dr. phil roe, from the great state of tennessee, and dr. scott dess jar less, who is like me, a family physician. and we'll be talking tonight. i thought i would give just a brief introduction about medicare and how that fits into the budget. i know that dr. roe is going to talk in more detail about that. well, no speaker would be complete without a chart. and i have several tonight. and this is one i think it's important for everybody to understand. this pie chart breaks up spending for the federal budget. and if you'll notice, the vast majority of this pie is in what we call permanent mandatory or so-called entitlement spending and interest. and what makes up a large part of mandatory spending is social security, medicare and medicaid and the size of this pie, this section of the pie is growing. in fact, if you recall that back in the 1990's we actually balanced the budget, the last time we balanced it i think was in the late 1990's. it it was a lot easier to do back then because entitlement spending, permanent spending, was not in place.

and i would like to recognize dr. roe. mr. roe: i was looking here tonight, over 200 years of experience, what a diverse group with nursing, den tieses and ob-gyn and surgery and so on and one of the greatest frustrations i have and dr. gingrey has been here longer and the greatest health care debate is this, with nine physicians in the u.s. congress in the 111th congress, not a single one of us was consulted about this health care bill. this was done on a completely partisan basis. i have to chuckle. i have never seen a republican or democratic heart attack in my life. i never operate odd a democrat or republican cancer in my life. these are people problems that affect all of us in this country and what we wanted to do as i stated, is to make the cost of care go down. this is not going to do thfment look, this is very simple. and we will have to use a different time, because it is so detailed. but just very briefly, this is how this works. 575 billion taken out, three million seniors a year going into medicare, reaching medic

. >> thank you, dr. roe. mr. tierney? >> thank you, madam chairman. i was wondering if dr. heck gets a -- from dr. roe, he has some loose cash. [laughter] our witness really have been helpful. we have been troubled by the fact that this is a partnership. the federal government, state, families, trying to get more people into college in an a fordable way so they can move on. states have backed away from that partnership in a huge way. we heard trement feedback from colleges and a lot of four-year colleges as well. if we hasn't done that, tuition would have gone up more. are you feeling it is not necessary anymore because schools are now trying do deal with this stuff on their own? >> i don't have a good answer. the pressures on states to cut fund arrange going to be with us for the -- funding are going to be with us for the next several years. this is not the time to take -- whether they can be strengthened or rewritten, i honestly don't know. i don't think the thing that is causing the cuts from states is related to federal funding. it is related to what's happening with st