dr. miller, you're recognized. dr. miller: mr. chairman, ranking member, i'm mike miller, on behalf of the commission i'd like to thank you for asking us to testify today. as you've already mentioned, we're a small congressional agency required by law to provide analysis and recommendations to the congress. our work in all instances is guided by three principles, ensuring beneficiary access to high quality care, protecting the taxpayer dollar and paying providers and plans in a way to accomplish these goals. with respect to the program's status, medicare spending is about $650 billion annually. a 3.5% of g.d.p. given the enrollment of the baby boom and rates of spending per beneficiary, the medicare program is projected to grow faster than the economy is projected to grow and continue to raise issues of affordability for both the taxpayer and the beneficiaries that finance the program. by law, our march report makes a series of payment recommendations on various fee for service sectors. each year we produce an analysis on access,

dr. miller. i want to follow up on my colleague from oregon's comments about hospice and the hospice recommendation in your bill. i also am very committed to hos pit care across america and -- hospice care across america and i work with my colleague quite bate on it. as you look at the hospice update and didn't recommend any update in the recommendation, my understand sug also look at quality of care in coming at that determination. could you give me any feedback into what you're seeing in the quality of care hospice environment that you saw in the report? >> this has been very difficult to track because there hasn't been until recently a lot of good measures of quality and recently they have gone dloebeg collect up measures. i'm not prepared to tell you how the quality profile looks. it may be measurable but i'm not able to pull it up. one thing that we've been thinking about beyond what has been being collected is looking at things like this. live discharges. we think live discharges if you hav

dr. miller, welcome. read your property your testimony and also your executive summary i was just struck by the thoroughness of the work you do. a lot of the issues are controversial. i remember when we first talked about controlling payments to that we s and the heck received and how much ontroversy it was. and you thought the sky was falling and it would never work out for physicians. and i mention that because i really think your report, and it has areas where there are differences of opinion, your thist shows how successful has been, this program, that is in some respects a public, not only public but public and private partnership. and with a lot of back and forth rom the private sector as rehe flected in your report. i just -- reflected in your report. i just want to comment for each of us on this committee, the subcommittee, when we go home we have lots of meetings with the various providers, the various groups. and they have differences of opinion. and they have some urging pleadings, but i really

dr. miller, thanks for joining us today. and for the important role that med pack plays in informing medicare policy. we've had a chance to look at your report. maybe not read each page the long one b, but an excellent executive summary. and unfortunately, as mr. teaberry and i have discussed, this is the first hearing of this subcommittee. and i regret that we did not have an earlier hear iing on th consequenceal health legislation that the republicans introduced and passed. that bill as we know would have taken away coverage from 24 million americans. while handing out nearly $1 trillion in tax cuts for the wealthy. indeed, the very wealthy incorporations. it would it would cut more than 800 million from the program. it would allow states to eliminate or weaken crucial market reforms including essential health benefits, community rating and preotectios for older workers. it was opposed by doctor, hospitals, patients, aarp, almost everybody who is our participant in the work you do, dr. miller, though all of our colleagues

dr. robert miller. abc7 news caught up with him as he arrived to work at california pacific medical center's campus on buchanan street. dr. miller has been riding his bicycle to work for 15 years now, from tiburon. 18 miles each way. >> about an hour and a half, almost two hours on the bike each day. so, it's a lot of exercise, but it's also saving gas, parking and tolls to the tune of $6,000 a year. >> got to be in fantastic shape. on the bike 3 to 4 hours a day. bike trips went up 10% last year. >>> abc7 news in walnut creek, warriors fans lined up for free car flags. flags being given away at warrior stores while supplies lasted. this is leading up to car flag friday. team fans want that yellow and blue banner wave while people are driving around the bay area. meanwhile the warriors will wait to see who they face in the conference finals. the spurs or the rockets. >> well, spencer christian is here to look at our weather. maybe a little less windy today? >> you're right, it is a little less windy. ea

dr. >> ude miller berk, the adversity advantage, turn your child hood adversity into career and life success. thank you for joining us. appreciate it >> shawn. >> i hope you guys have been outside because it is gorgeous. is up a great, i think it's my favorite day of the month. >> i agree with you so far. it is awesome >> the only thing wrong is it's not a weekend. where we're working today but wow, it was extraordinary, still beautiful evening ahead, shawn, but so many changes to talk about. four tomorrow, it will literally feel like we're changing seasons. 76 was our high many places will be in the 50's tomorrow, and rain will be in here in the morning hours, what can change that quickly? well, the wind direction for starters is going to load us up on a cool wind flow and there's a storm system heading our way that's going to be providing rain as early as tomorrow morning, and that's just day one, we'll likely edit a couple more days out of it. more rain coming but our temperatures this evening are so delightful it's 75 now. down from a high temperature of 76. off to the west, more like 70

dr. steve miller, chief medical officer at express scripts, one of the nation's biggest pharmacy benefitad to see you gentlemen today. we'll get into the details of this osteo drug. but just to start. i think we should talk about some of the legislation being proposed in congress, and maybe you can explain to us exactly where the stumbling blocks are to lower drug prices. because we always hear that drug companies blame pbns, they blame somebody else, there's all these middle men that everybody's like this. whose fault is it? and they're all pointing this way and it's really hard to determine who it is. who do you think it is, steve? >> you know, when there's competition in the marketplace, we do a great job of holding down prices. the best example is generics. so 90% of drugs dispensed in the united states are generic. the price of generics have fallen by 60% over the last sate years. now you hear exceptions to that when you see the generics where there's only one in the marketplace and the drug price spikes. but overall generics have gotten cheaper. >> does that mean 10% of the drug ar

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miller lite. hold true. any day now, mom. [singing] lil' sweet comin' out of deep end...totally dry. take this! mama, give your lungs a breather; those tired lips deserve something sweeter - a diet drweet! diet dr pepper. [singing] it's the sweet one. hi guys. in the desert.be here. at the mall. on the mountain. at school. at the beach. in the big easy. yeah. yeah. today i want to show you guys the next-gen chevy equinox. what do you think? that's pretty. pretty sexy. it's all-wheel drive. look at that. it looks aggressive. but not overbearing. it's not too big. not too small. it looks like it can go off-roading. but at the same time, it looks like a car you can take to a nice event. you can dress it up or dress it down. seems like the perfect car for anybody. i would take it anywhere. i want one. i love it. she's a bad mama jama. chevy stepped their game up. the markets can be new york life on the other hand is as consistent as my free throw shooting. they've paid a dividend to participating policy owners every year since 1854. it may not be sexy, but it works. be good at life. new york life. >> trevor: that's our show for tonight. join us tomorrow at 11:00. now here it is, your m