licensed provider and it is provided with other needed services.ahip is working with many others to improve prior authorization processes and by making prior authorization more fully electronic, we can fully improve its effectiveness and efficiency. health insurance providers also have invested billions of dollars to monitor, detect, and eliminate fraud. ahish p ahip is a founding member of a partnership that includes federal government, law enforcement, state agencies and health plans. since 2012, the fhpp has saved hundreds of millions of dollars. we are also working with others to simplify operations and the consumer experience without sacrificing quality. for example, through a partnership with the council for affordable quality health care, ahip members collaborate with other stakeholders to develop and adopt standard rules for electronic transactions. because of this work, an increasing number of transactions are now electronic. however, there's more work to be done. a 2016 caqh report estimated that more than 3 billion manual transactions oc

currently there is no such provider. to meet this obligation, cpmc has partnered with northeast medical services to bring in st. anthony's clinic as a primary care provider in the tenderloin. cpmc has reported that they are continuing to work with st. anthony's leadership toward a path for sustainability and outreach efforts. a grant of $35,000 was awarded to st. anthony's through the innovation fund to help increase capacity to do outreach. there are two provisions in the development agreement that pertain to the innovation fund. the first that cpmc is to make payments between 2013 and 2017 totaling $8.6 million. the total payment was made in 2017, and this completes their obligation to the innovation fund. the second provision describes how the funds will be used, and they're administered by the san francisco foundation. cpmc along with the department of public health and the san francisco foundation sit on a committee to grand awards that support community clinics, behavioral health, and other community based services

licensed provider. we are working with many others, including the ama, to improve prior authorization processes. by making prior authorization more fully electronic, we can improve its efficiency. health providers have also invested billions of dollars to monitor and detect fraud. we are a founding member of the healthcare fraud partnership which includes the federal government, state agencies, law enforcement and health plans. we have saved hundreds of millions of dollars through the detection and prevention of fraud. we are also working with others to simplify operations. for example, through a partnership with the council for affordable quality healthcare, members collaborate with other stakeholders to develop and adopt standard rules for electronic transactions. because of this work, and increasing number of transactions are now electronic. there is more work to be done. the report estimated more than 3 billion manual transactions occur each year between commercial health plans and providers. insura

the choice of the provider is such that on average individuals priced ix lower providers between their home and the location where they receive their scan. referring physicians heavily influence where their patients receive care. influence of referring physicians is dramatically the effective patient cost sharing. as a result in order to lower and reduce t costs total mri spending, patients must diverge from the referral pathways of their referring physicians. e also observe that patients with vertically integrated ie hospital referring positions are more likely to have hospital based and more costly mri scans. the couple of things about study, the outcomes -- i agree. doctors generally know cost.s a difference in they don't know the difference and don't have the tools to help better choices. i think that the outcome that hey noted is really an effect of education. so these were patients that did use price tools. they had access to one but it was a passive transparency program. education. no incentives. none of those things that help educate patients. huge opportunity. >> you've ready

through technologies and applications in choices provided to consumers. our policy frameworks that encourage more of this. we are pretty optimistic we will be able to do that. >> host: one point people brought up as a potential solution to helping the world digital divide that you talked about his potential for municipal brought into some of the fastest entered in the country in chattanooga and colorado are provided by utility companies as a sort of public service. your industry's been against this to some degree. do you personally think this is a potential solution and if not why not? >> we are for all of the above options when it comes to closing the additional divide, deploy broadband wherever reasonably it successfully can do so in a competitive marketplace where we want to be very careful as when using public dollars to deploy broadband to more focusing on directing those dollars with a laser beam focus on reaching the unserved and be very careful about our fiduciary credential obligation to make sure monies are being used while come and that we are

cpmc has -- provides -- met this requirement by providing grants, including community health programming and community outreach. i just want to note that these first two requirements are also verified by deloitte as a third party provision. the third provision was in effect until 2017, which was that cpmc was to maintain their current charity care policies. that obligation was met by the end of 2015. the fourth provision was that cpmc maintained charity care policies that are compliant with the state law, and that is the case as of 2017, cpmc's charity care policy was the same as it was in 2015. the last provision is for cpmc to continue to support bayview child center. since the ownership has transferred to the south of market health center, cpmc has provided an operations grant for five years, invested over $1 million, transfer assets, and is still serving as the clinic specialty and hospital partner. so the next three provisions focus on medi-cal, which is public insurance for low-income san franciscans. so the first provision, cpmc has continued to participate in medi-cal managed car

services provided and the population served. the aim of the deal was for sutter to care for lives into the tenderloin, not to just give isolated single services, sutter cpmc is non compliant with these services reporting requirements. the d.a. asked sut i remember to act in good faith to develop solutions for the sub acute sniff bed shortage in san francisco. specifically considering that sutter is shutting down to sub acute sniff unit at st. luke's left san francisco with no sub acute beds. the shut down with hospital base beds, many by sutter, has crowded long-term care patients out of town leading to a worsening critical shortage of nursing home beds all over san francisco. sutter's participation in the post acute care study was supposed to have satisfied obligation to find solutions. it absolutely did not. the study examined how hospitals could avoid loosing money on difficult patients but did not address the crisis caused by the serial shut down of hospital-based sub acute sniff and sniff beds in san francisco. sutter is no

there are so few black providers providing services to other families. many of my family's report when they see other providers in the system, they feel disrespected and judged and humiliated and they would rather not seek health care then have to face that on a regular basis. so i cannot fix these issues alone as a single pediatrician. it requires an institutional approach. that is why i am asking you to please, please ask the future director that you are considering if they have the capacity to really do this work. we need someone who doesn't just talk about equity but someone who has a viable plan and a passion for this work so we can actually see a difference. these statistics that i cited are not new. they have been going on for a very long time. in case you don't know what this communicates to the black residents of san francisco, is that their lives don't matter. how we can we make san francisco the kind of city where black lives do metrically we need a director will make san francisco the city who where everyone has equal opportunity for health.

the coverage provided by.so the health insurer, it looks as though, and as such, a deductible or co-insurance are falsely satisfied. to prevent the deductible and co-insurance to be falsely credited, when the patient pays for the drug, pharmacy managers have detected the ability to ensure the patient's deductible was not credited if there was no cost to the patient. these are called co-paya couple later programs. the number may grow to 50% over the next few years. patients have less worry when there is less drugs available, but still have concerns of it being falsely allocated if there was no cost to the patient. let's switch to health care costs and plan design. a net increase of 5% after employers use cash offer initiatives. five. two times wage increases and three times general inflation which continues to threaten the afford ability for all americans. today per-employee cost is expected to be $14,800 in 2019 of which employers will pay on average for out of pocket expenses. key drivers of high cost trend o

the choice of the provider is such that on average individuals bypass six lower priced providers between their home and the location where they receive their scan. referring physicians heavily influence where their patients receive care. the influence of referring physicians is dramatically greater than the effective patient cost sharing. as a result, in order to lower out of pocket costs and reduce total mri spending, patients must diverge from the established referral pathways of their referring physicians. we also observe that patients with vertically integrated ie hospital referring positions are more likely to have hospital based and more costly mri scans. consistent with your own understanding and experience? .> it is patients turn to their physicians for advice. because consumers are not used to shopping on the basis of cost, quality or patient experience, they follow their physician's advice. the physician may not know the price differential. >> very familiar with the study. i reviewed it for public forums and speaking engagements. a couple of things about the study, the outcomes

is providing fema the following military installations and staging areas. . virginia, and fort stewart georgia and fort campbell, kentucky, we have 80 medium vehicles each staged to respond quickly once they pass through the area. they are high-water clearance vehicles that can carry supplies in order to rescue trapped individuals or perform house checks. this capability was used during hurricane harvey last year. at hunter army air field, there are 35 helicopters for search and rescue operations. and at fort bragg g, north carolina, 40 high-wheel vehicles as well as the is seven helicopters are staged within a hurricane reinforced hang air for recovery missions. s ship has navy and marine personnel to include 16 helicopters and 16 mv-22's. we have the search and rescue packages and four teams to assist in search and rescue. we have additional search and escue teams. >> from the sea where we have in arlington and follow the storm in all the way through our army and the great support with the vehicles that are going to be able to be used in a high-water situat

if the care is provided by the primary care provider, the second opinion would be provided within the same medical group. if it is provided by specialists as a second opinion, as authorized by the members medical group or through the health plan, the insurance company portion of that. they would be some prior approval that would need to happen to seek that care. the results of a second opinion would be shared through the medical group's data sharing system and may also happen through provider to provider discussion for next steps. looking at pages four and five for united healthcare on page 4, the nonmedicare population, because it does differ. on the nonmedicare plan, members have the option to contact a doctor at any time to make an appointment for a second opinion they do not need to notify the current provider that they are seeking a second opinion. the services must be otherwise covered under the plan and the cautionary is applied on the network status. if they are in network or out-of-network out of network. the sharing of the results from the second opinion is really up to the

and high-performance by directly providing to healthcare providers or for their health and providers at local markets whether they are tripled from 3% in 2018, 11% in 2019. employers, seeing growth across all procedure base, and cardiovascular, fertility, orthopedics experiencing the greatest areas of growth. and in 2017, 18% in 2019. we asked employers questions regarding changes in the healthcare industry with provider consolidation with thoughts on industry mergers and new market entrants. a significant amount of market conditions over the years since the aca was enacted in 2010. this activity of hospitals or health systems acquiring other hospitals or provider groups, it happens at the local level rather than the national scale. we asked employers whether cost, quality and experience, are any better, prior to consolidation. and provider consolidation in healthcare costs which results in higher cost. employers mostly struggle for consolidation and excalibur -- reflects the lack of data. to performance indicators. we asked employers their perspectives on the impact to propose merge

in terms of technologies and choices that are being provided. we want a policy frameworks that are going to encourage more. we're pretty optimistic we're going to be able to do that. >> 1. that is a potential solution to helping the rule digital divide that you talk about is the potential for municipal broadband, some of the fastest it in the country chattanooga and and longmont colorado provide the utility cot of public service. your industry has been against the system degree. do you personally think this of potential solution, and if not one of traffic we offer all of the above options when it comes to trying to close the digital divide and blood broadband forever were greatly a successfully conducive any competitive marketplace. want to be very careful is that when we're using public dollars to deploy broadband with actual focusing on directing those dollars with a laserbeam focus on reaching the unserved and ensuring we are very careful about our fiduciary predigital obligation to make sure those monies are being used well, that we are ensu

i'm curious if that is a manner that dod provides funds that they have to provide last year in support of interestingly. >> working very closely with administrator long, i've not seen that be a factor. all the decisions made are made based on the requirements that are bundled up from the bottom up approach and so we have not changed our actions based on anything that you mentioned there nor has thescene from a ministry or long change in his perspective . >> one other quick follow-up, you talked about the duration of the storm and the electricity issue. did you forward more generators? was there a bigger effort to get more of those, do you have any sense of how much your electricity generating capability is going to be? >> in this case, as was mentioned, i think first is the civilian response is going to be robust and we have in place in court close coordination with fema. in addition to that, we want to be prepared and that's why we have the additional from the army corps of engineers and others generated capability because we know in this type of incident, that a power generation can

airport staff has issued a new request for proposals to provide the services. services include screening airport employees, badged employees, screening deliveries that vendors bring through, chekts into the sterile area and the terminals and providing gate access and monitoring of checkpoints on the air field. so, they are fairly critical responsibilities that need to be staffed full-time. we are almost finished with the request for proposals process and it will go to the commission for award in, at a meeting next month. >> that simple, huh? wonderful. thank you for the presentation. >> supervisor fewer: yes, i just have a question, you know, june 2017 covenant employees were, which were t.s.a. agents pled guilty to taking bribes and letting 50 pounds of cocaine go through security. so, therefore, abetting smuggling. how have the hiring practices changed? >> i just want to be clear, i can address that. but that contract with those employees, that's the t.s.a. contract with covenant, that is not this contract. that is not our -- the contract before you does not

and a maximum that our providers are paid is only $14 an hour so it's extremely hard to get providers to come help us in the home. on top of that there is the issue of curb cuts and basic access in restaurants and businesses where we might have an access to the front door but we cannot access the bathroom or get to the basic areas and just recently i have been yelled at by business owners just for being in a wheelchair in their business because they don't want me there. and they don't want me asking for anything. so i bring this to your attention with the hope that this can be addressed. i have brought some of these issues to mofd's staff at last month's meeting and i hope for some follow-up and investigation into these crucial issues. thank you for your time. >> co-chair sehaux: thank you, zack. we're going to -- any other public comment at this time? >> no. >> co-chair sehaux: okay, thank you. we'll go ahead and close public comment and go to information item number 4 which is the co-chair report. and i just wanted to share some information. first of all senior and disability action

other than to provide the service requested. this means no more prechecked boxes, no take it or leave it offers and no default consents. the second principle is transparency. consumers should be given the information they need to make an informed decision. explanations about how companies collect, use and maintain consumers' data should be easy to understand and readily available. the third is parody. consumers are best served by a uniformed framework that is applied consistently across the entire on-line ecosystem. it should not be based on who is collecting the information or whether a service is free or paid. the fourth principle is uniformity. for these protections to be effective, there should be a national standard that protects consumers on-line privacy whether a consumer's information is pro tected should not depend on where they live or travel. the final principle is security. at charter we believe privacy is security and security is privacy. strong security practices should include safeguards that protect against all u

the idea is to provide, if you cannot cover every train, provide the unpredictability of when you will be there. >> thank you. thank you, mr. chairman. >> thank you, senator sullivan. >> mr. pekoske, recent reports revealed concerning details about your agency's previously undisclosed quiet skies program. under the program, air marshals monitor american travelers who are not suspected of any crime and are not on any watchlist. mr. pekoske, i want to learn more about what exactly tsa is monitoring. does the tsa auditor whether americans go to the bathroom -- monitor whether americans -- during flights? >> certainly. -- >> does the tsa monitor whether americans go to the bathroom during flights? >> we place marshals on flights where some -- >> yes or no. do you monitor -- >> -- and follow the presence -- >> yes or no. >> yes. does tsa monitor what americans eat or drink during a flight? >> i would not use the term monitor. we observe. >> so the answer is yes. >> yes, sir. >> does the tsa follow americans after they deplane and walk to their cars or taxis? >> yes her. >> -- yes, sir . >>

additional answers to congress but they have yet to provide those answers. how does google square the stated privacy values and the very real possibility that it could be used to oppress human rights? >> first to stand by the long track record to launch those products and services consistent with those values i am familiar with that and my understanding is that we are not close to launching a search product in china and if we would or could in the future remains unclear. but if we were to finalize a plan my team would be actively engaged in privacy controls would be followed and any product would follow to be consistent with our values as i describe. >> where are these reports coming from? i would not speculate senator. >> i will look forward to continue dialogue and it is in google's interest to respond to members of congress about what kind of work you are doing with china and whether if you were even contemplating building a tool by a totalitarian regime. i would like to move on with the question. this is an interesting panel because we have internet serv

is this a high-quality provider? have people had great patient experiences with this provider?it will put us ahead. >> thank you.>> thank you, chair. >> thank you senders. >> thank you. the syrians have been helpful. your testimony in response to senator warrens question really interests me. and what to ask about your own amatory service center. let's talk about a hip replacement. if the price is $17,985. is that correct? >> yes. >> that is the amount that the center receives receive when you do a hip replacement for someone who is a medicaid patient? >> unfortunately, as an outpatient procedure it is not approved for medicare or medicaid. yet. >> is not approved by -- >> cms. >> they will not approve that for an outpatient facility either. ambulatory facility or outpatient? >> right now i think the total joint is knees but only hospital outpatient. not to asc. >> this is an interesting phenomenon. in your testimony talk about the quality of hip replacements. performed and other procedures performed in ambulatory service centers. in your view, should cms authorize outpatient hi

school and foundation plus provide a large plaza through an in-kind agreement. we will also generate 300 union construction jobs. i would like to introduce you to bob to walk you through the project design. thank you. >> ok. are we live, here? >> president hillis: do you want the computer? there you go. >> thank you. good afternoon, commissioners. i am the lead architect for gold evidence. to begin with context, situating new threats within the urban fabric, the hub is undergoing a transformation. we need to look at stops on the ground but to the city's vision for a new pedestrian friendly neighborhood. for us, that hub is familiar territory. it has been located on brady street since 2,000. we know the challenges of the area but also see the potentials we intend to remain here for many years to come. we designed -- it is not working we designed the current home of the city ballet and we are their neighbors and friends. we have seen a positive impact of an involved art organization on a local community. we are thrilled to be designing their new home. this time as

tmpson, providing -- i appreciate mr. thompson providing me with the time. i have examples if the time will allow. for me to just share some of the stories, just to give some face, mr. thompson, to some of the people served by the local shelters, programs, coalitions, funding for tribal governments, to provide essential services to survivors. in the state of washington we have inez who was 14 years old, the only survivor of a fire that killed her entire family. she was taken in by relatives only to be raped by her uncle at age 15. as so-called payment for her care. she gave birth to a son, manuel who was never allowed to call her mother. at 16 she meat tomas, thinking this would be an escape for her and manuel he promised her a life of love and security. but in reality, that security meant a locked closet where she and manuel were routinely starved and sexually assaulted. and when her second son miguel was born, inez decided she had to get away before she and her two sons were further victimized. inez learned of the domestic violence hotline from women she's

c-span is brought to you by your cable or satellite provider. >> u.s. telecom is a u.s. based trade association representing providers and does for the industry, membership includes groups such as verizon, at&t, centurylink, frontier. jonathan's walter is the president and ceo end a he is our guest this week. it has been a while since we have talked to you and couple of things have happened in that meantime. i want to get your review on them including the new european privacy rules when it comes to internet servers. >> these are important benchmarks that are becoming a global standard for how we need to assertively understand that consumers not only expect that demand strong privacy protection. , they havem members understood the sacred trust we have to have about her taking private information. are -- respects, the gdp called havey are become an area of great interest and is being applied by many companies here. we believe that it is time for our congress to take steps, to stand up and develop our own national for work -- framework, providing c

the park will be layered and provi provide ecological development. as discussed, the park will have a diverse trail network, including multiuse recreation path, the bay trail, and the park will be sprinkled with sculptures. finally, the shoreline treatment is unique in that the site is elevated at 25 feet behalf sea level and situated in such a way that this is minimal impact from sea level rise. existing wet lands may be inundated over time, and so we have created a series of terrace wet land to allow migration throughout the years. finally, the project will be built in three phases such that with each development phase, we will build a commensurrate amount of park space. that concludes my presentation, and i along with several of our team members are available for any questions. >> supervisor tang: thank you very much. now, colleagues, supervisor kim. okay. we will go first to miss topia. >> good afternoon, chair tang and members of the committee. i am the project manager with the office of economic and workforce development, and i am going to prov

luke's and the new bernal mission campus is providing. all i'm saying is that i just hope that as these programs have been moved -- and you're saying that some already have been moved, that maybe you sort of reflect on, in about three months or six months, i think, if, in fact, we are servicing and providing the quality that we've had a strong tradition of in this city, not only in reference to our community, our patients, but also in reference to places like san francisco general and others who you've always been a partner with us whenever there's a crisis, and we'll work together. you know, all i'm saying is i would certainly take a look at is there any way we could, you know, not change, but perhaps -- you talked about a continuum of care and continuum of access. let's think about it, and the quality your institution has provided in the city for all these years. i would hope you would increase that quality and community involvement and think about these things as you get underway in your new flagship. >> so commissioner, thank you for

as the best qualified to provide these services. we have, with us today from p.f.m., nick jones and kevin dong. bob gamble, our league representative, is unable to be here today because he is on the road. nick and kevin will be providing a lot of support in these projects. the contract budget is $108,000. we're allowing $20,000 for financial modeling. it's an estimate. data administration support another $70,000 with a contingency of $18,000, which could distribute into either one of those or some other services we may need. the term of the contract is two years with an optional one-year extension at the discretion of the executive director. with that, i will close my presentation and invite any questions or comments. >> madam secretary, are there any speaker cards for this item? >> clerk: no speaker cards, mr. vice-chair. >> anyone from the public wishing to speak on this item? hearing none and seeing none i'm closing public comment and i'll turn to my fellow commissioners for m any concerns or comments. commissioner singh. >> who

we also provide both pre-nd post exposure prophylactics for hiv prevention we also provide a range of women's reproductive health services including contraception, emergency contraception. sometimes known as plan b. pap smears and [inaudible]. we are was entirely [inaudible]people will come as soon as were open even a little before opening. weight buries a lip it could be the first person here at your in and out within a few minutes. there are some days we do have a pretty considerable weight. in general, people can just walk right in and register with her front desk seen that day. >> my name is yvonne piper on the nurse practitioner here at sf city clinic. he was the first time i came to city clinic was a little intimidated. the first time i got treated for [inaudible]. i walked up to the redline and was greeted with a warm welcome i'm chad redden and anna client of city clinic >> even has had an std clinic since all the way back to 1911. at that time, the clinic was founded to provide std diagnosis treatment for sex workers. there's been a big increase in std rates after the earthqu

or who provides the counseling. and to confirm effectiveness, the tool will be tested by students, financial aid advisors, advocacy organizations and other stakeholders. again, in person -- in-person counseling would be fine and best for some students when the institution can provide it, but having that flexibility is important as well. so i do urge support of the amendment and i yield back the balance of my time. the chair: the gentlewoman yields back the balance of her time. the gentlewoman from missouri is recognized. mrs. hartzler: thank you. i appreciate the gentlelady's support. with total student loan debt of over $1.3 trillion and rising and over 44 million individuals still saddled with student debt, we must take action. the student loan crisis looms over america's economy and we must make sure that students are aware of the financial obligations they are agreeing to and be cognizant of their ability to repay those obligations. personalized, face-to-face counseling can be an effective tool to address this c

provides services. that offers some promise to rural america. i do appreciate all of you for coming. we look forward to taking these ideas. we have had a lot of hearings about diagnoses. i'm getting excited to get to these prescription soon. >> i would be remiss if i did not mention the fact, with the senator asking about prenatal care, uva has a fetal heart rate monitor system through locus health called imprint. i know senator kane worked with karen on these exact issues. earlier, we spoke about the importance of that. this is something that my organization and 90 other organizations support. thank you. we would like all of the senators to join together to get that bill passed. >>> i want to respond to a couple of comments that were made about the fragmented financing. i was happy to hear that mr. levine sounds like he is endorsing the single-payer. [ laughter ] his talk about the fact that when you have all of these different payments, there is an administrative cost at the other end. hospitals have

currently health care providers are licensed by their state. if a health care provider travels with a team, professional, college, high school, out of state, to take care of the players they are responsible for, they could be practicing outs of the scope of their licenses. for example, this april when our kentucky wildcats go to minneapolis for the final four, the physicians notice health care people that travel with them need to be practicing within their licenses. clearly within the commerce clause for us to clarify this. it's important to do. i encourage the passage of this bill, this provision, and the overall bill. i appreciate it. i yield back the balance of my time. the speaker pro tempore: the gentleman yields back the balance of his time. the gentleman from oregon. mr. defazio: may i inquire as the remaining time. the speaker pro tempore: the gentleman from oregon has three minutes. the gentleman from pennsylvania has nine 3/4 minutes remaining. mr. defazio: i reserve. the speaker pro tempore: the gentleman from pennsylvania. mr. shust

at the same time, it is assumed that the names provided are aliases. furthermore, unlike the previous unsubstantiated affair, the to -- itide does say does not intend to do so from russia. nor did they intend to cooperate with russian authorities. why should they even try? londones not into her game. several delegations today, on the russian -- called on the russian side to cooperate. everything is exactly the opposite. we have been calling london to cooperate rather than london calling us to cooperate. london has been refusing this cooperation. london needs this story for one purpose. a disgustingd -- hysteria and to involve other countries in this hysteria. the number of inconsistencies and unresolved issues in connection with the new evidence is off the chart. for example, in the photos provided of the suspects, where they are shown going through the cor identical core door -- ridor. thetime corresponds down to second. according to information stated by theresa may, the suspects found themselves approximately .t noon in all police reports it was rep

provides. and then the community -- the facility c.f.d., the first funding will be available to the project sponsor for construction of roads and public open space, and on the second funding in 30 years will be taken by the city for the sealevel rise outside of the boundaries of the project. will be the entire -- entire amount shall be rebounded in 30 years. >> they will rebound for $33 million in 30 years and it's the city who can do what they want with it? >> it is the city. it will be -- but it is designated for sealevel rise, improvements, mitigation, all along the southern shoreline. we haven't even -- we haven't specified a boundary that that money can be used in. it will be used by the city for sealevel rise. both on the creation and park property and property surrounding the area. >> in 30 years that will drop to us as a $43 million as a payment or will it be given to us over time? >> it will be rebonded. we have not yet negotiated the rma for the c.f.d. that will trail the approvals. o

that is to provide a huge boost to the economy. what will the prime minister do to ensure the results. >> can i say to my honorable friend. i understand the importance across the region of the campaign of the proposal that he is referred to. i'm sure he understands. i would encourage all parties that are involved. to come to a workable solution. they have the growth deal. they will continue to work in partnership to deliver that. thank you mister speaker. they had been qualifying. what the scottish women's team. scotland was used as a guinea pig. it is even more unpopular. with the checkered flag. it is is the scottish national party. that was what they were talking about. delayed with the prime minister's question. they have said that it is not acceptable. they've called the government preparations your plan is there. the prime minister can finally concede that back in the single market. to protect jobs. can i say to the right honorable gentlemen. that we have the border proposal. to protect the jobs. they maintained the maintain