it speaks to outcomes. the initial upfront payment is held steady or reduced slightly, but we have found in our individual practices and health systems as a whole, if we do these things together because we are sharing the data. we are seeing data driven outcomes and the payment is enhanced. the thinking shifts from the traditional fee for service model. >> not everybody is ready to get on the escalator at the top. you can get on the middle, the bottom. all medicine in this country is local. when you have seen one health care market, you have seen one market. at different places, different providers, different levels, you need a variety of options to keep people moving. but you want to keep them all moving up the escalator. that is the point we all agree on. keep people pushing up the ladder towards better, more accountable, more person focused care. lots of metrics, metrics are the key. we have a long way to go in terms of the infrastructure. >> throughout all of this, all of this restructuring, we have a l

it's a positive outcome? anyway iraq can be fixed? >> you are assuming that the maintenance of iraq is a positive outcome. if we were talking to the kurds, there are not any kurds who want iraq to continue. they want to have an independent country in northern iraq. isn't that a bad thing? -- is that a bad thing? i do not. >> perhaps the best way to fix the is to break it up into several parts? >> when countries breakup -- who regrets the breakup of the soviet union? it was wanted. should the sunnis and be subjected to rule of the majority of the shiites win and they define themselves by their religion in a way that the sunnis feel excluded, arrangements which provide for greater autonomy for the sunni region makes a lot of sense. they have a constitution and it does and the weak central government by the design of its various people. it is not an accident. it is something the kurds very much intended. in fact, it was intended by at the time of the larger shiite party that was called the islamic revolution. it is not that to be outside

as a credible democratic outcome. it will produce an administration with whom we hope we can work over the long term. there's no reason to believe it wouldn't give them a slate of candidates were beginning to see emerge. but what is really important is that this election, the point that has been made frequently by not just united states, but many other international partners is this election is not viewed as being credible, inclusive and comprehensive. we are going to see it very difficult for many of our partners are for the united states to justify the long-term commitment we've made to afghanistan. so this is a really important moment. it's really profoundly different in many ways because there has been that maturation, the development of governments -- governmental institutions and the capacity. much needs to be done still. there's a long, long way to go ultimately in democratic institutions. but from where we were in on nights where we are today, that process has progressed a great deal. so there is a greater gov

vote for whom there i mean again it looks like the americans are sabotaging this by determining outcomes before people even sit down and talk if they want to talk at all. yes it's unfortunate because not only is the american side insisting on preconditions they're insisting on clear results which will has doomed and it goes sheet of process for the past two years and has directly contributed to this atrocious outcome not only in human terms but in strategic terms not just for syria but for the united states as well it is really i think strategic malpractises as i said before but i think ambassador murphy murphy's points are right just to call an election with asada running the history of that for syrians has not worked so i think what we have we have a really good asset with locked arbor he meet here at the u.n. at the table trying to organize this what he did for lebanon what he did for afghanistan what he did for iraq for somalia for haiti but he didn't just say call an election pretend that one man one vote is going to take care of the political problems here you know what he did in e

step what would be the major outcome of the summit if any? yes, the apec summit here in bali has been officially wrapped up and now you can see leaders going back home. apec is not much about outcome but about debates, meetings and commitments. what we have seen is that all the leaders, china, japan have actually made new commitments to the region, despite crises that are going on in their countries. that is the main worry, you are talking about opening up economies, working together, but you're suffering and struggling within your owning country. this region is the vital region for global recovery. that's what everyone agrees on. that is a major outcome although of course it is not a very concrete one as of yet. >> of course, president obama step was supposed to be at this conference. secretary kerry went in his stead. how was his absence felt there? >> yes, a lot has been said about the absence of one man, president obama. and many have of course down played the importance of his presence saying, he has been represented here but others have

a fuss about the structures in the outcome. i think what they have done is encourage people to really have peripheral vision. attack to cardiologists who are now talking to nursing home operators because they are responsible for the continuing care. that didn't happen before, so i do believe we are going in the right direction in terms to reorient into the egg dionne just the facilities, so i think that's positive. i also was struck by their reaction to the results of the pioneer because typically used by budget systems improve quality and reduce costs, that would be a great thing. i don't think we should understate the achievement started in the field. it's going to take time as a heavy list. >> it is going to take time because the economic model has to shift. if you look at a pair perspective, we have to be more comfortable sharing the management process, including data as you said earlier. in the provider side comments got to be less about volume and more about collaborating, getting people to the right. it's a major shift.

outcome. it will produce an administration with whom we hope we can work over the long term. there's no reason to believe that it wouldn't given the slate of candidates we're beginning to see merge. see emerge. but what's really important is if this election -- this is a point that's been made frequently by not just the united states, but many of our other international partners -- if this election is not viewed as being credible, inclusive and come prehence i, we're going to see -- comprehensive, we're going to see it very difficult for many of our partners and for the united states to justify the long-term commitment we have made to afghanistan. so this is a really moment. it's profoundly different than the last presidential election because the maturation of developmental institutions and the capacity governance. much needs to be done still. there's a long, long way to go, ultimately, in the development of democratic institutions and governance. but from where we were in '09 to where we are

the outcome. >> i'm happy because berlusconi and people like him were put in their place. >> a government collapse would have been the worst possible result, so this is much better. >> the vote of confidence in the government means italy can continue on its course of economic reform. >> let's do that right now -- let's take the focus off of berlusconi and get it on italy's stalled reform process. for that, we turn to our correspondent in rome. what now for italy? can it go ahead with reforms for brussels -- reforms that brussels and other creditors desperately want to see? >> i'm sure they have all the good intentions required. thinking back, though, to the technocrat government with mario monti last year, he had a year and a clean mandate o introduce all these reforms. for example, there was the abolition of the provincial layer of government in italy, which everyone knows is a waste of time and money -- he ailed getting rid of this bureaucratic hurdle -- he ailed -- he failed getting rid of this

if i cannot get my very best outcome, what are the other outcomes i can think about that might work as well, so to get back to my silly thing, if i am not going to the pta meeting, i will do the garbage thing and i will get over some of my guilt and be more efficient with some of my time. demandso these undermine american progress if we do not get women to find a balance in their lives? thanmen are getting more 50% of the college degrees and the medical degrees and the phd's. if we do not find a way to keep women in the workforce and keep them happy, we are throwing our investment down the drain. 's new text,ah spar "wonder women: sex, power, and the quest for perfection." it is an honor to have you on program. coming up up, a conversation with novelist t.c. boyle. stay with us. t.c. boyle has written 100 novels and short stories and many of them deal with immigration and environmental degradation. he has consistently been on the bestseller list. he has published his second volume of stories called "t.c. boyle stories ii." good to have you back on this program. chuck taylors on. i love

and my outcomes show that they benefit from that. >> thank you. [ applause ] >> you were a substance treatment expert for the medical center. i understand there is some promising new treatments about alcohol that maybe on the horizon. tell us about that. >> as far as treatment for alcoholism, the first things to consider is how somebody gets into treatment in the first place. there is 4 l's, liver, livelihood, lover or the law. those 4 things. liver, livelihood, lover and law. within those l's is when somebody shows up in my door, someone suffering, a family member suffering who brings somebody in. when it company ms to treat we know there is different types of treatment, there is evidence base treatment. there is good evidence for it, we do it. there is evidence free treatment, there is no evidence whatsoever and there is evidence proof treatment. one of those evidence proof treatment is incarceration treatment. there was an office inspection in general report and eventually matt case became supervisor for it. i have been involved in other places. treatment in custody doesn't work.

this system will support the department in its capacity to analyze and the outcomes related to program types and serviceses at the facility. the probation department is producing other programs using the same. it will provide an opportunity for both technical and operational leakages for more affective tracking of offender outcomes. the department has initiated efforts with the court system. this in addition with our partnership with apd will allow us to better track the arrest -- rearrest of young people after they left the ranch and understand the outcomes through the adult court system. for finding 3.1 law cabin ranch has the potential to become a sue peer yore for san francisco. with he agree with this finding -- we agree with this finding. 3.2 leads the ranch to uncertainty. we agree and partially disagree with this findings. we believe a needs assessment is ongoing to an assessment. that is underway and the final report is imminent. this will help inform the development of the master plan. as to recommendation number three, funding the master plan to determine the programic capit

have a better outcome. if you can prove that point in an aco environment, you'll win. and this is really kind of the first time that -- we've had that opportunity. and the innovation is following. it is a bit of a lag. there's a disruptive period. but it's there. >> i don't know how long you all have been sitting here, but i'm sure you're eager for your opportunity to ask some questions. i think we'll move in to the audience with some questions. ic you have probably already know the routine. there's a microphone going around. can you please let us know who you are and who you are with. so our panel is can structure their questions accordingly. >> i'm a practices primary care physician. i was wondering with the plans and moving parts aren't there going to be tremendous transaction costs with the new system which will also have significant health i.t. cost and significant management costs. no one has talked about the cost that comes specifically with this disruptive change. >> well, i would say there's tremen

if we do not stay aligned, if we splinter, outcomes will only get worse. loud and powerful voice speaking as one, defending the american dream, is what will make our efforts more successful. we are working hard on your behalf every day at the nba. our injury -- energy never wanes in our effort to fight the fight to protect the american dream of a safe and sustainable home. we are the nba. together, we are 100 years strong. we have all of you out here, this diverse set of stakeholders, all involved working to defend the opportunities for futures to come. let's not let them down. thank you. [applause] now, to lead off the next set of speakers for the conference, it is a great pleasure to have my and an absolutely amazing individual, secretary shaun donovan. was sworn, 2009, he in as the fifth u.s. secretary for housing and german development. -- urban development. fifth. ok. in just over four years, he has had a variety of the combatants. he has reaffirmed a commitment to building strong, sustainable, and inclusive communities. prior to his appointment by pr

i just want to get prepared because i know that outcome is coming. i don't know when the bond market will say we've had enough. okay? and when that happens, i believe there is so much money, so much money has been invested in stocks and bonds that are mispriced. nobody with an ounce of brains would accept 3% coupon in the world we live in today. but people don't have a choice because the fed has been pinning rates on the short end. and when the world was worried about a deflationary outcome, any amount of income was okay you knew the government would pay you back. if that collapse is off the table. and you have to go down the path of holding these bonds and getting something for them then the bond market can decline. if the bond market starts to decline and the fed can't control it, then at some point you get chaos in the financial markets. it won't be like '08. because it won't be the financial stimulus imploding on itself. but if bond rates around the world cannot be controlled by the central banks any more that would be a big problem. >> bill, las

there are meaningful, functional outcomes that patients can record. doesn't have to be all mysterious. then every little entity can report in to registries that then enable providers to improve and presumably succeeding with patients is why they went in to health care in the first place. there's a virtuous cycle when we focus it where value is actually created. >> all right. put up your hand if you want a question. we have a microphone that will come to you. please just state your name, state your question. we've probably got at lough them to try to make as quickly through as possible. and one last note, i want to brag that every one of these events the audience member survival rate is 1900%. [laughter] >> i wanted to say, first, i think it's one of the best panlts i've ever been on health care. so thank you. i want to go back to two comments you made and ask a question that combines them. there are problems in the health care system. it seems to me it's much more that not the health care system is broken, even though there are some problems. but that

or whether or not the blow includes the outcome. >> i don't know. >> jon: what do you mean you don'tnow. you wrote the book? >> there's so much i don't know. these books always raise more questions than they resolve. that's what they are supposed to do, right? they are supposed to kind of start. it would be really fascinating. i didn't do it. now i think i should have. to sit down next to bill clinton and ask that question. here is a guy who had the furthest thing from a silver spoon in his mouth. >> jon: no question. i don't know if he would share his story. he's receipt sent about that. >> very shy. >> jon: you might get a couple things. you might be like the book is too big last. laugh raises tons of questions and i think is a nice way to look at, you know, that old adage the lemons ants lemon yaid, that sort of thing. david and goliath. be a david, why not.

the outcome politically is very, very hard to see.nd maybe beyond health care. we dramatize everything in politics saying everything is life and death. we overuse that idea. whether or not you can access health care can be a life and death thing and even when it is not a life and death thing it is certainly a thousand of dollars for your family year after year for regular everyday families no matter how your family votes. if these differences in outcomes persist in a way that has a real material effect on people's lives, forget the politics. should we expect migration? shouldn't we expect that people might move from states where you can't get good health coverage for your family to places where you can get that coverage? it would have a huge material effect on your life if these differences between the states are sustained over time. this is a work in progress, but right now if you are in a red state without good health coverage, you probably are still screwed now and for the foreseeable future. but in some blue states that want this

there is not this is not a case of a good outcome and a bad outcome. all the outcomes are to the going to be good from our standpoint. i do think it's regrettable that it does in effect keep a saad in power, at least until next summer when the completion of this destruction occurs, assuming it occurs on time. and i think the united states must make it clear that our policy that a saad cannot remain has to be maintained and made clear to all concerned. >> then the question comes what happens after a saad? >> then history is replete with examples, charlie, where violent revolutions removed dictators from power, and replaced them with worst dictators. the best example and most obvious one is russia where people-- . >> rose: iran too. >> but russia. >> worked on some cases. >> and so it happens. and these revolutions take a long time. in the united states in a much simpler era, much single-- simpler from the time of fighting ened until our government was created it was 8 years. in france, 50 years, in england more than 200 years. these revolutions, counter

summit so i wish he cancel that that would be a good outcome of the shutdown it can actually save jobs and just briefly talk about the the outcome of the shutdown just how long could this shop continue for many say this is just an overreaction it could be two or three days it could all be result but could this go one of the one of the shutdowns last for something like three weeks in the past so could it get to that stage you think the political deadlock. we're talking to all of the people i know on capitol hill no one knows it could go that long this is it seems that no one's really talking about how to resolve this there is the talk about uncertainty there is a large degree of uncertainty as to how long this shutdown is going to last and the longer it goes the more painful it will be for the economy because it's great to talk to you thank you very much indeed cut as it is from the american jobs alliance live from new york thank you. thank you. much more government must now shut down until congress funds it again. britain's slow drift away from the rest of europe continues prime minist

one of the outcomes of fixing our broken system is a stronger housing marketplace.rom 2000-2010, immigrants accounted for almost 40% of new homeowners nationwide. that's a lot of demand for your products and services. so expanding the circle of opportunity for those who are ready to own creates incredible benefits. the president stressed that it's in all of our interest to get this done. so let's do it now. it's also in our interest to shape an environment that encourages good lenders to get the quality products to credit where the families. unfortunately, as you know better than anyone, and as dave talked about, one of the major obstacles that's blocking a full housing recovery is regulatory uncertainty. and i understand, having been a lender i can't imagine what it's like sitting at your desk back in your home state as you've watched the federal government respond to the crisis. we've taken a lot of steps that were, in my view, necessary to restore confidence and ensure that many of the bad practices that caused the mess were eliminated. one of the outcomes is tha

he had predicted this would be the outcome.ick a fight with ted cruz today. mccain and the leadership are getting the outcome, as bruised as they all are getting to this point, this is the outcome they want, to get it voted on today from the senate side, to not have someone like ted cruz interfere with what house republicans might do. these are steps that people had predicted. so far, they're falling into place, alex. >> nbc capitol hill correspondent kelly o'donnell, thanks as always for your time. i want to bring in nbc news other capitol hill correspondent luke russert. what is the latest on the house side? do we have any clarity on who's going first here? >> we expect the senate now to go first, if they agree to unanimous consent to move this forward in an expedited manner. i was forwarded an e-mail the house gop whip's office sent out to all members. expect multiple vote series this evening, the timing sun clear. this could be a late night on capitol hill. from everybody i've spoken to, they want to get this puppy, like st

that would be a terrible outcome for the country.re are some republicans that have said we can prioritize era debt. if we default on october 17, we can print -- prioritize era debt. guest: the federal government takes in $2.5 trillion per year and spends 3.5 trillion so you can do that for a while but eventually the money comes out. you can prioritize and try to do that but treasury says we don't have the ability from a systems standpoint to program the computers that way. even if they could, they spend more than they taken and that tricked tricked is not work for very long. host: then there is the concern that people stop buying treasury bonds. this is a story from the front page of "the wall street journal." guest: it's serious business and the u.s. should not dine and dasjh. when you have a country that for every dollar it spends, they don't have $.40 of a that the federal government level -- they overspend what they taken -- somebody has to float that debt and provide that lending capability to us. chinesecases, it's the and othe

patients what from doctors. >> it's our expectation that by crowd sourcing patient outcomes, we'll uncovere surprising information. >> reporter: it's that sort of crowd sourced treatment that turned jackie on to the site. >> i took that information with me as, you know, proof, and honestly i know that went a long way to convincing my own doctor, try. >> reporter: there are very real privacy concerns about putting all of that information out there. patients like me sells the data academics. >> i think there is an expectation that all of these systems come together that there will be a an incredible amount of data. >> reporter: david shuster, al jazeera. >>> october is almost over, we're finally going to find out about job growth in september. that's the good news. the bad on inside story, we bring ♪ >>> well the wait for september's delayed jobs figures ends tuesday. unemployment is expected to hold steady. 180,000 jobs are expected to be added. among the people who will be watching closely is leo, he says that the puzzle of creating american jobs during this recover is missing a key piece,

the outcome of that vote for you here in just moments. on wall street stocks closing higher.nal hour rally. the dow of 62 points. the s&p gained 13, nasdaq 46. volume on the big board is about to have billion shares with seems to be the level this week. shares of apple up nearly two and a half% after billionaire investor carl icahn tweeted -- i love this -- tweeting that he pushed hard for a $150 billion share buyback during his meeting with apple ceo tin cup last night. joining me now with his outlook for the market, steven wedding, global chief investment strategist for city private bank. could have your. this market, contrary as the dickens moving higher when most people were assuming we would see perhaps even a cataclysm in the market as a result of the shutdown. what is going on? >> i think that there is some hope that picking a fight over government shut down could be constructed on the debt ceiling. it is in a completely different league from the you're right shut down. people who are furloughed have not permanently lost their jobs. along the shut down in history was t

just expanding medicaid doesn't necessarily improve health care outcomes.wed no improvement in physical health outcomes after medicaid expansion. what we'reÑi doing instead, there was in lakeÑi charles, american press editorial praising our public-privateçó partnerships saying peopleÑi are getting better access to specialty health care. we're goingbq=bÑp+e a level oneráuza care center. a number two trauma care center in new orleans. we've got the v.a. children's hospital working together on a $2 billion health care complex. we believe we've got a better approach. 900,000 people out of an outdated paying for services, now paying for outcomes approach, we've got a better approach providing services to those people. if you believe the exchange claims -- and i'm not sure they're going to hit these targets, but the uninsured rate in louisiana will be below 60%. we think -- will be below 6%. this money is not free. people would like to think this is free. >> you talked generally about better approaches. as we pointed out at the beginning, you're not just governor

and to get the continuous improvement health outcomes. so we produce for all ryan white primary care on a semiannual basis to see how the catsors are coming on the national thresholds. that said this is not a new game for folks who have been doing this for 20 years were many of which have to do with more the technical data rather than the quality of care and courtney mentioned the an hiv waiver we used the money to develop the registery system so all the data is dumped into one system a new and improved threshold. that's one more recommendation coming here. i'm sorry. i'm talking fast a lot of information. i think about this is how does this work well in terms of addressing the gaps and improve health outcomes it's about partnerships. we need to kind of come together to make this happen. the task force is a great example of dph and consumers and the planning councils and i think what we plan to do now is actually, i was talking with one of the coaches the next council meeting we're going to get ahead of the curve to think about what's not

the outcome will be the same. every senator, every member will have to decide where he or she stands. i had no intention of delaying the timing of this vote. >> reporter: senator cruz saying he will not delay the timing of the vote meaning they'll be able to move forward it much more quickly. he'll still vote no, but it won't hold things up. we'll wait to see who votes no, and that will bring a sense of how far this bill will get before tomorrow. >> this was all month ago about obamacare. yet after all this drama there is no language about obamacare. >> reporter: the only thing that we're seeing talked about at any point is this tightening of requirements for people to prove their income and their financial status as they go to get subsidies under the federal healthcare law. everything else off the table. everything else completely done away with. the arguments that senator cruz made a couple of weeks ago not making any track in the process. >> maybe you'll get rest now, thank you very much. >>> the news is music

. >> reporter: the authorities held a news conference on the outcome soon after the trial. bo still enjoys strong support amongst the public and some members of the communist party. that's apparently why the court is aiming for some degree of transparency. the court of appeal was thought unlikely to have overturned the lower court ruling because communist party leaders are believed to have a hand in the outcome of both trials. this takes place just one month before a committee meeting, a key meeting in deciding policy. his verdict is in line with xi jinping's tough stance against corruption. >> that was nhk's reporter in beijing. >>> ministers from the 12 trans-pacific partnership country also have a final chance to seal their trade deal this year. they've scheduled a meeting in sing pore for december. it will follow on the heels of a world trade organization summit. they will finish business in indonesia on december 6th. but they've yet to reveal a date for the tpp talks. they targeted a broad agreement by the end of the year. they'll have to get past a few obstacles. lowe

however much you dislike the outcome, you respect the democratic process.hat's what is at stake in washington this week. the debate going on there was not trivial, not transitory and not about obama care. whatever you think about the affordable care act, it was a law that was passed by the house of representatives, then the senate, signed by the president, and validated by the supreme court as constitutional. that doesn't mean it can't be repealed. of course it can be repealed, as can most laws, but to do so, you would need another piece of legislation, one that says quite simply the affordable care act is repealed in its entirety. that would have to pass the house, the senate and be signed into law by the president. what you cannot do, what cannot be allowed to stand is a dproup of legislators that cannot convince a majority in both houses and the president to agree with them, would then shut down the government or threaten default until they got their way. that is not democracy. that is extortion. i would be happy to see president obama compromise on the

all of the mystery of outcome measures.i don't want you judging my dentist and whether or not i came out of the cleaning allies. you don't want the same outcome measures for everything. you want to think about what is it that we are trying to achieve for this set of circumstances and so think about that and then there are meaningful functional outcomes that patients can report. it doesn't have to be all mysterious. every little entity can report to the registries that enable providers to improve and presumably succeeding with patience is y. they went into health care in the first place. there is a virtuous cycle when we focus it where values are actually created. >> put up your hand if you have a question. we have a microphone that will come to you. please just state your name and state your question. we probably have a lot of them so try to make it through as quickly as possible and one last note i want to brag that it every one of these offenses the audience survival rate is 100%. [laughter] >> it want to say first that t

. >> it is just a game, but it affects the mood of your city especially with the outcome today. it is a long football season, too early to panic. but terrell suggs has declared what he calls a state of emergency. two straight defeats now. both heart breakers and this most recent one hurts because it comes at hands of the rival steelers. pittsburgh has been a place for some classic battles between the two teams. sunday was another one. touchdowns tough to come by. pittsburgh finds the end zone, shovel pass to miller, 7-0 pittsburgh with the heed. the ravens vowed to improve their running game but once again yards are tough to come by. pierce dropped for a loss. the ravens managed two field goals in the first half. fast forward to the third quarter when the ravens get tricky with an onside kick but justin tucker didn't kick it far enough and he takes a shot to the head. the pittsburgh steelers get a field goal out of this. down by seven, late fourth quarter, flacco with a play action fake and then a rollout. he'll hit clark in the end zone for a touchdown. just in time. it tied at

the interpretation, an interpretation of the natural law was thus decisive to the outcome of that case. several features stand out in the opinion. in the primacy of natural law over positive law it is prominent as is the idea that the natural law is rooted in the common nature of man such that the natural law is universal to all mankind. we'll revisit the themes later but let me examine philosophy of positive law. as many of you know story was a self-proclaimed disciple. they emphasized the importance of tradition and the formulation of positive law. they are afraid to put men to live and trade on own private reason because we suspect stock in each man is small and the individual is better to avail themself of the general bank and capital of nations and of ages. when surveying the men at the start of the french revolution, he observed that the best were only men of theory, lagging in all practical experience. as burke put it from the moment i read the list i say distinctly and nearly as it actually happened all that was to follow. in burke's view, the chaos of the french revolution dep

it occurred it was the right legally justified outcome. i just think that's the case where the case has a taint. it's not a conspiracy theory. it's now about how you communicate with the justice. it's what i said which was publicly known. the public confrontation of the court and the way john roberts responded by ruling the way he did in public which everybody can read and draw their own inferences from. [applause] >> sure. on the campaign -- it was not campaign at the stand. it was a campaign of respect. it was a campaign of respect. if you read that piece i wrote it was a completely mild manner. it sets out what john robert's vision is and said he strikes down the law he wouldn't be pursuing the vision. there's no stance. i also think you can't, randy, argue it's important to change heart and mind of the american public when it comes to constitutional arguments. then criticize congressmen -- commentators for making strong constitutional arguments and say the court would be violating if it rules a certain way. that's what a constitutional