going bankrupt which you guys are talking about then yeah let's let's read let's tackle the medicare part d. program that's a giant give away the pharmaceutical industry that sold it off and jump seventy percent the time. i want to express all the surprise at this point when this was several years in the making disingenuous yes yes can we talk about the levels of taxes involved here well well above the historical average and they will only continue and again i talked about the debt will only continue right to rise and he's attacked it all sounds and we're not talking about yet we're not talking about an increase in marginal tax rates here we're talking about closing tax loopholes that allow people like private jet owners to get by without paying taxes for a certain amount of years on the private jet we're talking about we're talking about tens of billions of dollars in. so these are the most profitable oil corporations in this world and yet we're supposed to think of these should be on the same level playing field as cuts to entitlement programs to me that doesn't matter this seems like something th

more than six million seniors have saved $6.1 billion in the medicare part d drug program. and begins next year -- beginning next year, tens of millions of americans who would otherwise be out without health -- without health coverage will have depend bl, quality health insurance. my republican colleagues say people want certainty. well, the certainty they would have if there was no affordable care act is that millions of people would be discriminated against because they had pre-existing health conditions. because they offer a rusk to the insurance -- a risk to the insurance companies to have to pay more money for their care. they have the certainty of knowing that insurance companies would do everything they could to keep them from getting coverage if it's going to cost the insurance companies main. and that's what we wanted to change. republicans still oppose the affordable care act. they are not taking a constructive approach and not saying what can we do to make this law and its implementation work more smoothly. they're saying what can we plame people who supported th

in january 2006 we implemented the medicare part d program, "time" magazine described the initial nightmare of implementation, noting the results of the moment comes singers. in vermont, implementation of the loveless described as a public health emergency. those problems are almost forgot until today. ultimately the part d program got off the ground and even those who initially voted against a bill like me took a stake in it at worked to fix the problem. the biggest problem, the doughnut hole was eliminated by the affordable care act. so i think as usual there's a lesson to be learned in this history. i hope the implementation of the affordable characters to play. i certainly hope more smoothly than the implementation of the medicare part d. i'm not naÏve enough and it should be to think it will be completely wrinkle free. what i do hope business problems provides we can work together to identify and fix instead of using it to score political points because we all have a stake in providing quality affordable health insurance coverage for all americans. i hope this hearing in our future wor

people point to the medicare part d program and point out the fact part d spending has been much lower than originally projected by cbo. that does ccp was not a fortuneteller and projections are fairly salty. in fact, the program has done better in terms of per capita prescription drug spending than the rest of the country. it's a pretty good indication. the last one i want to mention this to seniors make good choices? and this is a fair avenue and has to somehow wouldn't select take it plan. i will go to part d again. what a lot of analysts who don't like the idea have said is in the first year of medicare beneficiaries didn't hit plants. they paid more than they needed to. a recent study in the american economic review calls thinking, sending our money to spend and what it says something heartening for for all of those that when you turn 65 he don't lose your ability to think. what basically happened is not surprisingly it is pretty confusing for most people. the second year they looked around and said maybe there's a better option. it seems kind of expensive than for very large samp

guest: it is when the medicare part d program that provides description drugs was passed, and that was the condition of tom the hammer delay who was a leader of the house and it was obviously a concession to the drug companies and really pretty outrageous. it is the case, we buy wholesale. if you go in and buy 100 aspirin but you have to pay as if you are buying 100 individual tablets of aspirin. host: on the politics of this in "the washington times" this morning, it says this -- a quote from jim dean, the brother of former vermont governor howard dean and chairman of democracy for america, political action committee. he said, real democrats don't cut social security benefits, period, and it is shameful a democrat president is leading the charge to do so. the group vowed to recruit a primary opponent for any democrat in congress votes for a plan that cut social security. guest: it is really going to be rough politics on the democratic side for anybody who is going to be talking about chain cpi. the democratic approach, including president obama, has been to support social security. an

part d. in your budget you target party again, particularly the medicare advance programs, which is radically important in our state. i would ask you to take a look at that part d success rate. i think that is where some of the reforms can and should be made. thank you for your time today and your service. quite see why, senator. the why, senator. >> senator menendez. is a lot to a plot in the budget, certainly the hundred million investment to research all timers disease, something that's at my mothers life. the funny for community community health centers, incredibly important. the funding for community health centers. there are tough decisions to make. i think we did a lot of that in the affordable care act. real long-term savings can and should be found why encouraging the efficient delivery of healthcare. through measures such as increasing the use of electronic micro -- medical records. promoting the efficient the livery of medication. improving coordination between acute and postacute providers to ensure the appropriate care setting. do you share those views as it relates to how we sav

medicare benefit. in the 1980s, inform, d -- in fact, hospice did become part of the medicare program. hospice is paid on a per diem basis. just 25 years later, half of all hospices have become for-profit, and hospices have settled with the justice department for enrolling people in has possess care who are not dying which is fraudulent use of medicare. the largest for-profit hospice in the u.s. has been under federal investigation for fraud. a former manager accused the hospice chain of enrolling people who are not terminally ill. the parent company is roto-rooter plumbing. hospices spend money to defend these claims. they hire lawyers to do this. where does that money come from it comes from hospice revenues. where does that money come from? if you're paying payroll taxes from your paychecks, you're helping to subsidize the cost of defending the indefensible. and the reason i wrote this book, it was for the public to see the connections between the money that you pay, the money that we all pay, where it goes, who's getting it, how it's being used so we can use our democracy, be infor

medicare part d? >> i can't disagree with that. >> the biggest expansion of entitlement spending until the point as i recall. >> it was a program i thought at the time should've been paid for. >> is a great president obama has increased entitlement spending more with the so-called affordable care act? >> the affordable care act save the bottom line, so it's very distinguishable from the prescription drug benefits. >> do not agree is a massive expansion in entitlement spending? >> i'd be happy to address the issues you raise. >> usury rates is simple. why can i be more like president clinton famously president bush's? >> the reality of demographics and the difference of where we were in the 1990s and today is my generation is starting to retire. we attempted lots of people coming to social security and medicare and that is what is driving the percentages of spending. are we going to keep pace of that generation? .. we have had major savings in the affordable care act, and added a life of medicare trust fund. we're proposing in budget considerable new savings including fundamental structure reform. i don't disagree we need more sav

at medicare part d in spite of the fact that it is -- despite when the benefit was first created it still paying at a much more substantial rate than the veterans administration, the medicaid program and the bright of other programs that we are still paying premium dollars for a number of those drugs. and for these 9 million individuals, the budget assumes that on balance this is an appropriate way to both save some dollars going forward but also make sure that those beneficiaries receive the critical medications that they need. >> i just don't think research and develop a dollars -- if i may, another minute? >> final. >> final. with reference to hospitals, one was raise with you, cms is pinning something that was part of the affordable care act. it is a critical issue to new jersey hospitals, and we are awaiting a response. i just want to bring it up again, because it's probably life or death for a whole host of new jersey hospitals. and in line with hospitals, the medicare cuts to hospitals, the president's budget calls for about $11 billion to graduate medical education would have 77 million-dollar cuts for children's graduate medical education programs. both of these are criti

more than 6 million seniors have saved $6.1 billion in the medicare part d drug program.beginning next year, tens of millions of americans who had otherwise would have been without health insurance will have dependable quality health insurance. my republican colleagues say that people want certainty. the certainty they would have if there was no affordable care act is that millions of people would be discriminated against because they have pre-existing health conditions, because they offer a risk to the insurance companies, they have to pay more money for their care. they would have the certainty of knowing that insurance companies would do everything they could to keep them from getting coverage if it is going to cost the insurance companies money, and that is what we wanted to change. republican still oppose the affordable care act. they are not taking a constructive approach. they are not saying, what can we do to make this law and implementation work more smoothly? they are saying what can we blame people for supporting this law about problems that may come up? i am p