and for our providers. when we do get it wrong, we have processes in in place to help get it back on track, quickly. the aetna is driving innovation to improve the lives and the health of our members. in just the past four years, we have invested over $1.8 billion in health information technology. for example, some of that investment went to having personal health records that can empower consumers' decisions around their health. finally, we're also leaders in promoting wellness and prevention, and the management of chronic diseases. refocussing our system to prevent disease, and promote wellness can lead to better health for all americans, and is positively impact costs systemwide. i believe the competitive marketplace has played and should continue to play an important role in fostering the innovation that's necessary for our country to achieve true and widespread quality and affordability in our health care system. thank you, and i look forward to continuing to work with congress to pass health care refo

the medicare provider network.e structure that was trusted and accepted by the medical industry and providers, so could you comment on that? will they, if they are offered an option to opt out of the public plan, would they, do you believe opt out, or do you believe that they are there to support it? >> so the question as far as the physician community, if congress does not permanently repeal the payment formula and january 1, 2010, that is looking at a 20% some cuts and more over the next few years and then are expected to participate in a private public option plant where rates are tied to medicare. i am sorry, you do not have to be an nba. you will not be able to keep your options open -- you do not have to be an m.b.a. de-linking from medicare rates and making sure that this medicare payment formula is fixed will reassure the community from the positions standpoint that congress is serious about trying to get this thing fixed. i think they can comment. if you're looking at physicians participating in medicare a

and what we have also done is to provide tax credits for businesses so that they can provide affordableomprehensive coverage. what more do you ask? cbo says there will be 97% coverage. a dramatic increase in the coverage today, and my guess is that if you would replace all of us -- if you were to replace all of us with people who had no health insurance, that republicans as well as democrats would vote against this amendment. you talk about offshoring. so many of these jobs could never be sent overseas. you have opposition from the retail establishment. those jobs are going to be of short -- offshored? no, the fact is that so many of the businesses have been providing insurance, but a lot of the companies that are not have failed to do so, relying on those who provide insurance to cover their dependents. there has not been a single plan that i know of from the minority, a single plan that would lift the coverage for people in this coverage anything close to 97%. no proposal that would be scored as coming anything close. so, i say to you, if you want to pose this, come up with a plan tha

it is well thus, prevention, management of chronic illness, providing an incentive to providers to providen incremental bonus to our primary care providers in this program based on their adherence to standards of the national council on quality insurance. they get paid more for delivering better care. in medicaid alone we have seen an 11% decline in the number of admissions to our hospitals and a 6% decline in the emergency room usage. i think that we have a model that works. we have saved nearly a quarter billion dollars in medicaid over the last few years. for vermont, that is a lot of money. >> what is the one aspect of vermont reform that you have not seen represented in the national health care bills? >> to be honest, we have not seen the bill from the senate finance committee. i am not sure i could answer that specifically. i do appreciate the chairman of reaching out to governors. we have had a number of meetings and teleconferences. he has reflected some of the concerns we have raised. he has moved in the right direction. most governors want to see what it means to their individual

it is not a trojan horse for any thing, except to provide care for all americans, and also to provide innovation. the major reason for a public option is to drive innovation, but to drive in -- to drive a change in the way we deliver systems. you all say you want that, and yet when it comes to actually supporting something that will help bring about, you oppose it. you like to quote cbo when you like what it may say, but you will not quote them when they say something that says you are wrong. cbo's estimate says there will be about 9 million people in this plan. it will be a small percentage, less than 4% of the insured population at the time. that is what cbo has estimated carefully. so when you bring up this imagery to try to scare people, it simply will not work, and the public is already on to that tactic. if you ask the public did they want this kind of public option, they decisively say yes. there is such an urgent need for health-care reform in this country, and so much of a need for competition with the insurance carriers, i cannot believe anybody seriously says that the publi

what the public option will do is provide stability by being in every market, provides insurers to move in and out of market changes, make sure that they have consistent providers. the public option definitely promotes efficiency. the community health choice bill can achieve growth and fair competition, and also promotes innovation. our current health care system does not deliver value in the private market in the way our system is set up. it will promote it. the public option in the committee, and ordinarily i don't quote newspapers, but i bring to the attention the june 21 article by the "new york times" which calls for a public option. it calls for its because it talks about how we provide competition, comprehensive coverage and creating a new paradigm that rewards a culture of wellness and prevention, and also promotes innovation in that area. i would hope the gentleman's amendment would be defeated and look forward to other senators who wish to comment. >> madam chairman. >> i just wanted to call attention to this chart we passed out this is taken from a study the american medical

we have the most number of providers. that is whether you look city to city or the nation as a whole, we have the lowest price per minute, the highest minutes used, the most broad and usage. i look at that equation and look at what could go wrong. the industry is not perfect. but there has been an evolution in the technology space. in the last 18 months, we've seen carriers offering free trial period, terminating fees, allowing people to change elements of the contract without extending it. to me, there is nothing going wrong in this space. there is a lot that is going right right now. when you look at how the proposed rules had been memorialized 18 months ago, think of what they would have missed. think about the start changes in the last 18 months. i would argue we will see those kinds of changes in the next 18 months. >> net neutrality regulations would have stopped a lot of this innovation? >> i do not think we know that for sure. i am happy to say that when i listened to the chairman and some of his staff, it is a br

this information should be provided in more than one format.and on more than one occasion for full comprehension by the surviving spouse. goldstar wives seeks accurate information, pravachol resistance and increases allowable cost associated with military funerals and burials. we understand the va is in process developing a much needed brochure providing more information explaining the use of shelters. another issue being addressed by the va as a possibility of creating new va cemeteries in areas that normally would not qualify. gold start wives seeks and increases the bureau allowance. the number-one concern of our core families is financial stability. the removal of the dependent compensation dollar for dollar offset of the survival benefit plan s off said would have the impact. additionally h.r. 2243 surviving spouse's benefit improvements act of 2009 introduced by representative would increase the dic to provide payment of 55% of the 100% disability compensation bringing the di see in the line with other federal survive your programs. dic h

that is simply not true, and as providers -- ask providers if insurance companies do not dictate what they were received. if they are polite, they will not laugh. you cannot scare us away from taking steps that will truly began to change this system and provide affordable health care for all americans. i urged defeat of this amendment. >> let's be clear with the legislation is trying to accomplish. we are trying to accomplish a true national purchasing pool of exchange with a menu of health plan options for people to choose from. whether we like it or not, a large number of people in this country would like the choice of a public option in this exchange. we have been trying to do our best under this legislation and make sure that if there is a public option that moves forward, that it competes on a level playing field. it has to be self sustaining. whoever would be running the public option cannot be the one in charge of running the national exchange. an area where my friend from wisconsin may have legitimate concern is whether it makes sense to pay the reimbursement under the public

assistance to hospitals and other institutions to provide health care services for the uninsured. we already have $20 billion a year we are spending. what is not fully paid for gets bumped into the cost of private health insurance. we are paying for it one way or another. we either pay it from our health insurance premiums, federal funding. one hospital in atlanta, the local taxpayers pay for it. a chip in about $110 million a year to offset these costs. i like the point because it brings us back full circle to what we are trying to do. there is a lot of money spent on the uninsured the not too late in terms of when they get their health care. -- money spent on the uninsured, too late in terms of when they get their health care. >> the uninsured use about half the health care of the insured population even when you adjust for health status. while it is true that the uninsured receive some health care now, usually fragmented, when they receive coverage they will use a lot more care and hopefully care that will allow them to lead healthier lives. maybe over the long term to receive

what the public option will do is provide stability by being in every market, provides insurers to move in and out of market changes, make sure that they have consistent providers. the public option definitely promotes efficiency. the community health choice bill can achieve growth and fair competition, and also promotes innovation. our current health care system does not deliver value in the private market in the way our system is set up. it will promote it. the public option in the committee, and ordinarily i don't quote newspapers, but i bring to the attention the june 21 article by the "new york times" which calls for a public option. it calls for its because it talks about how we provide competition, comprehensive coverage and creating a new paradigm that rewards a culture of wellness and prevention, and also promotes innovation in that area. i would hope the gentleman's amendment would be defeated and look forward to other senators who wish to comment. >> madam chairman. >> i just wanted to call attention to this chart we passed out this is taken from a study the american medical

one provider may provide oxygen, one may provide a walker or a hospital bed.e have three different providers serving the same patients. the study determine as a result of this excluded from the medicare program and where medicare constitutes from my organization probably 60% of revenue, the companies that are not still contracted with medicare probably won't be around and the long run we're going to lose providers and as a result with less providers prices will eventually go up. that is what the study determined. >> host: sandra on the democrat line calling from virginia. >> caller: thank you for taking my call. i had a knee replaced in january of '08. i chose to come home. my husband is a supervisor in his office and he could be home with me and do his work from his computer here. many people don't have that option. as a matter of fact, i've had several friends in my same 60-ish age category who had knees replaced and i did much better than they did. my recouping time was faster. i was better guided on my therapy so that i had individual care with no distract

the bank has provided counseling, work shops, providing techniques when counseling. the result has been an extremely low default rate under the pell loans administered by the bank of north dakota. for all of these reasons, i have been a huge supporter of this program. i commend the work that the state employees have done to make college accessible. i have received concerns about altering its role in the student lending programs and i would like to address that issue. mr. miller: i thank the gentleman for his attention to this issue and i recognize that the bank of north dakota is an important institution in north dakota and different from any other lending institution in the country. mr. pomeroy: this assures a role of private lending in the servicing of loans. i thank the chairman for his inclusion of a provision that ensures nonprofit entities this will be able to ensure student loans. will you work with me to ensure the bank of north dakota can continue to participate in the federal lending program? mr. miller: i will work with you as this legislation moves throug

$20 will provide 1,000 meals. this comes out to only 2 cents per meal. where else could your pennies mean so much? please, call now. i hope you're saying right now i'm going to vote for the children of malawi. and you can do that right now by simply reaching over and picking up the phone and saying, i want to provide 500 meals. i'll give $$10. of course, $20 will do 1,000 meals, but $50 will do 2,500 meals. please, for such a small amount of money, you can do so much. so, give us a call right now. if you like, put it on your credit card or you might want to go to our secured website. now, let me give you a real challenge. go the second mile. it's gonna take a lot of support to move this rice from taiwan to malawi. would you get your group involved? go to your church, your business, your civic club, your school and just tell them, feed the children is trying to move 11 million pounds of rice to the hungry children of malawi. if you've got questions, give us a call. we'll get back with you. but, please, go the secon

now we see our nation providing housing, and providing food, providing education, and now we're talking about health care. this is a little different speed though. because before, when someone was hungry, the proposal was give them a food stamp, i'm not sure it's very efficient but it wasn't to federalize every grocery store and farm in america. this proposal is different. this is saying, we're going to step in and the government is going to take over 1/a of the u.s. economy. that is a pretty tall step to take in one pass. >> if the gentleman will yield. mr. akin: i do. mr. shadegg: that's a pretty tall step given the track record of the nation. the government does not do this very well. we had a bill to bail out the pension fund of postal workers because we had problems there. we saw the inepttude of the government in dealing with the hurricane. and the most famous of all, the auto -- >> mr. akin: the postal service, fema. mr. shadegg: we did cash for clunkers and flat failed at that, miserably. so the track record of government doing these things isn't good. mr. akin: let's stay on th

who is providing services to medicare beneficiaries also provide services to people participating in that plan, but after the first two years any provider can opt out and after the first two years there is a negotiation of rates which presumably based on all that we've been saying around here presumably would mean rates would go up if the rates are going to be negotiated to be competitive with other health care insurance providers, is that an accurate assumption? >> again, referring back to the c.b.o. analysis, they do assume that the rates, once the negotiation begins, would gradually increase. so that on average they would roughly equal the rates paid by private insurers operating in the exchanges around the end of the 10-year budget window. >> and how does c.b.o. score the amendment? >> c.b.o. scores the amendment as saving $50 billion over the 10-year window. >> ok. and do they have an estimate as to the number of consumers that would choose their insurance through this option if it occurred? >> they do. they estimate that in 2015 enrollment in the public plan would start out hig

it is well thus, prevention, management of chronic illness, providing an incentive to providers to provide a good quality of care. we pay an incremental bonus to our primary care providers in this program based on their adherence to standards of the national council on quality insurance. they get paid more for delivering better care. in medicaid alone we have seen an 11% decline in the number of admissions to our hospitals and a 6% decline in the emergency room usage. i think that we have a model that works. we have saved nearly a quarter billion dollars in medicaid over the last few years. for vermont, that is a lot of money. >> what is the one aspect of vermont reform that you have not seen represented in the national health care bills? >> to be honest, we have not seen the bill from the senate finance committee. i am not sure i could answer that specifically. i do appreciate the chairman of reaching out to governors. we have had a number of meetings and teleconferences. he has reflected some of the concerns we have raised. he has moved in the right direction. most governors want to see

then the provider has to make sure they are happy. finally, this is a almost an exception but a very important exception, is that were these genetic test relate to cldren, in general, genetic test should be delayed until the age of consent, until the child can giveonsent themselves unless there is a clinically important reason why that test should be carried out before the child reacd the age of consent. the web site is there. i think we will circulate the details of the consultation. i'd just like to add if i have a few more minuter on my personal views abt the direct-to-consumer test which will pass the material during the process of advicing on the genetic report. so in a response, especially i supposed it's inevitable that witnesses that gave evidence of the report held a wild range of views about the direct-to-consumer tests. we have the report including martin and he was looking at mode 23andme on the web site there. and it is valid and medically irrelevant, and it's very much question on if you want to do that, that's your busi

i truly believe that you can provide coverage for the same population that you are in providing the tax incentives for for 25% less. and did giving subsidies that will prop up the price of insurance, we create a market that would drive down the cost and provide less of a burden to the taxpayer. there is an additional benefit. by creating the market, we also show efficiency. the more efficiency we can show in the market, the more we all win. the competition is there for the market place. i have a concern about how you are paying for this. the wonder if the senator would consider, since i have amendment that is addressing the population between 200% -- up to and a% of poverty in saying we could provide cheaper care. the reason i'm asking this is because he is bringing of choice. this is about whether with and provide enough competition in driving down the price. i think there is a way year in which states can play a role in helping to negotiate for private coverage and get as better coverage. in some of us giving a tax subsidy of 200% of poverty so that they can go by $6,500 insurance and

it is not a trojan horse for any thing, except to provide care for all americans, and also to provide innovation. the major reason for a public option is to drive innovation, but to drive in -- to drive a change in the way we deliver systems. you all say you want that, and yet when it comes to actually supporting something that will help bring about, you oppose it. you like to quote cbo when you like what it may say, but you will not quote them when they say something that says you are wrong. cbo's estimate says there will be about 9 million people in this plan. it will be a small percentage, less than 4% of the insured population at the time. that is what cbo has estimated carefully. so when you bring up this imagery to try to scare people, it simply will not work, and the public is already on to that tactic. if you ask the public did they want this kind of public option, they decisively say yes. there is such an urgent need for health-care reform in this country, and so much of a need for competition with the insurance carriers, i cannot believe anybody seriously says that the publi

guest: they are actually employed by the provider of the health care.st: they are not government employees but provided by the health care. there is a misconception in the u.s., most of our providers are called foundation trust, they are independent of government. but they provide care for patients who are obviously through the single-paired system are funded by the government. so they are governed by the organization employing them. but we have a national agreement of what the salaries of such doctors should be. and there are local bonuses and incentives and others provided at every organization and at the local level above the level. host: ara darzi is a member of the doctor of sciences and he's a practicing health surgeon and at the imperial college at london, and provides information in the use of surgeon robots and he was knighted in 2002 and considered lord darzi, a former member of the house of lords. back to the phones, elria, ohio, wally on the line for democrats. caller: that's ok, thanks to c-span and the hosts and the great guests you have o

were provided by uniform members of the military? now here we have a situation where it appears that there is not enough military members, so we fill it up with contractors. the question is should we reinsuit the draft. if we did, i would suggest we would have thousands of young people in the streets like we did in vietnam, and have those people who are apparently in favor of the military operations in these two countries, their own sons might have to serve. so what we have done is privatize it to avoid the military, is my suggestion. your comments, sir. guest: as far as reinstate the draft, that's a policy issue, not mine. in the last 15 years there are three major conflicts, iraq, afghanistan and the balkans, and if you look at the ratios, it was 1:1 in the balkans as well. and there is increase on reliance on contractors and it's been rather stable in the last 15 years. back to the contractor congress, there was reliance for the revolutionary war. and in the civil war there was a tremendous problem from the perspective of congress

what the public option will do is provide stability by being in every market, provides insurers to move in and out of market changes, make sure that they have consistent providers. the public option definitely promotes efficiency. the community health choice bill can achieve growth and fair competition, and also promotes innovation. our current health care system does not deliver value in the private market in the way our system is set up. it will promote it. the public option in the committee, and ordinarily i committee, and ordinarily i don't " materials. but the editorial by the new york times calls for a public option. it calls for it because it talks about how we provide competition, comprehensive coverage, insist on creating a new paradigm that creates a culture of wellness and prevention and at the same time promotes innovation in that area. i would hope that the gentleman's amendment would be defeated and go forward to others. >> madam chairman? i just went to call attention to this chart that we passed out. this is taken from a study of the american medical association nd what

it does provide consumers more choice. there's no doubt about it. it provides more choice.'s just one example. but i think that the best approach, and again, is to try and get the information to the public about which interests are doing what. because there are a whole lot of people that are spending a lot of money in direct lobbying, but also through indirect methods. they call it astroturf methods. that's different than grass roots. astroturf is like fake grass roots. and so -- but no, there are companies, i just want to [laughter] there are companiesÑi that are trying to generateÑi at the locl level lv>$# + misrepresenting tho position. Ñione of my colleagues in virginia, tom. love was getting his mail from a group of ministers and i believe it was a public interest groups. it turns out they were forgeries. that obviously goes way across the line. i only mention that because qjÑthere are people lobbying thr members of congress, but lobbyist techniques have gotten a lot more sophisticated. now they are trying to influence çnbñrÑÑiño'ççr we all have a respo6s%1%qe to

if you do not make it so you cover your workers, the and you have to provide part of the cost with providing them with decent insurance, and what we call this a shared responsibility. it is, in fact, increase in the concept of a free rider fee but not in a way that is going to provide the kind of certainty and breadth of coverage to the employer-provided system that the country needs. we agreed to increase the cost of health insurance in america. $750 for each full-time worker, three tenths of $5 for a part- timer -- $375 for a part-timer. you can save money for everyone. why do i say that? because it is precisely what we're doing in massachusetts today. there is the director of the massachusetts business roundtable. the businesses in our state sign onto it. the president and ceo of the greater boston chamber of commerce. our chamber of commerce signed onto this, and finally, the present ceo of the associated industries of massachusetts, in here is what they say to us. our four groups wanted to take strong support for health reform in massachusetts. this is shared responsibility among all pa

and what observations have they provided?s the authority outlined in title 38, section 2401 regarding the cemetaries and memorials sufficient or is more authority needed to meet the nca strategic goals and missions? >> yes. they meet twice a year. they'll be meeting again this november. we can provide you notes from the last meeting that they would. >> that would be much appreciated, sir. and i understand that for safety reasons mourners are not allowed at grave site for funerals. however, this policy contradicts certain religious observances, such as native american burial rituals or jewish grave sithe practices. what is v.a.'s policy, the policy for v.a. funded veteran cemetaries to make accommodations for graveside services in respect to these practices? sort of a multipart question. do state cemetaries have the discretion to restrict or deny for safety reasons? and, if so, would it be possible for v.a. to offer a more concrete policy to its state veteran cremttris to accommodate for religious beliefs? >> first of all, our

provide services that we provide. the nurses do the hard work. host: and do they become, in a sense, the patient advocate also? guest: they become the patient advocate, the bridge between the patient, families and the physician. they are the glue that keeps the i.c.u. together. host: so are your duties u guest: well, i have two roles as a practicing physician. we have a patient-care responsibilities for the patients, particularly one as seen by my group, and bennett, also, the nurses will come to me -- and also, the nurses will come to me with issues that have to be resolved in terms of how patients are being cared for, even those that i am not directly involved with. we also have a policy where i can intervene if there is an emergency and i have to do this quickly, where we can be more direct in intervention. host: what is your role? what is the importance of family members? >> family members, family and friends, are vital parts of patients' universes' and need to be part of their care and recovery. host: are there -- universes. host: are there

it will provide insurance for those who don't. and it will slow the growth of health care costs for families, our businesses and our government. [ applause ] it is a plan that asks everyone to take responsibility for meeting this challenge. not just government, not just insurance companies, but everybody, including employers and individuals. and it's a plan that incorporated ideas from senators and congressmen. from democrats and republicans. and yes, from some of my opponents in both the primary and general election. here are the details that every american needs to know about this plan. first, if you are among the hundreds of millions of americans who already have health insurance through your job or medicare or medicaid or the v.a., nothing in this plan will require you or your employer to change the coverage or the doctor you have. nothing in this plan will require you to change what you have. what this plan will do is make the insurance you have better for you. it makes it illegal for insurance companies to deny you because o

the fun of 44% provides no treatment on a level. -- we found the 44% provide no information on treatment. ozark is doing the right thing. in the water comes from houston municipal water supply. it is further treated by reverse osmosis, carbon filtration and micro filtration. let me read what you'll find on a few key label. the purest water comes from the paris club. our rainfall is purified by trade winds as it travels across the pacific ocean to the filing -- to the island of fiji. that is one of the companies that claim purity but do not say how they purify it. every top water utility publishes a report listing group port for the year. corn 18% of bottled waters to the same. -- only 18% of bottled waters do the same. consumers are left with marketing claims. you have heard poland springs -- mountain valley became a remedy for it out. and beyond claims the water is a symbol of health and general well-being -. [unintelligible] path when you pay a premium for bottled water, you deserve more. we recommend labels and websites disclose the same information that the law requires the municipal

community colleges provide the first postsecondary experience for many students and critical in providing them the education and training required for the high-demand jobs needed to keep the united states competitive. i am pleased that my colleague, representative adler, has a similar amendment that will assist veterans who are seeking to attend four-year college or universities. making sure that veterans who want to pursue an advanced degree and that they are able to do so is the right thing to do for our local economies and to make us and continue us to be competitive in the future. i urge my colleagues to support this amendment and yield back the time. i recognize my colleague. mr. miller: i thank the gentleman for yielding. i thank him for offering this amendment. we would strongly support this amendment. as he's well aware of, and i think most of the nation is, that the young men and women who join the armed forces over the last eight or nine years left this country to serve in iraq, afghanistan, and elsewhere in the troubled spots of the world. many of them left as high school gradu

it will provide insurance for those who don't. and it will slow the growth of health care costs for our families, our businesses and our government. it's a plan that asks everyone to take responsibility for meeting this challenge. not just government, not just insurance companies, but everybody. including employers and individuals. and it's a plan that incorporates ideas from senators and congressmen, from democrats and republicans and, yes, from some of my opponents in both the primary and general election. here are the details that every american needs to know about this plan. first, if you are among the hundreds of millions of americans who already have health insurance through your job, or medicare, or medicaid, or the v.a., nothing in this plan will require you or your employer to change the coverage or the doctor you have. let me repeat this. nothing in our plan requires you to change what you have. what this plan will do is make the insurance you have work better for you. under this plan, it will be against the law for insu

is that we provide services to victims at every stage. and you can't meet all the needs but you do your very best to do so. >> now, some of the needs that you are describing seemed unrelated to court proceedings. are we able to provide those kinds of services on a routine basis? >> we are not able to provide them on a routine basis. this is a very extraordinary case, and in many cases we do make referrals for services, so it's really incumbent on the prosecutors to and the victim witness assistant offices to know the community resources that are available and to help connect victims with those services. so while you are not providing them yourself you are making an appropriate referral and kind of connecting the dots for the victims. >> and the final question is to simply whether or not providing assistance to the victims has at all complicated the prosecution of cases? >> providing assistance, does it complicate prosecution? >> compliance with the law, has that complicated the prosecution? >> i would say that it is an additional duty tha

it will provide more security and stability to those who have health insurance it will provide insurance for those who don't. and it will slow the growth of health care costs for our families, our businesses and our government. [applause] it's a plan that asks everyone to take responsibility for meeting this challenge. not just government, not just insurance companies, but everybody. including employers and individuals. and it's a plan that incorporates ideas from senators and congressman, from democrats and republicans. and, yes, from some of my opponents in both the primary and general election. here are the details that every american needs to know about this plan. first, if you are among the hundreds of millions of americans who already have health insurance through your job or medicare or medicaid, or the v.a., nothing in this plan will require you or your employer to change the coverage or the doctor you have. [applause] let me repeat this. nothing in our plan requires you to change what you have. what this plan will do is make the insurance you have work better for you. under this

teaches who provide education in the indian community. the senator described that. simply keeping pace with the inflationary pay costs and health benefits for park and forest rangers, indian health care professionals and other critical personnel required a $540 million increase in funding over the last year. senator feinstein talked about fires. it seems like when we read about fires or see them on television, they're all in california, and our hearts go out to the families who have lost their homes and a few, their lives as a result of these fires. but the fires are not all in california. the national forest service is busy spending too much of its time on fire protection. it has an effective fire protection unit that's part of its job. but what we've been doing is paying for fire fighting the way we used to pay for the iraq war. we did it off budget. we did it a little later. i would congratulate the administration and senator feinstein for putting into in budget the amount of money we think we'll actually need to fight fires this year.

it will provide more security and stability to those who have health insurance, provide insurance to those who do not, and slow the growth of costs for families, businesses, and our government. for the hundreds of millions of americans who have health insurance, nothing in this plan will require you wear your employer to change the coverage or the arrangement you have. nothing will change if you have insurance. what this plan will do is make the insurance you have worked better for you. it will -- we will put protections in place that will make it illegal for companies to deny purses -- to deny a person coverage on the basis of pre- existing conditions. [applause] we will make sure that we place a limit on how much folks have to pay for out of pocket expenses. for the tens of millions of americans who are uninsured, we will create an exchange, a marketplace where uninsured americans and businesses can choose help insurance at competitive prices, from a number of different options. by pulling the uninsured and small businesses together as a group, we give companies the incentive to pa

health insurance and is adequate, that employer would have to provide more money toward providing health insurance. it does not make sense. at the end of the day, if you pay tax to a payroll, it is a direct assault on providing jobs in this country. we ought not be doing this. an analysis that was performed by a model developed by the council of economic advisers demonstrated that this employee mandate, this tax on small businesses, would destroy -- could potentially destroy 4.7 million jobs. this is why we need to support mr. johnson's amendment. >> mr. johnson is prepared to close. i have two speakers. if you two would take that into consideration, we can dispose one way or the other. >> in any other given time in 2008, there were 65 million people unemployed, period. >> the reason that we are against this mandate is because the mandate will put more americans up to 114 million americans onto the government plan. the government plan that we have today, medicaid and medicare, are broken. they are trillions and trillions of dollars in the red. as long as we are going to send secretary ge

we provide billing, collection, payment back to the application provider that is a ball you added on top of distribution over the network. -- that is a value added on top of the distribution network. we're doing things to make sure we work with the developers to make their applications work well with our network and support capabilities we can provide that if they choose to take advantage of our a value. that does not prevent them from putting up their own applications on their own servers and making them available to smart phones or other connected devices. there is an opportunity for us to participate in the application value space and help drive network investment to the revenue that generates. >> what you think of his thoughts on wireless and a central management? >> if i could just respond to the dump site -- i hate that phrase. access is one of the most important things we have. it is highly differentiated. verizon has invested a lot into having a high quality internet experience both over a wire lines and wireless. i think people recognize the value of that and they achieve a

on the medicaid provider table is for the drug rebates show up. it is not really have anything to do with coverage. our analysis combined everything to present what we thought was an actual bottom line. had we done to separate tables the way that cbo did, we would have probably broken it up the same way. we have enough difficulty producing one table. i would have been overwhelmed by a second. this is so you could see what the impact of the chairmen of mark would be. >> that in fact that you have is almost exactly what the net impact of cbo has. this talk about a difference is a difference without a distinction. is the difference between showing it in one table and showing it into tables. i hope we do not get distracted by the difference without meaning. beyond that, there is no expansion until 2014. in the first three years, would that be 2014, 2015, and 2016. >> the first three years of the budget window. >> they will be getting extra money now. >> right away. >> honestly, if there is to be shared responsibility in this country and it is all to b

in a way, he is providing a wake-up call. does anyone care to respond? mr. kennedy, we're going to have one more round after this. then we will wrap it up. does anyone want to respond to mr. kennedy? >> chairman cozenagkucinich, wee submitted $500 million in potential savings. that is over. of time from 2010 until 2019. we will support that as part of the record. -- it was $540 billion. >> ok, that would be helpful. anyone who wants to submit similar information, we appreciate you doing that. as the go to the final round of questions here, i am sure the insurance company executives here recognize that everything has changed with respect to health care in america. you are facing a totally new environment than when you started your careers in health care. 47 million people are uninsured. another 50 million are under insured. many people are losing everything they have because they cannot afford to pay their hospital bills. many of those people had insurance. today, we are talking about this business model. what we also have to understand -- we appreciate being

it will provide insurance for those who don't. and it will slow the growth of health care costs for our families, our businesses and our government. it's a plan that asks everyone to take responsibility for meeting this challenge. not just government, not just insurance companies, but everybody. including employers and individuals. and it's a plan that incorporates ideas from senators and congressmen, from democrats and republicans and, yes, from some of my opponents in both the primary and general election. here are the details that every american needs to know about this plan. first, if you are among the hundreds of millions of americans who already have health insurance through your job, or medicare, or medicaid, or the v.a., nothing in this plan will require you or your employer to change the coverage or the doctor you have. let me repeat this. nothing in our plan requires you to change what you have. what this plan will do is make the insurance you have work better for you. under this plan, it will be against the law for insu

and additionalunding is provided by the folling supporters -

which provides care for all, including foreigners. that story tonight from teresa bo of al jazeera english. >> this is a common scene in argentina's public hospitals. this woman came from peru and is still an illegal resident. in spite of her status, argentine public health care system is a universal right and anyone, in spite of nationality, status or income, has the right to be treated. dr. jose lanes is the director of the fernandez hospital in buenos aires. he says he's proud of argentina's will to treat everyone. >> we have buses that come from the neighboring countries filled with people that need to be taken care of. we perform complex surgeries like cardiovascular surgery, but also basic treatment. the system was thought of when argentina was a rich country decades ago. >> in argentina, the public health care system is mostly used by those who cannot afford to pay a private insurance. and it is financed through taxes. this hospital treats argentinean and non-argentineans for free and in exactly the same way. but many here are

it will provide insurance for those who don't. and it will slow the growth of health care costs for our families, our businesses, and our government. [ applause ] it's a plan that asks everyone to take responsibility for meeting this challenge. not just government, not just insurance companies, but everybody. including employers and individuals. and it's a plan that incorporates ideas from senators and congressmen, from democrats and republicans. and yes, from some of my opponents in both the primary and general election. here are the details that every american needs to know about this plan. first, if you are among the hundreds of millions of americans who already have health insurance through your job or medicare or medicaid or the va, nothing in this plan will require you or your employer to change the coverage or the doctor you have. let me -- let me repeat this. nothing in our plan requires you to change what you have. what this plan will do is make the insurance you have work better for you. under this plan, it will be again

. >> we will be providing a mechanism for putting non-bank financial institutions out of everybody's misery. >> reporter: the administration wants to give that authority to the federal reserve. but there's no consensus that's the right way to go. while the fed had the power to regulate mortgages, it didn't do it, until it was too late. and many doubt giving the fed more power now would prevent a future crisis. but treasury secretary timothy geithner says someone needs to be in charge. >> if you give that responsibility to a bunch of people, then you can't hold them accountable for performance. >> reporter: there is also disagreement about creating a consumer financial protection agency. republican jeb hensarling says that approach is heavy handed and could extend to retailers who provide credit, like walmart, target, and macy's. >> we see something that is very broad, very draconian. >> reporter: but geithner says the goal is to keep potential problems from slipping through regulatory cracks. >> if you are in the business of providing financial credit, and that is your business and y

provide services that we provide. the nurses do the hard work.host: and do they become, in a sense, the patient advocate also? guest: they become the patient advocate, the bridge between the patient, families and the physician. they are the glue that keeps the i.c.u. together. host: so are your duties up there administrative more than patient, one-on-one? guest: well, i have two roles. as a practicing physician, we have patient care responsibilities for the patients, particularly ones seen by my group. and then also as the i.c.u. director. so the nurses will come to me with issues that need to be resolved in terms of how the patients are being cared for, even with those that i'm not directly involved with. we also have a policy here where we can intervene if it looks like there's an emergency and things need to happen quickly, where we can be more direct in the intervention. host: what's the importance of family members? guest: family members -- family and friends are vital parts of the patient's universe and needs to be parted of their care and

. >> wwill be providing a mechanism for putting n-bank financial stitutions out of evybody's misery. >>eporter: the administration wants to give that authorityo the federal reserve. but the's no consensus that's the right way to go. while the fed had thpower to regulateortgages, it didn't do it, until itas too late. and many doubt giving the d more powerow would prevent a future cris. but treasury secretaryimothy geithner says someone needs be in charge. >> if you give that responsibity to a bunch of people, en you can't hold them accountable r performae. >> reporter:here is also disagreeme about creating a conser financial protection agency. republicaneb hensarling says that approach is heavy hded and could extend to retaers who provide creditlike walmart, target, and my's. >>e see something that is very broad, very draconn. >> reporter: but geithner ys the goal is to keep potentia prlems from slipping through regulatory crack >> if you are in the busess of providing financial cred, and that is your biness and your competing withanks and thrifts that are doing tt, there shoulde a co

and that's reflected in the way we provide it.what were once separate forms of communication, were separate media, are not increasingly interconnected and interchangeable. so we no longer have a market, a newspaper market, a publishing market. we have indisputably and all media mart. third, the boundaries of what we mean by media are themselves disbanding. in japan, you can now buy yr granny a mobile phone called a raccoon raccoon, which means easy easy. does find under to build how many steps she is taking each day. and you can set that so it sends a daily mail to your inbox letting you know that your granny is still up and about and geing the right amount of exercise. there might be an advertisement attached. is that media or health care provision? or is it both? it all sounds like economic, exciting, thriving sector to b a part of. moving factor, being more interconnected, expanding its scope. and in some ways it is. but the present is not as great as we tell ourselves. you don't need to strack -- to scratch the surface very ha

this care that we provide for them is provided for charitable reasons. it turns out that we pay for that, everyone of us who has health care coverage in this country, everyone pays about $1,000 a page to provide health care for those who do not have it. i went to the y and got dressed and went to one of the bikes. as i rode the bike, i was multitasking and got into the new issue of "business week." this is an executive summary on page 5, the cost of health. what congress does not come through with sweeping health care reforms? that is the question. annual health-care costs for businesses will soar 166% of the next decade. $29,000 per worker. it looks even worse in the prior decade when it went by 131%. an hour or so after i read that article in "does this week," i was on the train heading down here. as we pass through new worked, i looked on lsi of my window and saw -- as we passed through new work, i looked out the window and saw chrysler plant that i worked for 29 years to keep open. it is closed. 4000 people who worked there not long ago do not have j

it will provide insurance for those who don't. and it will slow the growth of health care costs for our families, our businesses, and our government. [ applause ] it is a plan that asks everyone to take responsibility for meeting this challenge, not just government, not just insurance companies, but everybody including employers and individuals. and it is a plan that incorporates ideas from senators and congressmen, from democrats and republicans, and yes, from some of my opponents in both the primary and general election. here are the details that every american needs to know about this plan. first, if you are among the hundreds of millions of americans who already have health insurance through your job, or medicare, or medicaid, or the va, nothing in this plan will require you or your employer to change the coverage of the doctor you have. let me -- let me repeat this. nothing in our plan requires you to change what you have. what this plan will do is make the insurance you have work better for you. under this plan it will be ag

additional support is provided by the following... debi: welcome to a place of our own. i'm debi gutierrez, and today we're focusing on sibling rivalry, thanks to this email from carolina tapia in chicago, illinois. and she writes, "i have two sons who are 3 and 5. they seem to argue and fight more and more as they get older. what can i do to restore the peace?" joining us today with her insight on sibling rivalry is associate professor of early childhood education at el camino college, susan baxter. welcome, susan. susan baxter: thank you, debi. debi: what is sibling rivalry? susan: sibling rivalry is competition. basically, it starts as a feeling of competition. it's usually around wanting attention--wanting attention from someone who's really important to them. so it could be parents, it could be grandparents, it could be the care provider--sometimes even a teacher. so, really, it's wanting that focus or that special attention from the person that's important to them. debi: ok. and it sounds like it's pretty common? susan: very com