it's this work that elliot fisher and jack wennberg have explored at dartmouth. it's that we overbuild and, therefore, we use. and there's no limits, there's no cap, there's no control. and so we just spin the wheel. >> what's truly staggering is how much waste there is in our health care system. up to one out of every three of the more than two trillion dollars that we spend is wasted on ineffective, often unproven procedures, overpriced drugs and devices that are no better than the drugs and devices that they're replacing. unnecessary hospitalizations, unnecessary tests. now this may seem like an overstatement. i mean, how can it be that 1/3 of the money is wasted? we actually have close to three decades of research done by doctors at dartmouth university proving how much waste there is in the system. what the dartmouth research ended up doing was looking at health care all across the country and what they discovered is that in some high treatment states, like new jersey, medicare was spending 20% more per patient than the average. and in other low treatment st

at baseline, dartmouth hitchcock, as all of you know, has superb clinical reputation. over 1,000 physicians who provide excellent care in both urban, rural, and academic settings. and parallel to that we have cigna healthcare who over recent years has developed robust health advocatesy services, both teletonnic and internet based case management, disease management and wellness services as well as pretty significant health infomat ex services to guide the improvement in care. we had two problems. first of all, these clinical efforts were not ideally connected. so two systems running in parallel and we weren't getting the synergy we wanted ou out of connecting those two systems. the second was that our primary interaction to exaggerate the point was a periodic no, over fee schedules every couple of years and it was not an interaction where we sat down together and said, how do we improve fundamental value? how do we improve both quality and affordability, and how does the plan reward dartmouth for doing that? so we developed a new program together that has the key conce

at baseline, dartmouth hitchcock, as all of you know, has superb clinical reputation. over 1,000 physicians who provide excellent care in both urban, rural, and academic settings. and parallel to that we have cigna healthcare who over recent years has developed robust health advocatesy services, both teletonnic and internet based case management, disease management and wellness services as well as pretty significant health infomat ex services to guide the improvement in care. we had two problems. first of all, these clinical efforts were not ideally connected. so two systems running in parallel and we weren't getting the synergy we wanted ou out of connecting those two systems. the second was that our primary interaction to exaggerate the point was a periodic no, over fee schedules every couple of years and it was not an interaction where we sat down together and said, how do we improve fundamental value? how do we improve both quality and affordability, and how does the plan reward dartmouth for doing that? so we developed a new program together that has the key conce

he went to dartmouth, the rival school, though. was this about race or was this about something else? >> it was about a lot of things. i think the fact that sergeant crowley who i also know and who is a very decent man, his aunt has been helping us clean our house for 20 years, a wonderful woman, francine, i think the fact that he didn't believe that he owned the house immediately, the house has many pictures with skip and nelson mandella. after that it was contempt of cop or disturbing the police. if you talk back to the police that is going to happen. i got arrested in fenway park and taken away also twenty years ago. >> geraldo: you weren't streaking were you? >> a couple of seconds before the race. >> i think it was turning into class. it had been race and i think they stepped back saying this starts to look like, you know high brow harvard professor and a blue collar policeman but henry is a terrific guy and i love him. >> geraldo: we will take a break and be right back from break and be right back from rainy martha's break an

meanwhile in another town hall event in dartmouth, mass last night congressman barney frank dismissing a nazi comparison as all such comparisons should be dismissed. >> they say we need to limit medicare expenditures in order to do that, in order to reduce the deficit. that's the origin of this policy. this is the t4 policy of the hitler policy in 1939 where he said certain lives are not worth living. certain people we should not spend the money to keep them alive. my question to you is why do you continue to support a nazi policy as obama has expressly supported the policy. why are you supporting it? >> i'm going to revert to my ethnic heritage and answer your question with a question. on what planet do you spend most of your time? it is a tribute to the first amendment that this kind of vile, contemptible nonsense is so freely propagated. >> amen. time now to bring in our own howard fineman senior washington correspondent for "newsweek" magazine. good evening. >> hi, keith. >> a clear majority of americans in a poll conducted by a conservative leaning polling group want a public opti

the dartmouth ogan is "vox clamantis in deserto which is that voice cryg out in the wierness, and i thought it was a good anagy for me because i came here beuse i heard another voice, jack liberg, talking abt the disparities in the delivery of ouhealth care system and the irrationali of its utization. and, now, hang been here for 12 or so years, i realize it an uphill battle. you can't fighcity hall, but we're gointo try. >> in the early 19s dr. jim weinstn made a courageous cision. he decided to walk ay from tenure and an endod chair in the university of iowao go to dartmout where he would participate inevising ways to lp patients become involved making decisions about the own care. as a surgeonweinstein had long lt that patients just weren't getting a fair ske, as he put it. they weren't getng the inrmation they needed about the risks treatments. too ten, informed consent was informed persuasion. ultimately, illness in his o familyould drive that lesson home. >> my dahter's name is brienna. she had beautiful blueyes, curly brn hair; your first child, the light of yourife. 13 months ter i

elliott fisher, director of the center for health policy research at the dartmouth institute thinks it'sot a question of how much doctors are paid. >> we don't need to pay physicians less at all, we need to pay them differently, we need to give them rewards for improving the overall quality and lowering the costs of care and paying them more when they lower the cost of care. a lot of costs are in unnecessary hospital stays, patients could be cared for at home. there are ways of reducing the costs that would give us a little bit of money to reward the physicians for doing better and actually perhaps preserve or improve their incomes. >> reporter: other cost-savings features of the billings clinic include an electronic records system. that gives doctors quick access to patients' histories and treatments clinic-wide. and billings doctors are able to treat thousands of patients in remote areas of the state and in the neighboring western dakotas, wyoming and idaho through an integrated telemedicine program. >> i wanted to do a follow-up visit with you to see how things are going. >> reporter:

fix today's problem and worry about tomorrow's torrow -- and en you have hank paulson, this former dartmouth ftball player whichomes up in every profile of him because he feels like a football player, very restless, done 100 dels on wall street, very patient, very 2k3w6, gives orrs, expects people -- very gruff, gives people oders and expec them tocomply, sees hielf as the superior of all the c.e.o.'s, they come to tis ekend hoping toell lehman brothers to aritish bank like they had sold bear stearnsto j.p. morg/chase earlier, they don't ha a plan b and e rest is history. >> brown: there ishat sense of -- 's an interesting mixof making itp as you go but based on some experience. >> no, thiis all new. >> well, i think in a whe most eventi event isernanke since the man spends his tire previous adult life sdying the mistakes the fed made in cusing he great deession. ce he figures t that this is likehat again, heooks at the whole world through that lens. some people think he's overreacting or jst sticking to the paradigm heknows, but it becomes clear tat it is the right paradigm it is the right

congressman barney frank held a town hall in dartmouth, mass. that just finished a few moments ago. we were there to witness all of it and we have an update. >> leave it to barney frank to take a different tack with town hall meetings. he was as contentious and cantankerous with the audience as anyone i've seen. this just ended a couple of moments ago, ending just two and a half hours in an early part of the meeting. the party chair here had to try to escort someone out. take a look at what happened. >> get out. >> get out. >> ray, i have just ask the chairman to ignore the disruptions. >> and that chairman offering for both sides to be heard. people were giving a referendum on washington. they are upset on the deficit spending. they are upset about the things that are being done. >> do you really think that that is thoughtful conversation or that advance is your argument? i thought you were thoughtful people here to have a conversation. is it because you don't like what i'm saying? what is the matter with you all? what do you think you are accomplishing by yelling? >> he talked dow

i'm watching this thinking i feel like i'm back at dartmouth and down at the beta house fraternity basement. >> does the story die tonight? i hope so. >> i hope so. can i think there could be a reality show with gates and crowley. that would be a lot of fun. maybe fox can spin that off. >> i like the mod squad concept. >> i'll be julie leftin. i'll volunteer for that. i love the mod squad. don't you miss that show? >> no. i liked it but i don't miss it, i have a lot of things to do. >> do you notice when they were all toasting with the beer mugs, do you see the photo? where was biden in the photo? he was no where to be found. >> he's smoking pot. no, i'm kidding. >> he was gone. they wanted to make sure that he was under control during that. they had him there, they didn't want him in the photo. >> i like biden, i have to admit. i don't know why you guys don't like him. he says what is on his mind. he goes to the ukraine and says the girls are pretty and they are. come on, he is sitting there with a little brew. biden is probably the only one that drank the beer. i'm going on record. >> bil

the town hall meeting took place at a senior center in dartmouth. frank was talking about health care and financial issues. a woman holding a small poster that showed president obama with a hitler-type mustache accused frank and the president of supporting nazi policy. she said the plan they support seems to mace value on some lives over others. frank listened and then lashed out. >> compare the -- to increase health care to the nazis by answering you with it is a tribute to the first amendment that this kind of vile nonsense -- >> reporter: barney frank chairs the house financial services committee. he held a town hall meeting to reassure people that most taxpayers would not suffer under the plan being considered. >>> a soldier from our area has been killed in afghanistan. sergeant first class william woods jr. was from chesapeake, virginia. he died on sunday in germany at the medical center. he was shot two days earlier while on patrol in afghanistan. sergeant woods was assigned to the second battalion in maryland. he was 31 years old. >>> the fin

he's live for us this morning in dartmouth, massachusetts.ts best. you elect this guy, he's supposed to represent you and you guys have a healthy back-and-forth when you don't agree or you have questions. >> reporter: i was waiting for the congressman to remind people to tip their waiters and bartenders before the evening was over. yes, we've heard the white house suggest that the public is only seeing the rowdiest moments from these town halls. that is not the case with barney frank's town hall. there was nothing but rowdy moments. >> congressman barney frank. >> reporter: it didn't take long for the shouting to start. >> what's the lie? is. >> hey, hey, enough! >> which one of you wants to yell first? >> reporter: before the first question was asked, massachusetts democrat barney frank was swinging back at opponents of health care reform. >> disruption never helps your cause. it makes it look like you're afraid to have a rational discussion. you just drive people away. i'm not here -- this is the council on aging, not kindergarten. >> repor

here in dartmouth.i am joe, and i'm on the chairman of the veterans advisory board here in dartmouth, and i served it in him. and i have quite a few constituents who are worried about their care right now and they are in a special group that is growing very quickly because we are doing a very good job out in the field in iraq and in afghanistan bringing back more of our boys and girls that are doing a great job. but they have a lot of ailments. you did say that you are looking for other sources of revenue, and i understand the situation because dartmouth is looking for other sources of revenue as well. but my question is, as we introduce this new health care for everyone in the united states, including the extra 50 million that don't have any care, the rationing of, you know, resources is going to be very, very tight. how do we avoid the progress that the pa, the veterans administration, and the veteran groups have made so far in getting the care that they need in bringing up the level of care that they

. >> massachusetts congressman barney frank held a lively townhall meeting in dartmouth last night. and among the questions is how the government will pay for health care reform. and average taxpayers would not be hurt by obama package. >> townhall meeting today, lincoln davis, told the crowd where he stands. davis is very interested in health care coop idea. >> well some democrats are beginning to wonder if compromise on health care reform is possible at all. president obama wants a public option, of course. senate finance committee max bock baucus said his gang of six is set to reach a compromise but no guarantee that senators will vote for it. toed the white house said it wants all the g.o.p. votes it can muster. >> he can and will continue to work to try to go agreement on both sides of the aisle on this. the president believes this issue is far too important to not try. >> some liberals hope democrats will use all of their power to pass something, with or without, republican support. >> president obama wants religious leaders behind health care reform as well n a conference cal

massachusetts congressman barney frank firing back at a crowd in dartmouth. >> why continue to support a policy as obama had expressly supported the policy. why are you supporting it? >> let me, let me -- i will. >> a real solution. >> when you can smee thaet question i will revert to my ethnic heritage. on what planet do you spend most of your time? answer the question. yes, you stand there with a picture of the president with a face to look like hitler and compare the effort to increase health care to the nazis, my answer to you is, as i said before, it is a tribute to the first amendment that this kind of biocontempable nonsense is so freely propagated. having a conversation with you is like arguing with a dining room table. i have no interest in doing it. >> despite that, he answered questions for two hours. he's one guy who doesn't mind taking heat. one question a lot of you are asking, will health care reform lead to rationing? you heard the arguments and now josh levs and the cnn truth squad have a verdict on this, josh. oh, it's coming. that's a tease. josh, i was all setting y

. >> dartmouth, outstanding work, done there. he makes an important point here, because dartmouth has said, up to 30% of the money, spent does not improve health care outcomes. we can do so much better than that. >> one quick question just on politics. we've seen poll numbers that think the president's plan is a bad idea go up. we've seen cops escorting congressmen to their cars after town halls. what is different between what's happening now and what happened in '93? why are the wheels not coming off the bus, in your view? i assume you think they're not. >> i don't think they are. and i was deeply involved in '93, i was on the finance committee then. i was part of the main street coalition, democrats and republicans, that produced then a compromised plan, but we were prevented from ever offering it to our colleagues. i thought that was a big mistake at the time. that's not a mistake that's going to be repeated. we are going to have a chance to offer a bipartisan plan to our colleagues. and it is, i think, a way of addressing wha

andrew: things heated up at a town hall meeting at a senior center in dartmouth, massachusetts. wait until you see this. take a look at congressman barney frank, barney frank attacking the same people he is supposed to represent. >> >> trying to have a conner conversation with you is like arguing with a dining room table! i have no interest in doing it! andrew: joining us with dr. keith ablow, a psychiatrist and fox news participator. some of the things were wild and some of them uninformed and some of them intended to antagonize him regarding the questions but referring to his or comparing his constituent to a dining room table. what does that tell you? >> it is very unfortunate, obviously. i can't imagine what you achieve by doing that. i don't think you send out a signal, even to the faithful followers that you're someone to follow. in other words, it is the end of a discussion. it sounds like a schoolyard bully at that point, not somebody worthy of leading. i'm sure he regrets it, i would hope, the day after. andrew: should he be cool, calm and collected, it's all right, the

second, i appreciate the democratic town of dartmouth.ote that somehow it's become fashionable to denounce partisanship. people can get their disagreements as members of different parties can get too bitter or overcome where there should be agreement. maybe it's paradoxal but a poll down in washington as to which people on each party thought -- members of the other party were the most partisan or the most bipartisan and i was kind of pleased that i was the only one who was picked as both one of the most partisan and one of the most bipartisan. [laughter] >> that's 'cause i think that's what it's supposed to be. there are areas that differ and that's why we have parties and elections and you should be very vigorous and you shouldn't allow those disagreements to spill over so you can't cooperate when you have some agreement. so i'm pleased to be here. i do want to explain why i'm here. i know that a number of my colleagues have been having town meetings and because a number of people have asked me for a long time i'm going to call on one of

senator, congressman barney frank of massachusetts wrapped up a town hall meeting on health care in dartmouth, massachusetts. watch this exchange. >> why do you continue to support the policy as obama has expressly supported this policy? why are you supporting it? >> let me -- i will -- when you ask me that question, i'm going to revert to my ethnic heritage and answer your question with a question. on what planet do you spend most of your time? you want me to answer the question? yes, as you stand there with a picture of the president defaced to look like hitler and compare the effort to increase health care to the nazis, my answer to you is as i said before, it is a tribute to the first amendment that this kind of vile contemptible nonsense is so f e free. i'm trying to have a conversation with you would be like trying to argue with a dining room table. i have no interest in doing it. >> larry: we are now connected with governor dean. you can see a lot of this occurring across the country and comparing the president to hitler and conceptions like that. how did it get to this, howard? >> loo

. >>> dartmouth college is topping one list that pays off. 2009 college report shows the grads lead the country in pay. they have an average of $129,000. mism that's it from cnbc, first in business worldwide. back to msnbc. >>> welcome back, everyone. i'm tamron hall live in new york. >> and i'm david shuster live in washington. >> and, david, i have this hot note that just came in to us regarding senator chris dodd. he underwent prostate surgery today for early stage of prostate cancer. the surgery was a success, and senator dodd they say is doing well. he's going to remain in the hospital for a few days. after a brief recuperation at home with his family, he's looking forward to getting back to work later this month on behalf of the people of connecticut. we're just getting word that senator dodd did undergo surgery today to treat early stage prostate cancer. he's doing well and he's looking forward to getting back to work after the recess. >>> tamron, in the big picture right now, the growing saga involving south carolina republican govern

look at the dartmouth atlas program in which we've got about -- if you did the reforms that we've done in the upper midwest across the country, you could save 5% of g.d.p. in health care reform. neil: ok. governor, they're going to look at that, i'm sure after hearing you now. i do believe they watch us. they just don't say. thank you very, very much. good having you on. >> thank you, sir. neil: they call him romo for his tough political still. did he go too far? you all want to run your businesses more efficiently, so we've brought in a team of experts to help. one suggestion is to make your shipping more efficient with priority mail flat rate boxes from the postal service. call or go online for a free supply and up to $160 in offers from authorized postage vendors. shipping's a hassle! weighing every box... actually, with flat rate boxes you don't need to weigh anything under 70 pounds. if it fits, it ships for a low flat rate. ok, but i ship all over the country. you can ship anywhere in the country for a low flat rate. ship international, too. yes, but i ship hundreds of things, in

so, in new hampshire, three or four times, i went out with a young kid, from dartmouth.and this was a really interesting, i kept on wishing that i was a fly on the wall, or an ethnographer, watching us navigate our relationship. >> moyers: how so? >> and these encounters. because this was a kid who had, you know, voluminous knowledge about the sort of politics and the names, who was incredibly energetic, who had great ideas. who was completely urgent and impatient and a terrible listener, right? and also someone who stereotyped all of new hampshire. he thought they were all kind of backwoods, rural, country people. republicans, right? and that they hadn't really thought deeply about these matters. and that all he needed to do was feed them the information. right? and not expect them to change. my approach, of course, was one of beginning by listening to them. not assuming that i knew who they were, just because i knew where they lived. right? not beginning with a stereotype, but with trying to... with expecting that they had the capacity to think deeply, as well. and so

directives quoting in la crosse, wisconsin, the gunderson luther hospital system is according to the dartmouth least expensive place in america for the last two years of life. they have an advanced directive program and over 90% of the patients have an advanced directive. they have electronic health records so everybody knows what it is. the result is the last two years of your life and costs are about $13 $13,600. the last two years at ucla are $58,000. why should medicare pay $58,000 for the same outcome if it could pay $13,600? the point, when people decide what they prefer ahead of time it gives peace of mind not only to the family but happens to save everybody a lot of money. on air advertisements were provided for a company that has wills and living wills. just like advance directives, just like end of life counseling, it's a good thing. which brings us back to the cluster fox nonsense that is glenn beck. after he called president obama a racist with, quote, a deep seeded hatred for white people his advertisers fled. the late snet conagra, roche, radio shack bringing the total to a dozen

last night congressman barney frank held a town hall meeting on health care in dartmouth, mass pass and will a woman questioner compare obama health care with hitler. he didn't like the comparison and thought it was loony tune. >> why do you agree with the policies as obama has, why are you. >> when you're asking that question, i'm going to revert to my ethnic heritage and answer your question with a question. on what planet do you spend most of your time? it's a tribute to the first amendment that this kind of vile contemptible nonsense is so freely propagated. >> ma'am, trying to have a conversation with you would be like trying to argue with a dining room table. >> what do you say to someone zoned into some other universe? time for tonight's big number. covering all your bases. today president obama is calling on support from religious leader who's see health care reform as a moral issue. according to "the new york times," he'll address over 1,000 of those religious leaders in conference calls to get their support. he's reaching out to over 1,000 leaders of faith today to preach the

according to research terse at the university of massachusetts at dartmouth, paper money contain alarminglyn the u.s. revealed traces of cocaine on 210 out of 234 u.s. dollars sampled. can you believe that? >> wow. >> you might remember a lot of people talked about the fact that the paper dollars carry germs, so you're supposed to wash your hands if you handle cash, but cocaine? >> well, i have a feeling, moni monica, that one of my former college roommates unfortunately is accounting for some of that last we heard. just crazy. >> former roommate and now former friend. >> exactly. of course, no one knows which one it is. well, we know. monica, peta is out with a new outrageous and controversial campaign ad. a drawing on billboards in jacksonville, florida, shows an obese pom with the phrase save the whales, lose the blubber, go vegetarian. a lot of people think the ad is sexist, but peta defends it saying the billboard reminds people who are struggling to lose weight that going vegetarian can be an effective way to shed those extra pounds. >> come on. okay. first of all, i don't even know t

second, i appreciate the democratic town committee of dartmouth.olitical parties play a very portent role in america and in the democracy. i know it has become fashionable to denounce partisanship. partisanship can become excessive. disagreements people have as different parties get to better or overcome areas where they should be agreed in -- where they should be in agreement. the was a poll as to which people in each party that the other members of the other party were the most partisan or bipartisan. i was pleased i was the only one picked as both one of the most partisan and one of the most bipartisan. i think that's the way it's supposed to be. there are areas where we differ and that's why we have parties and elections. but you should not allow those disagreements to spillovers the you cannot cooperate when you have agreement. i want to explain why i'm here. i know a number of my colleagues have been having town meetings. because a number of people have asked me to, i will call one of my own later. i think it's odd that people oppressing us f

[laughter] at 24 he was a professor at dartmouth where he founded in psychology department and afterwas done and he had published his study of the origins and psychology a pleasure and pain, and after he had three children with his adoring wife and after have gained a small reputation as an academic innovator and receive the invitation to tour europe he was offered a the presidency of a small women's college in saratoga springs. this is where he stayed for the next 35 years, he played the organ a church and was a gifted pianist and gave concerts to the college community. although totally bald before u.s. 30, like all those graduate degrees, he was still fantastically handsome. i remember that as a kid it. he was fantastically handsome like ed harris only atoll. [laughter] and he was much loved by a student at the college whose names and faces he would never eyes before they even arrived as freshmen and. and so he would greet them by their names without ever having met them before. as he walked across campus, which flattened the heck out of them but also freaked that out. [laughter] a

well, it was at a senior center last night in dartmouth, massachusetts. it was extraordinary. hardly ever see an elected official bad mouth his constituents like barney frank who was frank and quite rude to some. here is another excerpt and he really shook it up. >> i'm just curious, do you really think that's thoughtful conversation? do you really think that advances your argument? i thought you were thoughtful people here to have a conversation. i guess i don't understand -- is it because you don't like what i'm saying that you don't want me to say it? what's the matter with you all? i don't understand your mentality. what do you think do you think you accomplish by yelling? what do you accomplish by yelling? brian: he doesn't take into account. the difference is he is entitled to give his opinion that's how he got the job. that's why he is in politics to make decisions. the problem is listening. he listens and just hears anger and he does the same thing with these constituents, 500 of which showed up last night dartmouth university at the senior center there instead of mirr

barney frank firing back at the crowd at dartmouth.y do you continue to support a policy as obama has, expressly supported this policy, why are you supporting it? >> let me -- i will -- >> a real solution. >> when you ask me that question, i am going to revert to my ethnic heritage and answer your question with a question. on what planet do you spend most of your time? do you want to answer the question? yes, as you stand there with a picture of the president defaced to look like hitler, and compare the effort to increase health care to the nazis, my answer to you is, as i said before, it is a tribute to the first amendment that this kind of vile, contemptible nonsense is so freely propagated. i'm trying to have a conversation with you, would be like trying to argue with a dining room table. i have no interest in doing it. >> okay. there are, as we know, critics out there that weren't just critics at this particular event, he made a mention of her, plenty of critics not all do the type of things -- i didn't get to see the picture but s

jim acosta, cnn, dartmouth, massachusetts. >>> all right, jim, more lawmakers meeting with their constituents here's a look at where town hall meetings are scheduled today. scattered across six states from alabama to texas and oklahoma. if you want to know more about the health care reforms and how it will affect you, check out our special health care in america section at health care in america. go to cnn.com/healthcare. >>> michael jackson's doctor, the man who was there when he died. he breaks his silence. you want to hear what he has to say. >>> nearly two years after michael rashard was executed, judge sharon keller is on trial for ethic violations. she is answering questions about why she refused to keep the texas court of criminal appeals open past 5:00 p.m. when his lawyers asked for more time to file appeals. she said she was never told of the delayed filing. >>> in about two hours we expect to hear from the mayor of milwaukee. the first comment since beaten saturday night after rushing to help a woman and her 1-year-old granddaughter. police say the man who beat him was the baby's f

and we thank him for taking time out of his schedule to attend this meeting here at dartmouth.to introduce you, congressman barney frank. [applause] [boos] >> thank you. first, i want to welcome some of the national press to southeastern massachusetts. stick around for a while, go to the whaling museum, go to the great beaches. you are in a town right next to two towns that are right together the most important fishing port in the united states. look at the great work force we have here and i am very pleased that we have been able to get some attention here and i hope people will hang around. if you want to hit a nice beach or to, you do not even have to go across any bridges. they are nearby and you can enjoy yourself. second, i think political parties play very important role in america and in any democracy. i did note that some out is fashionable to denounce department -- partisanship. it can become excessive. people can let the disagreements that they have get to bidder or overcome areas where there should be agreement. -- get too bitter or overcome areas where there should

their congressmen they get danced -- the congressmen danced on their head like barney frank did in dartmouth a couple of days ago, we are like wait a minute, we are the ones out here working, we are the ones paying these bills or are told our bills are being paid, they are not being paid. we have a $9 trillion deficit we are working with now and that is probably only the tip of the iceberg. our kids are paying for this while the printing presses run round the clock. this is out of control. it is insanity. and when people look at the obama care thing, they look at this and say we are in a lot of trouble. we are in a lot of trouble but for god sakes stop spending money and start listening to us. teaparty express is where it is at. >> folks will be listening as you gather steam and come here in september. >>> the president and the first family are now departing for martha's vineyard. they are aboard air force one. taxiing out to take off on a nice day. much better weather waiting for them at martha's vineyard. more on their visit, up next. i never thought it could happen to me... a heart attack

degree from cornell medical college following his undergraduate degree from dartmouth. after serving at an internship he did post-graduate training at the university of medicine, the boston's children's hospital the graduate school of medicine at the university of pennsylvania and received the doctor of science in medicine in 1947. he was a pediatric surgeon for many years. he's presently the liz professor of daughter mouth as well as the c. everett koop institute. he's an internationally respected pediatric surgeon and as you a know, he was appointed surgeon general and deputy secretary of health in the u.s. public health service in 1981. as surgeon general he oversaw all of the activities of the public health service commission corps. he took a great interest as many of you will recall in smoking and health, diet and nutrition, environmental health hazards, immunization and disease prevention and make the chief spokesperson on hiv and aids. he's a force in health and health education and we're most delighted to welcome this morning dr. koop. are you on the line? >> i'

how much of the bonus pool dartmouth gets, it's improved portability and improved quality.hat payment is made through a periodic care management payment on to the g code system rather than as a modification for the fee-for-service. so we feel that by getting the reward system lined up, by getting synergy and the clinical working together between dartmouth and that we're able to drive a much better outcome. >> thank you, we're hearing some wonderful patient stories and thanks for sharing mary. michael, if you would tell us what you're doing. >> yes, i'm president at group health physicians. like all of you, we seek better care at lower cost and we found out one year at 29% reduction in emergency room and urgent care visits and our pilot paid for itself. our practice has 900 physicians, 250 primary care practices and care for about 400,000 patients in the state of washington. we have made a strategic long-term commitment to effective primary care to apply to all of our clinics. first we ran a two-year pilot and we learned from that pilot many things to learn to identify eleme

from a hospital perspective, that number was derived by study called a dartmouth atlas of health care which showed significant variation in medicare costs per beneficiary. for example, in most of the metro areas in virginia, the cost for beneficiary is about $8,000 per year. yet, in south florida, the cost is about $16,000 per year. so you have -- so there's variation in costs per beneficiary. however, the proposed control in medicare expense is across the board percentage cuts. so there are states like virginia, wisconsin, minnesota, iowa that have good quality and relatively low cost, and then there are parts of states like florida, texas, new york, massachusetts that have relatively high cost. so a simple across the board percentage reduction in medicare reimbursement applied the same. it penalizes relatively low cost states and in effect, rewards relatively high cost to states. and i don't think that's a very good way to help us to eliminate the excess. i would like to see an approach which provides some incentives for cost reduction, but doesn't penalize those who are already in