he was on medicare. but because of the unresponsiveness and all the incentives in our system that lead to the american health care system cannot really be that concerned about the patients first and foremost, david's father tragically died. unimpaired you will talk more about that when you hear his remarks. so what's really great about david gold hill's writing and david's book is that he no one talks about the real people in her system, every american who interacts with the health care system and how and seize it in a way that makes us understand how much that our system could be, but he critiques of the free market point of view. he appreciated that are so me things about health care system that could be better precisely because it doesn't skew to market principle. one of the great clichÉs in health care policy debate is that health care is different. health care is somehow immune from the laws of economics that affect every other aspect of how we live. what david has done in this book is a great servi

use on medicare. but because of the unresponsiveness and all the incentives and our system led american health care system cannot really be that concerned about the patient first and foremost, david's father tragically died. and i'm sure he will talk more about that when you hear his remarks. so what's really great about david goldhill's writing, and david's book, is that he not only talks about the real people in our system who are affected, not just the uninjured, but every american who interacts with her health care system and, in a way that makes us understand how much better our system could be. but he critiques it from a free market point of view. he appreciates that are so me things about our health care system that could be better, precisely because it doesn't skew to market principles. one of the great clichÉs in health care policy debate is that health care is different, that health care is somehow immune from laws of economics that affect every other aspect of how we live. and what david ha

medicare, there are 700 government employees working for medicare. and 8,000 private sector contractors. the difference is they operate under the supervision of the law which says you can't overpay hospitals. and they operate under the supervision of a long time government civil servants who are actually really good at their jobs. but it is a private sector program. 8,000 private sector contractors and 700 government employees. so medicare is not a bunch of, you know, civil servants gone wild. it's not-- and it really works well. >> rose: i take the conversation here yesterday with the university professor at harvard at the business school but is as you know. >> yeah. >> rose: very distinguished professor at harvard who is fascinated and studying health care and many other things. here is what he said. and i want to see what your reaction is to it, roll tape. >> ultimately health care fails the most bake test of organization. and that is it's not organized around the needs of the patient. it's organized around the supply of the services. and until we

part c is medicare advantage. this is known as an alternative to medicare.ization or a preferred provider organizations receive their medicare covered benefit. most often it includes the part d drug benefit and often benefits that medicare does not cover, such as dental and vision services. the affordable care act made some important changes as to how the plans are paid. johnson tells little bit more about this. suffice it to say that in recent years the payment system has driven a dramatic expansion of medicare advantage plan availability and woman since 2006, which my colleague, tricia gretchen jacobson has been monitoring carefully. you can find this information on our website about medicare advantage availability and enrollment. today, 13 million people, about a quarter of medicare beneficiaries are enrolled in medicare advantage plans. part d is the drug benefit. it started in 2006 and is a voluntary benefit through stand-alone plan to supplement a traditional plan. those who in wool and it has more plans to choose from in each and each day, along with

he was on medicare. but because of the of responsiveness in the system that lead the american health care system to not be concerned about the patient first and foremost, david's father tragically died and i sure he will talk more about that in the remarks. what is in the kids bookies' he not only talks about the real people in our system who are affected, not just of the uninsured but every american in the health care system and how he sees it in a way that makes us understand how much better our system could be. but he critiques it from a free market point of view and appreciates there are so many things about the health care system that could be better precisely because it isn't in the market principles. one of the great cliches in the policy debate is that health care is different. health care is somehow immune until wall of economics that affects every other aspect of how we live, and what david has done in his book is a great service in that regard in explaining why fact health care is much like ot

or medicare advantage plan.alone plans to choose from in each state issue, along with many medicare advantage plans. plans are required to provide a standard benefit which is shown here. plans can very. the design of the benefit as long as it is at least equal in value, and those plans actually to offer an alternative to standard benefit. beneficiaries pay monthly benefits and cost during for their drugs through part d. if you everything about part d you may part about the coverage gap, which is also known as the doughnut hole. beneficiaries had a 100% of the cost in the doughnut hole until they reached catastrophic coverage. but as a result of the health reform law, the coverage gap will be closed by 2020. people with low incomes and assets are eligible for additional subsidies for part d premiums and co-sharing and about 10 million beneficiaries are currently saving the sectional. today about 90% of people on medicare have prescription drug coverage, most through a part d plan. the cost of providing all of the

every year, three quarters of those who are on medicare who depend on the medicare program, they have at least one physician's visit and one in five visit a hospital. he was shown some of those numbers in terms of utilization. in 2013, the average per capita medicare beneficiary would exceed expenditures of $12,000. most use medicare services infrequently, but the majority of the spending is on a relatively small number of beneficiaries here. one of the challenges that we face and looking at the program is essentially have to focus on that population. had to essentially look at those who are in the greatest use of services and the most costly services and some of the discussion around the dual eligible, there are about 9 million of them and they tend to have a high use of services. one of the questions is, are we doing the best job that we can to coordinate for this population? are we encouraging appropriate use between the two programs? it is a focus of the element of the aca. how best to target these individuals and how best to address those particular concerns and those particular

because doctors who treat medicare patients don't just treat medicare patients. they treat the rest of us as well. but we think is interesting is back here in washington we are in the midst of deep thoughts, deep discussions about budget realities and you know, medicare facing some financial challenges. but it's not just the medicare problem. it's the health care cost problem and what no one has yet uttered are the initial cbo and what the congressional budget office thinks will achieve budget savings is i think where policymakers focus a lot of their attention. and so what we're hearing now are things like raise the age of eligibility for medicare, and increase premiums that medicare beneficiaries pay. these are things that all have real dollars associate with them in terms of savings. we are not hearing them talk too much about the financial incentives that doctors face and ways to encourage greater care coordination. some of that was already taken care of, or at least addressed preliminarily in the affordable care act, but i think there is still this disconnec

be doing, you would be putting the most efficient player, which is medicare, medicare spends 80 to 90 to process a claim and the health insurance companies spend $25 to process a claim. health insurance companies pay two, three, four times what medicare pays through various services. if you lowered the age, you would put more people into the bucket of much more efficient health care. and the worst part about it is, the reforms that we have now, with the president's plan, are actually going to raise the costs because all of the people who are 60, 62, 63, who can't afford the premiums that they're going to have now, are going to be subsidized by the taxpayers. >> that becomes an argument for a single-payer system. >> here's an argument against that. 12 cents is the most important number. 12 cents is the portion of every health care dollar paid by the person receiving the health care. someone else is paying the rest. it was 47 cents 50 years ago when jack kennedy was president. now, let me ask the five of you a question, you go to doctor and they say i want to give you a following test?

congress, because of lobbyists have handcuffed medicare.are can't negotiate what it pays for any kind of drugs. it can't negotiate what it pays for wheelchairs, diabetes testing equipment. if congress took those handcuffs off of medicare you could get about half of the spending cuts that we're sitting around here talking about. >> is that true? >> you could get a fair amount. if they get the same prices for prescription drugs that medicare gets, it would save -- steven, i think your article was great. i don't believe that we can cut our way, change the pricing and still save medicare. the average person who's at medicare retirement age paid in some $122,000 in the system. they'll get back $370,000 back in benefits. we have to fundamental medicare reform. >> in the larger health care system, the government and all of us would actually save money if you lowered -- i said lowered the age for medicare. if the medicare age were 60 instead of 65, the economy and the taxpayers would actually save money and george, please don't look at me like that

it's medicare and medicaid -- >> but it hasn't been fixed. >> the best way to deal with medicare and medicaid is to get health care costs under control. what you want to do is basically use the bargaining of medicare and medicaid so that providers move from a fee system, a fee for service system to a fee for healthy outcome system. wouldn't you agree? >> well, absolutely. as you know, that's the proposal being pushed forward by dartmouth your alma mater. has a lot of viability to it. but it's easy to say but it's hard to do. the point is, however, that you've got to have a president who's willing to step up on the issue of medicare specifically and say we're going to try to control these costs and not just add to the costs. there's three things that could be done in medicare that would make a big difference. we could adjust to go -- raise the age over a long period of time so that people over the age of 20 aren't impacted but you change it over a long period of time which benefits it. and third values in outcome system than utilization system. none of that's being done. it's not bein

we have really lowered the growth of medicare. and in doing that we are creating tremendous savings for the government, but we are not hurting access to care right now. we need to preserve that. if we achieve greater savings on paper out of the medicare system, but destroy that system for people, that is not an outcome that is a good outcome for our country. and i think is much private sector innovation as there is an continue to be, let's be honest but if the private sector can do this, we have a functioning health care system outside medicare, and we don't. and we do because it takes all of us working together. most insurance companies today use payment systems which was developed through the medicare program with government. we've got to figure out how we can continue to collaboratively work, and hopefully take politics out of some of what medicare has become an move forward in a way that really improves our health care system. >> dana safran, you represent the other unrepresented elephant in the room, the insurance perspective

so when i found out medicare doesn't pay all my medical expenses, i got a medicare supplement insurance plan. [ male announcer ] if you're eligible for medicare, you may know it only covers about 80% of your part b medical expenses. the rest is up to you. call and find out about an aarp medicare supplement insurance plan, insured by unitedhealthcare insurance company. like all standardized medicare supplement plans it could save you thousands in out-of-pocket costs. call now to request your free decision guide. i've been with my doctor for 12 years. now i know i'll be able to stick with him. you'll be able to visit any doctor or hospital that accepts medicare patients. plus, there are no networks, and you never need a referral. see why millions of people have already enrolled in the only medicare supplement insurance plans endorsed by aarp. don't wait. call now. >>> in today's wjz health watch a new study is giving parents guy dense on tv. kids who watch tv too much are more likely to exhibit criminal behavior. children should watch no more than 2 hours of quality programming. >>> limit

, fifteen million enrolled in medicare advantage instead of regular medicare, medicare advantage costshan usually offers additional benefits like vision care and dental, but patients have to stay in their network which helps insurance companies save money with these plans in theory. private insurers provide the health coverage, seniors are reimbursed by the government, the proposed cuts in reimbursement was friday by the center for medicare and medicaid services, 45 day comment period and if ultimately approved would take effect for fiscal 2014. cheryl: there could be 45 days, we might have a glimmer of hope in this, peter barnes live from washington and for more on this report let's bring in steve phil mickelson managing director at healthcare service analyst thomas carroll. 45 days of comments when the companies can come back and tell the government wait a minute, here is where many analysts point the finger, in the report they say we pretty plans are facing several legislatively made changes. this can represent challenges the company comes back to the government and lobbied once aga

they're retirees that depend on social security and medicare. their workers who have to get up early tomorrow morning and go to work to pay the bills. they're immigrants who came here because they were stuck in poverty and the countries where the government dominated the economy. the tax increases and the deficit spending you propose will hurt middle class families. it will cost them their raises. it will cost them their benefits. it may even cost some of them their jobs. it will hurt seniors because it does nothing to save medicare and social security. mr. president, i don't oppose your plans because i want to protect the rich. i oppose your plans because i want to protect my neighbors. hard-working middle class americans who don't need us to come up with a plan to grow the government. they need a plan to grow the middle class. economic growth is the best way to help the middle class. unfortunately our economy actually shall rank during the last three months of 2012. but as if we can get the economy to glow at just 4% a year, it would create mi

like all standardized medicare supplement plans, they pick up some of what medicare doesn't pay.ve 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-pock

those people will be in medicare as well and in medicare -- but the effect in medicare is not just the number of people but the cost of per person. 2023 relative to 2012. 40% more beneficiaries. so the disability insurance is growing more slowly. just in numbers of people who will be receiving the medicare subsidies for their health care are growing so rapidly that costs will grow rapidly even as costs per person doesn't grow at all. medicaid is also affected by the aging population because it pays a significant share of long-term care in this country, nursing home bills in this country. >> in your estimates, you have taxes going to 19% of g.d.p. in a couple of years, which is 1 percentage point greater than the average the last 40 years of 18%. what is the reason for that? and second question is, you project under current law that the deficits over the next decade are roughly $7 trillion and you don't have a number for the alternate fiscal scenario and can you give us an actual number if you include some of the current policies being continued. >> yes. so, we do actually have an alter

like all standardized medicare supplement plans, they pick up some of what medicare doesn't pay.ave 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 noetworks, 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-pocke

this past one -- really since medicare's inception, it was not the cost of medicare growing, it was the aging population growing that was the driver of the cost in medicare. >> thank you both. >>> coming up, a last word exclusive. the shooting victim who ted nugent attacked after the state-of-the-union address. and how did marco rubio do in his audition for the presidential nomination last night? was a star born? and later, more readings from the nra's enemy's list, and why does the nra's enemy's list have so many jewish organizations on it? a hybrid? most are just no fun to drive. now, here's one that will make you feel alive. meet the five-passenger ford c-max hybrid. c-max says ha. c-max says wheeee. which is what you get, don't you see? cause c-max has lots more horsepower than prius v, a hybrid that c-max also bests in mpg. say hi to the all-new 47 combined mpg c-max hybrid. >>> what does the anti-defamation league have in common with the ywca? all three of them on the national rifle association enemy's list, as is richard gere and lou gosset jr., it is the craziest list you have e

i am sorry -- medicare. i have paid all of my life into medicare.tarted working in 1965, and i have paid. so why is it you want to call it an entitlement? that is a debt owed to the people who paid for it. now, if you want to cut down on social security benefits, start at the top. if they can afford to pay for all medical, let them pay for it. guest: a couple of questions. her first point as far as subsidies to corporations and these businesses that are making millions of dollars -- salaries in millions of dollars -- i agree completely with what the caller was saying. she says republicans and their cohorts may not be on the same page as her. we are absolutely on the same page as her, and we absolutely past part of the budget last year that it absolutely what the caller said, but it never did. what our budget would do was to say to those big businesses that are subsidized, we are going to end your tax subsidies and close those loopholes so you will not be subsidized any more. if that means you have to cut salaries, so be it. o we will and callers lik

remember, all medicare supplement insurance plans help cover what medicare doesn't pay.d could save you thousands a year in out-of-pocket costs. call now to request your free decision guide. and learn more about the kinds of plans that will be here for you now -- and down the road. i have a lifetime of experience. so i know how important that is.

this past one -- really since medicare's inception, it was not the cost of medicare growing, it was the aging population growing that was the driver of the cost in medicare. >> thank you both. >>> coming up, a last word exclusive. the shooting victim who ted nugent attacked after the state-of-the-union address. and how did marco rubio do in his audition for the presidential nomination last night? was a star born? and later, more read iings from the nra's enemy's list, and why does the nra's enemy's list have so many jewish organizations on it? [ male announcer ] you are a business pro. executor of efficiency. you can spot an amateur from a mile away... while going shoeless and metal-free in seconds. and you...rent from national. because only national lets you choose any car in the aisle...and go. you can even take a full-size or above, and still pay the mid-size price. now this...will work. [ male announcer ] just like you, business pro. just like you. go national. go like a pro. just like you. when i take a picture of this check, it goes straight to the bank. oh. oh look the lion is ou

remember, all medicare supplement insurance plans help cover what medicare doesn't pay. could save you thousands a year in out-of-pocket costs. call now to request your free decision guide. and learn more about the kinds of plans that will be here for you now -- and down the road. i have a lifetime of experience. so i know how important that is. ch stay with us. the day's "top lines" are coming up. [ whispering ] i've always preferred the crème part of an oreo. [ whispering ] that's crazy, the cookie's the best part. crème. cookie. crème. cookie. [ whispering ] crème. [ whispering ] cookie. [ whispering ] crème. [ whispering ] cookie. [ whispering ] crème. [ whispering ] cookie. crème! [ fire alarm ringing ] [ whispering ] fire! crème. cookie. crème. cookie. [ whispering ] i'm calling the cops. [ police siren wails, car horn blares ] crème. cookie. [ whispering ] you guys have to stop fighting. we're the cops. [ male announcer ] choose your side on instagram @oreo. >>> from saluting a new york city mayor and chris christie's new slogan to more gun sanity. here are today'

medicare is unsustainable. social security disability insurance -- which we do not talk very much about, and i think that is really a very important topic that i would love to see either this committee or some other committee take a look at because i got concerned about this last year when i started reading about how it will go bankrupt in 2016. a big concern. then on the education site -- pell grants. $1 million shortfall in fiscal year 2015. then annual shortfalls of $5 billion or more from fiscal year 2016 through 2023. all of these programs as we are looking at them -- it is very scary to see that they will go bankrupt unless we have some form of reform. let me now turn to look at the health care issue because cbo sites that rising health-care costs are the leading driver of our debts and deficits. the federal exchange subsidies loaned are expected to cost $1.20 trillion, while the medicaid expenses are expected to reach $638 billion. in knowing all this, will this increase in spending -- well, first of all

medicare and social security benefits. that idea is even worse. ( applause ) yes, the biggest driver of our long-term debt is the rising cost of health care for an aging population. and those of us who care deeply about programs like medicare must embrace the need for modest reforms. otherwise, our retirement programs will crowd out the investments we need for our children. and jeopardize the promise of a secure retirement for future generations. but we can't ask senior citizens and working families to shoulder the entire burden of deficit reduction while asking nothing more from the wealthiest and the most powerful. ( applause ) we won't grow the middle class simply by shifting the cost of health care or college on to families that are already struggling or forcing communities to lay off more teachers and more cops and more firefighters. most americans, democrats, republicans and independents, understand that we can't just cut our way to prosperity. they know that broad-based economic growth requires a balanced approach t