reduce commissions like the medicare payment advisory commission made nonbinding recommendations. some congress adopts and others that doesn't buy at least the decisions are reviewed. now we are creating a system which all of these flawed recommendations will become law. i would like to read a couple of sentences from a letter i have about the board. and it is signed by 75 members. an executive branch medicare board would also effectively eliminate congress' ability to work with the center for medicaid and medicare services create and implement projects designed to evaluate new and advanced policies such as home care for the elderly, the patient-centered medical home, less invasive surgical procedures, evers between hospital and physicians and programs designed to eliminate fraud and abuse, national policies that would flow from such a board would ignore the significant differences in health care needs of the states and communities. all of the providers in all states would be required to comply even if these policies were detrimental to the patients they serve. such a commission c

she served in republican administrations and on medicare payment commissions. she also sits on the board of the insurance company united health group. first, let's start by helping people understand what the c.b.o. report is. neera tanden, what is it? what is it and what isn't it? >> well, basically, there's a new package of proposals that merge it is house and senate health care bills. we had a vote in both chambers, now the normal process is to have a conference but over the last several months they basically have come to an agreement between the two houses as to what they would like the final bill to be. and what c.b.o. bill did was an analysis of how... of that bill, the merged bill, the reconciliation bill and it tells us how many people we're covering, how much it costs, what the revenue estimates are. so that's what c.b.o. found today. >> brown: gail wilensky, it's an estimate, it's not something that you can hang your hat on for ten or 20 years out but it's a respected estimate. >> let me first explain what the congressional budget office is in case som

one of the ways to do this is through a new medicare commission that's going to basically have independent authority to make decisions about what should and shouldn't be paid for under medicare. it's mandated to tamp down on excessive growth. type will this be broadly they'll say these practices don't -- guest: yeah, interesting question. the thing about this medicare commission, it basically leverages congress' inability to act. so the commission, by law, needs to find certain amount of savings in a group of people to keep pace with gpped, so medicare growth has to keep pace with growth. and if the senate and congress doesn't like the list of cuts that this commission has come up, with they have 30 days to come up with a separate list of cuts that achieve the same amount of savings. we know congress has a hard time acting in the course of a year, let alone 30 days, so it's basically leveraging the inability of congress to act. these decisions won't be subject to official review. they've actually exempted the courts from being able to review the decision. there's no appeals process for ben

4.8 million fewer seniors will be enrolled in these plans in 2019 and the independent medicare advisory commission, to enroll in medicare advantage for the results of that policy. $156,600,000,000 in cuts to in patient and outppient services,ç in patient rehabilitation facilities, inpatient psychiatric hospitals, skilled nursing facilities, ambulatory and hospice and ambulance and dialysis facilities and durable medical equipment suppliers. $37.7 billion in health cuts to health care providers. 22.one billion dollars in additional cuts to hospitals by slashing reimbursements designed to assist hospitals that serve low-income patients. $27 billion in cuts to the medicare improvement fund intended to fund improvements to medicare benefits, not to finance a new entitlement. and the yet to be determined cuts from the hands of the federal board. $2.3 billion in cuts to imaging reimbursements to other procedures. and cuts to wheelchair suppliers. and money taken from seniors in higher premiums. the $569,200,000,000 in taxes and the $523,500,000,000 in cuts to medicare to fund a new entitlement program a

house bill did not have any version on the tax on high end, number one, and the powers of the medicare commission to reduce cost were largely advisory in the house bill and they are in fact, far more significant incentive bill. one the actuaries look, he may well reach a different conclusions. i guess i would say to my friend who sort of made a wager. his amendment seems to say if the actuary says this will bend the cost curve we should vote for it. i would ask him why when the cbo says he won't go for that. he seems to be saying if an expert offers an opinion he agrees with, it's authoritative. if he offers an opinion he disagrees with, it isn't. >> would you yield? >> wait until it's your time. >> i agree it's authoritative, but it's also looking at a different time. i would yield back to my friend. it's her turn to yield. >> ms. moore wanted to add a bit. >> just very briefly, this is a very interesting discussion. because my good friend from my state, the distinguished ranking member gave such a reaction to ms. de laurel when she talked about bending the cost curve for private insurance when

medicare and social security benefits. that's what real life is. but this would instruct the commission to cut entitlement benefits, medicare and social security, to increase taxes and use it to fund more discretionary spending. and that is not good, and people should not vote for an amendment that would do that. we're going to have to wrestle with the entitlement commission. it has not binding authority. it's a recommendation to us. maybe they will have some recommendations we can all support. but it's not going to be fun, it's not going to be easy. there is no free lunch. nothing comes from nothing. somebody will pay to fix entitlements. and they are at the present time in surplus and the surplus that they are producing from the revenue from social security withholding and medicare withholding, that is being spent for discretionary spending. so to raise their income for those accounts and to cut spending in those accounts to allow even more spending on the discretionary side i think would be very unwise. perhaps that's not what was intended, but that's what appears to me to be pretty

one of the things they are saying is we're putting the new commission in charge of medicare, and, that is not elected, unelected bureaucrats to ration care, and put the clamps down on spending and they say if the commission does its job and cuts medicare across the board it will happen and other point is the president's own chief actuary, medicare and medicaid says the opposite and is saying, this is going to increase health care costs by $222 billion, over the first ten years, and, instead of bending the proverbial cost curve down it is going up and when you look at a real-life look at how these numbers add up, and take out the smoke and mirrors, the cbo cannot take out in their analysis, it reveals these things as not being true. >> chris: another point, let me just -- >> go ahead, i want to go on to another subject. now, malpractice, in the summit, republicans kept talking about malpractice reform, limiting doctors' liability and in fact house leader, john boehner, your leader, said medical malpractice and defensive medicine are the single biggest driver of medical inflation, and th

we have a new medicare commission called the independent payment advisory board that makes independent cuts based on cost considerations, bipassing the authority of congress. we have a new u.s. preventive task force, an agency that recently said women in their 40's don't need to do mammograms. that's given unprecedented power to make decisions that are normally made by patients and doctors. what this bill does is it says this. we are no longer going to trust the will, the interest, and the decisions of patients and their doctors. they don't know you have enough. we're going to take the poe you are and -- power and money from the citizens, washington knows best. washington will set up elaborate boards and bureaucracies of technocrats who can better micromanage those decisions. and the only way to get this debt crisis under control, the only way to get it under control is to ration care. with that, mechanic, i -- mr. speaker, i reserve the balance of my time. the speaker pro tempore: the gentlelady from new york. ms. slaughter: i ask unanimous consent to submit the following for the reco

we know in medicare, according to a june 2008 medicare payment advisory commission report, that 29% of the medicare beneficiaries it surveyed had trouble finding a primary care doctor. that's up from 24% in 2007. mr. president, if the doctor is not in, it is not health care reform. how can i go back to my seniors in florida and say, we're creating this new program by taking money out of your program and you may not be able to find a doctor who's going to see you anymore. it's not conscionable. florida will be disproportionately affected by these cuts. it has the second highest population of seniors and the highest concentration of seniors in the nation at 19%. let me tell you specifically how it will hurt one portion of health care for seniors, and that's home health care. i talked to ron malone, who is the vice president of gentiva health services and one of the largest providers of home health services in florida. he said, look, senator, it's not going to hurt us so much. we're a big company and we can spread costs. we'll get more market share. but it is going to hurt the smaller com

in section 3403, it's the creation of the medicare rationing commission and what this does, they havere in fact required to recommend medicare cuts and their goal is simple to give less resources to medicare payment. >> i have to ask you, you're in a unique position as second cousin to the president of the united states. have you talked to the president about this, have you had conversation was him? have you said, sir, with all due respect you're family, but i've got a problem with this? >> i have not spoken to-- about this with him directly, but the opinions of doctors are very well-known. it's by no mistake that the vast majority of doctors in this country are opposed to this because we know it will be harmful to our patients. >> also, some of the positives in this plan, we had dr. segal on the show earlier this morning and he said he pointed out some pros on this and you know, we went through actually some of the positives. he says medicaids rates will be closer to the medicare costs and hospitals, excuse me, hospitals are now actually being paid for this. regional exchanges on the

according to medpac, it is a bipartisan commission that advises congress on medicare payments. that organization says that medicare plans are paid 13% more than traditional payments. they strongly recommend that we reduce that overpayment because it causes a great inefficiencies. i might also say that today because of the overpayment all seniors on medicare -- i'm talking now especially about seniors who -- who take a fee-for-service. all seniors on medicare pay for these overpayments. even if they're not on medicare advantage plans. how? basically because every senior pays $3 more per month on part-b premiums. what so seniors paying paying for the overpayment for medicare advantage plans. medicare advantage overpayments drain resources from the medicare trust fund. if they're overpaid, that means they're draining excessive resources from the medicare trust fund. in fact, the -- the -- the government estimates that medicare advantage overpayments speed up insolvency of the medicare trust fund by 18 months. after that, there's no evidence that overpayments to medicare advantage

more government controls put in place, more commissions, more regulatory processes that are put in place. $406 billion in new taxes, $507 billion in cuts to medicare what is it, $940 billion cbo number, which even they say it's not the real number because there are other features of this when they kick in will jump the cost over $2 trillion so this is the predicate that has been laid for the health care debate that concerns people. i think that rhetoric is reflective of how people feel, and the concern that they have, and i think it's important for the administration and the leadership on the hill to understand that. >> governor, at what cost will victory abchieved? >> david, this is going to be great for democrats. i've been on a ballot seven times and won seven races. i would love to be running on this and i think the extreme nature of the rhetoric shows you how worried the other guys are. this bill passes right away seniors get a break on purchasing prescription medications, right away small businesses get a tax credit so they can afford to purchase insurance for their employees, right away, parents will be able to keep kids on their policies u

commissions and mandates including a new army of irs bills. and it still forces taxpayers to fund elective abortions. all of these new taxes, medicareuts, all of the new mandates kick effective immediately. there are no new benefits coming to the american people for at least four years. some of the sweetheart deals are still in this bill like the louisiana purchase. we have already discovered new ones like the bismarck bank job. democrat leaders are trying to assure their colleagues that if this bill passes it will become more popular. i think they are dead wrong. it is normal in washington that once a vote occurs on a big bill like this people move on to the next thing but i can assure you we will be talking about this for months and months to come. the american people will hear about every page of, every kick back and every swede ideal that comes out and democrats really do use the slaughter solution to pass this bill without voting on it, that vote in and of itself will be just as controversial as the bowl. the president is doing the hard sell on this bill telling democrat members that his presidency is on the line. is a vote is

medicare or raising taxes and all the details are available at healthcare.g healthcare.g healthcare.gop.gov. the bill raises premiums and ushers in a massive expansion of government with roughly 160 new boards, bureaus and commissionsof finding a responsible way to pay for all of this, democrats impose more than a half a trillion dollars in medicare cuts and more than half a trillion dollars in tax hikes. in fact, this bill requires den years of tax increases and ten years of medicare cuts just to pay for six years of supposed benefits. many of which don't even go into effect until 2014. that's not reform. >> the health care debate provides us with a sound of the week this morning. >> take a listen to just some of the rhetoric we have been hearing. >> kill the bill! kill the bill! kill the bill! >> i'm confident it will pass and the reason i'm confident it's going to pass is because it's right thing to do. >> we have made clear it's time to scrap the bill. they'll continue to ram, ram, ram this bill through the congress. >> just as co-pays for one month is $350. he's diabetic. he's got asthma. high blood pressure. tie cbo report we have again speaks so eloquent throw the savings that are there for the american peop

commissions, mandates, including a quhole new army of i.r.s. staff, and it still forces taxpayers to fund elective abortions. all of these new taxes, medicareew mandates take effect immediately while there are no new benefits coming to the american people for at least four years. some of the sweetheart deals are still in this deal. like the louisiana purchase. we have wlr discovered new ones, like the bismarck bank job. this is not counting whatever 11th-hour items may show up in this bill. democratic leaders are trying to assure their colleagues if this bill passes, it will become more popular. i think they are wrong. it is normal in washington that once a vote occurs on a big bill like this, people move onto the next bill. i can assure you that we will be talking about this for months and months to come. the american people are going to hear about every sweetheard deal that comes down. the depems really do use the slaughter solution to pass this bill without voting on it, that vote in and of itself will be just as controversial as the bill. the president is doing the hard sell on this. this vote isn't about saving the presidency or saving

commissions. instead of finding a responsible way to pay for all of this, democrats impose more than 5$50 billion in medicare cuts and tax hikes. in fact, this bill requires ten years of tax increases and ten years of medicare cuts just to pay for six years of supposed benefits, many of which don't even go into effect until 2014. that's not reform. >> check out this video here. a shocking pedestrian accident caught on tape. the woman is okay. but wait until you hear what the driver did afterwards. > a woman crossing the street was hit by an suv, caught on tape. here's the video from the dash cam of a police cruiser near atlanta. now, we want to assure you this woman is okay. as you c see there, she was crossing the street in a crosswalk when she was hit by another woman driving an suv. now, what the video does not show is the driver leaving the scene of the accident. yeah. a police officer saw the accident and stopped to help the woman. >> i just remember crossing the street and i saw a police car waiting for the light as i crossed, and it just came out of nowhere. i just can't get up. my knee is swollen so

medicare benefits progressive while strengthening the safety net of low-income americans. on the side of revenues, president barack obama was correct in my view in refusing to take any options off the commission's likes raising revenue. if you are going to buy, you need to pay. president clinton proposed an economic plan aimed at accomplishing fiscal balance. he paved the way for the greatest american prosperity in generations. he had a bipartisan tax compromise in 1986 which showed the importance of a simplified, more efficient tax cut. if need be, i am hopeful that both parties will agree to look at revenues as far as a solution compromise that cuts spending and balances the budget. none of this is easy. it will take bipartisan trust. there is not much of that and supply nowadays pri presidential leadership, i think there is a lot of that and supplies. we need a public spirit that many assume is beyond america's breach in the year 2010. i do not share that sentiment. america has made a career of proving such cynicism long. as jim fallow said ,"when theodore roosevelt set aside land for national parks, when dwight eisenhower created the pentagon research agency that gave rise to the internet,

medicare and if medicare makes a mistake or do something wrong you are a congressman, you can set them straight. if oxford does he get on the 800 number or call the state insurance commission and asked them to help out. that is the difference. we have competition for the last 44 years between an efficient low cost successful popular plan that is extended life expectancy of seniors by 10 years which is a wide reason it has a cost problem and dropping people making enormous amounts of profit has an approval rating only slightly above ours and that is the issue we are trying to deal with so that is the choice we are making. that is why when we drive a hard organ we are doing it for citizens. when they drive a hard bargain it is to make more profits for themselves. >> reclaiming my time-- mr. sessions, mr. sessions. reclaiming my time. i would like to yield back to the chair. >> thank you mr. perlmutter. >> thank you madam chair. i wanted thank everybody on the panel today. i know you have put in a lot of hours equally to the number on the committee but i appreciate the number of hours you have put into get the piece of legislation. we talk a lot about the process and have we

s forecast that an independent, nonpartisan commission of experts with authority to determine payment rates under medicarewill save the treasury $13.3 billion over a ten-year period. c.b.o. also credits medicare payment refor that seek to limit hospital readmissions and hospital-acquired infections with that encourage physicians to group together in cost-saving organizations with with $4.9 billion in savings. we know these things work because places like the mayo clinic in minnesota are out there doing that right bill prot the medicare ust fund and preserve medicare benefits, it also reduces spending growth in the out years. the savings i have been talking about are not just a one off proposition and then back on the spending growth ratchet. this bill reshapes the delivery system so that federal health care costs should never grow at this outrageous rate again. c.b.o. and commonwealth economists find that the bill reduces medicare rate of growth by 2%. president obama's council of ecom e bill will reduce the annl growth rate of federal spending by a percentage point in the upcoming decade and by an even g

may come with it, all of the new government boards and commissions, a program that cuts cuts $500 billion from our seniors who depend upon medicare for their health care and raises taxes by another $500 billion. the american people are saying stop and start over. they know that we have good ideas. they have listened to that summit last week that i was able to attend at the white house, and they have heard that republicans say let people buy insurance across state lines. that will help 12 million more people get insurance today. they say let's deal with lawsuit abuse. that will help cut down the cost of these unnecessary tests which are done as defensive medicine. they understand the american people, the value of allowing small businesses to join together to help more effectively get down the costs of care, and that's why half of all americans say stop and start over. one in four just say stop. only one in four americans say yes, pass the bill. so three in four do not want what the president seems to be wanting to shove through congress and shove down the throats of the american people. the american people are incensed, and that's

commissions. a program that cuts $500 billion from our seniors who depend upon medicare for their healthcare and raises billion. the american people are saying stop and start over. they know that we have good ideas. they listened to that summit last week that i was able to attend at the white house. they've heard that republicans say let people buy insurance across state lines. that will help 12 million more people get insurance today. they say let's deal with lawsuit abuse. that will help cut down the cost of these unnecessary tests which are done as defensive medicine. they understand american people, the value of allowing small businesses to join together to help more effectively get down the cost of care. and that's why half of all americans say stop and start over. 1 in 4 just say stop. only 1 in 4 americans say, yes, pass the bill. so 3 in 4 do not want what the president seems to be wanting to shove through congress and shove down the throats of the american people. the american people are incensed and that's what i heard in wyoming this weekend and i'm sure from my colleague who is here from mi

medicare benefits progressive while strengthening the safety net of low-income americans. on the side of revenues, president barack obama was correct in my view in refusing to take any options off the commission'sperity in generations. he had a bipartisan tax compromise in 1986 which showed the importance of a simplified, more efficient tax cut. if need be, i am hopeful that both parties will agree to look at revenues as far as a solution compromise that cuts spending and balances the budget. none of this is easy. it will take bipartisan trust. there is not much of that and supply nowadays pri presidential leadership, i think there is a lot of that and supplies. we need a public spirit that many assume is beyond america's breach in the year 2010. i do not share that sentiment. america has made a career of proving such cynicism long. as jim fallow said ,"when theodore roosevelt set aside land for national parks, when dwight eisenhower created the pentagon research agency that gave rise to the internet, the american system seemed open to it. saving america from debt would be long next to those accomplishments because in every era, these very fiscal issues are among the greatest tests a nation can

medicare benefits progressive while strengthening the safety net of low-income americans. on the side of revenues, president barack obama was correct in my view in refusing to take any options off the commission's table. no one likes raising revenue. if you are going to buy, you need to pay. president clinton proposed an economic plan aimed at accomplishing fiscal balance. he paved the way for the greatest american prosperity in generations. he had a bipartisan tax compromise in 1986 which showed the importance of a simplified, more efficient tax cut. if need be, i am hopeful that both parties will agree to look at revenues as far as a solution compromise that cuts spending and balances the budget. none of this is easy. it will take bipartisan trust. there is not much of that and supply nowadays pri presidential leadership, i think there is a lot of that and supplies. we need a public spirit that many assume is beyond america's breach in the year 2010. i do not share that sentiment. america has made a career of proving such cynicism long. as jim fallow said ,"when theodore roosevelt set aside land for national parks, when dwight eisenhower created the pentagon research agency that gave rise to

medicare benefits progressive while strengthening the safety net of low-income americans. on the side of revenues, president barack obama was correct in my view in refusing to take any options off the commission's buy, you need to pay. president clinton proposed an economic plan aimed at accomplishing fiscal balance. he paved the way for the greatest american prosperity in generations. he had a bipartisan tax compromise in 1986 which showed the importance of a simplified, more efficient tax cut. if need be, i am hopeful that both parties will agree to look at revenues as far as a solution compromise that cuts spending and balances the budget. none of this is easy. it will take bipartisan trust. there is not much of that and supply nowadays pri presidential leadership, i think there is a lot of that and supplies. we need a public spirit that many assume is beyond america's breach in the year 2010. i do not share that sentiment. america has made a career of proving such cynicism long. as jim fallow said ,"when theodore roosevelt set aside land for national parks, when dwight eisenhower created the pentagon research agency that gave rise to the internet, the american system seemed open to it. savi

according to medpac, it is a bipartisan commission that advises congress on medicare payments. that organization says that medicare plans are paid 13% more than traditional payments. they strongly recommend that we reduce that overpayment because it causes a great inefficiencies. i might also say that today because of the overpayment all seniors on medicare -- i'm talking now especially about seniors who -- who take a fee-for-service. all seniors on medicare pay for these overpayments. even if they're not on medicare advantage plans. how? basically because every senior pays $3 more per month on part-b premiums. what so seniors paying paying for the overpayment for medicare advantage plans. medicare advantage overpayments drain resources from the medicare trust fund. if they're overpaid, that means they're draining excessive resources from the medicare trust fund. in fact, the -- the -- the government estimates that medicare advantage overpayments speed up insolvency of the medicare trust fund by 18 months. after that, there's no evidence that overpayments to medicare advantage