mr. john scully. took a turn for the infamous after he ordered another government official to withhold information from congress. that information was how much president bush's medicare prescription drug benefit would cost. publicly the bush administration was saying no more than $300 billion. privately, they knew was more like $600 billion. but thomas scully made sure the congress never knew. a bush administration investigation found that mr. scully threatened to fire the actuary who came up with the real cost figures if that actuary gave those real cost numbers to congress. and while he was doing that, mr. scully was also busy getting himself a special waiver, that would allow him to get a job as a health industry lobbyist soon as he left government. think about this. he helped that prescription bill guess passed by hiding its true costs, then he immediately went to work for companies who stood to make a mint from the fact that he got that bill passed. nice work, if you can get it. right? you know,

mr. scully will keep an open mind. if i say anything you don't understand please interrupt me and ask a question. ok, your claim is that since medicare doesn't pay enough, hospitals have to charge private insurers more money to make up for the loss than the medicare payments . now, if this were true it would have to be on a hospital by hospital basis. it doesn't do hospital b with all the medicare patients any good if hospital a charges private insurers more money. and this is true that private insurers do pay hospitals with differently sums of money for the same treatment. so if there were cost sharing hospitals with a large volume of medicare and medicaid patients would have to be paid and have to charge more to the private insurers. but medpac has looked into this and there is absolutely no correlation between the volume of medicare and medicaid patients and the amount the hospitals charge private insurers. some hospitals have a lot of medicare patients and they get paid less than private -- by private insurers than

mr. scully just said?caller: well, i think, again, it's been very illuminating to watch -- guest: well, i think, again, it's been very illuminating to watch the health care debate. because patients suffer when there's no coordination, when there's no assumption of responsibility in the health care system. and yet the fear that americans appear to have of having anyone in charge of the health care system is very real and not entirely misplaced. and until we can really have sort of an honest, calm political discussion about how much we want to avoid making decisions or taking responsibilities for some of these issues so that everyone and every doctor can do whatever he pleases, even at the enormous cost, both human and economic that that generates, we are going to have a hard time solving any of these problems. host: and finally, bruce vladeck, what do you do today? guest: i sort of split my time between public policy work and consulting and advocacy as an employee of nexseria consulting which is a subsidiar

mr. scully will keep an open mind.f i say anything you don't understand please interrupt me and ask a question. ok, your claim is that since medicare doesn't pay enough, hospitals have to charge private insurers more money to make up for the loss than the medicare payments . now, if this were true it would have to be on a hospital by hospital basis. it doesn't do hospital b with all the medicare patients any good if hospital a charges private insurers more money. and this is true that private insurers do pay hospitals with differently sums of money for the same treatment. so if there were cost sharing hospitals with a large volume of medicare and medicaid patients would have to be paid and have to charge more to the private insurers. but medpac has looked into this and there is absolutely no correlation between the volume of medicare and medicaid patients and the amount the hospitals charge private insurers. some hospitals have a lot of medicare patients and they get paid less than private -- by private insurers than o

mr. scully just said?r: well, i think, again, it's been very illuminating to watch -- guest: well, i think, again, it's been very illuminating to watch the health care debate. because patients suffer when there's no coordination, when there's no assumption of responsibility in the health care system. and yet the fear that americans appear to have of having anyone in charge of the health care system is very real and not entirely misplaced. and until we can really have sort of an honest, calm political discussion about how much we want to avoid making decisions or taking responsibilities for some of these issues so that everyone and every doctor can do whatever he pleases, even at the enormous cost, both human and economic that that generates, we are going to have a hard time solving any of these problems. host: and finally, bruce vladeck, what do you do today? guest: i sort of split my time between public policy work and consulting and advocacy as an employee of nexseria consulting which is a subsidiary of

mr. scully threatened to fire the actuary who came up with the real cost figures if that actuary gave those real cost numbers to congress. and while he was doing that, mr. xwuly was also busy getting himself a special waiver, getting a job as a health lobbyist as soon as he left government. think about this. he helped that prescription bill guess passed by hiding its true costs, then he immediately went to work for companies who stood to make a mint from the fact that he got that bill passed. nice work, if you can get it. right? you know, it is technically legal to interfere with a federal employee trying to -- be congress. started raking in the d-o-u-g-e, dough. where's he today? scullsy a general partner at a firm investing in a lot of different medical company, everything from kidney dialysis centers to nurse temping agencies to manufacturers of heart and vascular defect devices. one of the companies they recently invested heavily in is ca solantic. a florida based urgent care providing taking a walmart-like for-profit to health care. the chairman sn a man named rick scott. rick scott. r

mr. scully, i'd like to ask you a question. i'm fortunate to be a young woman, 54, that i've had to get on disability. and i'm having to wait 24 and i'm having to wait 24 months before i can get on i cannot figure that out. i discussed it with them pretty often and explained the issue. i am hoping in march i will get mine. -- my medicare. the senate takes quarters -- you said it takes -- what you have to get to be your medicare? guest: to be automatically eligible, you have to pay the taxes a certain way. if you paid your 1.45% for 10 quarters during her lifetime, at 65 you are eligible for medicare. either you are emigrated or were not here for that time, you can buy into the program. host: 10 quarters if you work full-time for 2.5 years? princeton, new jersey, 65 and older. what i am a 71 year-old retired mathematician. there are a lot of myths associated with health care. i want to talk about the myth of cost share. i knew you people get attached to it. i hope you'll keep an open mind. i will try to get slowly. please come i

mr. scully just said?aller: well, i think, again, it's been very illuminating to watch -- guest: well, i think, again, it's been very illuminating to watch the health care debate. because patients suffer when there's no coordination, when there's no assumption of responsibility in the health care system. and yet the fear that americans appear to have of having anyone in charge of the health care system is very real and not entirely misplaced. and until we can really have sort of an honest, calm political discussion about how much we want to avoid making decisions or taking responsibilities for some of these issues so that everyone and every doctor can do whatever he pleases, even at the enormous cost, both human and economic that that generates, we are going to have a hard time solving any of these problems. host: and finally, bruce vladeck, what do you do today? guest: i sort of split my time between public policy work and consulting and advocacy as an employee of nexseria consulting which is a subsidiary