and i think, you know, generally speaking, medicare beneficiaries like the medicare program, you know, i don't think they think in terms of fees for service versus others as much. >> you said that, quote, life under fee for service has to get more difficult, unquote. >> yes. >> tell me what that means. what's that mean for the patient? >> better care, i believe. >> life getting more difficult means better care? >> for fee for service providers encouraging them to move to new payment methods that are more focused on producing high-quality care. >> life getting more difficult, you want life to get more difficult for the folks taking care of the patients? >> and open doors for them to new payment methods. >> when life gets more difficult, how does life get better for the patients of this land. >> the key point, dr. price s that our goal is not just to make life more difficult for doctors, but also we want to create new opportunities. >> so one of your goals is to make life more difficult for doctors, i guess, i just heard you say? >> we think there needs to be pressure on fee for service

medicare is one of our nation's best programs. but it needs fine tuning and changing to keep it relevant. do iing so would dest nate them. the majority on them list on tight fixed in cucomes. increased coste iing leads to increased production. the costs discourage people from receiving necessary health care. the home health co payment for instance, i think is largely ascribed to be used by old sick poor widows. there are other offsets available as well. the over seas operations money. is available to us. and i dislike the notion that we need to increase cost for beneficiaries to fix the payment system. i look forward to your thoughts and for the people eligible for medicare and medicaid. i hope you will address the idea that medicare is going to go broke. the adjustments menecessary to keep medicare alive less than a 3% increase in premiums. age and differences and changes that we have already done. i thank you and i thank again chairman holder for holding this hearing and inviting you back to in form us about the state of medicar

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so it's very different if you start on medicaid and age into medicare versus if you start on medicare if you have a functional decline that makes you medicaid eligible. and the models are whether should be would be -- whose care is improved by care transitions. all of those things are highly dependent on what drove a person to be in the program, what their care needs are. who they trust to get information about those care needs, all very different. depending on which "m" you start with. so we're doing a lot of work in that area. then lastly i would say -- those of you who are researchers will appreciate, we're making enhancements to the chronic warehouse, so we have conditions for diagnoses for serious mental illness, for alcohol use, for intellectual and developmental disabilities. if we again are going to truly understand the prevalence of chronic disease for this population by sub populations, we have to continue to add to those -- to the diagnoses that are in the ccw, particularly those that are going to reflect things that medicare maybe hasn't looked at so much as medicaid has i

that is the only way we are going to deal with our cost challenges in medicare in the broad medicare system. >> you are seeking to do this and i holistic fashion, right, rather than an instrument. i know of no small amount of irony that some of my republican friends are all in favor of shifting much higher costs onto the backs of senior recipients looking for systems with higher co-payments and out of pocket expenses, more confusion if you will and complexity of this is in the aggregate that somehow when you are offering things that are more nuanced and fine-tuned that somehow we are biting and and suggesting that this is something that is nefarious and with all due respect i reject that notion. i deeply appreciate what medpac has done in terms of trying in an unfurnished fashion. it's congress that is continually added complexity that hasn't stepped up for decades now we've reached a point it can't continue as it is the transitional care process in terms of care coordination. we have legislation we're reintroducing to have a transitional care payment in light of the larger context.

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medicare advantage is a very important part of medicare. one out of four medicare beneficiaries are enrolled. enrollment is absolutely -- the caller is absolutely right. it is not immediately available across the country. virtually everyone has the opportunity to join the plan but not everyone does and some people at many many more choices than others. that simply reflects the fact that this is private sector, the private health plans contract for various areas and they essentially within limits get to pick the areas that they service, and then they don't have to serve either other parts of the state or the counties or for whatever reason they have. maybe they can't establish a provider network very easily in that county. so it does mean that you can have one beneficiary living in a county, one county away from where there are a lot of choices than that person has very few choices. >> host: a handy chart from medicare advantage, penetration by state. the dark blue is the most penetration, the red is the least penetration. is there a reason

like all standardized medicare supplement plans, they pick up some of what medicare doesn't pay. save you up to thousands of dollars in out-of-pocket costs. call today to request a free decision guide to help you better understand what medicare is all about. and which aarp medicare supplement plan works best for you. with these types of plans, you'll be able to visit any doctor or hospital that accepts medicare patients... plus, there are no networks, and you'll never need a referral to see a specialist. there's a range of plans to choose from, too. and they all travel with you. anywhere in the country. join the millions who have already enrolled in the only medicare supplement insurance plans endorsed by aarp, an organization serving the needs of people 50 and over for generations... and provided by unitedhealthcare insurance company, which has over 30 years of experience behind it. call today. remember, medicare supplement insurance helps cover some of what medicare doesn't pay -- expenses that could really add up. these kinds of plans could save you up to thousands in out-of-p

>> toward exactly wages said, medicare for all.we need to expand medicare for all the citizens of this country. of course this is something the insurance companies do not want to happen because of the milly, medicare for all will not worked if the people are not in charge of its. the insurance companies will be calling the shots. they will be restricted more than they were in the past. for instance, one of the great things about today is the provision they cannot deny people because of pre-existing conditions. apparently, that stands. the fact parents can keep their children up to the age of 26 on their health insurance, that stands. there are the smaller provisions -- the key talking about the mandate been the centerpiece. there are other pieces up the law i think are just as important if not more so. the mandate -- i mean, i have never supported it because it mandates people to give money to these profit-making insurance companies. it would be dirnment ran that you and i were in charge of, then, yes, everybody has to be part of t

>> toward exactly wages said, medicare for all. we need to expand medicare for all the citizens of this country. of course this is something the insurance companies do not want to happen because of the milly, medicare for all will not worked if the people are not in charge of its. the insurance companies will be calling the shots. they will be restricted more than they were in the past. for instance, one of the great things about today is the provision they cannot deny people because of pre-existing conditions. apparently, that stands. the fact parents can keep their children up to the age of 26 on their health insurance, that stands. there are the smaller provisions -- the key talking about the mandate been the centerpiece. there are other pieces up the law i think are just as important if not more so. the mandate -- i mean, i have never supported it because it mandates people to give money to these profit-making insurance companies. it would be different if it was something the government ran that you and i were in charge of, the

as with all medicare supplement plans, you can keep your own doctor and hospital that accepts medicareget help paying for what medicare doesn't... and save up to thousands of dollars. call this toll-free number now. a cup of johan is a 600 horsepower sports coupe that likes to hug curves. ♪ your curves. smooth, rich, never bitter, gevalia. >> according to a report in today's politico, the republicans running the house have decided game over until after the fall election. joining me now is jake sherman. how do the leaders explain doing nothing all summer? >> the issue is simple. they think they are far too far apart from president obama on taxes on entitlements and spending. these are very real issues. taxes will go up on every american. they will pass bills and as we have seen over the last day or two, the president does not seem willing to raise taxes on the highest earners. they are going to do some stuff, but nothing that is going to be law and they decide these things get in the lame luck powers. mitt romney said he didn't want anything on the lame duck to president obama. >> it be

so that the folks who are 45 to 64 before they're coming on to medicare there's a huge opportunity for us to do care coordination or medical homes or care management to improve their utilization and the prevalence and the intensity of the disease when they get on medicare. then the folks who are on medicare, there's a lot we could be doing to prevent their decline on to medicaid. and so far the financing and the incentives between the two programs haven't supported that work. i'm hopeful that once we get through dealing with the 9 million folks who are on the program we can really shift attention to the preduals and doing a much better job of managing i would say the progression of folks to dual eligibility status. so with that, i will close and just say thank you again for being part of the panel. >> thanks very much, melanie. we're going to turn now to joe newhouse. joe it's often asserted that the u.s. is an outlier in spending. how big of an outlier are we if we are? >> thanks, susan. this discussion somewhat reminds me of that movie. not many of you have seen it. its a classic --

and establish medicare expected cost of care in a similar manner, medicare fees at medicare fee levels. in other words we establish a credit system, an expected cost of care as a credit to the panel. debits are the fees themselves. and what we would say to the panel is, you manage the medicare patients in a similar manner to the way you managed the care first and you look particularly for the chronic disease, which is medicare is the chronic disease capital. >> what mr. burrell is doing at care first has popularity locally. so it has credibility. and one of the main features is that there is help given to the primary care provider to nurses to manage the more complicated and more costly patients which i think gives confidence that this is not an effort to deny care to people in order to reach the target, but to manage the cost of high interventions in a more cost effective way, the question i would have for you mr. burrell or anyone else on the panel, you mentioned that you oversight to make sure that quality is maintained. but there's always a fear that the bonuses are based upon doll

as with all medicare supplement plans, you can keep your own doctor and hospital that accepts medicaret help paying for what medicare doesn't... and save up to thousands of dollars. call this toll-free number now. bill: the mitt romney team jumping on the jobs reports. the house speaker john boehner and eric canter reacting to the news the unemployment number ticked up in the month of may. >> it's pretty clear that the american people are still asking the question, where are the jobs. another month of disappointing job gains, it's pretty clear the american people are hurting. small businesses continue to avert hiring any additional people. and it's clear that the policies we have seen are not working. i would just hope that the president and my colleagues in the senate will look at our plan to create american jobs. passed over 30 bills sitting in the united states senate. we could help people in our time of great need if the senate would just look at the bills before us. you watched us for the last year and a half come up here every day and every week making clear our focus is the focu

as with all medicare supplement plans, you can keep your own doctor and hospital that accepts medicareget help paying for what medicare doesn't... and save up to thousands of dollars. call this toll-free number now. >> bret: welcome back to wisconsin you're looking live inside here at waukesha. we're waiting for governor walker to speak. there, you can see them maybe getting ready as you hear the crowd chanting. as the speech happens you'll see it here on fox. let's get the other side quickly from maryland democratic governor in our washington bureau. governor sh thank you for being here. >> thank you, bret and your reaction tonight? >> this is a night where we would have hoped to have been victorious. we were not as you've pointed out rarely that any governor is ever recalled but to be outspent 10-1 and wage such a cure ragis race, i think all of us are proud of mayor barrett and the campaign he waged. i think one of the telling numbers that came out of the exit polls i was watching on your program is that many people felt short of misconduct we shouldn't have a recall before a four-y

like all standardized medicare supplement plans, they pick up some of what medicare doesn't pay. and save you up to thousands of dollars in out-of-pocket costs. call today to request a free decision guide to help you better understand what medicare is all about. and which aarp medicare supplement plan works best for you. with these types of plans, you'll be able to visit any doctor or hospital that accepts medicare patients... plus, there are no networks, and you'll never need a referral to see a specialist. there's a range of plans to choose from, too. and they all travel with you. anywhere in the country. join the millions who have already enrolled in the only medicare supplement insurance plans endorsed by aarp, an organization serving the needs of people 50 and over for generations... and provided by unitedhealthcare insurance company, which has over 30 years of experience behind it. call today. remember, medicare supplement insurance helps cover some of what medicare doesn't pay -- expenses that could really add up. these kinds of plans could save you up to thousands in out-

as with all medicare supplement plans, you can keep your own doctor and hospital that accepts medicareat medicare doesn't... and save up to thousands of dollars. call this toll-free number now. much coffee are you fellows going to need today? three...four cups? [dumbfounded] well, we... doesn't last long does it? listen. 5-hour energy lasts a whole lot of hours. so you can get a lot done without refills. it's packed with b-vitamins and nutrients to make it last. so don't just stand there holding your lattes, boys. make your move. we'll take the 5-hour energy. smart move. 5-hour energy. hours and hours of energy. five." ♪ ♪ >> kimberly: my gosh. what is going on with him? anyway. the medicated -- >> dana: i know it's unappropriated. >> juan: what was inappropriate. we're doing a story here about the police, are we not? >> greg: yes. >> juan: i said i could be your dick tracy. i could be your guy. it could protect you. >> kimberly: anyway. i'll tell you. eight muslims in new jersey bapt to put an end to controversy surveillance program that targets some muslim groups, neighborhoods and m

all medicare supplement plans let you keep your own doctor, or hospital that accepts medicare. there are no networks and no referrals needed. help protect yourself from some of what medicare doesn't pay... and save up to thousands of dollars in potential... out-of-pocket expenses with an aarp... medicare supplement insurance plan... insured by unitedhealthcare insurance company. call this toll-free number on your screen now... for this free information kit, including this... medicare guide and customized rate quote. annual conference for software developers tomorrow in san francisco. tim cook is expected to announce new soft water for the ipad, iphone and mac. thomas roman is live where some developers are already lining up . >> ama, this conference gives software developers a look at what is going to be in the near future. the announcement of a new operating system is like honey to the bee. tonight there are about a dozen develop everybodies -- developers camped out in san francisco. by tomorrow about 5,000 will lineup from all over the world to enter the wwwbc. >> just to sho

as with all medicare supplement plans, you can keep your own doctor and hospital that accepts medicare, get help paying for what medicare doesn't... and save up to thousands of dollars. call this toll-free number now. >> bret: welcome back to wisconsin you're looking live inside here at waukesha. we're waiting for governor walker to speak. there, you can see them maybe getting ready as you hear the crowd chanting. as the speech happens you'll see it here on fox. let's get the other side quickly from maryland democratic governor in our washington bureau. governor sh thank you for being here. >> thank you, bret and your reaction tonight? >> this is a night where we would have hoped to have been victorious. we were not as you've pointed out rarely that any governor is ever recalled but to be outspent 10-1 and wage such a cure ragis race, i think all of us are proud of mayor barrett and the campaign he waged. i think one of the telling numbers that came out of the exit polls i was watching on your program is that many people felt short of misconduct we shouldn't have a recall before a four

we brought medicare and medicaid on. we had a whole bunch of really important new innovations that fundamentally changed how we treat patients. neonatal intensive care units and treatment of low birth weight babies, treatment of cardiovascular disease. so it's a very different time period. so what i'm going to spend my discussion on is looking at the time period between the early 1990s and today and i think the point i'll make is even during that time period, the year-to-year changes and what's driving the growth in spending is somewhat different. but i want to look at some of the long-term drivers here that are more recent. i've sort of taken -- you can decompose this in a lot of ways. i have tried to sort the data two three ways. looking at the change in spending linked to the change in prevalence of treated disease. looking at the change in spending linked to how much we spend to treat a case. and obviously the interactions between the two of those. and if you look at a long-term component here, say late '80s to today

as with all medicare supplement plans, you can keep your own doctor and hospital that accepts medicare and save up to thousands of dollars. call this toll-free number now. >>> in a large hangar last week just off the las vegas strip, a transformation took place. over the course of a few hours, a group worked methodically with a collection of assorted supplies, measuring, peeling, affixing, and trimming as glimpses of a final product begin to materialize. the idea was nothing new. no car or truck on the road would miss it. a few more people would be reminded of the clash fast approaching between the unfamiliar combatant and the celebrated titan. two men, who with fight week nearly upon them, had transformed into boxing machines. las vegas was beckoning tim bradley and manny pacquiao. >> last day. man, last day. last day before the big show. it's going to be no joke today. no joke. >> over the past eight weeks, tim bradley's logged more than 150 rounds of sparring. today comes his final 12. >> hey, remember what we talk about? >> uh-huh. >> okay. i want you to follow the plan, okay? don'

to apply your approach to the medicare payment system. so, i just, to me, if you could tell us the degree to which sjr could be modified that could help us to decide what to do about it. >> let me describe how we do it which is similar to the way that premiums are established. you have a panel. the question is, how many patients do those primaries have? who are the patients that are attributed to them? and the first question we ask is once we know that. what are the experiences of those patients. the age, the sex, the illness, the health, it reflects everything about the health care. when i said it would be the case that 3,000 members would be in the panel on ours, they would be expected to have $12 million a year today in health care expenditures. we take that base, and that is the target? >> no, that is the base. in this case we use 2010 an unmanaged base. before the program started. we look at the illness burden that is in that panel and we take that into account and apply an overall medical trend factor which reflects what we believe

as with all medicare supplement plans, you can keep your own doctor and hospital that accepts medicare, get help paying for what medicare doesn't... and save up to thousands of dollars. call this toll-free number now. ♪ ♪ we all need it. to move. to keep warm. to keep us fed. to make clay piggies. but to keep doing these things in the future... at shell, we believe the world needs a broader mix of energies. that's why we're supplying natural gas to generate cleaner electricity... that has around 50% fewer co2 emissions than coal. and it's also why, with our partner in brazil, shell is producing ethanol - a biofuel made from renewable sugarcane. ♪ >>a minute, mom! let's broaden the world's energy mix. let's go. >>neil: and we have to wait for the supreme court's ruling on the health care law but christians are raising their voices today. not so much to god but over the health care mandate and they do not like it. this we do not want it. when it comes to catholics, father john says very good reason. father, good to have you. >>guest: good to be with you. >>neil: how is this shifting amon

as with all medicare supplement plans, you can keep your own doctor and hospital that accepts medicareget help paying for what medicare doesn't... and save up to thousands of dollars. call this toll-free number now. bill: we have some breaking news. we had the report on what is happening in egypt. get this. in libya, tripoli, an armed brigade surrounded the airport. tripoli international airport is forcing flights to be diverted to the capitol's military airport nearby. this group, 60 some odd miles southeast of tripoli, demanding the release of one of their lead that's disappeared two nights ago. the situation around the airport is very tense. tanks are surrounding the building. no one is allowed into the building. this follows a year of unrest in libya as you recall and killing of qaddafi. we're watching that story move across the wires right now. >>> also a small army battling a wildfire that has now become the largest in new mexico's history. more than a thousand firefighting are trying to control the flames burning in and around hila national forest. this is huge. only 17% contain