fee-for-service medical sector for over 30 years who has been basically at the mercy of whatever medicare, cms, decides every year what my services are worth, i have to tell you this when you talk about, let's not talk about more money in the system. and i'm not talking about that either. i would like to see them shift some money in a system that when an air nose and throat doctor gets more money for cleaning blocks out of my patience here because that is a surgical procedure, then i get from a 90 year-old woman comes into me and tells me she has had a little spell and i have to use my time, my diagnostic skills to try and figure out is a serious, does she need to go to the hospital, do i need to do some tests in the office, what can i get away with with this woman and it might take me an hour. and somebody cleans wives out of an ear and gets more money. i would say there is a problem with the system. and in my estimation, and i talked about medicare being flawed system. it is very flawed, but it is fixable. it is fixable. if someone will sit down with doctors who have been doing this for a wh

. >> se ha visto en algunos estudios como poder ir creciendo prÓximamente entre 80 cm y hasta 1 m, o daÑo. >> el tiburÓn ballena no es una especie en peligro de extinciÓn,pero sÍ es una especie protegida porque es muy vulnerable,quizÁs porque nada muy lento. hay algunos paÍses como china donde todavÍa se lo cobran. >> las tomas que ven fueron mÉrito de fernando lozano. y si por casualidad, alguno de ustedes hace cursar con un ejemplar marcado con el nÚmero 712 sabe que proviene de las costas de cancÚn. >> e impresionante. precisamente gracias a estas marcas se sabe que los tiburones guayana,poder recorrer 8000 km en un aÑo,despuÉs de tres aÑos en las placas se caen por sÍ solas. y las mascotas tienen un nombre en tailandia, te ha convertido su hogar en el punto de reuniÓn de decenas de curiosos, es que el sujeto tiene mÁs de 1000 escorpiones y se los coloca sobre el cuerpo y juega con los temibles animalitos como si fueran mansos patitos,si usted quiere ver mÁs impactantes imÁgenes sÓlo tiene que visitar univisiÓn. com. un nuevo tratamiento es una luz de esperanza para los mÁs afecta

this is a 65 cm ball. i see people might, 5' 4", they sit on the ball. i am much higher than 90 degrees behind my knee. i am higher than that. when i tried to do my work, this can throw me off balance. some sit on this ball at their desk. it is good to help you with your posture. but if you have the wrong size, it can for you forward. >> so a 5' 4" lady and her 6' s pension i use the same ball. >> correct. -- should not use the same ball. >> correct. >> we use this mainly for abdominal work. you'll come out under the ball so your feet get stabilized in front of you. then you want to be able to come back with your body and curl up. >> you're pushed should not be on top of the ball but on the corner of it. >> yes. if you laid back, you will fall off. he did not want to do this. >> all right. >> this is hyperextension. it can kill. you want to come back when you are right here with the floor. it i am sitting here and doing bicep curls or shoulder presses, wait. if you're going to walk out or lay on the bench like doing chest presses -- make sure your head a

what does the health care cost and i'm getting the stuff from the cms, the medical government web site and from the state department, and of massachusetts web site and please look them up, okay? i will not run through the numbers, i want to look at the numbers. >> the congressman walking away there and wield that he have congressman's response and significantly more of this match-up coming up in our next hour. >> jamie: the last several days we have seen a number of town hall meetings, and like the student, talk about the health care bills, providing money for abortions. when a voter challenged senator specter about it last tuesday evened there was no language that provided for abortions but the constituent took it a step further. listen here. >> the bill says nothing about abortion or reproductive rights. i have read that very carefully. there are nine amendments in the senate and the house which have attempted to prevent taxpayer funding in that bill. rejected. senator coburn, senator hatch, senators and representatives, and they have all been rejected. >> jamie: why rejected and the

>> this was a misstep by cms. the formula that they use was flawed. has a lot of methodological flaws. we're asking that they pause, not institute this and 123 days. review that methodology and improve it. patti ann: is there talk of doing that, holding back, and may be revisiting this issue? is there momentum for this idea? >> we are hopeful. we know that the survey had very few respondents. we know that cms is chock full of good people trying to do the right thing. there has been an outcry from cardiologists and their patients that this was an unintended consequence. i'm very hopeful that this will be set aside. patti ann: thank you for joining us. bill: breaking news in california. massive wildfires burning out of control near los angeles. 6:38 in the morning. in some places, it is only 5% compared -- only 5% contained. we're live in the fire line as the sun dawns on a dangerous day. patti ann: tropical storm danny causing dangerous records all of the east coast. the coast guard is calling off its search for a young boy swept out to sea. when you c

commercial enterprise in the late 18s and 90s, a fascinating read and i reviewed joe scarborough of cms nbc post of the morning show, the last best hope. i am a big fan of him on tv. i was disappointed in the book which seem superficial, particularly in its stated goal of trying to offer a true alternative to a kind of big government program coming out of washington from republicans and democrats. there are a few other books i have in my reading cue, two of which are about the very popular novelist who is generally derided as an awful stylist certain and bad writer. she is finally getting, in this age of large state enterprises, she's getting a long look from a couple serious scholars. one of these books are due out in october. one of them is called ayn rant and the world she made, sympathetic social biography, the other one is by jennifer burns, it is called goddess of the market, it is

president, and finally sometime during the bush administration, the centers for medicare and medicaid, cms, said, okay, fine, we'll begin to pay for this. well, it shouldn't be that hard. we're more than happy to pay for a pill or pay for a procedure. how do we change behaviors? how do we convince the medical establishment to do that? there is just a lot that needs to be at least included even if we can't get to the finish line right away. >> you're passionate about this. do you ever wish you were back in the white house running? >> i feel like i gave my blood, sweat and tears, and i think we, despite all of the difficulties of that effort, we got people thinking. and we helped further the debate. it was, you know, disappointing that we didn't get it all done, but we got the children's health insurance program done, we got portable insurance. we got some things accomplished in the '90s and actually under the bush administration some changes were made so that the government said to hospitals, we're not going to pay for never erchts. people shouldn't get bedsores, people should pay for aspir

president, and finally sometime during the bush administration, the centers for medicare and medicaid, cms, said, okay, fine, we'll begin to pay for this. well, it shouldn't be that hard. we're more than happy to pay for a pill or pay for a procedure. how do we change behaviors? how do we convince the medical establishment to do that? there is just a lot that needs to be at least included even if we can't get to the finish line right away. >> you're passionate about this. do you ever wish you were back in the white house running? >> i feel like i gave my blood, sweat and tears, and i think we, despite all of the difficulties of that effort, we got people thinking. and we helped further the debate. it was, you know, disappointing that we didn't get it all done, but we got the children's health insurance program done, we got portable insurance. we got some things accomplished in the '90s and actually under the bush administration some changes were made so that the government said to hospitals, we're not going to pay for never events. people shouldn't get bedsores, people should be given an a

it get it from the cms, government medical website, state department of massachusetts website numbers. please look them up, okay. i won't run through the numbers. i want him to tell us the numbers. i think we should release the plans in a couple different states. conservative plan in a couple states, a -- that's okay. i'm your representative for healthcare guys. i'm a patient advocate and i'm here for patients. congressman scott, please. can you show me the numbers where the public option plan did what you want, bought down cost, increased access, because it's not working. we need to have the numbers to show it. i see people every day and we can't have the wrong choice. >> the american medical association represents the physician -- >> 29, 29% of physicians. >> numbers. >> 29% of the physicians are in the ama. >> i want number how the public option will work. it's not working in massachusetts. healthcare cost is going up in massachusetts. i have talked to you about that. you're not answering that. you have to do this. i know you're a good man. you've got to. >> what do we got? >> jami

he was concerned about commercial real estate, cm, bs backing those through it, possible extension. what do you think? is commercial real estate a legitimate concern right now in front of the next couple months? i think it is for the regional banks a problem.m. we all know this though. it's only 2% of gdp. this has been the most advertised train wreck that's been happening now. i think given everything else we've had with sub prime all day, everything else, the yield curve is steep.p. the earnings power of these banks has never been greater. we haven't even seen any m and a and equity issuance yet outside of financials.. i think we can earn our way out of this problem. >> here on the desk, given everything he's saying is going to happen tomorrow or the next day how do we trade this market? what will the reaction be with no change whatsoever in the statement? >> time heals all wounds tan seems to be as joe said for the banks, it's always the guys most exposed to the consumer and extending out credit card liability and mortgage problems. i love jp morgan. the stock still trades well a

>> we like cms energy, it serves michigan, it has some automobile exposure but it's got one of the lowest payout rates in the industry at 40%. decent and rapidly improving balance sheet and one of the best earnings profiles in the industry. we also like constellation energy, which reduced its dividend earlier this year. so they have that behind them. they're rapidly derisk be their business model and they're growing significantly faster than the average utility. and finally, we like first energy, which is going through some depressed earnings but still is only paying out about 62% of their earnings. they're going to have a down year in 2010, but we expect a pretty significant earnings recovery in 2011. >> yeah, mike, let me ask you the same question but let me also say in aefrnt of disclosure here that both of you guys actually own all of the names that we're talking about here today. now let's get some of your picks. >> love coke, colgate, kraft, intel, and the new york stock exchange. all have significantly good yields, higher than the market, very strong balance sheets, incredibly good

of course, in america you don't know the 58 cm. [laughter] what is it? it shows his command with unbelievable excitement? why he is so excited? number one, because it is illegal. e been he is a date image year. he is officials who is comrade stalin. he is now president for prime minister he is general secretary. that is all. he is a leader and so on beneficially he is nobody actually. so the signature meant nothing but there is a more important reason for shut -- such and excitement. what is it? the common border is a very big danger for it stalin. but he is excited. the key is the alligator in this to and if he is the alligator i would like to have some type of fire i hate him i do not want to be in the same room with him and if stalin is a worry about adolf hitler he can say you take half of poland and i have a half of poland's but let's leave between us some kind of small paul went so you cannot attack me by surprise and i cannot detect you by surprise but stalin says half for you and half for me. and there is one more. one more document. it is actual

way to go i think before it is embedded in the major legislation, but in conversations, the senate, cmsink people know that we need care innovation as much or more than we need payment reform. and i sincerely hope that this is the place in which doctors, hospitals and patients can come together in a different way. thank you. [applause] >> good morning, and thank you, susan, and to health affairs reporting on this very important event. what i thought i might do is give it a little bit and talk some of the issues that were brought up early in the morning but really start with the facts. the facts on the american hospital association. so as we think about bending the cost curve, let me start with two commitments that we have made on behalf of the nation's hospitals. the first is, as you have

animalito que aÚn no se decide a vivir permanentemente fuera de la bolsa de su madre, mide unos 40 cmmente al arroz. bueno, como decÍa en tu perfecto acento espaÑol, hay veces que llega gente y no sabemos quÉ darle de comer entonces hay que buscar... te digo, no sÉ qué desayunan aquÍ ustedes pero h@h@to@mvgvíp precalentado. agregamos la cebolla primero, la vamos a dorar un poco. logramos y tenemos aquÍ nuestro ajo, muy espaÑol tambiÉn. que no lo podemos agregar al mismo tiempo que la cebolla, como tÚ el ajo se convierte to@mvgpeskph@h@h@É doradita... ¡ole! ( risas ) ay, como son ustedes... >> es que la cocina tiene que ser divertida hay to@mvgvuokph@@ pollo. agregamos, mezclamos y es muy fÁcil. lo vamos a tapar... primero vamos a hervir, como todo arroz, que necesita 20 minutos para estar listo, ¿verdad? pero lo que vamos a ser despejar que se cocine sÓlo 10 minutos, y antes de que el stade completamente cocinÓ vamos a agregar del resto de los ingredientes. con la magia de la televisiÓn, agregamos nuestra ragÚ. agregamos un poco de polvo de chile, para que pique y estÉ delicioso, nues

government in particular having been the administrator of the healthcare financing administration now the cms from 1990 to 1992 and also having served in the white house under president h.w. bush as a health policy advisor there. gail is then going to talk about how the government's role might change under leading health reform bills now in congress. so first let me turn to you, lynn nichols. ..

way to go i think before it is embedded in the major legislation, but in conversations, the senate, cmsthink people know that we need care innovation as much or more than we need payment reform. and i sincerely hope that this is the place in which doctors, hospitals and patients can come together in a different way. thank you. [applause] >> good morning, and thank you, susan, and to health affairs reporting on this very important event. what i thought i might do is give it a little bit and talk some of the issues that were brought up early in the morning but really start with the facts. the facts on the american hospital association. so as we think about bending the cost curve, let me start with two commitments that we have made on behalf of the nation's hospitals. the first is, as you have probably seen, in conversation with the white house and with the senate finance committee, we have committed to contributing to again, bending the cost curve and contributing $155 billion over 10 years. $155 billion over 10 years. that would come # over time, we have committed to accepting a lower pa

cms does regulate them tightly. host: about 600 plants or s our offer? > guest: there's an average of 34 plans, private plans available to seniors. host: when somebody turned 65 years old, you have been using $11,000 as the average cost per year for medicare a there's a $1,068 deductible. for medicare part b there is a $96.40 premium. what is the premium that a medicare part c person would have to pay? guest: you pay your premium in the system. if you turn 65, your $96 premium is automatically taken out of social security. host: how much will the premium the? guest: the $96 comes out of yourselves security check at and then goes to pay your premium. is bundled up and sent to the private insurer. 94% of seniors that are offered a plan that has no additional premium. most of them have drug benefit. if you go and buy a drug benefit additionally, medicare part b has a part b premium and then you buy a drug benefit, part d, then you say you want them all in one. you go to a private insurer and do is sign up for the aetna or aarp health plan. 94% of the cases,

from the iacc perspective, we have a service group made up of family members as well as somebody from cms who has been leading the charge -- the president of the autism society of america. they have been listening to families about these issues and trying to come up with recommendations. i am sure that group would love to have an audience and get some ideas that they have been grappling with. >> you just wrote about standards. someone mentioned that you get all kinds of misinformation. you have been on this telehealth for three years now. when you mention standards, is that what you're talking about? >> absolutely. when we start our treatment program, it is a comprehensive treatment program. unfortunately, families can pop up in the internet search and tiepin -- type in telehealth treatment. i do not see how it is possible to form a true therapeutic bond and go ahead and treat the child. is very disconcerting. you can quarry pretty much anything with autism and related disorders. whether it is some way to repair your car, somebody who can paint your house, it is so sporadic. parents do no

way to go i think before it is embedded in the major legislation, but in conversations, the senate, cmshink people know that we need care innovation as much or more than we need payment reform. and i sincerely hope that this is the place in which doctors, hospitals and patients can come together in a different way. thank you. [applause] >> good morning, and thank you, susan, and to health affairs reporting on this very important event. what i thought i might do is give it a little bit and talk some of the issues that were brought up early in the morning but really start with the facts. the facts on the american hospital association. so as we think about bending the cost curve, let me start with two commitments that we have made on behalf of the nation's hospitals. the first is, as you have probably seen, in conversation with the white house and with the senate finance committee, we have committed to contributing to again, bending the cost curve and contributing $155 billion over 10 years. $155 billion over 10 years. that would come through three major areas. fact one is lower payments.

>> cms? >> [inaudible] in my lifetime this level of standards, so i commend you for that. are you also planning on parallel working towards national assessments, because we do know that this is just the beginning. we know that assessment tries instructions. how hopeful argue that the states will actually adopt these national standards, understanding that they will have to revise state assessment to match the standards, which is a very expensive proposition. i am wondering the incentive for them to be able to do this. is the federal government going to be supporting the development of these new assessments to match the standards? >> when we had the meeting in chicago with 37 states represented, one of the things that particularly the state superintendents emphasize -- and we gave them a draft memorandum. they said, we do not see assessment in here. this is not going to be real unless assessments are linked to these. on their urging, we added the second phase. to develop assessments. i think that the state leaders recognize exactly what you are saying. in terms of support fo

i get the sense big drug companies would rather negotiate with cms? and the reason for that, by the way, is because the private market is actually working. the private market is putting a lot of pressure on pricing. and on cost control. and i'm still a fundamental believer that the government should set the general -- the general road map and then let the competition fight it out. walmart fights it out with all the retailers, right? where there's competition, when the rules are set and clear and the government can lay that down and let it fight very well. you know, mayo and cleveland clinic, they compete with each other. and have inspired a higher level of care, as you well know, more than just a government. >> thanks. we want further than we wanted to, but i think we got a lot. it's uft we have to say good bye to you. >> sure. thank you. >> back with earnings next up. >> thank you. >> are you going to -- >> okay. let's talk a little more about health care companies. they have poured millions into health care reform. drugmakers, doctors, insurance, th

then finally during -- sometime during the bush administration, the centers for medicare and medicaid, cms, okay, fine, we'll begin to pay for this. well, it shouldn't be that hard. you know, we're more than happy to pay for a pill or pay for a procedure. how do we change behaviors? how do we convince, you know, the medical establishment to do that? there's just a lot that needs to be at least included, even if we can't get to the finish line right away. >> the passion about this, did you ever wish that you were back in the white house running this? >> well, i feel like, you know, i gave. i gave my -- my blood, sweat, and tears, and i think we, despite all of the difficulties of that effort, we got people thinking. and we helped to further the debate. it was, you know, disappointing that we -- that we didn't get it all done, but, you know, we got the children's health insurance program done, we got portable insurance. we got some things accomplished in the '90s and actually under the bush administration some changes were made so that the government said to hospitals, we're not going to pay

to play, so in addition to the employees at the administration on aging, if we have both partners at cms the inspector general and the department of justice. they are all actively working on this. my father was a member of congress in 1965 when president johnson signed the medicare bill into law just over 40 years ago. it was one of the most important steps on behalf of seniors that was ever taken, certainly the biggest advance after social security in the truman days. back then, and it is hard to imagine, but seniors were among the poorest and most of the normal populations because of health care costs and rising bills -- they were one of the most vulnerable populations because of health care costs. now they have some of the best care in america and have security about the health care that they have. unlike private insurance, when you turn 65 or when you qualify as a disabled american, you cannot be dropped because of health coverage. you cannot be denied coverage because of a pre-existing condition. your rates don't change depending on your specific health situation. it is what insuran

everything that cms represented to me was entirely inapplicable to one of the best hospitals in san antonio, which is physician-owned. it has 24/7 board certifiy eiei staff. 51% of the patients treetd etre covered by medicare. it's in the top 10% of all u.s. heart programs as determined by health rate. it exceeded the 90 percentile on overall patient satisfaction. it outperforms larger competitors on many of the key processes. and charges actually less than the general hospital. the problem with the provision as we presently find it is it doesn't reck mognize the efficiencies of hospitals that are physician-owned. we can close our eyes to some of the abuses and shortcomings as i earlier stated. why aren't we working with some sort of measurement that will allow for physician-owned hospitals that perform within certain guidelines and do it well? to protect us from certain abuses that are out there in today's operations. >> will the gentleman yield? >> only if you agree with me. >> i do agree. >> i'm being facetious. >> i go gree with what you said. you talked about the good and bad actors. t

million claims 21 points finally different suppliers and providers everyday out of the centers for cms we need to pay quickly and efficiently so doctors can be reimbursed, farmers and -- pharmaceutical manufacturers, a quick managers reimbursed and seniors get the care that they need. but how do we make sure the claims payment goes on quickly and efficiently but also making sure those claims are legitimate? there are several prevention and enforcement programs to do just that but over the years, the amount of claims payment and financing has grown far faster and our response. and the five years since 2003, medicare spending went up 10% per year but on the health care fraud it went up just barely 1% per year in spite of the fact we now know the investment yields huge returns and then adding a whole new prescription drug program with medicare part d but to monitor and make sure claims payments are legitimate have barely increase. since taking office in january president obama has recognized that this is a real and important tension comment that he not only provided additional resources,

to play, so in addition to the employees at the administration on aging, if we have both partners at cms, the office of the inspector general and the department of justice. they are all actively working on this. my father was a member of congress in 1965 when president johnson signed the medicare bill into law just over 40 years ago. it was one of the most important steps on behalf of seniors that was ever taken, certainly the biggest advance after social security in the truman days. back then, and it is hard to imagine, but seniors were among the poorest and most of the normal populations because of health care costs and rising bills -- they were one of the most vulnerable populations because of health care costs. now they have some of the best care in america and have security about the health care that they have. unlike private insurance, when you turn 65 or when you qualify as a disabled american, you cannot be dropped because of health coverage. you cannot be denied coverage because of a pre-existing condition. your rates don't change depending on your specific health situation. it

. >> former v.a.d.o.d., cms, congress. in the 1970's, i want to challenge how we're approaching this. in the 1970's, late 1970's, we built an inner city, public-private comprehensive health system, one of the larger communities in the united states and the key, we learned a lot from it to learn what you actually need to produce healthy communities and healthy people. the health reform to date has been good slices, like primary care, health insurance, this kind of thing. speak to me a little bit about what we would really need, what's missing from the health reform discussion about if you really want to build healthy communities, and make that happen. >> healthy communities. >> well, i think most held policy experts and public health experts in particular, would agree that there isn't a whole lot of emphasis on public health in the reform bills. now, there's some. there's more payment for preventive care, etc., etc. but we look at some of the situations that we face now, for example, the obesity crisis and we know we're goi

for service medical sector for over 30 years who has been basically at the mercy of whatever medicare cmsdecides every year whaty services are worth, i have to tell you this, when you talk -- let's not talk about more money in the system and i'm not talking about that either. i would like to see some shifts of money in the system. when an ear, nose and throat doctor gets more money for cleaning the wax out of my paent's ear because that's a surgical procedure than i get when a 90-year-old woman comes in and tells me she had a little spell and i have to use my time, my diagnostic skills to try to figure out is this serious? does she need to go to the hospital and it might take me an hour and somebody cleans wax out of an ear and get more money well, i'd say there's a problem with the system and in my estimation -- and i talked about medicare being a flawed system. it is very flawed but it is fixable. it is fixable. if someone will sit down with doctors who have been doing this for a while andglxsay, you know how would you fix this? ist right that an mri scan is reimbursed at $1200 but you

if i could also add, we do have a services group made up of family members as well as somebody from cmsas been leading this charge along with the president of the autism society of america. together, they have been listening to families about these issues trying to come up with some recommendations. if we could be helpful as you pulled together some of these ideas, i love that group would love to have an audience >. >> somebody mentioned about how you go on the internet and get all kinds of misinformation. mr. cox, you have been on this tele-held for three years now, but you are dealing with trained professionals that you work with. when you mentioned standards, is that when you are talking about, setting up those kinds of standards? >> absolutely. when we started our treatment program, it was comprehensive that for started with face-to- face interaction. unfortunately, families can pop up any internet search and tight end tel-e health treatment -- tyep ipe in tele-health treatme. it is very disconcerting. you can query pretty much anything with autism and related disorders and you will

way to go i think before it is embedded in the major legislation, but in conversations, the senate, cmsthink people know that we need care innovation as much or more than we need payment reform. and i sincerely hope that this is the place in which doctors, hospitals and patients can come together in a different way. thank you. [applause] >> good morning, and thank you, susan, and to health affairs reporting on this very important event. what i thought i might do is give it a little bit and talk some of the issues that were brought up early in the morning but really start with the facts. the facts on the american hospital association. so as we think about bending the cost curve, let me start with two commitments that we have made on behalf of the nation's hospitals. the first is, as you have probably seen, in conversation with the white house and with the senate finance committee, we have committed to contributing to again, bending the cost curve and contributing $155 billion over 10 years. $155 billion over 10 years. that would come through three major areas. fact one is lower payments.

fee-for-service medical sector for over 30 years who has been basically at the mercy of whatever medicare, cms, decides every year what my services are worth, i have to tell you this when you talk about, let's not talk about more money in the system. and i'm not talking about that either. i would like to see them shift some money in a system that when an air nose and throat doctor gets more money for cleaning blocks out of my patience here because that is a surgical procedure, then i get from a 90 year-old woman comes into me and tells me she has had a little spell and i have to use my time, my diagnostic skills to try and figure out is a serious, does she need to go to the hospital, do i need to do some tests in the office, what can i get away with with this woman and it might take me an hour. and somebody cleans wives out of an ear and gets more money. i would say there is a problem with the system. and in my estimation, and i talked about medicare being flawed system. it is very flawed, but it is fixable. it is fixable. if someone will sit down with doctors who have been doing this for a wh

from the iacc perspective, we have a service group made up of family members as well as somebody from cms who has been leading the charge -- the president of the autism society of america. they have been listening to families about these issues and trying to come up with recommendations. i am sure that group would love to have an audience and get some ideas that they have been grappling with. >> you just wrote about standards. someone mentioned that you get all kinds of misinformation. you have been on this telehealth for three years now. when you mention standards, is that what you're talking about? >> absolutely. when we start our treatment program, it is a comprehensive treatment program. unfortunately, families can pop up in the internet search and tiepin -- type in telehealth treatment. i do not see how it is possible to form a true therapeutic bond and go ahead and treat the child. is very disconcerting. you can quarry pretty much anything with autism and related disorders. whether it is some way to repair your car, somebody who can paint your house, it is so sporadic. parents do no

we are looking for a kill on the payload part, 5 cm is what we were off by. the kill vehicle diameter is not the same as the thickness of the target. other questions? >> one of the options that was talked about by congress and the administration was an option in case an option to aero three. we had done analysis of what a configuration would look like. that program is a very good program in the budget that starts the effort next year, funded by congress. additionally, there is part of the review, options for a land- based system street that can be used for --. it is a configuration that has a lot of merit as far as technical. we believe that it is something that we can make work. i had -- i had it at morris town. we know how to do a land-based launch. this is not something technically in a bridge too far. is it what the nation wants? >> thank you for your leadership in this program. [applause] sunday frank rich reflects an 15 years of political columns for the new york times including his look at the future of the internet from 1995. in his column falling 9/1

. >> i am the principal investigator for the cms practice group project. >> i am a family physician anda national medical director for performance measurement and improvements >> imb deputy director of the colorado department of health care policy and financing agency administers the public health insurance programs like medicaid and our schip program. >> i am david dorr, a practicing doctor at oregon health and science. >> i am a family physician with carolina's health care system now. i am the chair of the community care in north carolina and formally the medicaid director and state secretary of health. >> i am with the national economic council curator of one to thank everyone for coming. -- i am with the national economic council. i want to thank everyone for coming. i want to take a few minutes to talk to you about another person to event primary care and frame a discussion for afterwards. as nancy-ann said, we are thrilled that this year we got health care reform in ways that could reduce the costs for american families and businesses, increase the quality of care and expand acces

fee-for-service medical sector for over 30 years who has been basically at the mercy of whatever medicare, cms, decides every year what my services are worth, i have to tell you this when you talk about, let's not talk about more money in the system. and i'm not talking about that either. i would like to see them shift some money in a system that when an air nose and throat doctor gets more money for cleaning blocks out of my patience here because that is a surgical procedure, then i get from a 90 year-old woman comes into me and tells me she has had a little spell and i have to use my time, my diagnostic skills to try and figure out is a serious, does she need to go to the hospital, do i need to do some tests in the office, what can i get away with with this woman and it might take me an hour. and somebody cleans wives out of an ear and gets more money. i would say there is a problem with the system. and in my estimation, and i talked about medicare being flawed system. it is very flawed, but it is fixable. it is fixable. if someone will sit down with doctors who have been doing this for a wh