i want to pause here from my prepared remarks to talk about the colonoscopy benefits. you will probably hear about our hips and knees referenced by saying, and i'll be happy to talk about it, but also in the blue shield plan, we did implement a colonoscopy benefit, whereby if a member seeks their colonoscopy from an ambulatory surgery centers, they do not have a share of costs associated with that for the same facility because those numbers were also real. you can see variations from a few hundred dollars from the same procedure up to $8,000. we saw the same variations for hip and knee replacement that went from $15,000 to $110,000. we also have a pricing program for inpatient hips and knees. as i said, there are dramatic price variances for the same procedure in the same locale with no relation to quality or clinical outcomes. we have also seen in the rate needed -- negotiations over the last eight years our utilization in terms of increased actually flat in and in many instances decline. yet, our unit costs trend continue to run in the double digits. i want to talk a

colonoscopy, routine screening for cancer. those numbers range from about $900 to over $8,000 for the same procedure across the spectrum here. that green line herethat green e places, it cuts off at some number which they declare as the reference price. what does that mean? if you are an employee of this company, they will pay it up to what ever it is -- $1,500 -- for a colonoscopy. you decide where you want to go. here is the data. we can assure if you go to the centers to the left, you will be fully covered. to the right, you will be out of pocket. that is one approach that could be used. supervisor campos: is there a difference in the quality of care? >> great question. i wish we knew. for something like colonoscopy, in the centers that provide that service, there are lots of safety checks done by the state. they have to report to various entities, so it would be much better if we knew the data. i have to tell you, caterpillar, in illinois, obtained the data from their endoscopy centers for this procedure on quality, and th

from an old problem with as much to procedures like colonoscopy is, i depend on cpmc on monday of this week, my daughter gave birth to my 9 pound 12 ounce grandson. my daughter was first treated for type one diabetes at cpmc and of all of her pregnancies are high risk requiring best possible care. from an old problem of asthma to procedures like colonoscopies i depend on the cpmc doctors for my most important medical needs. i want any children and grandchildren and great grandchildren to have access to the same great care that we have been sing. the proposed plans to build a new hospital will ensure that people of san francisco continue to have access to great care they have been receiving from the hospital in many cases longer than i. this rebuild is vital for our future's generations health, well-being. thank you for your time. please support the rebuilding of cpmc. thank you. >> congratulations, g >> good evening. my name is vanessa gutierrez and my daughter was a patient of cpmc. on may 2007 my 4-month-old daughter became very ill. after rerushed her to the e.r., at st. lukes docto

i'm not sure what you get for a $7,300 colonoscopy but it shouldn't be that way. what we need is complete transparency in the system. think of open table for restaurants. for exarvings-rays, for vaccines, for shots. they will redefine equality for the routine services that they got. that will do more to redefine between a.c.o.'s and a consumer marketplace. more to redefine the shape of our system and the cost structure and pricing in our system than any that is contemplated. so with that i'll turn it over to our next speaker. [applause] >> well, he is going up. let me remind the audience that you have a require opportunity to ask questions of so please, i think you go to world conk.com and we'll make sure that we have to answer that as soon as we can. >> good morning. i spoke to transparency and prevention and the need for improvement in health care as well as a system where the lines are there to produce that. i want to thank the world health congress for bringing us together to call all question and the cost is because i want to speak directly to the issue of th

i am not sure what to get for a $7,300 colonoscopy [laughter] may be a movie. it should not be that way. what we need is complete transparency in the system. bank of open table for restaurants, think of open table for physicians for lab tests, x- rays, vaccines, shots. allowing people to read the fine quality as convenience for the routine services that they get. that will do more to read the fine between aco's and a consumer marketplace and redefine the shape of our system and the cost structure and pricing in our system than anything the affordable care act contemplates today. i will turn it over to our next speaker. [applause] >> let me remind the audience that you a rare opportunity to ask questions of the panelists. you can go to world health.com and submit your questions. >> good morning. the previous speaker poked -- spoke to the importance of prevention and transparency and the need for the transparency yielding improvements in health care as well as a system where the incentives are aligned to produce that effect. i want to think the world health congr

cpmc has donated x-rays, mammograms, colonoscopy is, exercise tolerance tests, encouragement, help us to apply for grants, and literally hundreds of specialty visits that have been donated to our patience when needed. the have been a huge part of our ability to deliver care. they are good people. they knocked on our door. i tell a similar story to the gentleman that just spoke. they knocked on our door and offered to help. it has been tremendous, freely given, never asking anything in return. it has literally been hundreds of services donated from every level of the hospital, from the nursing staff to the position staff. my hope is that you will agree with their plans for rebuilding. thank you. president olague: if i called your name and you can make your way to the microphone, that would be great. >> good evening. my name is gordon mar, with jobs for justice, a coalition of community and labor organizations in san francisco, working together to build a strong economy for all san franciscans. we have joined with the good neighbor coalition and the coalition for health care planning in

as a member of your family had a colonoscopy in a freestanding center far from a hospital? hospitals and doctors compete for patients just as hospitals compete with each other. another big driver is inappropriate care. this includes care that is unnecessary and care that is needlessly duplicated. you would be amazed how much of what passes for health care has never been tested or proven to have a beneficial effect for the patient. it makes money for the provider. it may make the patient feel something has been done or tried, but the outcome does not change. duplication of expensive diagnostic testing is essentially troublesome. as a family member or friend been referred to a specialist or up to ucsf or into cpmc from out of town with no record of what was done for the referral, so blood tests are done all over again? this happens every day. another external driver is poor quality care. about 10 years ago, the concept of never events began to take hold. this is surgery on the wrong leg, a drug those that combine with another can be lethal. an infection that could be prevente

colonoscopy, routine screening for cancer. those numbers range from about $900 to over $8,000 for the same procedure across the spectrum here.

and the scrutiny is going to be worse tan colonoscopy. i'm going to be honest.bama has not gotten that scrutiny. is this a legitimate question he should had been asked considering he had radical an e sos in the past? >> more important what is he going to do about the economy. to articulate a poll -- >> sean: is this a fair question? >> it is a fair question but there is no evidence to suggest that the two have links. >> are we gonna know what the truth -- will the truth come out? regarding farrakhan he's a radical he's made awful comments about jewish people. >> sean: would it mean anything if they were friends? if they did eat together, counsel each other? >> it concerning. he's the leader of the free world and hanging out with these radicals. >> sean: even if it was early in his life? >> we could spend the entire segment talking just about the people he associated with. >> sean: we have a lot to get to, including john boehner's comments that has some tea party members upset. more after the break. and grilled shrimp salad combination? or maybe skewers of wood-g

know if leaving cbs is a good idea unless she's planning to launch her violent torpedo of colon colonoscopyth tour. before the presidential election in 2012. who will be brave enough to ask sarah palin questions that should be easy to answer now? katie couric has not commented on the story because she's in iraq right now. geraldo is in libya. geraldo loves to be in danger. his magic mustache somehow protects him from any harm. whenever there's trouble in the world, fox news sends geraldo. they've been try to get rid of him for years. yesterday, he was in ben ghazi, libya, where the locals made him feel very welcome. [ gunfire ] >> take a knee take a knee. [ continued gunfire ] [ speaking in foreign language ] >> get out of the car! get out of the car! [ gunfire [ [ watch it, watch it! [ gunfire ] tell them not to shoot us. don't shoot us. don't shoot us. [ speaking foreign language ] [ gunfire ] >> oh! jz >> jimmy: see, that's smart. a lot of reporters don't think to tell the army not to shoot them. if you just tell them, they won't. and they didn't. [ applause ] the college basketball ncaa

americans prevent illness or disease by providing free preventive services like mammograms an colonoscopies repeal would allow insurers to charge expensive co-pays for these important services, thus discouraging people from getting colonoscopies or mammogram screenings. if we pass this bill, this bill to defund the affordable care act, congress will turn its back on america's seniors after hard-won improvements in medicare benefits and damaging the program's fiscal health. it would open the medicare part-d doughnut hole exposing seniors to the full cost of drugs when they need the most assistance. repealing the affordable care act would increase seniors's drug prices on average by more than $800 this year and $3,500 over the next 10 years. it would roll back the unprecedented investment the affordable care act makes in medicare fraud prevention turning back the affordable care act would hurt seniors's access to rural areas by eliminating incentive participates in the affordable care act paid to rural primary care providers. repealing or defunding, as this bill would do, defunding the afford

another example in the city of san francisco a routine colonoscopy costs anywhere from 1,000 to hundred $50 to $7,300. now i'm not sure when you get for 7300 dollar kowalski. [laughter] media movie? [laughter] but it shouldn't be that way. so what we need is complete transparency in the system. think of open table for restaurants, think of open table for physicians come for lab tests and x-rays and vaccines, flu shots. as an approach of allowing people to redefine quality as convenience for the routine services that they got. it will do more to redefine between the aco and the consumer marketplace more to redefine the shape of the system and cost structure and pricing of the system than anything with the affordable care act contemplates today. with that i will turn it over to the next speaker. [applause] >> while dr. bertolini is coming up, we have a real opportunity here to ask questions of the panelists and so please a few questions put to congress, and submit questions and we will answer as many as we can. thank you. john? >> good morning. both previous speakers spoke to the importan

and then have programs such as mammograms and colonoscopies. and help children to grow up healthy and strong to prevent obesity. we want to start working together to solve the real problems facing our nation. i ask my colleagues to oppose this partisan and divisive legislation. and i yield back the balance of my time. the chair: the gentleman's time has expired. the gentleman from pennsylvania is recognized. mr. pitts: mr. chairman, i at this time yield three minutes to the distinguished vice chairman of the subcommittee, the gentleman from texas, dr. burgess. the chair: the gentleman from texas is recognized for three minutes. mr. burgess: i thank the chairman for yielding. mr. speaker, i do rise today in support of h.r. 1217, the bill that as we already heard repeals the public slush fund that was included in the patient affordable health care act passed a little over a year ago. this fund called the public health fund is almost $18 billion that accounts for the next eight fiscal years, and the secretary of health and human services gets to s

during a colonoscopy, doctors found nathan had a malignant tumor, stage three rectal cancer.nine days later alisa was diagnosed with stage four breast cancer which is considered incurable. >> that made me angry. i don't ask really why we have cancer but i was angry at my tumor that it was going to get in the way of takening ca itaki her. >> reporter: he wouldn't have to go it alone. in a testament to just how much they are loved, friends from all corners of the country showed up at the bond home in brooklyn. they divided up the work from taking nathan to chemotherapy to girl time with alisa. because of the treatments alisa quit her job and nathan is on leave. with mounting medical bills their friends created a website for donations. al lolisa is blogging about the journey through cancer. >> it is strange to me that something so horrible could bring about so many blessings. >> reporter: while the future is uncertain what has never been in doubt, the bond between them and their unflappable spirit. >> we are determined to get through this. if you envision our circumstance, don't

another example in the city of san francisco a routine colonoscopy costs anywhere from 1,000 to hundred $50 to $7,300. now i'm not sure when you get for 7300 dollar kowalski. [laughter] media movie? [laughter] but it shouldn't be that way. so what we need is complete transparency in the system. think of open table for restaurants, think of open table for physicians come for lab tests and x-rays and vaccines, flu shots. as an approach of allowing people to redefine quality as convenience for the routine services that they got. it will do more to redefine between the aco and the consumer marketplace more to redefine the shape of the system and cost structure and pricing of the system than anything with the affordable care act contemplates today. with that i will turn it over to the next speaker. [applause] >> while dr. bertolini is coming up, we have a real opportunity here to ask questions of the panelists and so please a few questions put to congress, and submit questions and we will answer as many as we can. thank you. john? >> good morning. both previous speakers spoke to the importan