in addition to that, we're part of the long-term care council. the council has developed a second one, so we are in the midst of implementing the recommendations at this time. a couple of years ago, because we recognized -- you might go back to the fast-growing population is at 85 +. we decided a couple of years ago that we would take on the issue, and this document, wises -- which is a 10-year plan, and we will be doing an update to the plan in the fall so we can make sure any new things that have happened since we first did it will be in the plan. and anything new we have undertaken is in one of these plans. the plans reference each other and have many crossroads between them. whether or not it would be it would be the grant of about 7 million to the city and county of 3 million to us, we have been working on transition from hospital to home for a very long time we are now in discussions about the centers for medicare and medicaid to talk about contract with them, so that we can have federal support for the work being done in the community. we h

the amendment is simple. short term versus long term. and in the short term you may have a slightly better deal for more traditional fossil fuel based options, but in the long term you are continually locked into having no other options. the reason that we are considering alternative fuels is so that we're not locked into a situation that we've been in the last several years, when the price of oil goes up and the cost of the d.o.d. goes up enormously because she have no other option. we've seen and are all familiar whip the spike in gasoline prices and oil prices that have happened periodically over the course of the last nine or ten years and frankly the solidly high level that it stayed at, the department of defense spends more money on energy than any other entity in the united states. it issen enormous portion of theirs budget. when those costs go up and they have no other alternative but to buy gasoline then they just have to eat it. we're trying to develop alternatives to get to the point where when those prices spike, they can do s

the short term plan is going to be the readily achievable solution. the long-term plan could take 20 years. i do not know. your business might not be making huge profits. you may need to be saving money for the long term. but it is your obligation to plan for the long term as well as the short term. the ada has a set of priorities that guide you on how you will be serving your property. the ada says a certain party of getting in the front door, but you are logical, you want your customers to access your services. be that steps, be that ramps, if the door is not wide enough, if the landing is not level enough. priority two is actually travel. once you get into your business and start speculating the wits of your files. access to all of your services. [inaudible] rearranging furniture. that is something we would call readily achievable, if you move your table out of the way to allow a person with a wheelchair access to your space. restroom facilities only come into play after you have already made the entrance accessible and you have trouble accessible. restaura

the short term plan is going to be the readily achievable solution. the long-term plan could take 20 years. i do not know. your business might not be making huge profits. you may need to be saving money for the long term. but it is your obligation to plan for the long term as well as the short term. the ada has a set of priorities that guide you on how you will that guide you on how you will be serving your property.

. >> i should mention that the planning department has joined with the long term council in network group. one of the really interesting things about that is that it has attracted people that we do not normally come into contact with. we got a couple of architects interested in this issue. people from different parts of the city. yes, we need all of those people involved. " supervisor olague: i will save my comments for later, but i have become more familiar with seniors in public housing and how they have been exposed to those nuances. i am sorry, supervisor chu? of supervisor chu: taking a look at the report earlier and the demographics of where seniors are living, there is a dark green in the district. we have talked about this before. i spoke to you about the different communities that have different structures. many seniors are living in their own homes and the services that we provide in things we might want to look at might be different from the other things. what are the plans for these hard to reach areas? traditionally, we have not had very large spaces. there are limited commer

the changing contractor permit terms. it is brief, so i will read the first part. they are not intended for long- term, on the street parking. my concern is that i would need to have defined for me what long term means. we have a lot of contractors with multiple permits. coming to and from their place of business over the course of a day, they could be several hours and one job location, or back at their place, take care of all of the paperwork. coming and going is an integral part of the business. if the legislation seeks to clarify the business of keeping your vehicle at 1,500 feet, or three blocks, instead impacting the workday, it becomes a very expensive issue for all the people in my association. everything in construction is very competitive. every minute on a generally been project is more than $1.50. if you have these electricians working and walking to and from, as opposed to working, it becomes very efficient. i would like to take that into consideration. >> leonard lynch. followed by micro mark orszag. >> my name is leonard lynch. in a third-generation san franciscan. our cost per mi

i want to look at the long-term drivers here that are more recent. i've sort of taken -- you can decompose this into a lot of different ways. i've looked at this and tried to sort the data into three buckets, looking at the change in spending linked to the chang in the prevalence of treated disease, looking at the the change in spending linked to how much we spend to treat a case and obviously the interactions between the two of those. and if you look it-from-the late 80s to today, about 60% of the growth is linked to rising prevalence of treated disease. we'll go into what accounts for that. some of that is going to be good, i'll argue, some of that is going to be bad that we can go in and potentially do something about. so just to give you a sense of some of these -- the magnitude of the changes here u, you can down by medical condition and see the prevalence increases and in each of these condition, the factor driving the growth are somewhat different. if you look at the treatment of cholesterol, mental disorders, those have obviously increased ver

especially, especially the experience of long term unemployment. but i would argue you absolutely see it at the end of life, at the end of the working years as well. people who are close to retirement age, who have had to, kind of throw that out the window, whose economic security has been completely undermined, and who find themselves i mean really on the brink of experiencing hunger, rates of hunger have gone up tremendously over the past, over the past few years. as has reliance on, what used to be called food stamps. but rates, measured and measurable rates of hunger have actually gone up. which again, has long term impacts. especially in terms of child nutrition, so, there are many -- things that we can glean from the past. but, now, we're ig paying closer attention to the long term impact. >> we have a couple minutes left the i will ask you both more broadly. if you want to add on, that's fine. we touched on this a little bit. we're here with historians at the annual meeting. when people ask why should we study history? why is it important? >>

we need to be clear about the long-term consequences of any single currency. in britain, in the united kingdom, we've had one for centuries. when one part of our country struggles, other parts step forward to help. there is a remorseless logic to it, a rigid system that locks down each state's monetary flexibility, yet limits fiscal transfers between them, can only resolve internal imbalances through painful and prolonged adjustment. so in my view, three things need to happen to function properly. first, the high deficit, low competitiveness countries in the periphery of the euro zone, they do need to confront their problems head on and cut their spending, increase their revenues to become competitive. the idea that high deficit countries can borrow and spend their way to recovery is a dangerous delusion, but it is becoming increasingly clear that they are less likely to be able to sustain that necessary adjustment, economically or politically, unless the core of the euro zone does more to support demand and to share the burden of that adjustment. now, in brita

the community safety element establishes a framework for long-term recovery and reconstruction. i will talk about some of the major programs and how they are featured in the element. one of our major initiatives is called the resilience san francisco the initiative. it is a comprehensive planning platform that leverages the efforts of our partners. they are doing extraordinary emergency planning work. we want to make sure that efforts are not overly duplicated, that they are coordinated. and that we have a big picture of how ready to recover the city really is. this advances are over all resilience by providing a framework and a roadmap to coordinate all of those types of work going on in terms of our individuals and the community. this helps us to solve problems together in a comprehensive way. it is a very innovative initiative. it is one of the first of its kind in the country, following some of the directorate's. it has earned our program a lot of a national recognition. it gets us out there and gets all the agencies out of their silos. these are some of the examples of the p

soap if you look at the long-term trends here, and hopefully we're stabilizing it a little bit, it's doubled since the mid-1980s. and if you look at some of the, you know, calculations that are just linking, or looking at how much of the growth in spending is due solely to obesity holding neckful knowledge constant, treatment constant, depending on the period you want to look at it accounts for 7% to 10% of the rise in spending. cbos did an estimate, they came up with 8%. of all the things we can quantify to joe's point, to the things we can try to quantify, it is a, an important contributor. if you look at medicare spending, about one thempd -thie growth in medicare spending over the last decade is linked to sort of cardiovascular risk kingses. diabetes, arthritis, hypertension, mental disorders. the thing that's interesting about those particular conditions in the medicare program is that those are conditions that are ambulatory treated with appropriate medication. unless you botch it up somehow, with the exception of kidney disease, you really have nothing to do with in-patient hos

the massive trading loss. trying to jump up short-term earnings at the expense of long-term growth? they may disagree on a lot of things but the left and the right won't see granny getting thrown off a fiscal cliff. is medicare on the chopping block? you're watching cnbc, first in business worldwide. that bringing you better technology helps make you a better investor. with our revolutionary new e-trade 360 dashboard you see exactly where your money is and what it's doing live. our e-trade pro platform offers powerful functionality that's still so usable you'll actually use it. and our mobile apps are the ultimate in wherever whenever investing. no matter what kind of investor you are, you'll find the technology to help you become a better one at e-trade. >>> 45 minutes left in the trading session. time for a quick stat check. the markets, if you're just joining us, is a risk on day for the markets. materials, consumer discretionary leading the charge after the latest polls out of greece overnight showed support for the pro bailout for the conservative political parties there. it's a

and social services, and it is where we see a lot of cuts in terms of reimbursement rates at the department of public health and some of the long-term care money we get at the department of social services. there are also stay consider having to our communities that the city does not actually pay for at the moment that we need to decide as a city how much we can afford to backfill. for example, there are a lot of cuts this year being proposed to hiv services that the city has actually never paid for before, and we're getting a lot of requests to pay for things that the city has never paid for before. they have been state and federal responsibilities in the past. we will have more information as the state completes their budget and estimates there may revise. we do have a fairly large stake reserve this year. it becomes part of the trade-off conversation that the board of supervisors and the mayor's office and the community need to have. but how much we can prioritize this. you know, we definitely need the help of you and the rest of the community to go back to the state and the federal government and make your voice is heard to

the long term is that -- the long-term plan for santa cruz and then watsonville is really the marathon. and you talk about what makes good plans and good planning is really good process and you have to design the process to respond to the conditions in your community or your community. you could have multiple plans in a larger city, for example, and then try to coordinate those altogether. now, the question here -- seen here is, how do you involve the community? and there's sort of this whole notion of bottom up instead of top down. actually you need both. you need both. we sort of overreacted in the 1970's about experts or just paid hacks and that sort of things and there are still consultants out there that will just listen to the community and all they get is something from the community which is all wonderful expression of values and valuable but recovery is all about investment, right, particularly in the business district? you have people to risk real money on real projects in your downtown which means you need expertise on retail. we tried to design a process that involved the w

one of the long-term impacts. a lot of research being done about the effects. they had to downsize early on in the career. the input is not just felt for a couple of years. it's literally following you throughout your career. especially the experience of long-term unemployment. you see it at the end of the working years. people who are close to retirement age who had to throw that out the window whose economic security has been undermined. who find themselves really on the brink of experiencing hunger. the rates of hunger have gone up over the past few years. reliance on food stamps. measure and measurable rates of hunger have gone up. again that has long-term impacts. especially with childhood nutrition. many things we can glean from the past, but now we are paying closer attention to the long-term impact. >> we have a couple minutes left. it ends at the handle meeting. >> why should we study history. >> that are provides us with a way of understanding the world and paying close attention to the sources of the past and trying to figure out how people in the pa

-term. >> the long-term recovery we stand in the way of recovery. america stands in the way of recovery. not investing in our own long-term. see, what concerns me about what i call the g-zero world is that it's not, it doesn't create urgency for the united statesment it doesn't compel us to action. and if we decide that we don't want to bomb iran or press them to change their nuclear issue, that's a problem for us, that's a much bigger problem forchina over the long-term. if we leave afghanistan, obama goes and signs that agreement. it's a much bigger problem for pakistan and india than it is for the united states. we're to the going to be force odd to fix our deficit in that environment as quickly as we should. we're to the going to be forced to deal with infrastructure, critical infrastructure in the u.s. that is failing. >> rose: what could force us to fix it. does not the sense that if we don't do something about debt, we will be a-- we will be greece. >> well, i guess that's my point. is in a g-zero world were things are much more volatile and r

long-term leases. twitter signed in for a good 10 years. others have signed long-term leases as well. they are in it for the long haul. i think they are measuring their success, building it up on that. not only innovating and starting up, we want them to stay and grow. we have been creating those conditions for that conversation to happen. >> michael connolly said, anything to add to that? is this the right time in the valley? is there a bubble? >> i would like to speak about the clean technology sector. there was a little bit of a bubble that emerged in 2005, 2006, 2007 time frame. what has happened since then is you see the landscape changed. there have been a lot of companies and vc's, founders, that are focused on very few investments in companies but are in it for the long run. the time and invested it takes to build a clean tech company. the difference with clean tech, there might be large facilities required, investment to build your first plant, for instance. we are seeing a change in the landscape. one thing i want to add, too, for clean tech, there are organizations like the clean tech opened that foster inn

then there are other things for the very long term but there is a government about long term and focused on delivering in them them. investing in infrastructure, finding new ways to finance roads and securing the house supplies of to remember. reforming welfare so it always pays to have a job, to get a job shs and we want to build a country that commits everyone to work not a life on benefits. of course shs we're reforming our schools so the next generation has the knowledge and ambitions to match the very best in the world if if you like, this is our plan for growth. short term, medium term, long term. i believe there is still more we can do. we can use the hard-won credibility of the countries's balance sheet to help the economy grow without adding even further to our debt. let me tell you what this means. in many areas we're already using the credibility we've earned to pass on the benefit of low interest rates to businesses and to families. so we have the credit's and programs for small businesses. we have the mortgage help for people who want new homes and then there are the guarant

so the trend in the long term is positive. this is one day and the suggestion from analysts is, give this some time and let's see what happens. look on the bright side. zynga, when zynga went public in december of 2011, its ipo price was $10. guess where it closed? it closed 5% lower. $9.50. so at least look on the bright side. facebook didn't end lower than its facebook ipo price. >> and remember, too, to be fair. there are a bunch of people in menlo park, california, who are now millionaires. people who have been investors for a long time. thanks, alison. >> i finally tweeted something out today for all the facebook haters out there. this isn't a public vaccination. if you didn't want to buy facebook stock, you don't have to buy facebook stock. felicia taylor's on the floor of the new york stock exchange. phylici phylicia,, let's talk about something for a second. there was definitely something up with the trading, as alison said, at nasdaq. you know, for us old-timers, that didn't used to happen. >> no, there's no question a

the sooner we begin to make changes, the easier it will be to ensure they are sustainable for the long term. for 20 years washington has not done much, and we have waited almost too long. the sooner we solve this problem, the sooner we will finish, but everyone knows what the menu is. it is just a matter of having the guts to choose what is on the menu. it is not like going out to dinner we know what the problem is. it is a matter of having both sides come to agreement about what is on the revenue side. good >> i saw tim geithner on the way out, and i said what is going to happen to the debt ceiling? i said, i do not know if we can do it, and he said you are wrong. he knows in his heart is the right thing to do. he was smiling, but he was not joking, and that was before i saw your speech, so is the debt ceiling going to go up? >> i think i have made it clear. allowing the debt ceiling to go up without addressing our fiscal challenge would be the most irresponsible thing i can do. >> are you going to let it run out? >> it took me eight months to get people interested in talking about fixing

think the battle over the internet stuff is in the short-term sense it may well turn out to be mow nop lis particular but if you let the technology go in the long-term it will be more competitive and the dynamic element inclienz me towards light handled regulation. i want to pick up on what peter said. i thought this was about technology and the high tech industry, but i have had the miss fortune of teaching both environmental law and the fda law and the level of public ignorance and disgrace in these statutes is simply too much. pam said earlier on with respect to wicked in filming, get over it. i can't get over it. let me give you a specific story as to why i cannot. when the fda was founded in 1906, it could not regulate the manufacturer of drugs within the states. it only got the power in 1938. people talk about the level of progress. i will talk about insulin as one of these particular items. insulin was a drug invented by a man that could only be described as a lun particular who worked in canada and eventually got the support of eli lilly which was a great company at the time and doing this and this is the progress of this. he figured ou

also just make them a little angry at the president. >> when hogan said he didn't know the short-term versus the long term effect for the republicans or the democrats, i think that's right about the short-term. i think the politics that you galvanize some of obama's base, some of the republican base. who knows how that will play out. long term i think there is no question how it plays out. long term you see the last 15 years, the support in all of the polls for gay marriage going from 2-to-1 against to around 50/50. that's not going to stop that people under 40 support it by two thirds so. the arc of history is pretty clear here. it's not going to suddenly people 30-year-olds are not going to suddenly say i was wrong about that. i don't want gay people to get married. >> i agree with that. i think the short-term political question is how close the election is going to be otherwise. i think that's when it starts to matter. as curt said, the long term vectors among the youth population are clear. where it could matter is if the race is very close in swing states and among conservative -- socially conse

and for the long-term. we believe that if we build a product where people can connect and can express all the things they want about themselves that over the very long-term we'll have a lot of people doing that because that's a core human thing where people want to do that and it will be very active and we'll have opportunities to sell advertising and do all these things and build a great business. but none of that is the leading thing we're pushing are for, what we are pushing for is the mission. we think if we succeed on that we'll build a great business. now if, i just think there is this core part of people where they want to express things about themselves. so the question isn't what do we want to know about people, it's what do people want to tell about themselves. and we try to answer that question continuously. what do people want to tell about themselves that they can't tell now. we think this year that one of the big things that people want to express that they haven't had a way to, what are my fav

tool to speed growth may actually harm the economy in the long term. let me skip to the end and make the point here that among other provisions in the sound dollar act, we grant a permanent vote to all the regional federal reserve bank presidents because as important as new york and washington is, there is much more to america's economy. therefore, it should better reflect our geographic diversity. we require the fed for the first time to articulate its lender of last resort policy in order to reduce uncertainty of moral hazard. we speed the release of transcripts in five to three years to create more timing of transparency. we make sure the new consumer financial protection bureau is accountable to hard working americans by funding it the same way as other agencies do. mr. chairman, i've included my full testimony for the record as well. >> i thank the gentleman. now mr. frank is recognized. >> thank you, mr. chairman. i appreciate your acknowledgment of the work we did together. it actually is work that began with one of your texas colleagues, mr. g

the longer term though. >> ifill: that's exactly the question. i'll ask you this and then seth as well which is i always wonder about sending messages and whether the longterm commitment means anything more than those words. we don't have those numbers attached. >> the second thing that i think the agreement does do is set up a structure for this relationship that didn't exist before. there's a bilateral commission that puts the issue... focus on issues like corruption and political reform in afghanistan. i've not read the agreement itself but i've been told it has serious commit manys from the afghan government on fighting... political reform which is as important... we could be building security forces on a foundation that's not very stable without those commitments in our afghan partners. >> ifill: seth jones? >> well i think one issue that is still is not addressed-- and i know afghans continue to be concerned about-- is what will the structure look like that will fight against the taliban and the range of other insurgents groups including the ha cany network. many afghans are concerned about their own survival. will the taliban take control of terr

and the long term needs of growing population and economy. before we discuss, recommit ourselves to investing in our own nation. the development of transportation infrastructure that supports economic growth and success and shared national priorities. it plea wish we had been able to write a comprehensive transportation authorization bill in a bipartisan manner characterized by previous house bills. as the house has failed to act the senate passed legislation must form the basis for discussion. there are several provisions i will recommend to the legislation i know that the senate bill reauthorize is the disadvantaged enterprise program to mediate the program. i strongly support these programs. information from the department of transportation regarding these programs. >> without objection we will do that. >> let me make clear as ranking member on oversight and reform i will strongly oppose any proposal that might be raised to use federal workers as a piggy bank to pay for a highway bill for any other legislation particularly when we have refu