear is what we are missing and a system is this. we are driving care decisions based on these economic incentives but it's not as subtle as the island is a this great come we're making private insurance more money. i want to spend one more second on consumer service. 50 years ago there were 20,000 computers in the world. 10 years before that this was there were 250. there are probably 100,000 people who knew how to use them. computers were extraordinarily complex. today, almost all of us are carrying at least one on us. several have two, three, four, ma five. all of us, everywhere on earth. what happened as we all know is that everybody became really smart about computer science the we all were required to take in school. and so this product that 50 years ago only 100,000 people on earth co

care model. we have people for life after their return from service, and do a good job taking care of them. i understand that we provide care that is of similar or better quality to most private institutions in the united states at costs that are much lower. >> you have a provocative statement about the interests the ama may be serving. can you elaborate on that? >> i am happy to. my personal position on this is that this subcommittee of the ama wields inordinate power over physician rate setting. i know we are trying to get away from remuneration, but the federal government is sending a clear price signal to students about what the federal government would like them to practice in. i think to minimize that is a little bit dangerous. my personal view is that physician groups treat public affairs as though they were their own income programs, rather than a source for the u.s. population. >> thank you, senator murphy. senator? >> thank you. i have two questions. one would be more specific, and the

more care over good care. more expensive care over less expensive care and less investment in the kind of things that still your patient customers that do care about them which is safety and service and handling of information and all the other little things we see. and it's great in politics to find this you know drug companies are in terse, the unions, but the problem is the spending time in health care what you find is people who are often so motivated there are people who are devoting their whole lives to carry and others and the evil the institutions you will find lots of people who got into it and they're still in it because they think they're helping others. so you have an interesting mix, a system that i regard as catastrophic and a number of ways, and people who seem to be motivated by greed reasons for being there. to me the bridge between understanding goes to is just the incentives in the system. the economic incentives for the bad outcomes are so powerful that it overwhelms the efforts of good int

it comes to health care. it is a complicated topic. i know health care has been on the lips of many. watercolor topic that it may be. -- watercolor subject that it may be. there was a conversation of -- about who is the easiest person to operate on. one doctor said the easiest people are mathematicians. when you open them up, all their parts are numbered. very easy to reassemble. an easier category is librarians. you take them apart and there alphabetized. only 26 letters. the third doctor said i know it better categoric operate on -- mechanics. they understand if you do not get finished on time and their exports, that does not cause the much concern either. the last doctor says i can say by far the easiest people to talk -- to operate on our politicians. you open them up and find out the have no heart, no spine, no guts and their head in their rear end are interchangeable. [laughter] i think that defines some of the challenges we face as we develop policy year. -- we develop policy here. the mixtec by tellin

and everybody cares about health care and everybody is affected by bills. and it just struck me that i had never really read anything that said okay, here's why it costs this much. whose's making the money. ges making money on the cat scans, the hospital c.e.o. it turns out is making 2 or 3, or $4 million. that is the stuff i started to find out. >> rose: you did what any good reporter does, go to the original source. >> i just got bills am everybody said first you will never get bills because there are proif see issues. i said well i will promise the patients privacy but some of these patients will be so angry they will beg me to put their names in, which is what happened. and then came the really hard part. the bills if you have ever looked at a hospital bill and you may not have because you have good insurance, the bills are indecipherable. they are in like double code. and no consumer can understand those bills. they're acronyms, numerical codes and line by line i just decoded them. and figured out what they cost. for example, if one of the patients is

if we forget every single patient care is that momoment -- moment with the care is like, it is all for nothing. it is the most important thing. to your point, how do we balance a system and infrastcture that let us provide the bebest care, provididing value, but have the patient feel like we are focused on them. >> you have a businessss mind but you did not take an easyy industry decing to keep your focus medicine. it is a chahallenging iustry where you have to constantly stay ahead of your competition. you have found innovative new partnerships. tell us about the cleveland clinic f for a ship. >> we are very excited about our relationship with them. it started severeral years ago whwhen we came together with a dstar institute for innovation and the cleveland clinic institute. no matter our size, no matter how proud we are, we have e to as a leader have no approaches to health care. in the hrt space medst washington hospitacenter has been the clear l leader for many years. the regional leader -- with the clinic -- cleveland clinic heart and vascular, the national leader for 17 and 18 y

so everything from prenatal care everything from prenatal care to end-of-life care and everything in between is their responsibility, regardless of whether they personally delivered day care or it happens somewhere else in the system. that's a very different mindset, and leads to very different behaviors and relationships and staffing models and conditioning engagement models from them all models from them officers were only responsible for the patient was in front of you at this moment, that you will bill for and then they will be on their way. so creating that kind of longitudinal accountability is one very important difference of the model. a second very important difference of the model is that it is based on a global budget for that population. and they are shared savings and there's also risks. there's all kinds of protection so that that is not an unreasonable risk and the budgets are set in a way that is accounted for that patient population and what's been spent to take care of them up to that point under the fee-for-service model. so that the provider begins knowing that th

to her younger children need child care, one is school age so she needs after school care. and she was in a panic when she got notice that her child care was being terminated. not because she no longer qualifies, but because the state budget cuts -- wants to cut those in the upper income level. and these family need to keep their jobs. they want to make sure they don't lose their jobs. fortunately this parrottv didn't lose [speaker not understood] because [speaker not understood] was able to give her a program that would prevent her from losing her job. one thing that i would really like to highlight is the constant tug and pull of budget cuts and [speaker not understood] and the safety of our children. and the sooner approve of backfill and this add back backfill to help [speaker not understood] the sooner we help these families. [speaker not understood]. thank you. >> thank you very much. next speaker, please. >>> good afternoon, supervisors. my name is mollie steyn ert, and i'm with stepping stone, we run four day care centers in san francisco. and i'm representing all o

joseph kelly doesn't care where the republican party is going, he cares about his kids. fiona doesn't care where the republican party is, but the ability to stay in this country to help all americans, republican, democrats or independent. i can assure you katie and her mom don't care what republicans are advocating here. they want to see results. the point of my talk today is to say that we republicans in the house are dedicated to those. >> can you say a few more words about what you see is the proper role for the federal government in education. i understand why democrats and progressives want centralized education programs. don't republicans see it as a state and local function? >> as a parent of three kids, all of whom went to public schools and two in college and one in the work force right now, one in the work force right now, education starts with parents.

so the name of your book is "catastrophic care" how american health care killed my father and how wecan fix it. now, are you a doctor? >> no. >> stephen: you are not a doctor. you are, in fact, the president and c.e.o. the the game show network. >> that's correct. >> stephen: why is the president and c.e.o. of the gameshow network trying to fix our health care. aren't sick people home from work your core audience? [laughter] >> well, i hadn't thought before. >> stephen: you should think about that. you are shooting yourself in the foot right now. [laughter] >> can i go on anyway. it's a good point. >> stephen: sure. >> my interest actually came from my father's death from a hospital acquired fengs which is an all-too common experience but broadly i approach it as a business person with 300 employees for whom health scare an important issue. a prnt, a patient myself. when i see is a system broken in so many ways but that i think all of those problems have one cause that i think it has in common which is we're not the customer of the health care system. >> stephen: what? i'm the guy go

instead of having a set standard of care, even if it's an altered or austere standard of care, what we want to have is good decision framework. until you are in the situation you can't determine what you would actually be doing and what resources are still available. >> do we have other questions from our audience? one final question and this is for our civilians. you got to see all kinds of cool stuff yesterday down at moffat's field. i want to see if there's one or two that stuck out. >> i think the c130 definitely blew me away, the fact it can transport 92 people, patients, was incredible. the other 1 that stands out is the mobile decon patient, that it can decontaminate a patient that was not able to stand. >> the team from the hospital that i was with and the other hospitals really looked at what were their hands on capabilities and some of the things that stood out the most is a portable oxygen generator that sits in the corner of the shock trauma platoon unit and doesn't have to be hooked up to our large liquid oxygen tanks and all that piping that might get disrupted during a m

so what happens to this. >> if you like your health care plan you'll be able to keep your health care plan period. >> brenda: all this as the price tag keeps growing. someone here says the number of surprises will grow, too. are they right or wrong? i'm brenda buttner and this is bulls and bears. let's get right to it. the bulls and bears this week, we've got gary b smith, jonas max ferris, john layfield along with john tobacco and steve murphy. welcome, everybody. president obama expected to tout the health care law in his state of the union on tuesday, but john, you say this law isn't doing anything, but making america sicker? >> yeah, brenda. i mean, after years, literally the last three years, barack obama's been telling americans, you won't lose your doctor, if you like your health insurance, you can keep your health insurance, now post-election, surprise! 7 million americans, the numbers are going higher. the cbo reports the dollars continue to go higher and really what it comes down to, we cannot afford this. small businesses can't afford to keep medicating their people and kee

then you goat love, really love the care work you're doing and you hear people who are taking care of elderly they tell you how the elderly person gets to love them and look up to them. and the care for the that they are giving them. the bad thing about the job, i would say is sometimes the pressures. there's no guidelines. lower pay as the report will show. how many workers are working below the minimum wage in the job. and then there is the long hours that you work as a care giver in some person's home. i was working between 12 to 1 hours a day. some people work longer hours as much to ask -- [inaudible] it depends on the job you are doing. at one point i did a 24-hour job for ten months. i started with five-week old baby and sleep in the same room with the baby and i had to wake up in the night and take care of the baby every three hours. and then again, there is the lack of benefits in these jobs. i had no health insurance, and one of my jobs i had no social security, and the report will show only 9% of the employers pay social security for their workers that theism employ. >> thi

and it's often called president obama's proud jewel of achievements during his first term health care reform but is obamacare actually the answer to us that the us healthcare crisis are four on that coming up. it's monday february fourth five pm in washington d.c. i'm meghan lopez and you're watching r t today marks john kerry's first official day as the sixty eighth secretary of state and perhaps not a moment too soon topping secretary kerry's agenda is the push to restart peace talks between israelis and palestinians and in the more immediate future he plans to address the volatile situations in egypt and also in north africa his appointment comes amid dropping u.s. approval ratings in the middle east something that hillary clinton addressed last week. some of the success is that being attributed to you is mending or fix in you know it's the it's relation with an open muslim or yet the statistics contradict that if you look at the pew set this it shows that actually your favoritism in compared to the bush administration is lower and in countries like turkey and other places so what

care, those without insurance, it might be more cost effective

national more care over good care, more expensive care over less expensive care and less investment in the kind of things that tell your patient customers that you care about them which is ct and service and handling information and all of the other things we see. it's great in politics for the evil drug companies and insurers and the unions, but the problem is if you spend the time and health care what you find are people who are often so motivated they are almost saints. there are people who are devoting their whole lives to the care of others even evil institutions you'll find lots of people that got into it and are still in it because they think they are helping others so you have a mix of systems i regard as catastrophic and people who seem to be motivated for great reasons by being there and to meet the bridge between understanding those is just the incentives in the system. the economic incentives for bad outcomes are so powerful that it over roms the efforts of the good intentioned people and not exactly a very catchy phrase, right? down with the incentives isn't going to ge

medicare will be managed care. in san francisco there are two plans that are responsible for providing that health care delivery. one is san francisco health plan and one is anthem bluecross. san francisco health plan is the non-profit provider and anthem bluecross is the for-profit provider. in san francisco we have the two-plan model. for those people who are seniors and people with disabilities on medical only, those people have already moved into managed care and have seen how it works or doesn't work. we have had a lot of challenges with that over the past year or two. in the next couple of years, people who are duly eligible, on medical and medicare at the same time will be entering into that systemment on one hand it's kind of scary because we saw to people with disabilities and seniors on medical only moving into the system and it's been confusing. on the other hand it's a great way to look at how we can make it stronger and better for people. so one of the things that we have been doing at the department o

food, clothing and health care. basic fundamental things people like in american society, particularly poor african-americans. >> host: were the founders? >> guest: the founders were bobby seale and huey who are interesting because they are migrants from the south. the black panther story is a great migration story, so they come from texas and louisiana to the bay area to oakland and they find themselves in the center of history a couple decades later. >> host: your book focuses on medical care. you write that the black panther party, the panthers were heirs to an unchartered tradition of african-american health politics. >> guest: it means we haven't looked closely enough at the fact that the civil rights tradition, even if we think about the 20th century, because it was always a medical act to this tradition, so i think we understand the forms of discrimination, jim crow racial segregation that we understand this is part of the early 20th century african-american life also included health care. if you go back acro

s of united health care are literally billionaires and those models for health care reform across the atlantic are now disappearing one by one the latest victims of conservatives and their banks stir austerity programs at least in places like greece and spain the people are putting up a fight against these profiteers and it's a fight that's long overdue here in the united states of america we should all ask ourselves why is it that thousands are taking to the streets to demand to defend their public health care systems in europe but not once has there been a legitimate rally here in the united states to defend our privatized health care system that kills tens of thousands of americans every single year. answers pretty obvious deep down inside we know we're getting ripped off just like the greeks and the spaniards know they're getting ripped off let's hope that the decision the banks has made to target universal health care rights in europe will inspire a new struggle in the united states that affirms that we are indeed our brothers and our sisters keep. and that's the way it is tonigh

care. it's the largest federal health program covering -- in terms of dollars -- covering 50 million people at a total cost, a total this year approaching $600 billion. it was enacted back in 1965. i first came to work on the hill in, are you ready for this? -- 1969. and i can't remember a single year since then when congress hasn't done something important with the medicare program. this this is a huge, popular and expensive program. it delivers health care to almost one in the five americans, particularly those over 65 and those with a disability. so there's a need for all policymakers to understand how medicare works. plus there were some stamm changes -- substantial changes to the program in the affordable care act in 2010, and we'll hear about those changes as well today. our partner and co-sponsor in this briefing, the kaiser family foundation, turns out some of the best, most understandable analyses of medicare you're going to find. and the person who is responsible for a large part

we did nothing with health care. we pushed off the cough and all the things that are going to happen into this election cycle after the last election and we're starting to see this now. this is not free. >> brenda: in fact, cbo, which is nonpartisan says that debt will rise sharply relative to gdp after the health care plan is fully implemented. jonas, does that concern you? >> you know, it isn't going to raise that much because there are offsetting taxes to increase some costs and there's going to be increased costs and we've seen from the taxes and more taxes in a few years. and it gets to the point, you know, the employer is-- the quote that's wrong from the president there in that reelection thing is, it's not your health insurance, you don't have health insurance, your company takes the health insurance plans for the employees and not yours to keep or take. if they want it kick you off because there are cheaper government plans, it exists because of the tax loophole and companies can buy you insurance and not ha

we should also care about the size of government. we should care about both. what we have done over the past several years is we have eliminated concerns about the deficit. we have done that to a large extend by increasing the size of government. and the bigger government is the fewer resources there are for california families and california businesses to do what they want to do with them. and so so you got to take both of those in to account. and i think that one of my concerns if we simply say look, deficits aren't a problem. everything is better. what we're ignoring is that other dimension. because in reality what happens is policy makers are making two decisions. one, about deficits or surpluses. allocating over time. are we going to borrow four state's north income. when they make decisions on size of the government. they are allocating resources between the public and private sector. they are making decisions how efficient the state economy is and how much it's going grow. i can't answer on the specific of california. as a collective group that was deci

another example is accountable care organizations. when we released the first proposed aco rules, we received a lot of feedback, some of it not very positive, from the physician community. much of it was -- much of it told us that the rules came up short, if you mentioned a few specific areas. you told us we needed to reduce the reporting burden. so we did, cutting the number of quality measures by about half. you told us there have to be an option for smaller organizations that need help with startup costs. so we agreed, creating the advance payment aco model. you told us we needed to create pathways for providers who wanted to take on less risk, and again, we responded to that request. and i think the results speak for themselves. not only do we now have hundreds of acos around the country, but they really reflect the full diversity of america's health care system, from major academic medical centers to rural health clinics and physician led organizations. and that never would've happened without your input. our department has also

if you were in our other presentation, we're very careful about not giving them air time. we don't want brute knowing he's the most prolific tagger in the city. that's not to my benefit, only to his. but we will say, for example, of the top 10 taggers one has been arrested. we will make that information known in a generic way during our press conferences. >> what type of material are you using for the panels. >> the panels? >> yeah. >> we haven't determined yet what we're going to use for the panels. it will really depend what structure we end up looking it on. we're looking at 4 locations for the free wall at this time. again, everything that i've seen shows that they don't work. we're kind of caught between a rock and a hard place on this in that the public art plan was approved by city council that includes the creation of free walls so we figure better to control it as opposed to fight it because we weren't going to win the fight. again, by taking this approach we think we'll have some really good empirical data at the end of it to say, look, this is how much graffiti

and the care that, for the care that they're giving them. thing about the job, i would say, is sometimes the pressures. there's no guidelines. the low pay. as the report will show, how many workers are working below the minimum wage in these jobs. and then there is the long hours that you're working as a caregiver in some person's home. i was working between 12-14 hours a day. some people work longer hours, as much as 24 hours. it all depends on the job that you're doing. at one point i did a 24-hour job for tens where i started with a five-week-old baby and sleep in the same room as the baby, and i had to wake up in the night and take care of the baby every three hours. so, and then again there is the lack of benefits in these jobs. i had no health insurance, um, and one of my jobs i had no social security. and the report will show only 9% of employers pay social security for the workers that they employ. so this is the, this is, um, some of the challenges that you get in working in the home. >> let's hear more of that. ai-jen, you're the n

comes to health care. it's a complicated topic and it's certainly an important topic and i know health care has been on the lips of many, the watercooler topic that it may be. i have heard the story of the four country surgeons in utah talking about health care issue and they got into the conversation of who is the easiest person to operate on? and the one doctor says i can tell you the easiest people to operate on a really mathematicians. when asked why mathematicians come to when you open them up and take them apart all of their parts are numbered so it's very easy to reassemble. an easier category are librarians. why library is? if we take them apart there alphabetized with only 26 letters, much simpler design and easy-to-use reassemble. the third doctor said 12 i know a better category to operate on and those are mechanics. why mechanics? well they understand if you don't get finished quite on time, and if there is some excess parts that doesn't cause too much concern either. the last doctor says i can

there was emergency contact, care preferences hall facing the vault so that the care providers know what to do. and the supporters know what his wishes are and they can share tips and ideas and emotional support to him. dale is future-proofed. pieces of this idea staying connected to a good life is about having some peace of mind as we think about the future. i encourage you all about what makes a good life for you. i encourage you to reach out to others to make it happen. it won't happen in isolation, there is no independence without tinterdependence. when we reach out to others, everyone benefits. reaching out and making connections for a good life provide peace of mind for you, but for every one that loves you as well. if there is one final message i would like to leave you with, it is that we are, quite simply, better together. if any of you are interested in learning a little bit more and seeing a live demonstration, i will be over in the south court this afternoon and in the lunch break. i would be delighted to chat with you. in the meantime, thank you so much. [applause] >> oh, co

serving as a homicidal force for others because people do in fact die for lack of access to health care in the richest country in the world that's the us of a human consumption is in fact exhilarating the destruction of our planet people do in fact die in wars waged based on lies that profit a precious few over five million children globally each year do not reach their fifth birthday because they die of starvation all of this is not because the system that puts man on the moon or can squeeze an entire library onto a computer chip the size of a thumbnail has failed to find a way to solve these problems rather our system without apology places corporate greed. and greed take back the popular phrase is not good now the question many within the occupy movement are trying to solve is this one what would world look like that had a culture and an economic system that places human need above corporate greed and how do we bring that world into being cares what it is call call it socialism call it real democracy now call it chunky monkey cherry garcia the world needs to change radically needs to

of care. why do you think such a consistent, long-term relationship is so important to an infant's development? babies need a steady, consistent, small group of people to whom they can relate. it takes lots of time and consistent contact for babies to intimately know and trust caregivers outside the family circle. in order for this kind of meaningful relationship and bonding to develop, it's especially important that our infant/toddler group sizes remain small. a small group size-- one adult to 3 or 4 infants is most frequently recommended-- ensures that we are available to satisfy each infant's needs for attention and affection, not to mention the need for routine care as feeding, bathing, and changing. woman: it's so different to work with infants and toddlers instead of preschoolers. first of all, i notice that the rhythm slows way down. you have to be much more relaxed, and you really have to be there physically, so you have to feel comfortable being down on the floor a lot and being much

care. i know you can't talk about the economy unless talking about health care. you're views on health care, the impact of health care on the economy and how do we make it a positive impact versus a drag on the economy as we've had? >> we're getting into a pattern here. i will start off. health care is a huge part of the economy. one of the questions people often ask about the first year of the obama administration. why did you take on health care at the same time we're having all these other issues? the reason was health care is not just a huge moral, social issue also an economic issue. we have to deal with that is something that can be helpful for the economy going forward. if you ask, what is the positive on health care? how is the economy doing? what is the snerkt the economy that is adding jobs? it is the health care sector of the economy. i think it is -- that's partly because it is a dynamic sector coming up with incredible innovations, the amount of exciting discoveries that are lo

often more cost-effective for physicians to provide free medical care that it is to provide care to aaid patient. so the reason it is cause for concern is that adding a million additional people to the medicaid system means that there needs to be some sort of incentive for physicians and other health care providers to see those additional people. melissa: it makes perfect sense, and when you're trying to dig at the stats for this camino, we found that it is anticipated right now that the state is going to be about 752 dr. short in the near term, but i also saw that it is estimated that primary care physicians make about $226,000 in florida. that isn't enough money to attract more people into the field to be primary-care physicians? does that number right to you? it seems like a lot of money. >> that does seem like a lot of money, and it seems a little bit high to me based upon the figures that i have seen. i think there may be some conflicting data on that. primary-care physicians in general are not paid as well as the specialists are. and when you couple that with the cost of adminis

should be congratulated but let's not forgot when an important piece of legislature didn't get taken care of and seniors who lived in an sr o that does not have a bathroom and i'm one of them and i don't benefit from this legislature and i'm buttoned i'm wondering how many people benefit from this. and in the hotel i live in, if a room comes available it's first come first serve and the first room with a bathroom that becomes available you can get it if you would like and i'm not saying it's knot with every sr o with the nonprofit and is i know for a fact where i live, it is and it's a fact that the bit of legislature that is going suppose to help seniors and disabled in a way doesn't because of that lack and i understand why and i know the cost but with that being said, let's remember that in the future when at all possible. sooner rather than later, let's fix that loophole and have all rooms with bathrooms. thank you. >> thank you.. >> davideliot louis. good afternoon i'm here representing the central city collaborative here supporting the legislative and nobody spoke against it and nob

better care requires a doctor that cares about you. you need a doctor, not a name on the card but a person in the end of the phone and someone you can call and trust. >> you knowledge somebody in congress realize whata a mess. democrats and republicans who didn't vote for it any hope that you can see when you talk to members of congress that may might want to change thing >> indeed, i have seen some home. independent payment advisory board, there is it a co-sponsorship to ripeel that. and hope to ripeel the device tax. and all of the device companies decided to move off shoir and firing people and not developing research. >> doctor, i want to make sure our audience understands. braces on your dids teeth, to being a walker or a wheelchair or bag or anything. there is it a tax for having the. i never understood that one. >> indeed it is it a 2.3 tax on total revenue for everything over $100 . that will be passed on to the consume . >> and really, talk about unaffordable and unacceptable . again, i have to stress that good care is it abou